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Insurer Rejected Rs 30 Lakh Accidental Death Claim Citing Alcohol Consumption; Consumer Commission Upholds Payout
Sentiment: NeutralHigh Priority
What Happened?
A family contested an insurer's rejection of a Rs 30 lakh accidental death claim after a pensioner died in a road accident. The consumer commission found discrepancies in the insurer's evidence and upheld the claim.
Key points
- The pensioner held an accidental death insurance policy linked to his pension account.
- The insurer rejected the claim citing alcohol consumption as a policy exclusion.
- The District Consumer Commission ruled in favor of the family, ordering the insurer to pay the claim.
- The State Commission upheld the District Commission's decision, awarding Rs 30 lakh plus interest and compensation.
- Discrepancies in medical records and evidence were highlighted by the Commission.
Key insights
- The ruling may encourage other families facing similar insurance claim denials to contest decisions.
- Insurers may need to improve their evidence-gathering practices to avoid similar rulings.
- The case highlights the importance of clear documentation in insurance claims.
Why it matters
This ruling reinforces consumer rights in insurance claims, particularly regarding the burden of proof on insurers.
Source
Times of India
