The kin of a home guard who died in a road accident were in for relief after a consumer commission directed an insurance company to pay ₹5 lakh as accidental death coverage. The company had repudiated the insurance claim stating that the victim was under the influence of alcohol, which the commission did not accept.
The District Consumer Disputes Redressal Commission at Nalgonda was dealing with a complaint filed by Shakuntala Bai (35), wife and nominee of Venkoba Shary, with the Inspector General of Police and New India Assurance Company as the opposite parties.
The victim was a member of Telangana Transport and Non-Transport Auto Drivers, Homeguards and Journalists Social Security Scheme, and was covered by a group insurance policy extended by the State government. In October 2017. he was riding a two-wheeler when he met with a road accident and succumbed to his injuries. In February 2018, his wife filed a claim. Four months later, the claim was repudiated on the grounds that the victim was under the influence of alcohol, a condition which is not covered under the policy.
Contesting this, Ms Shakuntala Bai cited the National Consumer Disputes Redressal Commission, which noted that ‘merely because case history reveals factum of alcohol influence without any supportive or cogent evidence, it cannot be concluded as person was under alcohol influence’.
For their part, the company stated that patient discharge records of Nizam’s Institute of Medical Sciences reflect that the victim was under the influence of alcohol at the time of the road accident, and cited two orders of Supreme Court.
The commission was of the view that the cause of death as recorded in the post-mortem report was ‘blunt injury to the abdomen’. It also stated that ‘there was no report with regard to the contents of viscera tested in lab for any alcohol presence in the stomach of the deceased’.
“Except for the clinical history of the deceased in Exs.B-3 and B-4, there is no supporting investigation report or any lab report filed by Opposite Party No.2 to establish that the deceased died due to influence of alcohol in the road accident. Hence, it is concluded that the cause of death of the deceased is due to road accident and not due to intoxication,” an excerpt from the order reads.
The commission stated that the company was deficient is service and directed them to pay ₹5 lakh with 9% interest per annum.
Published - July 03, 2021 08:14 pm IST
