Insurance firm told to reimburse Rs 4.25 lakh

HYDERABAD: A district consumer forum here on Saturday directed HDFC ERGO General Insurance Company Limited and HDFC Bank Ltd. to reimburse Rs 4.25 lakh and pay an additional Rs 1 lakh to a consumer for repudiating his claim without giving a valid reason.
The complainant had submitted that his father purchased a vehicle in the year 2013 by obtaining a loan from HDFC Bank. Upon the insistence of the bank officials, he said that his father opted for an insurance policy from the HDFC ERGO General Insurance Company to cover the loan by paying a onetime premium amount of Rs 6, 438.
He submitted that his father expired on May 30, 2015, and subsequently, he filed the insurance claim. the complainant said that his claim was repudiated by the insurance firm claiming that it is not covered under the policy. Claiming that his father paid all the installments regularly and that he was forced to pay Rs 4.25 lakh and close the loan account, he filed this complaint seeking refund and compensation.
The insurance firm, in their written version, contended by stating that the complainant cannot claim the amount under the credit shield insurance as his father died owing to ailment disease. They claimed this claim doesn’t fall under the terms and conditions of the policy.
The bank officials, meanwhile, said that they are not liable for said repudiation as they only financed the vehicle. They claimed to be the agents only and added that providing insurance coverage does not arise.
During the trial, the Hyderabad-III district consumer forum redressal bench said the fact that the opposite parties disputed repudiated the policy belies their negligence and deficiency in service.
“The terms and conditions submitted by them very obviously includes “Renal Failure”, as a critical illness and the policy has to include it and duly reimburse the policyholder,” said the bench adding that the insurer was only 59 years old at the time of his death and that his death was certainly premature and unexpected.
They said that the opposite parties failed to file any tenable evidence to suggest that he was suffering from any debilitating conditions at the time of acquiring the policy. Apart from refund and compensation, Rs 10, 000 was awarded towards costs of the complaint.