Case title: New India Assurance Company Limited & Anr vs. Shubham Khattar
Summary
The State Commission in Chandigarh has found ‘New India Assurance Company Limited’ liable for rejecting a complainant’s insurance policy due to unreliable evidence regarding the complainant’s alcohol consumption. The complainant was involved in an accident while attempting to rescue street canines, and the insurance company claimed she was under the influence of alcohol, citing the PGIMER record. The District Commission partially granted the complaint, directing the insurance company to pay ₹4,79,000/- with 9% interest, ₹20,000/- as compensation, and ₹10,000/- as litigation expenses. The complainant lodged an appeal with the State Commission, arguing that the District Commission neglected to consider the complainant’s circumstances and that the claim cannot be disavowed on the premise of unreliable evidence. The State Commission upheld the District Commission’s decision, and the appeal was dismissed.
About The Case
The State Consumer Disputes Redressal Commission in Chandigarh, which is presided over by Justice Raj Shekhar Attri (President) and Mr. Rajesh K. Arya (Member), has found ‘New India Assurance Company Limited’ to be liable for rejecting the complainant’s insurance policy on the basis of unreliable evidence regarding the complainant’s alcohol consumption.
New India Assurance Company Ltd (Appellant) insured the complainant’s Honda Jazz vehicle for ₹4,80,000/- from December 15, 2022, to December 14, 2023.. Regrettably, the complainant was involved in an accident on 04.02.2023 at approximately 4:30 AM while attempting to rescue some street canines with her vehicle. The complainant was transported to the hospital in an unconscious state by the police as a result of grievous injuries.
The complainant’s statement was recorded by the police after they were declared competent. The complainant subsequently submitted the necessary documents for the surveyor’s report in order to claim the insurance policy. Nevertheless, his assertion was denied. The complainant lodged a complaint with the District Consumer Disputes Redressal Commission-I, U.T. Chandigarh, as a result of feeling aggrieved.
The insurance company claimed that the complainant was under the influence of alcohol, which justified the rejection of the claim, citing the PGIMER record. The District Commission partially granted the complaint in an order dated 07.10.2024, directing the insurance company to pay ₹4,79,000/- with 9% interest, ₹20,000/- as compensation, and ₹10,000/- as litigation expenses. The appellant lodged an appeal with the State Consumer Disputes Redressal Commission, Chandigarh (“State Commission”) after being dissatisfied with the District Commission’s decision. New India Assurance Company’s contents include:
The Appellant contended that the rejection of the claim was permissible under clause 2(c) of Section 1 of the Insurance Policy; however, the District Commission neglected to take this into account.
Furthermore, there were no reliable eyewitnesses present due to the early morning nature of the accident. Additionally, they argued that the complainant was under the influence of alcohol, as evidenced by the medical records. Observation of the State Commission:
The Commission noted that the complainant did not undergo a breath analyzer or blood test to ascertain the extent of their alcohol consumption.
The police transported the complainant to the hospital immediately following the accident, where they provided the necessary information. However, the physician who prepared the medical report declared the information provided to be unreliable due to the fact that the individual was not related to the complainant and had not observed the accident.
Consequently, the commission emphasized that the claim cannot be disavowed on the premise of such unreliable evidence regarding alcohol consumption.
Consequently, the District Commission’s decision was upheld by the State Commission, and the appeal was dismissed.
