FACTS
The complaint was filed about Group Personal Accident Policy that covers police personnel. Complainant’s husband, late (Shri) Gurdev Singh, insured under the policy for Rs. 1,00,000/- had died in a road accident on 22.04.2009 and its claim was settled by the company for Rs. 75,000/- only. Hence, feeling aggrieved, she had approached this office for release of the remaining balance amount.
FINDINGS
The insurer submitted that the Company was informed about the death of late (Shri) Gurdev Singh after seven months, which was in violation of the policy term and condition. He clarified that considering hardship being faced by the family of the deceased, a liberal view has been taken and claim was settled on a sub-standard basis by paying 75% of the admissible amount. Complainant represented that the family was in a state of shock, even then necessary documents were produced for a claim.
DECISION
It was held that penalizing a widow for the delay caused in lodging a claim is not justified as reasons for the delay in communicating the claim were spelt out by the widow. Accordingly, an award was passed with a direction to the insurance company to release the balance payment of Rs. 25,000/-.
