Insurer has to pay repatriation expenses if the insured person dies while travelling abroad even if he/she didn’t reveal their pre-existing medical condition while taking the insurance.
The Vadodara district consumer disputes redressal commission (additional) has ordered an insurance firm to pay Singaporean $3,978 (roughly Rs 2.5 lakh) to the family of the deceased towards the expenses of flying his remains to India.
The family of Mafatlal Chauhan had filed a complaint against Oriental Insurance Company Ltd and a travel firm after the insurer rejected their claim. Chauhan had taken overseas travel insurance while travelling to Singapore in March 2010. During his stay there, Chauhan died of ischemic heart disease. His remains were flown to India for the final rites.
Chauhan’s family then filed a claim for the expenses of bringing his body back to the country. The insurance firm, however, rejected the claim stating that Chauhan had a preexisting heart condition and it wasn’t revealed while taking the travel insurance cover.
The firm said that the policy carries specific exclusion of all medical expenses incurred directly due to past history ailments and consequences attributable to accelerated by or arising therefrom as per medical history. Chauhan’s wife Sudha and son Vikramsinh then filed a complaint at the consumer forum in 2012. They sought $ 25,000 towards personal accident cover and $ 3,978 towards repatriation expenses.
The insurance firm and other opponents then produced cashless process papers for the deceased’s mediclaim from another insurer regarding the percutaneous transluminal coronary angioplasty (PTCA) to prove that the deceased had a pre-existing heart condition. But the deceased’s son said in his reply that he wasn’t aware of any such mediclaim policy or the alleged treatment of PTCA.
The forum observed that for the repatriation benefits, only the death of the insured outside India and proof of expenses are relevant. Finding the reasons for repudiation of the claim unjust and arbitrary, the forum ordered the insurance firm to pay $ 3,978 along with nine percent interest from the date when the complaint was filed till the date of payment.
The insurance firm will also have to pay Rs 10,000 towards the litigation cost and another Rs 10,000 for mental harassment to the complainant.
The complainant had also sought $ 25,000 for personal accident claim but the forum didn’t accept it by saying that Chauhan died of ischemic heart disease and it cannot be treated as an accidental death.
