Insurance firm told to pay Rs 5.25 lakh

Tribune News Service

Jalandhar, November 14

The permanent lok adalat (PLA) has directed Star Health and Allied Insurance Company Limited to pay Rs 5 lakh to a Kapurthala-based woman, Jaswant Kaur, for its laxity in providing benefits under the Pravasi Bhartiya Bima Yojana policy. The firm will not only pay compensation with 9 per cent interest per annum but also the litigation charges of Rs 25,000.

In an application submitted to the PLA, the woman, who is a nominee of the policy, mentioned that her husband Surjit Singh had purchased the policy from the company in 2006 that provides a personal accident cover of Rs 5,00,000 in case of death and permanent total disability.

However, after the accidental death of her husband in Oman, the insurance company denied to pay the amount. Reportedly, the insurance policy, purchased by Surjit before going abroad, was valid for a period of two years — October 31, 2007, to October 30, 2009, — and he died in a traffic accident on September 13, 2009. Hence, after presenting the requisite documents, along with the copy of death certificate issued by the Directorate General of Civil Status, Royal Oman Police, Jaswant Kaur approached officials of the company, that not only refused to provide the insured amount but also rejected the documents. Thereafter, the applicant served a legal notice on the company, but to no avail. It was again after 7 years and 10 months of the closure of the claim by the company, she served one more legal notice on November 13, 2011, and approached the PLA for the settlement of her case. After hearing all questions and formulating terms of possible settlement, a copy of settlement, mentioning that the respondents (insurance firm) should reopen the case of the applicant (Jaswant Kaur) and settle the claim within 30 days or pay the sum insured — Rs 5,00,000 — to the applicant with interest at the rate of 9 per cent per annum from the date of death of the insured till the final payment, was issued to both parties.

Territory manager Punit Wason on behalf of the firm made a statement that the proposed terms of the settlement were not acceptable to the respondents, following which PLA counsel consisting, Chairman, SS Sahni and members Sushma Handoo and SK Julka, heard arguments and evidence of both parties and came to a conclusion that even after presenting valid documents, the company remained negligent in providing the insured amount to the applicant. Hence, along with the insured amount, Jaswant was also found entitled for a litigation cost of Rs 25,000.