Insurance firm fined for refusing claim

Avneet Kaur

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Jalandhar, March 17

The District Consumer Disputes Redressal Forum has directed a private insurance company to pay Rs 24,750 as cost of repair of a mobile phone handset with Rs 20,000 as compensation and Rs 7,000 as litigation expenses to a city-based resident for repudiating his mobile phone insurance claim.

Dr Raman Kumar Gupta, a resident of Model Town, had filed a complaint against The New India Assurance Company Limited, alleging that he was lured into buying a mobile phone insurance, i.e. Gizmo Secure Ultimate Plus Policy, with a promise that it covers accidental damage, including theft and burglary.

He said he paid Rs 2,499 as insurance cost on April 14, 2015, which was valid for one year.

In his complaint to the forum, the complainant said on October 10, 2015, while he was leaving for his duty to the hospital and was about to sit in his car, the handset accidentally fell down on the ground and suffered major damage to the tune of Rs 24,750.

He said since the handset was duly insured, he lodged his claim of insurance and submitted all relevant documents required for the settlement of his claim to Financial Heights (Gizmo Help Claims Division) as well to The New India Assurance Company LImited.

He said in spite of complying with all requirements and documents needed, the insurance firm illegally repudiated his claim on false and flimsy grounds of tampering, fraud and misrepresenting of facts.

Meanwhile, the opposite party, New India Assurance Company, in its reply to the forum said, the complainant in his complaint said his cell phone was damaged while he was sitting in his car while going to hospital from his house as accidentally it fell from his hand and got damaged.

However, as per details sent to the insurance company by Financial Heights (Gizmo Help Claims Division), it has been stated by the complainant that while sitting in the car his mobile phone fell down from his hand and the screen got damaged.

Thus, there is a difference in the two statements of the complainant in respect of the damage caused to his mobile phone handset.

There is a misrepresentation of the facts either in the claim form or in the details sent to them by the Financial Heights.

The company further said the damage to the mobile phone handset of the complainant could not occur by falling/slipping of the handset in the car and that the complainant was not disclosing material facts, resulting into the loss to the handset.

After considering the overall factors as elaborated in the complaint as well as in the written reply of the opposite party, the forum in its judgment said the plea taken by the insurance company for repudiating the insurance claim of the complainant was totally arbitrary and against the principle of natural justice and the same was not sustainable in the eyes of law. Moreover, it has failed to provide any document, which was tampered by the complainant.

Hence, The New India Assurance Company Limited is directed to reimburse the repair cost of the mobile set, i.e. Rs 24,750 with interest at 12 per cent per annum from the date of repudiation of claim, i.e. November 21, 2015, till realisation.