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Insurance firm told to pay Rs 40L claim to BMW owner

Insurance companies show all types of green pastures to a customer at the time of selling insurance policies, but when it comes to claim payment, they give all sorts of excuses to deny the same. Observing this, the District Consumer...
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Insurance companies show all types of green pastures to a customer at the time of selling insurance policies, but when it comes to claim payment, they give all sorts of excuses to deny the same. Observing this, the District Consumer Disputes Redressal Commission, Chandigarh, has directed an insurance company to pay Rs 40.13 lakh to a city resident along with interest at 6 per cent per annum from the date of closing the claim.

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Navjeevan Jit Singh, a resident of Chandigarh, in the complaint filed before the commission said that he owned a BMW X5. The SUV was insured with the Bajaj Allianz General Insurance Co. Ltd till January 12, 2027. He said that on January 30, the vehicle, which was being driven by one of the family relatives, who had a valid driving licence, met with an accident. Since there was no fault of any of the parties, they compromised the matter in the presence of police officials concerned of police station, Sector 21, Panchkula.

Meanwhile, he immediately informed the insurer regarding the accident and accordingly the claim was lodged on February 3. The dealer, Krishna Automobiles, issued the repair estimate of the vehicle totaling Rs 49.58 lakh. On March 27, he received a letter from the insurance company informing that the driver of the vehicle had not provided any police report as well as medical report, so his claim was not given.

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In the reply, the insurance company stated that they conducted a survey, where the investigator was not provided with the documents, i.e. police report, MLC as well as chemical report of the driver who allegedly sustained injuries during the accident. The documents are required to determine the authenticity of the claim, but no such documents were provided by the complainant. The investigator said the DDR clearly mentioned that the driver of the vehicle was under the influence of alcohol or some other form of intoxication.

After hearing the arguments the commission said that the complainant had specifically stated that no MLC report was ever provided by the hospital and as such the insurance company could not be allowed to harass the complainant by compelling him to produce the report which is not in his possession. “The complainant has placed the certificate issued by the police mentioning that a “mutual agreement” was reached between the parties regarding the accident. The closing of the claim by the insurance company cannot be justified. It also failed to prove on file that the driver had consumed alcohol at the time of accident. In view of this the company is directed to pay Rs 40.13 lakh to the complainant,” it said.

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