Insurance company directed to pay Rs15 lakh for denying claim 

The complainant N. Sangeetha said her deceased husband, Ramana, took the policy for a period of 30 years on March 31,2012

Hyderabad: Giving a ruling in favor of complainant, District Consumer Redressal Forum, Hyderabad-lll directed insurance company - Birla Sun Life Insurance Company Limited - to pay a policy amount of Rs 15 lakh with 9 percent interest per annum from the date of claim till realization, along with a compensation of Rs. 2 lakh.

The complainant N. Sangeetha said her deceased husband, Ramana, took the policy for a period of 30 years on March 31,2012 and he also paid the premium of Rs. 6,651.

But one month after the policy was taken Ramana fell ill and had been admitted in hospital. Due to lack of experts at K.V.R Hospital in Kurnool he was moved to care Hospital, Hyderabad where he stayed from April 28 to May 6 in 2012, Sangeetha told the Forum.

Ramana died of swine flu on May 6, 2012 while undergoing the treatment and despite being informed to the company and company’s ombudsman her claim was rejected, making her stance as wrong by filing a false counter that her husband had been suffering with serious disease -haemoptysis- from 10 years.

The company also collected evidence from a hospital in Kothapet, Hyderabad. However, the forum ruled that the evidences doesn’t suffice that he suffered from disease from past 10 years and moreover it said that he died of swine flu making the company’s insurance rejection claim as ‘unjust’.