Consumer Commission directs bank and insurance company to pay Rs 30 lakh claim to Mumbai policeman who was injured in an accident | mumbai news

Consumer Commission directs bank and insurance company to pay Rs 30 lakh claim to Mumbai policeman who was injured in an accident |  mumbai news

MUMBAI: The Consumer Commission here has directed Axis Bank and New India Assurance Company to pay an insurance claim worth Rs 30 lakh along with interest to a policeman who sustained permanently disabling injuries after an accident in 2017.

The District Consumer Disputes Redressal Commission, South Mumbai, in an order issued on March 11, noted that as per the facts, the bank and the insurance company had agreed to provide insurance cover to the police personnel as per the Memorandum of Understanding (MoU). Between the bank and Mumbai Police.

It noted that the insurance claim submitted by the policeman was “arbitrarily rejected/dismissed.”

The committee said in its order, a copy of which was made available on Sunday, that it was based on an “erroneous interpretation” and therefore the refusal order was found to be unsustainable under the law.

The plaintiff, Rajesh Pawar, was present at Kasturba Marg police station on the outskirts of Borivali (name not mentioned in the order) at the time of filing the complaint in December 2020.

He claimed that as per the memorandum of understanding signed between the bank and the police department in 2015, when employees open an account in the bank, they will be given a Power Salute Debit cum ATM card, along with personal accident insurance of Rs 10 lakh and an air ticket. Accident cover of Rs 25,000.

Thus, he opened an account with the bank branch in Dadar (East).

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The complainant had an accident in October 2017 and said he was hospitalized for an extended period of time.

The complainant said he suffered “severe physical injuries and permanent disabilities” that kept him out of work for approximately one year.

According to the certificate issued by the government medical authority, the policeman is “71 percent disabled.”

After recovering from his injuries, the complainant requested insurance from the bank by submitting the necessary documents in April 2019.

The insurance company rejected the claim on the grounds of late submission of documents and failure to cover partial disability in the terms of the policy.

The bank confirmed, in a written response, that the complainant had made a “false claim.”

The policeman receives his salary every month without interruption. The bank confirmed that there is no loss of job or any psychological or physical harassment.

She also said that partial disability is not included in the scheme.

She added that the claim must be submitted within 90 days from the date of the accident, adding that the bank’s role is limited to an agent for companies and that the actual insurance is issued by the insurance company.

The insurance company also disputed the claim, saying that to claim, the insured must immediately provide notice with as full details as possible.

The insurance company said that in this case, the complainant referred after a break of one year and 7 months.

Moreover, the insurance company stated that it was not aware of what happened between the bank and the Mumbai Police.

The insurance company also said that it had not entered into any agreement with the Mumbai Police and therefore the agreement between the bank and the Mumbai Police was not binding on it.

After considering all the submissions, the committee said that the facts reveal that the opposite parties had agreed to provide insurance cover to the police personnel under the memorandum of understanding between the bank and the Mumbai Police.

“Thus, from the defendant’s conduct, it was shown that to avoid insurance liability, the claim was arbitrarily denied/dismissed,” the commission said.

It added that, therefore, the order rejecting the claim was itself arbitrary and based on a wrong interpretation and was therefore found to be unsustainable under the law.

The committee said that the complainant was justified in demanding Rs 30 lakh at an interest rate of 6 per cent from the date of rejection (June 5, 2019) till its actual realization.

I directed the bank and the insurance company to issue the claim jointly and separately.

The commission also ordered them to pay Rs 2.50 lakh to the constable as compensation for mental anguish and Rs 25,000 towards litigation costs.

    (tags for translation) Mumbai News 

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