Rajasthan Consumer Commission Orders Insurer to Pay 75% of Accident Claim
In a significant ruling, the Rajasthan State Consumer Disputes Redressal Commission has declared that genuine accident claims must not be rejected based on technical procedural lapses, such as delays in filing an FIR or the absence of a postmortem report. The commission directed Tata AIG General Insurance to settle 75% of a Rs 15 lakh personal accident claim on a non-standard basis, overturning a previous district commission order from December 2023.
Case Details and Background
The case involves Durg Singh, who tragically lost his life after sustaining fatal head injuries in a road accident. The incident occurred in August 2020 on the Shergarh–Setrawa road when his vehicle overturned while attempting to avoid a nilgai. Singh succumbed to his injuries during treatment, leading to a claim filed by his family.
Initially, the district commission had rejected the claim, citing that the victim was brought dead to the hospital. However, the state commission, comprising Chairman Devendra Kachhawaha and members Surendra Singh and Liaqat Ali, reviewed the evidence and found this conclusion to be flawed.
Commission's Findings and Rationale
The bench meticulously examined hospital records, which clearly documented "head injury due to road accident." Additionally, a doctor's statement confirmed that death resulted from excessive bleeding, directly linking it to the accident. This evidence was pivotal in refuting the insurer's argument that procedural issues should invalidate the claim.
On the matter of procedural lapses, the commission emphasized that delays in filing an FIR or the lack of a postmortem cannot be attributed to the claimant. It noted that the delay was approximately 40 days, not exceeding two months as previously claimed by the insurer. Citing Supreme Court rulings, the bench affirmed that genuine claims should be settled on a non-standard basis to ensure justice for victims and their families.
Directives and Implications
As a result, Tata AIG General Insurance has been ordered to pay Rs 11.25 lakh, which represents 75% of the original Rs 15 lakh claim. This amount must be paid with 9% interest accruing from February 23, 2022. Furthermore, the insurer is required to cover Rs 10,000 in litigation costs incurred by the claimant.
This ruling sets a precedent for future insurance disputes in Rajasthan, reinforcing that technical grounds should not overshadow the merits of genuine accident claims. It underscores the consumer commission's commitment to protecting policyholders' rights and ensuring fair treatment in insurance settlements.
