3 days ago
Andhra Commission Orders Insurer to Pay Rs 50 Lakh Claim
A man named Divakar Reddy Yellala died after a motorcycle crash.
His insurance policy promised Rs 50 lakh, and his brother, who was the nominee, asked the insurer to pay.
The insurer refused, saying there had been misrepresentation and that some documents were missing.
A consumer commission reviewed the case.
It said the insurer did not prove what information was supposedly misrepresented.
It also found no proof that the insurer’s requests for documents had reached the nominee.
The insurer’s own investigator had found the accident genuine and the cause of death consistent with the post-mortem report.
The commission ordered the insurer to pay the Rs 50 lakh claim, plus compensation and costs.
If the main payment is late, annual interest will apply.
Kurnool District Consumer Disputes Redressal Commission directed an insurer to pay Rs 50 lakh to Divakar Reddy Yellala’s nominee.
Divakar died after a motorcycle accident on NH-40 on April 14, 2025; the post-mortem recorded head injury as the cause of death.
The insurer rejected the claim, alleging misrepresentation and citing documents it said the nominee had not provided.
The commission found no proof that the insurer’s document requests had reached the nominee and no specific misrepresentation had been established.
The insurer must also pay Rs 20,000 for mental agony and Rs 5,000 in costs within 45 days; otherwise, the Rs 50 lakh carries 9% annual interest from October 6, 2025.
- Who
- The Kurnool District Consumer Disputes Redressal Commission, the insurer, and nominee Yellala Jagadeeshawara Reddy.
- What
- The commission ordered the insurer to pay Rs 50 lakh, Rs 20,000 compensation, and Rs 5,000 in costs after rejecting its claim-repudiation grounds.
- Where
- Kurnool district, Andhra Pradesh; the accident occurred on NH-40 near Ganesh Godown in Govindapalle village, Sirivella.
- When
- The order was passed on October 1; the article does not specify the year.
- Why
- The insurer did not prove the alleged misrepresentation or establish that its document requests had been served on the nominee.
Nominee and Commission
Insurer
Reason for rejecting the claim
Nominee and Commission
The nominee challenged the rejection, and the commission found the insurer had not identified or substantiated the specific information allegedly misrepresented.
Insurer
The insurer said scrutiny and verification revealed misrepresentation of facts and that the claim did not fall within the policy terms.
Requested documents
Nominee and Commission
The commission found no evidence that the insurer’s communications requesting documents had actually reached the nominee.
Insurer
The insurer argued that the nominee had not supplied requested documents, including the final police report, despite repeated requests.
Accident and police report
Nominee and Commission
The insurer’s investigator found the accident genuine and the cause of death consistent with the post-mortem report; the commission found no proof that the missing police report invalidated the claim.
Insurer
The insurer cited the absence of the final police report as part of its position on the claim.
Key facts
- Sum assured
- Rs 50 lakh
- Additional compensation
- Rs 20,000 for mental agony
- Costs awarded
- Rs 5,000
- Compliance period
- 45 days from receipt of the order
- Late-payment interest
- 9% annually on the Rs 50 lakh sum assured, from October 6, 2025, until realisation
- Policy period
- December 19, 2024, to December 18, 2025
- Premium
- Rs 4,767
- Claim filed
- May 8, 2025
Quotes
Kurnool District Consumer Disputes Redressal Commission
The consumer commission that ruled on the nominee’s insurance complaint.
“The rejection/non-settlement of the claim by the Opposite Party, without establishing a valid and substantiated ground under the policy terms and conditions, amounts to deficiency in service.”
financialexpress.com
Sources
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