7 hrs ago
Telangana Commission Awards Widow Rs 5 Lakh After Drowning Claim
A fisherman in Telangana died after falling from his motorcycle into a pond.
His widow asked his insurance company for the money promised for accidental death.
The company refused, saying a health problem may have caused him to fall.
The consumer commission examined the police records and found that he died by drowning.
It said the insurer had not provided enough evidence for its explanation.
The commission also rejected the claim that the fisherman was a good swimmer.
It ordered the insurer to pay the widow Rs 5 lakh.
It also added Rs 10,000 for mental distress and Rs 5,000 for legal costs.
The Adilabad District Consumer Commission awarded a fisherman’s widow Rs 5.15 lakh.
The fisherman died on October 11, 2023, after falling into a pond and drowning.
The insurer argued that a pre-existing condition involving “fits” caused the death.
The commission found the available records supported accidental drowning and rejected the insurer’s argument.
The insurer was ordered to pay Rs 5 lakh, Rs 10,000 compensation, and Rs 5,000 in costs.
- Who
- A 39-year-old widow, her deceased fisherman husband, and the insurance company were involved in the dispute.
- What
- The Adilabad District Consumer Disputes Redressal Commission ordered the insurer to pay Rs 5.15 lakh over a rejected accidental-death claim.
- Where
- The drowning occurred in a pond near the route from Mallapur to Chinthalachanda village in Telangana, and the case was heard in Adilabad.
- When
- The fisherman died on October 11, 2023; the commission’s order was dated September 23.
- Why
- The insurer alleged that a pre-existing condition caused the death, while the commission found the records supported accidental drowning.
Consumer Commission and Widow
Insurance Company
Cause of death
Consumer Commission and Widow
The widow relied on records showing that her husband fell from his motorcycle into a pond and died by drowning.
Insurance Company
The insurer argued that the death was caused by a pre-existing health condition and a sudden attack of “fits,” rather than an accident.
Evidence for rejecting the claim
Consumer Commission and Widow
The commission said the FIR and final report supported drowning and that the insurer had not produced sufficient evidence for its alternative explanation.
Insurance Company
The insurer maintained that the policy excluded deaths caused by the alleged health condition.
Swimming ability
Consumer Commission and Widow
The commission said there was no evidence that the fisherman was a good swimmer and held that the circumstances supported drowning.
Insurance Company
The insurer contended that the circumstances did not establish an accidental death, including by disputing the basis for treating the drowning as covered.
Key facts
- Award
- Rs 5.15 lakh total
- Insurance amount
- Rs 5 lakh for accidental death
- Additional compensation
- Rs 10,000 for mental agony
- Costs
- Rs 5,000
- Death date
- October 11, 2023
- Policy
- Group insurance for members of the Fisheries Industrial Co-Operative Society
- Scheme
- Pradhan Mantri Matsya Sampada Yojana, with premiums contributed by the Telangana government
Quotes
Adilabad District Consumer Disputes Redressal Commission
Consumer commission comprising President C H V Narasimha Rao and member Madhavi Sasa.
“There is every obligation cost upon the opposite party (insurance company) to come to the rescue of the nominee of the insured in case of sudden death of the insured. As such, non-settlement of the claim by the opposite party is nothing but deficiency of service which amounts to unfair trade practice.”
indianexpress.com
“The husband of the complainant may have the existing disease of fits, but the circumstances of the accident disclose that he fell from his bike into the pond and thereby he died due to drowning.”
indianexpress.com
Sources
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