LCI Learning

Share on Facebook

Share on Twitter

Share on LinkedIn

Share on Email

Share More

prashant1314 (HR Learner)     25 March 2017

Pune - Dengue death - insurance covered??

Dear Seniors,

One of  (Pvt Limirt - Manufacturing Comapny at Pune ) employee died on 17th September, 2016 due to Dengue. He was 34 years old without any medical history. He had home loan insurance of HDFC Ergo. Due to his death we have claimed for his Home Loan Insuance which is rejected by the HDFC Ergo stating reason that Dengue is not covered under Crical Illness as well as Accident Category.

He was also covered under GPA policy as per TPA Dengue death is not accident so not covered so insurance under GPA can not be claimed.

Can we take help of below case to file case in Consume Court Pune? If you have any second opinion please advice.

https://indianexpress.com/article/lifestyle/health/death-due-to-mosquito-bite-an-accident-says-consumer-disputes-commission/

 



Learning

 5 Replies

Suri.Sravan Kumar (senior)     25 March 2017

The National Commission in its recent judgement held that Mosquito bite is accident hence Dengue fever also causes due to mosquito bite only as such the claim is payable by the Insurance Co.

Kumar Doab (FIN)     25 March 2017

You can take help of the judgments and prcedences.

I am sending you links and ou may discuss in person with your own counsel at your location specializing in consumer matters.

prashant1314 (HR Learner)     25 March 2017

Sir,

As  the finance company is not interested to accept the claim what should be our legal stand to fight the case at Pune?

Kumar Doab (FIN)     27 March 2017

Not accepting the claim: The insurer can not deny accepting the claim under proper acknowledgment.

It can repudiate the claim citing T&C if any.

Kumar Doab (FIN)     27 March 2017

If it has declined to pay then you can escalalte as per matix narrated and pubished in policy and/or approach Consumer Fora.

Hanover the matter to your legal cell/ engage a very able counsel specializing in such/consumer matters.


Leave a reply

Your are not logged in . Please login to post replies

Click here to Login / Register