Group Personal Accident Policy Claim
Iqbal A. M. Shaikh
(Querist) 25 April 2009
This query is : Resolved
Dear All,
My son died in an accident on Dec 26, 2008. He was working for a compnay who had subscribed to a Corporate Group Personal Accident Policy from Bajaj Allianz.
I had claimed through the company for the claim under the said policy. After submission of all the relevant documents the Insurer is persistently sent emails that it will take 10-15 days for the claim and the matter is under investigation. One of their TPA had sent some investigator to my house and he insisted on phone for documents and then collected all the documents duly notorized from me. He also had some sort of form in which he wrote his report. Now the Bajaj Allianz people have sent me an email that it will take another one month to process the claim and the claim is under investigation.
I would request you to guide me on the following.
1. Does any previous accidental injury which did not result in any disability has any bearing on the claim. Does the revelation of the same in proposal form essential.
2. Is there any remedy through which I could compell insurer for an early settlement of my claim.
3. What are the legal remedies. Please cite relevant provisions and case laws.
4. What are the options of approaching IRDA.
5. Procedure of writs to compell for an early settlement.
6. In case of denial, legal remedies available.
Thank you,
Regards,
Iqbal
adv. rajeev ( rajoo )
(Expert) 25 April 2009
Insurance companies only after the investigation they will pay the compensation.
If in case of denial U can file workmen compensation case in the Court of Workmen Compensation against the company and insurance company, because ur son is died during the course of employment.
Reg., ur 1 que, it need to show the previous accident in the proposal form.
It is better to file workmen compensation case.
There is no provision to compell them to settle the claim earliest, U can issue a legal notice to the co., for early settlement.
Y V Vishweshwar Rao
(Expert) 26 April 2009
I agree with suggestions made by Mr Vadrali & Mr Prabhaker
it is true the Insurance company is taking long time , the reasons should be informed to the Claimants
The Company in which your son worked, is expected to take up the matter with insurance Company for early settlement
Unless the Reasons are made clear the stand of the Insurance company is not known
with regards !
