The district consumer disputes redressal commission in Thiruvallur has instructed an insurance company to pay a sum of 15.5 lakh to a victim of a road accident. The victim, M Nagabushanam, sustained severe head injuries in a March 2020 accident while riding his two-wheeler. After undergoing treatment for over eight months, Nagabushanam slipped into a coma following a surgery.
As Nagabushanam had insured his vehicle, his son, N Nethaji, filed a claim for the damage caused to the bike. Oriental Insurance processed the claim and settled it accordingly. However, in the subsequent months, Nagabushanam experienced complete disability and eventually passed away in May 2021. Subsequently, his family submitted a separate claim under his personal accident policy. Unfortunately, the same insurance company rejected the claim, citing that it was filed eight months after the accident occurred. The policy guidelines state that such applications should be submitted within six months.
In response, Nagabushanam’s wife, N Rani, sought relief from the Thiruvallur commission. The insurance company argued that they had already compensated 40,000 for the vehicle damage, and even the insurance ombudsman ruled in their favor.
The commission acknowledged that it is impossible to predict death or permanent disability within six months after an accident. The insurance company had previously confirmed that Nagabushanam was in a coma. The patient’s medical records attested that his death was a result of the injuries caused by the accident. Therefore, the commission deemed the insurance company at fault, referring to orders from the Madras High Court.
Consequently, the commission ordered the insurance firm to pay the 15 lakh claim amount along with an additional 55,000 as compensation for the mental anguish and hardships endured by the complainant. The payment must also include a 6% interest rate.
