Insurance firm pulled up for inventing grounds to reject claim

Birla Sun Life Insurance Company Ltd has been pulled up by a consumer forum here for "inventing grounds" to reject the claims of a woman whose deceased husband had been insured with it.
The New Delhi Consumer Disputes Redressal Forum, presided by C K Chaturvedi, also asked the insurance company to settle the claims of two policies and also pay a compensation of Rs 50,000 to the man's wife.
The forum, also comprising its members S R Chaudhary and Ritu Garodia, said the company was "just inventing grounds to defeat the just claim" and asked it to settle the death claim filed by Punjab resident Rashpal Kaur for her late husband.

"We...Find that opposite party (insurance company) is just inventing grounds to defeat the just claim. His (man) going to the school upto primary or leaving it, or his being a farmer etc. Are no grounds to deny the death claim," the forum said.
"We hold the insurance company guilty of arbitrarily repudiating the claim and guilty of deficiency in services," it said.
It said that it was for the insurance company to verify all facts before giving insurance cover and having accepted his certificate, it cannot be allowed to repudiate the claim.

"None of the grounds amounts to suppression of material facts nor has the opposite party been able to discharge burden of proving suppression of facts by leading cogent evidence," the forum said.

According to the woman, the company was not releasing the claims of the two policies of her husband who was insured with it, of Rs 5 lakh and Rs 1.5 lakh respectively.
The company had rejected the claim on the ground that the man's school certificates showing his date of birth was found fake by an investigation conducted by the insurer.
In its reply before the forum, the company had also stated that the man was a semi-literate farmer, alcoholic and unemployed. However, no investigation report was placed on record.