The Maharashtra State Consumer Disputes Redressal Commission recently ordered an insurance company to pay around Rs 9 lakh to the widow of one Ganesh Sawadekar, who died while crossing the tracks in Pune in 1999.
National Insurance Company Ltd had repudiated the claim on the grounds that the act of trespassing the railway line was criminal and illegal act and hence the insurance claim would not be payable. However, stating that the act cannot be called criminal, the commission observed, "When a railway line is going through the city area, we find that at many places people have to cross from unmanned crossings."
Holding the company guilty of deficiency of service for repudiating the claim on flimsy grounds, the commission said, "This is not a criminal act. It was purely an accidental death for which claim should have been allowed."
The insurance company will now pay Sangita Sawadekar Rs 5 lakh together with 7% per interest from the date of repudiation of claim in April 2001 till actual payment. She will also receive Rs 5,000 towards the cost of the complaint.
On May 15, 1999, Ganesh Sawadekar, an employee with an engineering and locomotive company, died after he was hit by a train while crossing the railway tracks in Pune. Through his company's employee welfare association, the insurance company had offered the employees a personal accident insurance policy. On payment of premium of Rs 200, the insurance company had assured to give nominees Rs 5 lakh in case of death.
Sangita filed the claim through the welfare society giving all relevant documents. However, the insurance company repudiated the claim on the ground that Ganesh had committed a "criminal act" by trespassing on the railway line and the railways did not establish the death as accidental. Sangita pleaded that she was never issued a policy of the insurance company mentioning the exclusion clause. She then filed the consumer complaint.
National Insurance Company Ltd had repudiated the claim on the grounds that the act of trespassing the railway line was criminal and illegal act and hence the insurance claim would not be payable. However, stating that the act cannot be called criminal, the commission observed, "When a railway line is going through the city area, we find that at many places people have to cross from unmanned crossings."
Holding the company guilty of deficiency of service for repudiating the claim on flimsy grounds, the commission said, "This is not a criminal act. It was purely an accidental death for which claim should have been allowed."
The insurance company will now pay Sangita Sawadekar Rs 5 lakh together with 7% per interest from the date of repudiation of claim in April 2001 till actual payment. She will also receive Rs 5,000 towards the cost of the complaint.
On May 15, 1999, Ganesh Sawadekar, an employee with an engineering and locomotive company, died after he was hit by a train while crossing the railway tracks in Pune. Through his company's employee welfare association, the insurance company had offered the employees a personal accident insurance policy. On payment of premium of Rs 200, the insurance company had assured to give nominees Rs 5 lakh in case of death.
Sangita filed the claim through the welfare society giving all relevant documents. However, the insurance company repudiated the claim on the ground that Ganesh had committed a "criminal act" by trespassing on the railway line and the railways did not establish the death as accidental. Sangita pleaded that she was never issued a policy of the insurance company mentioning the exclusion clause. She then filed the consumer complaint.
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