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Faulted for agent's lapse

AK Chandok approached the consumer court when his claim was rejected by an insurance company even though he had informed its agent of his accident.

Rakesh Rai | Print Edition: Nov 29, 2007

AK Chandok
AK Chandok

I took a personal accident policy for a sum assured of Rs 1 lakh from New India Assurance on 2 February 1999 that was valid for a year. I met with an accident on 22 March 1999 and fractured my leg.

Despite the trauma, I informed the agent of the insurance company about the accident and the resulting claim within two days. I did so in writing. After pursuing the claim for over a year, I was shocked when the company said that I was not eligible for it because the insurer was informed about the claim only on 3 July 2000, after a gap of 15 months.

My contention that since the agent, who had been collecting premium and other charges from me on behalf of the company, was informed in time, it was for the company to penalise the agent instead of me, fell on deaf ears. I then approached the district consumer forum, where my complaint was dismissed.

I then filed an appeal at the State Commission in Delhi. It was here that my point of view was taken favourably and the court ruled in my favour (on 3 September 2007), directing the company to pay Rs 1 lakh towards insurance and Rs 10,000 as the cost of litigation.

The commission held that since insurance companies collect the premium to run their business by appointing agents, the obligation of the assured stands discharged immediately after he informs the agent and delivers all the requisite papers in support of his claim.

I didn’t fight the case for six years just to get Rs 1 lakh but for what was my right. I had been renewing my personal accident cover from the same insurance company for 10 years and paying regular premium to them till the accident happened. I didn’t file any claim in all these years. But when I actually met with an accident the company refused to honour our long association. Today I am satisfied because through my case there will be thousands of others who stand to gain.

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