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INDER SINGH MEHTA
Care Health Insurance Limited – Appellant
Versus
Virender Kumar – Respondent
ORDER
Present appeal is preferred against the order dated 20.12.2023 of learned District Commission, Chamba, H.P. in consumer complaint No.23/2022 titled Virender Kumar Vs. The Religare, Health Insurance Company Ltd. & Anr. whereby the complaint filed by the complainant was allowed.
Brief facts of the Case:
2. Briefly, case of the complainant is that father of the complainant Sh. Narain Singh (since deceased) during his life time had taken finance of Rs.5.00 lac under the KCC scheme against his landed property from the opposite party No.2/Himachal Pradesh Gramin Bank and the opposite party No.2/Himachal Pradesh Gramin Bank provided Health Insurance Policy bearing No.1483126 from the opposite party No.1/insurance company in the name of Narain Singh, which was valid from 07.09.2019 to 06.09.2022. During the existence of the said policy, father of the complainant Narain Singh died due to sudden fall in bathroom who had sustained head injuries. After death of Narain Singh, the complainant submitted all necessary documents to the opposite parties, but they lingered on the matter on one pretext or the other and are not interested to pay the claim on account of death of father of the comp
Medical Practitioner – In the absence of Medico Legal Certificate and Post Mortem Report issued by Medical Practitioner, the certificate issued by the Pradhan, Gram Panchayat, who is admittedly not a....
(1) Failed to discharge the services – The insurer failed to discharge its service obligations by rejecting a genuine claim based on a Chemical Analysis report showing alcohol presence, while ignorin....
(1) Since the insured while sitting on the chair fell down on the ground, got head injury and surface undoubtedly a hard surface, injury is accidental.(2) Respondent’s husband is covered under clause....
Claim – No claim should be disallowed purely on technical ground or in a mechanical manner; the insurance company should reject the claim only when the insurer finds that it was liable to be rejected....
Insurance policy cannot be cancelled unilaterally by Insurance Company unless personal intimation is given to insured.
Inactive Policy – If a policy is not active, the claim for the Accident Benefit is not payable to the complainants as per the terms outlined in the insurance contract.
(1) Terms of insurance policy have to be strictly construed, and it is not permissible to rewrite contract while interpreting terms of Policy.(2) In a contract of insurance there is a requirement of ....
The claimant must establish a direct causal link between the accident and the injury for compensation under the accident policy.
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