ICICI Lombard to Pay Rs 50 Lakh Claim, Can't Add Conditions: Kurnool Consumer Court

In a significant ruling protecting policyholders from post‑contractual hurdles, the District Consumer Disputes Redressal Commission, Kurnool , has directed ICICI Lombard General Insurance Company Limited to pay ₹50 lakh to the nominee of a personal accident policy. The bench, comprising President Sri Karanam Kishore Kumar , Member Sri N. Narayana Reddy , and Member Smt S. Nazima Kausar , held that an insurer cannot demand documents—such as income tax returns or bank statements—that were never required at the proposal stage, and that a chargesheet itself constitutes the final police report.

A Fatal Crash and a Stalled Claim

Gandla Mulaiah , a 58‑year‑old self‑employed resident of Nandyal, had taken a personal accident policy (sum assured ₹50 lakh) from ICICI Lombard, valid from 9 June 2025 to 8 June 2028 , paying an annual premium of ₹14,445 . His wife, Gandla Prameela , was the nominee.

On 28 July 2025 , Mulaiah was standing beside a road near Tellapuri Village when a rashly driven mini truck hit him. He succumbed to grievous head and leg injuries the same night at Government Hospital, Nandyal. The police registered FIR No. 55/2025 , conducted an inquest and post‑mortem, and eventually filed a chargesheet before the Judicial First Class Magistrate, Allagadda.

The widow‑nominee promptly lodged a claim with the insurer, attaching the policy, death certificate, FIR, post‑mortem report, inquest report and the chargesheet. Yet ICICI Lombard repudiated the claim, first on 3 October 2025 claiming the “Police Final Report” and income‑tax return had not been provided, and again on 4 November 2025 demanding one‑year bank statements.

Insurer’s Demand for New Documents Sparks Legal Battle

ICICI Lombard contended that the complainant failed to supply mandatory documents, despite reminders, and that the repudiation was therefore justified. It argued that the chargesheet is not the “final report,” and insisted on the production of income‑tax returns and bank statements to process the personal accident claim. The insurer’s list of required documents ran into ten points, including a police final charge sheet, court final order, and even a Forensic Science Laboratory report.

On the other side, the complainant maintained that the chargesheet is the final police report under Section 106(1) of the Bharatiya Nagarik Suraksha Sanhita , and that she had already submitted all essential documents. The demand for income‑tax returns and bank statements, she asserted, was never part of the original proposal and had no nexus with an accidental death claim.

Commission Rejects Hyper‑Technical Repudiation

The Commission examined the policy schedule ( Ex. A1 ) closely. It found that when ICICI Lombard accepted the proposal on 9 June 2025 , it recorded Mulaiah’s age as 58 years and occupation as “self‑employed”—with no column or requirement to disclose income details or whether he was an income‑tax assessee. “Having accepted the risk and issued the policy without insisting upon such particulars at the inception of the contract, the Opposite Parties cannot subsequently, at the stage of claim, insist upon production of Income Tax Returns or income proof,” observed the bench. “Such conduct … amounts to introducing new conditions post‑contract, which is impermissible in law.”

On the “final report” point, the Commission was unequivocal: the chargesheet filed after investigation is the police final report. The accident and the cause of death were already conclusively proved by the FIR, post‑mortem report, inquest report, and the chargesheet. Refusing to settle the claim on that ground was therefore baseless.

Legal Precedent Against Frivolous Rejections

Relying on the Supreme Court’s decision in Gurmel Singh v. Branch Manager, National Insurance Company (2022 SC 2486) , the Commission reminded the insurer that “insurance companies should not be too technical and cannot reject the claims on flimsy grounds” and must not insist on documents that a claimant cannot produce due to circumstances beyond control.

Applying that principle, the bench observed: - “The repudiation of the claim on the ground of non‑submission of the Police Final Report is unsustainable.” - “Further, the requirement of furnishing the Income Tax Return and one year’s bank statement has not been shown to have any nexus with determining the liability under an accidental death policy.” - “The insurer … is estopped from raising such objections at the claim stage, particularly when the claim arises out of an accidental death, which stands independently established by cogent evidence on record.”

The Commission found the repudiation to be an arbitrary and unreasonable deficiency in service , causing the nominee unwarranted mental agony and financial loss.

Judgment: ₹50 Lakh Payout and Penalties

Partially allowing the complaint, the District Consumer Disputes Redressal Commission, Kurnool, directed ICICI Lombard (both the Mumbai head office and the Kurnool branch) jointly and severally to: - Pay the sum assured of ₹50,00,000 to the complainant, - Pay ₹20,000 towards compensation for mental agony, - Pay ₹10,000 towards the costs of the proceedings.

The amounts must be paid within 45 days . In default, the ₹50 lakh will carry 9% per annum interest from the date of filing of the complaint (4 November 2025) until actual realization.

This order reaffirms that insurers cannot turn a claim‑processing exercise into a hyper‑technical obstacle course, and that a policyholder’s promise—once accepted without reservation—cannot later be diminished by demands for documents that were never part of the bargain. For the widow of Gandla Mulaiah, it brings closure after a year‑long battle; for the insurance industry, it serves as a clear message to honour the spirit of the contract.