Pune Consumer Forum Rules Against Insurance Company for Denying Widow’s Claim
The Pune District Consumer Dispute Redressal Forum has made a landmark ruling against a prominent private bank’s insurance company for wrongfully denying a widow’s claim following her husband’s COVID-19 death. The forum has ordered the insurance company to pay a substantial amount of ₹36.40 lakh along with a 5 per cent annual interest within 45 days, in addition to ₹60,000 for mental agony and complaint expenses.
The case revolves around Shubhangi Pradeep Sonawane, who took legal action against HDFC Life insurance and Indostar Housing Finance companies after her husband Pradeep’s insurance claim was rejected. Pradeep, a businessman in the transport industry, had obtained a loan of ₹57 lakh in November 2020 to expand his business. As part of the loan agreement, he was required to secure an insurance policy worth ₹45.70 lakh for the loan’s protection from the insurance company affiliated with the finance company, with a repayment period of 15 years.
Tragically, Pradeep succumbed to COVID-19, leaving Shubhangi unable to meet the monthly loan installment of ₹71,000. When she filed a claim with the insurance company, it was turned down on the grounds of her husband’s pre-existing conditions, including diabetes, hypertension, and epilepsy. Disappointed by this decision, Shubhangi sought recourse through the Consumer Forum.
Despite being summoned by the commission, no representatives from the bank’s insurance company or the finance company attended the hearing, leading to a one-sided ruling by the forum. The forum deemed the denial of the claim based on pre-existing conditions in the event of a COVID-19 fatality as illegal and constituting deficient service.
This ruling is expected to serve as a precedent for insurance companies that reject claims for COVID-19-related deaths by citing pre-existing conditions. The lack of evidence supporting the assertion that Pradeep’s demise was linked to diabetes and hypertension underscored the service inadequacies of the insurance company.
The decision by the Pune District Consumer Dispute Redressal Forum highlights the importance of fair and just treatment of policyholders, especially in times of crisis such as the ongoing pandemic. It sends a strong message to insurance companies to uphold their obligations and not resort to unjust practices when assessing claims.
As the case sets a significant precedent in the insurance sector, it underscores the need for transparency and accountability in handling claims related to COVID-19 fatalities. The ruling serves as a reminder to insurance providers to act in good faith and honor their commitments to policyholders, particularly during challenging times like the present.
The outcome of this case not only brings justice to Shubhangi Sonawane but also serves as a beacon of hope for others who may find themselves in similar situations. It underscores the importance of consumer rights and the role of regulatory bodies in safeguarding the interests of individuals against unfair practices in the financial services industry.