HYDERABAD: Hyderabad District Consumer Forum-II directed Bharti Axa to compensate a policyholder with Rs 12 lakh for indulging in unfair trade practice by repudiating his claim within 45 days.
Yekkiral Venkata Ramanuja Swamy from Prashanthnagar filed a complaint against Bharti Axa Life Insurance from which he had taken a medical insurance policy in 2018 by paying a yearly premium of Rs 1.25 lakh.
He said the agent had assured that the policy covered outpatient expenses and that there was no need for a medical examination. The complaint that was filed on March 10, 2021, said that Swamy’s wife P. Vedavalli was admitted in Care Hospital, Banjara Hills, on December, 12, 2018 and died on January 21, 2019, due to ‘refractory septic shock with MODS’. The GHMC issued the death certificate on February 16, 2019.
Swamy filed a claim with Bharti Axa on March 7, 2019 which the company repudiated as the patient’s medical history was not disclosed in the proposal form.
The forum found the proposal form was not filled by the insured but by the agent. The forum also found that the test reports of the deceased were within normal limits.
Holding the insurance company guilty of deficiency in service, the forum ordered Bharti Axa on January 13 this year to pay Swamy Rs 12,41,649 with eight per cent annual interest from the date of death till realization. The complainant was also awarded Rs one lakh for the agony he underwent and another Rs 10,000 to cover legal costs.
