Vadodara: The date on which a disability certificate is issued cannot be treated as the date on which a person actually became physically disabled, observed the Consumer Disputes Redressal Commission in Chhota Udepur district. It also directed an insurance company to reconsider a rejected claim.The case concerns Ekta Joshi, a Chhota Udepur resident who suffered serious injuries in a road accident in 2018. She underwent prolonged medical treatment at different hospitals between 2018 and 2020 and was later diagnosed with permanent locomotor disability. In 2021, a govt doctor issued her a certificate confirming 56% physical disability.Joshi subsequently filed an insurance claim with Bajaj Allianz General Insurance Company Ltd. After the insurer rejected the claim, she approached the Chhota Udepur District Consumer Disputes Redressal Commission in April 2023.The insurance company argued that under the policy terms, permanent total or partial disability had to occur within 12 months of the accident. Since Joshi’s disability certificate was issued in November 2021, the insurer contended that her claim did not meet the policy conditions. The insurer also alleged that she had not submitted the required documents.The commission rejected the argument that the date of the certificate established the date of onset of disability. It observed that the key issue was whether Joshi’s disability was caused by the accident.“To believe that disability happened on the date when the certificate was issued is not appropriate. The certificate is to officially determine the disability and its extent,” the commission said.It also noted that Joshi had sustained injuries in the 2018 accident and later suffered another fall at home, following which she developed permanent disability.The commission directed the insurer to reconsider the claim based on Joshi’s disability certificate, medical records and police documents.The insurance company was ordered to determine the amount payable under the policy and disburse it to Joshi within 60 days of the order. It was also directed to pay Rs 3,000 towards mental agony and Rs 2,000 towards legal expenses.
