Vadodara: “What is not known, not communicated and not disclosed cannot be used as a weapon to defeat a legitimate claim,” the Gujarat State Consumer Disputes Redressal Commission observed while granting an insurance claim to Bharti Prajapati, a resident of Vadodara. The commission ordered the bank and the insurance firm to jointly pay the insured amount to Prajapati.Prajapati’s husband had a savings account with Union Bank, from which Rs 100 was deducted towards a personal accident insurance policy. In January 2018, he died after a fire broke out at their house due to a short circuit. Prajapati came to know about the policy only three months later while checking the bank passbook. She approached the bank and submitted an insurance claim in April 2018. However, the bank mistakenly sent the claim intimation form to the wrong insurance company, delaying the process further until June 2018. The Oriental Insurance Company Ltd rejected the claim in September 2018, citing the delay in submission. “The bank and the insurance firm did not even provide the policy schedule to Prajapati or her husband. The complainant is engaged in housework, and the premium was just Rs 100, so she could not be expected to be aware of the policy,” said advocate Akhil Dave, who represented Prajapati. She then approached the Vadodara consumer forum, which in 2022 directed the bank to pay her Rs 5 lakh with interest. The bank challenged the order before the state consumer commission in 2023. The state commission noted that the insurance firm had sought an explanation from the bank in June 2018 regarding the delay and had also asked for additional documents. “The email demonstrates that the opponent insurers were actively considering the claim and had not treated it as barred or non-maintainable,” the commission said. Observing that the complainant was never given a copy of the policy, the commission held that the bank committed a deficiency in service by failing to provide the document and by forwarding the claim papers to the wrong insurer, thereby contributing to the delay. It also said the insurance firm repudiated the claim on purely technical grounds. The state consumer commission, comprising presiding member A R Raval and member P R Shah, ordered the bank and the insurance company to jointly pay Rs 5 lakh to Prajapati with 8% interest from the date of filing the complaint.
