The District Consumer Disputes Redressal Forum in Hisar, Haryana, has found HDFC ERGO General Insurance Company Limited guilty of providing deficient services and engaging in unfair trade practices. The panel, consisting of Jagdeep Singh (President), Rajni Goyat (Member), and Dr. Amita Aggarwal (Member), issued this verdict following the improper denial of an insurance claim due to the supposed lack of necessary documentation, which was actually not crucial for settling the claim. As a result, the insurance company has been ordered to cover the claim amounting to Rs. 25,300, along with a compensation of Rs. 10,000 and litigation costs worth Rs. 5,000 to the complainant.
The case began when Mr. Sanjay, the complainant, reported that his insured motorcycle worth Rs. 25,300 had been stolen in 2018. He had promptly filed an FIR, notifying the police and his insurance company. Despite providing the necessary documents, the insurance company denied his claim. After multiple unsuccessful attempts to resolve the issue with the insurance company, Mr. Sanjay turned to the District Consumer Disputes Redressal Forum in Hisar for assistance.
The insurance company defended its actions by stating that Mr. Sanjay had not met the terms and conditions of the policy. They claimed that he had failed to provide the required documents and had not cooperated adequately, leading them to close the claim with a ‘No Claim’ status.
Nevertheless, the District Commission found that Mr. Sanjay had adhered to the first policy condition by reporting the theft to the police on the same day. Post the FIR, he had filed an insurance claim, and an investigation by the police had concluded with a final report accepted by the Judicial Magistrate First Class. The Commission also noted that the insurance company had not assigned any surveyor or investigator to further look into the matter.
The Commission pointed out that the allegedly missing documents such as previous insurance policy, bank statement, or canceled cheque were not vital for settling the claim. It added that the insurance company had failed to demonstrate any breach of policy terms or conditions by Mr. Sanjay, nor any lack of cooperation or contract violation on his part.
Consequently, the District Commission declared HDFC ERGO General Insurance Company Limited guilty of deficient service and unfair trade practices. The company was directed to pay Mr. Sanjay Rs. 25,300, the insured value of the vehicle, along with an interest of 9% p.a. from the date of complaint filing (10.7.2019) till the realization. Additionally, the company was ordered to compensate Mr. Sanjay with Rs. 10,000 and cover his litigation costs of Rs. 5,000.
This verdict serves as a reminder to insurance companies to act in good faith and not arbitrarily reject claims. It also emphasizes the importance of understanding your insurance policy’s terms and conditions to ensure your rights as a policyholder are protected.
