Bagchi, a resident of Thane, had bought a Home Suraksha Plus policy from HDFC ERGO for 50.91 lacs against his home loan.
A Home Suraksha Plus policy can be bought along a home loan and covers damage to buildings and apartments due to fire, allied hazards, earthquake, and terrorism. It also provides cover to the extent of loan amount in case of a severe illness such as cancer, renal failure, first heart attack, kidney failure etc.
In 2019, Bagchi received a diagnosis of acute chronic renal failure, necessitating twice-weekly dialysis. Bagchi then tried to make a claim under his policy but it was denied by insurer stating a pre-existing illness. According to HDFC Ergo, his discharge card noted that he had diabetes, chronic hypertension, and other medical conditions. As per policy wordings, "Any Insured Event arising on account of or in connection with any Pre-Existing Illnes"
The commission received a complaint from Bagchi. It was mentioned at the hearing that he had no health issues, never missed work, and was in perfect health. The State Consumer Disputes Redressal Commission (SCDRC) member ST Barne and president Justice SP Tavade on reviewing the facts and post no response from insurer, signed an order on April 5 awarding Bagchi the claim of 51 lacs. Insurer was also ordered by consumer panel to pay additional Rs. 1.25 lakh for mental suffering.
Do you think the order by consumer forum was correct, pls mention your views in comments.
Comments