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Navsari Commission Awards Rs 2.24 Cr to Doctor's Mother
12 Sep
Summary
- Insurance company ordered to pay over Rs 2.24 crore with interest.
- Claim denied due to alleged pre-existing liver ailment.
- Commission found no conclusive evidence linking ailment to death.
The Navsari District Consumer Disputes Redressal Commission has mandated an insurance firm to disburse Rs 2.24 crore, along with a 7% annual interest, to the mother of an NRI doctor. This decision follows the doctor's death from a brain hemorrhage after an accidental fall in 2024. The commission rebuked the insurer for its claim rejection, which was based on the assertion that the deceased had a pre-existing liver condition.
The commission highlighted the insurer's failure to present concrete evidence of the liver ailment or establish a connection between it and the doctor's demise. The policyholder, Dr. Satyen Desai, who practiced in the US, purchased the policy in November 2022. He tragically suffered a severe head injury on May 15, 2024, leading to his death on May 19, 2024, despite medical intervention.
Insurers contested the claim in November 2024, alleging non-disclosure of a liver condition and citing an investigation report suggesting prior medical tests. The commission, however, found the insurer's objections regarding policy details and nomination invalid. It emphasized that medical records clearly indicated the brain hemorrhage following the fall as the cause of death, not the liver condition.
