cpc

accidental claim


 

Last month my brother, 29 yrs old, died in an accident. After that we have proceeded for insurance claim against his policy, so submitted postmortem report and other required documents to him. Now insurance company need a written interview by his family doctor regarding his past heath records and death causes. But actually he never had any family doctor since his health records was superb from his childhood.

Now problem is it, if any how we provide interview by any doctor, not awared from his health records, it may be troubled us and doctor by insurance company in future also. And second point is it, it's only an accident case so why insurance company is needed his past heath records?

Need the suggestions, legal solutions for the case.

 

Regards
--Ankur

 
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practicing advocate

Insurance company will not make a hurry to settle the claim, they only make hurry to issue the police taking premium.

If you are cliaming by Life Insurance co., then Issue notice to the insurance company to settle the claim within 10 days from the date of receipt of this notice, if they failed it amounts to failure to provide better service>  Hence it comes under consumer protection ACt.

If you want to claim the compensation from General Insurance Companies then you will have to file MVC case.

 
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Educationist/Lawyer

I fully agree with Rajeevji.

 
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marketing

has the insurance company demanded such requirements for an accident claim in writing?

His past illness have no relevance to accidental death,except incase of mental health.

if proved that your brother was mentally ill, the company may claim that the accident was due to that.

donot respond to the requirements made orally by the company.  If you havenot received a written request for the requirements, send a letter to the divisional manager of the company,asking the present position of the case.

Donot immediately jump into legal proceedings which is time consuming and incurring expenses.

please use other channels of grievances like insurnace ombudsman etc.

 
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Thanks to reply. Yes, Insurance comapny (TATA-AIG) demanded family doctor interview in written. And he died on the spot due to head injury after his scooty slipped, and even his friend was driving the scooty, not he. He was perfectly healthy, and no meaning of mentally illness. He was working in an MNC, Gurgaon.

Thanks again

 
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marketing

you can reply that we have no family doctor.  The concept of family doctor is not very common in India. As such it is true that we consult different doctors at different time.

i remember reading a novel based on american insurance companies.  Since AIG is an american one i quote this.  the novel is based on an american insurance company,wherin there policy is repudiate all claims.only few go for cases etc. in the story a youngman of about 22 years died of lukeimea.  The company repudiated the claim stating that he had influenza two months before taking the policy and he has concealed this fact at the time of taking policy. in the story,even though the claimant won the case in the court stating tht the influensa has no chance of becoming a blood cancer .  however by the time of case victory,the concerned company became bankrupt.


In your case  it is better to reply them and wait for their action before moving legally

 
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Thanks Mahendra ji...

 
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