Does an insurer have a right to request to furnish bank account statement of a deceased insured?

Bank account statements are NOT a standard or mandatory document for accidental death claims unless:

The policy explicitly links coverage to account activity, minimum balance, or transaction conditions, OR

There is prima facie suspicion of fraud, which must be communicated in writing.

Policy terms govern claim eligibility

You cannot be compelled to submit documents without knowing the contractual basis

Under IRDAI Regulations:

Insurers are mandated to provide a copy of the policy to the claimant on request

Non-supply of policy = deficiency in service

Even if the insurance is “complimentary”:

You are still a beneficiary under a valid contract of insurance

“Free” does not mean “unregulated” or “discretionary”.

You may resort to legal action by first sending a legal notice and follow it by filing a case before consumer commission.

Yes,Insurer has right to ask/request you to furnish your mother's bank account statement as your mother's bank had offered complementary personal accident insurance policy to your mother so insurer wants to assure that after getting the policy her bank account was maintained or not.

As insurance policy is conditional on having a bank account, the insurer can ask for proof that the account was maintained until the death of the insured in the required manner. What is the problem? The bank can and should help the nominee under the insurance.

Is this not an instance of much ado about nothing!

Thank you for the reply Sir!

I asked them to provide me with the specific reason & legal basis for such a request, to which they haven't replied till date. 

Their actions seem shady. 

I threatened them to take the matter to the ombudsman & to no surprise, they paid no heed to it. 

So before sending a legal notice, I am planning to raise the issue on the ombudsman portal. Would that be a right route? Please guide.

Raise the issue with Ombudsman with all relevant records.

You may not get any or a proper  relief or remedy through Ombudsman  in this spect against the insurance company hence without delaying any further you may first get involved in legal action by first sending a legal notice  followed up by appropriate legal action as per law. 

Do you want to get the insurance money or go on fighting with the insurance company? What exactly is your problem in giving the particulars of the bank account of your late mother?

Dr. MPS RAMANI Sir,

As mentioned in the original post (query), I suspect that they may analyze the bank account statement first (if provided) & then reject the claim by choosing appropriate policy schedules on the basis of which the claim can be rejected. If I have policy schedules, they can't dupe me but if I don't, they may reject the claim by choosing schedules that work in their favour.  

The amount of compensation is not small. It is much more than an average complimentary personal accident insurance offers (to be more specific, more than double to what a similar insurance offers). Moreover, its a complimentary insurance so the insurer hasn't recieved any monetary benefit (in the form of premiums) from our end. In such a case, I believe the insurer will try its best to reject the claim. Nobody, especially insurers like to pay from their pockets for someone else's loss.

Insurance industry is already infamous, especially in our country for their unethical & sometimes even illegal practices. Moreover, this is India, not U.S. or any other developed country, so such practices are more common here.

I am surprised to see that you didn't utter a word about the insurer not providing basic documents like policy schedules despite repeated requests. Don't you find it shady?

You may ask yourself what exactly is the insurer's problem in giving the policy documents? I believe that question itself will answer your question of I being hesitant to provide the account statement.

What all have you submitted to the insurance company? The minimum that you have to submit are evidence   that (1) your mother had an account with the bank (2) the account had an accident insurance policy attached to it (3) your mother died in an accident on a certain date (4) the account was maintained properly up to the time the account holder's death (5) you are the nominee for the account and for the insurance amount. Have you submitted all these? Is it that you have submitted all the above except a statement of deposits and withdrawls? Such a statement may not be necessary to settle an insurance claim? But I am not able to make out how such a statement could be used against your claim.  

I think insurance claims are settled by insurance tribunals. You go to the tribunal. If the tribunal says that you have to submit the statement of account, submit the same. If the insurance company still refuses to settle your claim, again go to the tribunal. There is no other escape.

I have submitted the bank account details like bank name, account holder's name, account number etc. I believe that much is enough for them to verify from the bank itself that she held an account with the bank, the account comes with a complimentary personal accident insurance & nomination details for the account. I have also submitted all the evidential documents requested by them, proving that it was an accidental death. 

I agree that account maintenance can only be proved by account statement but I am afraid that the real reason behind requesting this document might be something else. 

Nomination details for the insurance amount should be with them. I repeatedly requested them to provide me the policy schedules so that I can confirm nomination details but they always kept mum.

After analyzing the statement, they may issue a policy schedule(s) with suitable wordings/terms & conditions on the basis of which the claim can be rejected. If I don't have the same (policy schedules) beforehand, I will have to accept thier decision since I won't be having any evidence to prove that they issued a different policy schedule(s). 

I wouldn't mind giving the statment if they provide me with the policy schedules before I do so. 

From my limited knowledge, have three options:

1. Approach IRDAI
2. Approach Ombudsman
3. Send a legal notice through a lawyer

You can also go to the consumer court. If you go to the consumer forum make the bank also the opposite party. Actually the bank is the real culprit. In order to attract the customers they introduced this scheme. They should help the customer get the insurance amount.

In order to go to the consumer forum a lawyer is not essential. I have successfully fought cases in the consumer forum. You can download the consumer protection act and it will give all the necessary advice.

Thank you Sir for the advice. Will give it a thought.