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The Delhi State CDRC awarded compensation, holding the insurer liable under Mediclaim policy clause 4.2 for failing to prove exclusion despite continuous coverage, and reinforced that insurers must substantiate exclusions to protect policyholders.
The Punjab State Consumer Disputes Redressal Commission held that an insurer’s refund of premium without informing the insured constitutes a deficiency in service under Section 12 of the CPA 1986, leaving the policyholder uninsured at the time of loss. It affirmed compensation of ₹9 lakh with 8% interest, ₹2 lakh for mental agony and ₹21,000 costs, affecting policyholders who rely on timely renewal notices.
The West Bengal Consumer Commission ruled that Section 157 of the Motor Vehicles Act governs only third-party risk insurance, so insurers cannot deny own-damage payouts on the basis of a transfer of policy. This limits insurers’ ability to invoke Section 157 to reject claims for damage to the insured vehicle itself, affecting vehicle owners seeking compensation for their own losses.
Insurers may not rely on informal security measures not written into the policy to deny coverage, and a corporate entity is recognised as a consumer under the Consumer Protection Act. The commission awarded the claimant Rs 44.53 lakh with interest and costs. This ruling mandates that policy exclusions be expressly documented and extends consumer protections to corporate borrowers.
The Calcutta High Court held that a deliberately caused act can still qualify as an ‘accident’ under Section 166 of the Motor Vehicles Act, raising the award to Rs 60 lakh with 6 % interest and rejecting the insurer’s Mediclaim set-off claim.
Uttarakhand State Consumer Disputes Redressal Commission holds banks strictly liable for failing to auto-debit PMSBY premiums, even with adequate account balance. The ruling establishes a duty of care in automated welfare schemes, entitling policyholders to insurance payouts for bank negligence.
NCDRC rules that insurers cannot delay repudiation for nine years or withhold survey reports, as it amounts to deficiency in service under the Consumer Protection Act. The Commission awarded Rs. 4,75,648.71 with 6% interest, reinforcing the duty of insurers to act transparently and promptly in claim settlements.
The MP State Consumer Commission ruled that a 29-day delay in filing an FIR for a stolen truck violates insurance policy terms, justifying claim repudiation. Insurers can now cite procedural lapses in theft claims, impacting policyholders' burden of proof under the Consumer Protection Act.
NCDRC holds that mis-selling of life insurance policies to senior citizens through false income declarations vitiates contract, entitling refund of premium despite free-look period.