Delhi Consumer Commission Clears Ambiguity About ‘accidental Death Benefits’

by Savitha C Muppala on  December 3, 2008 at 12:46 PM Health Insurance News   - G J E 4
 Delhi Consumer Commission Clears Ambiguity About ‘accidental Death Benefits’
If a man dies of a heart attack after a road accident, can it be called  an accidental death?

This question was posed to The Delhi Consumer Commission by The Life Insurance Corporation (LIC) of India to have clarity while handling the case of Jagdish Lal, who died of a heart problem following a road accident in January 2004.

So, apart from insurance benefits, is the kin of Jagdish Lal entitled to payment under the clause 'accidental death benefits'?

The LIC argued that since Lal had died due to negligence of health, the insurance corporation was not liable to pay him the additional benefits. 

Justice J D Kapoor, President of The Delhi Consumer Commission has rejected the claim of the Life Insurance Corporation (LIC) of India, ruling that the insurance company is bound by rules to enable the family with additional cash benefits under 'accidental death benefits' clause. He explained that the interpretation of the technical clause must be tuned towards the consumer, lest it go against the consumer protection act.

"If any person meets with an accident, including vehicular accident, and if death occurs due to myocardial infraction consequent to a coronary artery disease, precipitated during vehicular accident, it amounts to accidental death. The insured is thus entitled to accident claim benefits," Justice Kapoor explained.

The commission held that since death was fuelled by the accident, the insurance company cannot afford to overlook the connection between 'mishap causing death' and as a result the kin of the victim must receive the additional benefits. 

Source: Medindia

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