Ranga Reddy: Go Digit refuses driver accident coverage of insured vehicle, told to pay Rs 15 lakhs

Hyderabad: The District Consumer Redressal Commission in Ranga Reddy has directed Go Digit General Insurance Ltd to pay Rs 15 lakhs towards death benefit/accident cover and a compensation of Rs 25,000 for mental agony to a resident of Ranga Reddy district.

Case details

Jakalapally Sunitha is a resident of Puttapadu Village, Kulakacharla in Ranga Reddy district. Her husband J Hanmaiah is the registered owner of the motorcycle and he insured his vehicle with Go Digit General Insurance Ltd valid from December 22, 2021, to December 21, 2022, and paid a premium of Rs 702. Hanmaya worked as a primary school headmaster at Puttapahad.

On June 25, 2022, Hanmaiah along with his daughter were returning from duty on the motorcycle and when they reached old PHC Hanwada, a lorry hit the motorcycle which was crushed under the wheels of the lorry. Hanmaiah died on the spot and his daughter sustained grievous injuries. Hanwada police station registered a case under sections 304(A),337 and 338 IPC against the lorry driver.

Go Digit refuses PA claim coverage

Sunitha lodged a personal accident (PA) claim with Go Digit General Insurance Ltd on July 26, 2022, by submitting the claim form and enclosing the required documents as mentioned in the claim form.

Instead of settling the claim, Go Digit General Insurance Ltd sent a letter on August 23, 2022, stating that there is no PA coverage for the owner-driver who opted under the policy and rejected the claim.

As per the guidelines of the Insurance Regulatory and Development Authority of India (IRDA), it is mandatory for the insurance companies to cover owner-driver under PA coverage whether the insurer opts or not but the rejection of her legitimate claim under the guise of no PA coverage for owner-driver opted the policy is not acceptable and the same is against the IRDA guidelines.

IRDA states insurance companies to pay compensation to the policyholder

The IRDA guidelines also clearly stated that under the motor insurance policy, the company should pay compensation in case of bodily injuries, death or any permanent disability resulting from an accident.

The limit of coverage is defined as Rs 15 lakhs by IRDA. In case of death benefits equal to 100 per cent of some insured shall be payable on the death of the insured person due to an injury sustained in an accident during the policy period provided that the insured person’s death occurs within 12 months from the date of the accident.

Go Digit remained silent on legal notice

Sunitha issued a legal notice through her counsel demanding the PA claim of her husband.

Go Digit acknowledged the notice but did not send any reply and maintained a stony silence. The act of Go Digit in refusing to pay on the pretext of no coverage of the PA of her husband has caused a lot of mental agony which resulted in the complaint to the Consumer Commission. Go Digit General Insurance Limited also remained absent and did not choose to file a written version within the stipulated period.

The commission noted that Hanmaiah met with an accident while driving his motorcycle and succumbed to death and the same was mentioned in the FIR and postmortem.

The vehicle was insured with the opposite party and the policy was in subsistence at the time of the accident. After hearing the arguments from Sunitha, the commission also noted that the deceased owner-driver held an effective driving licence in accordance with the provisions of Rule 3 of the Central Motor Vehicles Rules, 1989 at the time of the accident.

Sunitha is eligible to receive death benefits from her husband

The commission ruled that Sunitha is entitled to receive death benefit/accident cover of Rs 15 lakhs from Go Digit on the death of her husband J Hanmaiah along with Rs 25,000 towards compensation for mental agony and Rs 5,000 towards the cost of the complaint.