An insurance company in India has been directed to pay Rs 16 lakh to a family who lost their loved one to Covid-19. The deceased, Mohan Jatav, had taken out a home loan cum life insurance policy in 2016. However, when Jatav died on May 15, 2021, as a result of Covid-19, the insurance company refused to settle the family’s claim by stating that Jatav’s cause of death did not satisfy the terms of the insurance policy. According to the policy, the borrower would only receive the money if they died due to a chronic illness, such as cancer, end-stage renal failure, multiple sclerosis, major organ transplant, heart valve replacement, coronary artery bypass graft, stroke, paralysis, and myocardial infarction.
The insurance company argued that Jatav died of Covid-19, which was not considered a chronic disease under the insurance policy. However, according to medical records, Jatav’s cause of death was a cardiopulmonary arrest, acute respiratory distress syndrome, and organ dysfunction caused by Covid-19. The consumer court ruled that Jatav’s family should receive the insurance amount, as the definition of chronic disease was not defined in the contract. The court directed the insurance company to pay the family Rs 15,83,998, in addition to Rs 1 lakh for the education of the girl child and Rs 50,000 for mental agony.
This case highlights the importance of carefully reviewing insurance policies to understand the terms and conditions. It is important to ensure that the policy covers the circumstances that one might find themselves in, as unexpected events can occur. In this case, Jatav’s family was thankfully able to receive the insurance amount they were entitled to, despite the insurance company’s initial refusal. It is always best to seek legal counsel if one is unsure about the terms and conditions of an insurance policy to avoid any misunderstandings in the future.
