Every dengue, malaria death now can be claimed under accident policy
(unless turned down by Supreme Court)
(unless turned down by Supreme Court)
Death by mosquito bite an accident, insurer must pay up: NCDRC
In my presidential speech at the Central Council Meeting in Amritsar, I had said that IMA wants the Health Ministry to declare an epidemic or disaster fund for providing free services to all those affected. In any flood, fire or train mishap the government announces ex gratia grant to the families, the same should be announced for any death during the epidemic or for any calamity in the family.
In my presidential speech at the Central Council Meeting in Amritsar, I had said that IMA wants the Health Ministry to declare an epidemic or disaster fund for providing free services to all those affected. In any flood, fire or train mishap the government announces ex gratia grant to the families, the same should be announced for any death during the epidemic or for any calamity in the family.
The National Consumer Disputes Redressal Commission (NCDRC) recently held that a malaria death caused by mosquito bite is an accident, and directed the insurer to honour its policy to a widow. (The same will be applicable to dengue deaths also). As per Justice V K Jain, presiding member of NCDRC: "An accident is something that happens unexpectedly and is not planned." and "It can hardly be disputed that a mosquito bite is something which no one expects and which happens all of a sudden without any act of omission on part of the victim."
The claim was filed by Mousumi Bhattacharjee, who lost her husband Debashish in November 2012 to malaria in Mozambique where he worked in a tea factory. The husband had availed of a policy "Bank of Baroda Home Loan Suraksha Bima" to cover death by accidents. He paid a one-time premium for the sum insured, Rs 13.15 lakh, to be paid in case of "death due to accident".
The claim was filed by Mousumi Bhattacharjee, who lost her husband Debashish in November 2012 to malaria in Mozambique where he worked in a tea factory. The husband had availed of a policy "Bank of Baroda Home Loan Suraksha Bima" to cover death by accidents. He paid a one-time premium for the sum insured, Rs 13.15 lakh, to be paid in case of "death due to accident".
The insurance company rejected it saying a mosquito bite was not an accident under the policy, and that malaria was a disease.
But all three consumer fora, right from the district and state consumer forums to the apex National Consumer Commission, held the company's stand incorrect. The national commission observed that the insurer had included snake bites, dog bites and frost bites under the ‘accident’ category.
The commission also cited Black's Law dictionary that describes an accident as "an unanticipated and untoward event that causes harm".
Pradhan Mantri Suraksha Bima Yojana covers accidental death and disability cover of Rs 2 lakh at a premium of Rs 12 per year.
The benefit of accidental insurance cover of Rs 1 lakh is also extended to all with accounts under the Pradhan Mantri Jan Dhan Yojana (PMJDY) launched on August 28 by the Prime Minister. The premium for the insurance cover is borne by the National Payments Corp of India.
Dr KK Aggarwal
National President IMA & HCFI
Source : http://www.emedinexus.com/user/postdetail/361461
