New India Assurance Company asked to pay Rs 58 lakh to wife of man who died in mishap

Sunil Seth had a personal accident insurance policy from New India Assurance with a coverage of Rs 58,75,000, and validity from September 17, 2016 to September 16,2017.

Seth met with a fatal accident on February 5, 2017 while driving a motorcycle. His widow, Mala Sahni Seth, lodged a claim. The insurer appointed Somen Media as the surveyor, who recommended payment. Disregarding the recommendation, the insurer repudiated the claim. The reason was Seth was riding was a high-end motorcycle which his friend had hired under an agreement with a firm. The argument was Seth was aware such a motorcycle could be used only after undergoing a special orientation programme, yet he disregarded safety protocols. It termed Seth’s death an act of deliberate selfinjury, which was excluded under the policy, and refused to settle the claim.

Mala challenged the repudiation before the National Commission. The Commission observed Seth did not ride the motorcycle with the intention to injure himself or commit suicide. So, his act might be rash and negligent, but it could not be termed an act of intentional selfinjury, hence the exclusion clause would not apply.

By its order of October 8, the National Commission held the insurer liable to pay Rs58,75,000 toward the sum insured, besides 6% interest and litigation costs of Rs.50,000.

Source: The Times of India

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