Page 56 - Insurance Times March 2023

Commission orders to pay expenses of ments and consequences attributable to accelerated by or
arising therefrom as per medical history. Chauhan's wife
flying man's remains to India, insurer
Sudha and son Vikramsinh then filed a complaint at the
told consumer forum in 2012. They sought $ 25,000 towards
personal accident cover and $ 3,978 towards repatriation
Insurer has to pay repatriation expenses if the insured per-
expenses.
son dies while travelling abroad even if he/she didn't re-
veal their pre-existing medical condition while taking the The insurance firm and other opponents then produced
insurance. cashless process papers for the deceased's mediclaim from
The Vadodara district consumer disputes redressal commis- another insurer regarding the percutaneous transluminal
sion (additional) has ordered an insurance firm to pay coronary angioplasty (PTCA) to prove that the deceased had
Singaporean $3,978 (roughly Rs 2.5 lakh) to the family of a pre-existing heart condition. But the deceased's son said
the deceased towards the expenses of flying his remains to in his reply that he wasn't aware of any such mediclaim
India. policy or the alleged treatment of PTCA.
The family of Mafatlal Chauhan had filed a complaint The forum observed that for the repatriation benefits, only
against Oriental Insurance Company Ltd and a travel firm the death of the insured outside India and proof of expenses
after the insurer rejected their claim. Chauhan had taken are relevant. Finding the reasons for repudiation of the
overseas travel insurance while travelling to Singapore in claim unjust and arbitrary, the forum ordered the insurance
March 2010. During his stay there, Chauhan died of is- firm to pay $ 3,978 along with nine percent interest from
chemic heart disease. His remains were flown to India for the date when the complaint was filed till the date of pay-
the final rites. ment.

Chauhan's family then filed a claim for the expenses of The insurance firm will also have to pay Rs 10,000 towards
bringing his body back to the country. The insurance firm, the litigation cost and another Rs 10,000 for mental harass-
however, rejected the claim stating that Chauhan had a ment to the complainant.
preexisting heart condition and it wasn't revealed while
The complainant had also sought $ 25,000 for personal
taking the travel insurance cover.
accident claim but the forum didn't accept it by saying that
The firm said that the policy carries specific exclusion of all Chauhan died of ischemic heart disease and it cannot be
medical expenses incurred directly due to past history ail- treated as an accidental death.

The Insurance Times March 2023 49