Denied Disability Claim: Policyholder Fights for Compensation.
07 June 2024
Consumer Protection Act >> Consumer Rights | Insurance >> Personal Law
An Indian resident is locked in a legal battle with their insurance company over a denied disability claim. The policyholder, who resides in the United States, is seeking full compensation for a permanent hand injury.
The crux of the dispute lies in the differing assessments of the policyholder's disability. A US court ruled in favor of the individual, awarding compensation based on a 100% disability rating. However, the Indian insurance company contests this, citing a 15% disability determined by an Indian doctor.
The disagreement has escalated through the Indian consumer court system. The initial District Forum sided with the policyholder, influenced by the US court judgment and evidence of complete disability. This decision was overturned by the State Commission, which prioritized the Indian doctor's assessment and Indian legal jurisdiction.
Undeterred, the policyholder has filed a revision petition before the Supreme Court. Key questions remain:
- Does the US court judgment hold weight in an Indian insurance contract?
- How will the court weigh the evidence - the US doctor's certificate versus the Indian doctor's evaluation?
- Ultimately, what level of disability will be accepted, and what compensation will be awarded under the policy terms?
The Supreme Court's ruling will determine whether the policyholder receives full compensation based on the US judgment or a lesser amount based on the Indian assessment. This case has implications for policyholders residing abroad and the enforceability of foreign judgments in disability claims involving Indian insurance companies.