Consumer panel orders HDFC ERGO to pay policyholder entire claim of ₹50 lakh under Home Suraksha Plus Policy

Photo: Facebook/HDFC ERGO General Insurance Company Limited

The Maharashtra State Consumer Disputes Redressal Commission recently held that HDFC ERGO General Insurance Company Limited is “guilty of deficiency in service” and directed it to pay a policyholder the entire amount of his claim of ₹50 lakh under the Home Suraksha Plus Policy.

Sarbendu Bagchi had booked a flat in 2014 and approached HDFC Limited for a housing loan. He was sanctioned a housing loan of ₹50,91,080 on December 12, 2014 with conditions to repay within 17 years. Thereafter some agents of the HDFC Bank explained to Mr. Bagchi about the ‘Home Suraksha Plus Policy’ and he bought it against the payment of one-time single premium of ₹3,91,080.

In 2019, Mr. Bagchi was diagnosed with a major medical illness of end stage renal failure. He had purchased Sarva Suraksha Claim and Home Suraksha Plus Policy in 2015 for five years. HDFC settled the claim under Sarva Suraksha claim and paid ₹1,00,000 but the claim under Home Suraksha Plus Policy was repudiated on vague and irrelevant reasons.

The claim arose under the policy after four years and eight months of the policy which cannot be called in question and there is no ground for repudiation of the same. Mr. Bagchi contends that the company has played fraud in the transaction and cheated him. Hence, he filed a complaint claiming ₹50,91,080 under the policy along with costs and compensation.

The commission noted, “Mr. Bagchi was working in Raymond India Limited and he had not taken medical or any other leave for more than two days during his tenure of 15 years. No material is produced on record to establish that prior to obtaining the policy he was suffering from kidney-related disease which was concealed by him. The claim under the Home Suraksha Plus Policy was denied to him.”

‘Not justified’

President Justice S.P. Tavade and judicial member S.T. Barne said, “The company was not justified in repudiating the insurance claim of Mr. Bagchi on the ground of suppression of material. Therefore, Mr. Bagchi is entitled for compensation under the policy, namely Home Suraksha Plus Policy,” the order read.

The commission held, “HDFC ERGO General Insurance Company Limited is guilty of deficiency in service” and directed the company to pay ₹50,91,080 along with interest @ 9% per annum from the date of repudiation of the claim i.e. from November 29, 2019 till realisation of the entire amount. The commission also directed the company to pay a compensation of ₹1 lakh to Mr. Bagchi for mental agony and ₹25,000 towards costs of litigation.