Vadodara Resident Triumphs in Six-Year Insurance Dispute After Industrial Accident Abroad
In a landmark ruling, the Vadodara District Consumer Disputes Redressal Commission has ordered Bajaj Allianz General Insurance Company Ltd to compensate a local resident for medical expenses incurred after a severe industrial accident in Argentina. Salim Sindhi, a resident of Savli town near Vadodara, successfully fought a six-year legal battle to secure his mediclaim, which was initially denied by the insurer on contentious grounds.
The Accident and Insurance Policy Details
Salim Sindhi, employed by a private firm, purchased an overseas insurance policy from Bajaj Allianz, valid from June 2019 to June 2020, as part of his official work requirements. His company dispatched him to Argentina to execute orders for overseas customers. During a visit to a client in July 2019, Sindhi met with a tragic accident while operating an automatic machine, resulting in the amputation of his left hand and mid-forearm. He was promptly admitted to a hospital in Argentina, where he underwent necessary medical treatment.
Claim Rejection and Legal Proceedings
Following the accident, Sindhi filed an insurance claim amounting to Rs 4.81 lakh to cover the costs of his medical treatment abroad. However, in November 2019, Bajaj Allianz rejected his claim, arguing that injuries sustained from operating machinery were not covered under the overseas policy he had purchased. The insurance firm further contended that Sindhi had voluntarily taken on a hazardous job and unnecessarily assumed the risk, thereby disqualifying him from the claim.
In response, Sindhi filed a formal complaint with the Vadodara consumer forum in July 2020. His advocate, R J Rana, highlighted that the commission firmly regarded the incident as an accident, emphasizing that a person cannot be held responsible for unforeseen accidents. The forum's observations underscored this principle, leading to a decisive verdict in Sindhi's favor.
Consumer Forum's Ruling and Compensation
The Vadodara District Consumer Disputes Redressal Commission ruled that the insurance company's denial was unjustified. It ordered Bajaj Allianz to pay Sindhi Rs 4.47 lakh, along with 9% interest calculated from the date the complaint was filed. Additionally, the commission mandated the insurer to compensate Sindhi with Rs 5,000 each for mental harassment and litigation costs, bringing the total award to approximately Rs 4.8 lakh.
This case sets a significant precedent in consumer rights and insurance claim disputes, reinforcing that accidents are unforeseeable events and should not be dismissed based on speculative risk assessments by insurers. The ruling not only provides financial relief to Sindhi but also sends a strong message to insurance providers about adhering to policy terms and ethical practices.
