Delhi High Court Seeks Response From IRDAI On Plea Alleging Failure To Protect Interests Of Policy Holders

Under Section 14(b) of the IRDAI Act, 1999, the authority is entrusted to protect the interests of policy holders in matters concerning assigning of policy, settlement of insurance claims, etc.

A Delhi resident namely Faizan Mumtaz has approached the High Court claiming that the authority has been unresponsive on his claim dispute, forcing him to initiate legal action.

He alleged that as against an insurance policy coverage of Rs. 5,00,000/- the concerned insurance company paid only a meagre amount of Rs. 1,63,679/- upon demise of his father due to Covid-19, that too without assigning any reasons for deduction.

He further claimed that despite making a representation, no action has been taken by the IRDAI against the company till date.

"There is no doubt the insurance company (Respondent No.4) is under a legal obligation to settle insurance claims fairly and in accordance with law. However, taking advantage of a number of claims in pandemic and general inability of the persons like the Petitioner the insurance company (Respondent No.4) is not honouring its legal obligations and is not even making payment to patients upto the insured amount," the plea stated.

He added that the authority has miserably failed in its statutory duty to ensure that Respondent No. 4 acts fairly and in a transparent manner to indemnify the policy holder.

Taking note of the submissions advanced by Advocates Talha A Rahman and M Shaz Khan, a Single Bench of Justice Pratibha M. Singh has issued notice to the Respondents.

Notice is also issued to Max Super Specialty Hospital, Saket, that allegedly did not extend the benefit of the rates applicable to treatment for COVID-19 related diseases as prescribed by the Ministry of Health and Family Welfare, GNCTD vide its circular dated 20th June, 2020.

The matter is fixed for hearing on May 19, 2021.

Case Title: Faizan Mumtaz v. IRDAI & Ors.

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