Federal Insurance Ombudsman, Raeesuddin Paracha orders to pay accumulative Rs 7.5 million monetary relief to policy holders in the form of amicable settlement on different claims filed to this secretariat.
Earlier, a company M/s Rizwan International obtained three fire policies in May 2013 to cover the building, machinery and stock of their factory premises. As per policy Respondent Company had to provide cover against risk of fire at the premises, within a year in 2014 a fire broke out in the factory which caused heavy loss to building, machinery and stock.
The complainant lodged claim of Rs 28.5 million for the compensation of their loss. But respondent company on the basis of filed claim appointed surveyor to assess actual loss but in spite of numerous requests from the complainant they had not settled the claim. The complainant approached FIO forum to seek remedy.
Later on, an extensive hearing was conducted by the FIO and he directed in his order that settlement of claim was unnecessarily delayed due to submission of survey report belatedly & the loss was assessed by the surveyor fell to almost 5 per cent of the total loss without given any cogent reasons and data in support of such a low assessment of loss. Further, it was observed that insurance policies were unilaterally and arbitrarily cancelled by the respondent company without any notice to the complainant even the paid of premium falling beyond the cancellation of date was not returned to the complainant.
All the three policies remained effective up to June 2015 on renewal and in time payment of premium. Hence claim was neither rejected nor paid. The parties after the intervention of the FIO office were brought to an agreeable settlement at Rs 4 million. FIO finally issued order to respondent company to settle the claim by paying Rs 4 million to the complainant within one month.
In yet another case, a widow Naheed Akhtar filed a complaint for non settlement of her husband death claim for Rs 2.8 million. After the death of her husband she lodged a death claim with Respondent Company on the basis of entitlement that her husband was duly medically examined at the time of preparation of policy proposal form but respondent company repudiate death claim by taking plea that policy-holder had disclosed only diabetes as his illness, whereas he died of heart failure due to hypertension and renal failure. Eventually complainant widow approached FIO forum for the settlement of her claim. After several hearing and detailed deliberations both the parties reached to an amicable settlement after the intervention of FIO forum at an agreed amount of Rs 700,000/- as full and final settlement of the death claim of diseased policy-holder.-PR
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