Consumers cannot claim accident insurance if death is caused by fall due to ill health


The difference between a fall due to ill health, and a genuine accidental fall, would determine whether a claim under an accident insurance policy is payable or not. Case Study: Kishan Lal Jain suffered a fall in his bedroom on March 16, 2009, resulting in a serious head injury. He was admitted to Jaslok Hospital and kept in the ICU. The hospital had registered a medico-legal case and reported it to Gamdevi police station, which recorded his statement. Kishan Lal was discharged in two days.

On March 23, 2009, Kishan Lal had another fall at home, injuring his head once again. He was admitted to Jaslok in an unconscious state, where he expired on April 7, 2009 due to cardio-respiratory failure. Later, in July 2009, his son Pravinkumar came across an individual personal accident insurance policy obtained by his deceased father from New India Assurance.

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