Belgaum District Commission: Single Personal Accident Cover Extends to All Vehicles; HDFC Ergo Liable for ₹15 Lakh Claim
Pranav B Prem
The Additional District Consumer Disputes Redressal Commission, Belgaum Bench, comprising President Mahantesh Shigli and Member Girishagouda Patil, has held HDFC Ergo General Insurance Co. Ltd. liable for deficiency in service for failing to settle a personal accident claim of ₹15 lakh arising from the death of the complainant’s husband.
Background
The complainant’s deceased husband was the registered owner of a four-wheeler car and a two-wheeler motorcycle. His car was insured with HDFC Ergo, which included a personal accident cover of ₹15 lakh for which a separate premium of ₹375 was paid. The policy was valid between 28.01.2015 and 27.01.2016, and the complainant was named as nominee under the insurance contract. On 23.03.2015, the insured met with a fatal accident while riding his two-wheeler, losing control and sustaining grievous injuries. He was admitted to the Government Hospital, Kurnool, but succumbed soon after. A criminal case was registered under Section 173 of the Bharatiya Nagarik Suraksha Sanhita (BNSS).
The complainant’s son immediately informed the insurer of the accident, and on the company’s instructions, the complainant submitted a claim form along with requisite documents seeking the assured sum of ₹15 lakh. Despite repeated follow-ups and issuance of a legal notice, the insurer failed to process or settle the claim. Left with no alternative, the complainant approached the District Commission.
Proceedings Before the Commission
Notably, HDFC Ergo did not enter appearance despite service of notice. Consequently, the matter proceeded ex-parte. The Commission carefully examined the documents produced by the complainant, including the insurance policy, registration certificate of the vehicle, and legal notice issued to the insurer. It observed that the policy was issued in the name of the deceased after due verification of all documents and specific premium was collected for personal accident coverage. The Bench further relied upon IRDAI’s circular dated 11.12.2018 (amended in 2019) which clarified that a single personal accident cover is sufficient to extend protection across all vehicles owned by an insured person. It held that once the insurer had issued the policy after due verification, it was bound to honour its liability. Failure to settle the claim despite complete documentation amounted to deficiency in service and unfair denial of legitimate benefits.
Findings and Relief
Holding the insurer accountable, the Commission directed:
Payment of the personal accident claim of ₹15 lakh with interest at 9% per annum from the date of filing of the complaint until realization.
Compensation of ₹25,000 for mental agony and inconvenience caused to the complainant.
₹10,000 towards litigation costs.
The District Consumer Commission at Belgaum thus allowed the complaint, fastening liability on HDFC Ergo General Insurance Co. Ltd. for its failure to settle the personal accident claim. The insurer has been directed to pay the insured sum along with compensation and costs, reaffirming the principle that once a valid policy is issued with accident cover, the company cannot evade its responsibility by denying or delaying settlement.
Appearance
For complainant: Rohit N Latur
Cause Title: Smt. Baklavva V. Branch manager, HDFC Ergo General Insurance
Case No: Complaint No. 227/2025
Coram: Mahantesh Shigli [President], Girishagouda Patil [Member]
