Income Tax return required for Road Accidental Death Compensation

Accidental Death & Compensation:
(Income Tax Return Required)
If a person has an accidental death and the person was filing income tax returns for the last three years, then the government is obliged to give ten times the average annual income of the last three years to that person’s family.
Yes, you will be surprised by this, but this is right and it is Government rule. For example, if someone’s annual income is 4 lakh 5 lakhs and 6 lakhs in the first, second and third years respectively, its average income is ten times of five lakhs.. means five million rupees, family of that person is entitled to receive from the Government.
In the absence of much information, people do not take this claim with the Government.
If any return is missing, mainly last three years, this could lower the claim amount or even no claim because court takes ITR as only evidence. NO wealth record, FD’s; business etc. is given that much importance as compared to ITR in the eyes of law.
Many a time, people do not file ITRs regularly..or it will be taken lightly..
Due to lack of information the family receives no economic benefits.

Source – forwarded
Section 166 of the Motor act, 1988 (Supreme Court Judgment under Civil/ Appeal No. 9858 of 2013, arising out of SLP (c) No. 1056 of 2008) Dt. 31 Oct. licvaithi

Accidental Death & Compensation:
(Income Tax Return Required)

https://www.ayupp.com/social-viral/road-accidental-death-compensation-income-tax-returns-required-14980.html

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Insurer must alert client in case of premium default

Case Study: Nagu Gouda worked as assistant teacher at a school under the Karnantaka government’s block education officer (BEO). He took a policy of Rs 1.25 lakh under LIC’s Salary Saving Scheme, which provided that the employer would deduct and remit monthly premium to LIC.

The last premium was remitted in August 2009. Later, Gouda took ill and was on leave without pay. So premium could not be deducted. Gouda died on July 20, 2010. His widow, Seeta, made a claim under the policy, but LIC refused, saying the policy had lapsed due to unpaid premium.

Seeta filed a complaint in the district forum against LIC and the BEO that the employer couldn’t remit premium as Gouda was on leave without pay and Gouda should’ve been told to pay instead of letting the policy lapse. She alleged that failure to intimate Gouda to pay was ‘deficiency in service’.

LIC said Gouda’s premium for last 10 months was not remitted by the BEO or by Gouda. It said the policy had lapsed and the claim was rightly repudiated. LIC sought dismissal of the complaint.

The district forum held LIC and the BEO jointly and severally liable to settle the claim. It ordered payment of the sum assured with accrued bonus and 9% interest.

LIC challenged this order, but its appeal was dismissed by Karnataka State Commission. LIC approached the National Commission and contended that Gouda alone was responsible for failure to remit premium, and that the BEO as employer could not be held liable as Gouda had opted for premature retirement on June 30, 2010. LIC also said that Gouda had given that he would be responsible for consequences of non-payment of premium.

The National Commission observed that LIC and the employer have a duty to inform the employee.

By its order, the National Commission said there was deficiency in service Thus, he ordered holding the employer and LIC jointly liable to settle the claim was upheld.

Conclusion: The employer and LIC have to inform the insured about default in payment of premium under Salary Savings Scheme.

(The author’s e-mail is jehangir.gai.columnist@ outlook.in)

Jehangir B Gai

https://timesofindia.indiatimes.com/mumbai/insurer-must-alert-client-in-case-of-premium-default/articleshow/63163131.cms

Insurer must reimburse diabetes patient cost of glucometer test strips under mediclaim

Diabetics, especially those who are insulin dependent, have to monitor their blood sugar before every shot of insulin, to determine its correct dosage.This requires a glucometer and test strips, which are quite costly. Can the insured recover the cost under a mediclaim policy?
Case Study: Purvi Kamlesh Shah and her daughter were covered under a mediclaim policy issued by New India Assurance. The policy was first taken in 2005 and then renewed without any break. However, while renewing the policy with continuity, a fresh proposal form had been obtain in 2008.

During the tenure of the renewed policy from March 13, 2010 to March 12, 2011, Purvi had to be hospitalized on July 13, 2010 due to fluctuating blood glucose levels. After she was discharged on July 16, 2010, she lodged two claims, one for the hospitalization expenses of Rs 55,409 and the other of Rs 7,680 towards medicines. The insurer’s TPA, MD India Healthcare Services settled the claims at Rs 47,931 and Rs 3,680 respectively. The deductions were in respect of expenses incurred on purchase of glucometer strips to check the sugar levels. The reason for disallowance was that these were considered as “nonmedical expenses“, and so were not payable under the policy .

Purvi protested against this disallowance, but New India’s Grievance Cell failed to respond to her representation. She filed a complaint before the South Mumbai Forum through the Consumers Welfare Association and sought a direction to reimburse these expenses along with interest and also claimed compensation and costs.

The TPA as well at the insurer contested the case and claimed that the amount had been correctly computed. They claimed that Purvi was not entitled to dispute the amount after having accepted the claim in full and final satisfaction.

The forum observed that the policy conditions had been changed, so a fresh proposal had been taken in 2008. So the new terms under the revised policy would be applicable, which provided for limiting the claim on the basis of the room category. The forum concluded that there was no deficiency in service and dismissed the complaint. Purvi challenged the order, but her appeal was dismissed by the Maharashtra State Commission. Purvi then questioned the orders in revision. The National Commission noted that various clauses of the policy providing for certain exclusions had been inserted in the Mediclaim Policy (2007). The Commission observed that it was beyond comprehension how any claim for medicines could vary with the room category opted for, as medicines treatment would be the same regardless of the room category .

The Commission pointed out that glucometer strips are essential for a diabetic to monitor blood glucose levels and adopt a medical regime to prevent the consequences of elevated or declined blood sugar levels. So it would be wrong to consider the expense on the test to be nonmedical expenses. The deduction of Rs 9,350 on this pretext was held to be wrong.

The National Commission’s bench comprising of justice D K Jain, along with M Shreesha, held the TPA and the insurance company jointly liable to pay the cost of the test strips amounting to Rs 9,350 with interest at 9% from the date of filing of the complaint. Six weeks time was given for compliance of the order. In addition, costs of Rs10,000 were awarded to Consumers Welfare Association for espousing the cause of the consumer.

(The author is a consumer activist and has won the Govt. of India’s National Youth Award for Consumer Protection. His email is jehangir.gai.columnist@outlook.in)

Jehangir B Gai

ePaper, The Times of India (Bombay), Oct 30 2017, Page 7 :

Burglary Insurance: Absence of Force Will Mean No Burglary Claim

A Supreme Court (SC) judgement on a theft claim filed by a public sector unit in Odisha states, “In the absence of violence or force, the insured cannot claim indemnification against the insurance company. The terms of the policy have to be construed as it is and we cannot add or subtract something. Howsoever liberally we may construe the policy, we cannot take liberalism to the extent of substituting the words which are not intended.” It is based on another 2004 SC judgement. The new SC judgement is clear that the terms of the policy are sacrosanct; it can’t be subjected to interpretation. The liability of the insurer would depend strictly on the policy conditions.
Home insurance, travel insurance, commercial insurance, etc, may cover ‘burglary’ and not ‘theft’. For a layman, both seem to be same. ‘Burglary’ is theft that has to be accompanied by forced entry, violence, or threat of violence. ‘Theft’ may not have a forceful or violent entry to cause a loss to residential or commercial property. It can even be an insider job by an employee or a family member.
Your case may fall under a long list of exclusions, or the semantics of the policy, which differentiates between ‘theft’ and ‘burglary’. Burglary is the criminal offence of breaking into and entering a building illegally for the purpose of committing a crime. On the other hand, theft is the act of stealing; the wrongful taking and carrying away of the personal goods usually without force. If the home insurance policy excludes burglary and covers only theft, then you are at a disadvantage. What about theft or burglary while travelling?
Moneylife had written about the case of Cox & Kings (C&K) tourists being robbed in a bus in Italy which was not covered by the insurer. (Read http://tinyurl.com/hcojgq9). It helps to clarify what is burglary versus theft which is applicable to home as well as travel insurance. While buying travel insurance, customers hardly know what is really covered.

6 Mediclaim Blunders To Avoid

Warning:You may be denied your claim even though you may have done nothing wrong

Financial planners tell customers to buy mediclaim of Rs5 lakh or more, to be covered adequately. While this is, indeed, good advice, planners do not tell customers about the shortcomings in the product itself which can mean that your claim may not be fully paid. Product drawbacks, like room rent limits or procedure sub-limits, can lead to partial claim settlement and reduced compensation claim amounts, about which you can try to get informed from the policy wordings. But what about things which are not defined in the policy but can still render the mediclaim useless? There could be complete rejection of claims, for no fault of yours.

You can only control what you know; but most of us cannot anticipate the various conditions which can lead to claims denial. We are highlighting some of the cases which we came across from Moneylife Foundation Insurance Helpline or emails received from Moneylife readers. Avoid the pitfalls which no financial planner or insurance advisor will tell you about. Nor can these be known from studying the mediclaim policy document.

Mediclaim is not a simple product. It’s not a product you can purchase and forget about. It is a product which will keep you on your toes. Unfortunately, insurance fraud is a reality and insurers’ steps to counter it may adversely impact an innocent policyholder. Read on to avoid blunders that can lead to rejection of claim or, even worse, make your mediclaim policy worthless. There are no easy solutions for some cases and even your best efforts for a fair claim can be met with unfair rejection by insurers.

Continue reading 6 Mediclaim Blunders To Avoid

ASCI upholds complaint against Bajaj Allianz false advertising

The Truth about New India Assurance’s top-up policy

Newspapers have claimed that New India Assurance’s newly launched top-up policy is the cheapest. These articles assert that you can even do cosmetic surgery and claim the amount over the deductible, for expenses covered by mediclaim. Here is the truth

New India Assurance (NIA) has launched a top-up plan, which is being hailed by few newspapers like the Times of India (ToI) and Economic Times (ET) as the cheapest product available. This is incorrect. The NIA top-up plan is not the cheapest and it is more expensive than super top-up products which are a better option.

The ToI article states – A unique aspect of NIA’s cover is that for the threshold limit to be reached, all hospitalization expenses are taken into account irrespective of whether the expenses would qualify as an insurance claim. This means that the insured can spend Rs5 lakh on a cosmetic surgery (which is not covered under mediclaim) and recover any additional health expense (covered under mediclaim) under the top-up plan. This is absolutely incorrect information. Moneylife wrote about the discrepancies to New India Assurance, but there was no response till the writing of this article. In fact, there is no health insurance product that covers cosmetic surgery.

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