Surat: The Navsari consumer disputes redressal commission (CDRC) ordered an insurance company to pay a Rs 15 lakh claim that was repudiated for the lack of a postmortem report.A resident of Navsari died five months after his two-wheeler accident. As he had a personal accident (PA) cover of Rs 15 lakh, his family made a claim which was rejected by the insurer. The CDRC observed that the insurance company had failed to prove that a postmortem report is mandatory for a claim under PA cover.Ramesh Patel had a two-wheeler policy from IFFCO-Tokio General Insurance for the year starting Nov 14, 2021, with Rs. 15 lakh PA cover for the owner\driver. On May 8, 2022, he had an accident and suffered serious head injuries. After treatment at hospitals, he died in his house on Oct 20, 2022. After the death, the family filed the claim for Rs 15 lakh PA cover and submitted the required documents such as the FIR and panchnama.The insurance company demanded a postmortem report and inquest panchanama and refused the claim. After this, his wife and son filed a complaint with the Navsari CDRC on Aug 5, 2025.During the hearing, the insurer’s advocate argued that the claim has not been repudiated but closed. The applicant had failed to provide the postmortem report and documents pertaining to the medico-legal case, among others. Because of this, the complaint ought to be treated as premature and rejected, in view of the policy conditions.After hearing both sides, the consumer forum refused to accept the insurance company’s arguments. The CDRC observed: “After the accident, an FIR was filed with Navsari Rural police station. Police also visited the place of accident and filed a panchanama for it. This proves that the death had taken place due to an accident. As the company had asked for a postmortem report, the complainant had made it clear that after the prolonged treatment at various hospitals, the victim had died at home. Thus no postmortem was done. The company had failed to prove that a postmortem is compulsory for a person who has died due to an accident under the Insurance Act and related laws.”With these observations, the Navsari CDRC ordered the insurance company to pay Rs 15 lakh with 9 % interest to the family of victim. The company was also ordered to pay Rs 25,000 for the harassment and expenses caused.
