Insurance sector makes for most consumer cases

Law State

Of the 12 sectors in the consumer disputes redressal commission, insurance has 26000 cases.

The insurance sector has the most number of consumer court cases filed against its enterprises from the beginning of 2023 till Sept. 2023. Monthly statistics given by Karnataka State Consumer Disputes Redressal Commission (KSCDRC) shows that the number of cases filed in the consumer court against the insurance sector are around 26,000.

Sector-wise cases filed in consumer courts across Karnataka (Last Updated: September 2023)

Other sectors which have high number of cases filed against them are private societies/builders, banks and electricity corporations. The KSCRDC has listed around 12 industries in the statistics for cases filed, disposed of and pending in the consumer courts across the state. Consumers can file a case in the consumer court under the Consumer Protection Act, 1986.

Gangadhar, who lives near Nandini Layout, has filed a court case against an insurance company for claiming health insurance. He said, “The claim, which was about Rs. 6 lakhs, was to be given when I was admitted to a hospital due to a liver surgery I had to undergo. It has been one year, and they have not given the money yet, saying that I don’t have proper documents, but I have them all.”  He added that the case has been ongoing since February this year, and he had to pay money from his savings to the hospital after the surgery was successful.

Advocate Kumaraswamy B., who has been working with consumer court cases for insurance policies, said that most of the cases that are filed are for medical and life insurance. “Most of the cases are because the company does not pay the amount on time, or creates unnecessary procedures for claiming the insured money. One can also file a case if the company refuses to solve the grievances they are supposed to in a given time period,” he added.

Karnataka consumer dispute redressal commission (KSCDRC) deals with consumer cases filed for the state of Karnataka. Picture Credit: KSCDRC

The registrar of KSCDRC said that accidental claims and medical insurance are registered  in the court often. She said, “The complaints where the consumer does not get claim on vehicle insurance because the insurance policy does not cover certain parts of the vehicle are the cases which are often registered here.” She added that even before 2016, the insurance sector had  the most number of cases filed against them in the consumer court.

Mr. M.P. Nagendramurthy, senior faculty at JSS Law College (Autonomous), said that the terms and conditions under which an insurance policy is sold becomes a source for such disputes. “The terms and conditions of the policies, for example in the case of  vehicle insurance, exclude certain parts of the vehicle. So, if someone wishes to claim after an accident, they might not get the claim,” he added.

He also said that having proper documents at each step of complaint is important for the consumer during the case. He said, “Legally, first the consumer has to send a notice to the company, as a warning. If that does not help, they can go tothe consumer dispute redressal commission at the district level, from where the case goes to the consumer court.”