KARACHI - Federal Insurance Ombudsman (FIO) Raeesuddin Paracha has ordered payment of accumulative Rs7.5 million monetary relief to policy holders in the form of amicable settlement of different claims filed to this secretariat.
Earlier, a company, M/s Rizwan International, had obtained three fire policies in May 2013 to cover the building, machinery and stock of their factory premises.
As per policy the respondent company has to provide cover against risk of fire at the premises.
But within a year, in 2014, a fire broke out in the factory which caused heavy loss to the building, machinery and stock. The complainant lodged claim of Rs28.5 million for the compensation of their loss.
But the respondent company, on the basis of filed claim, appointed surveyor to assess the actual loss, but in spite of numerous requests from the complainant, the claim could not be settled. The complainant approached FIO to seek remedy.
Later on, an extensive hearing was held by the FIO at the end of which it was directed that settlement of claim was unnecessarily delayed due to submission of survey report belatedly and the loss was assessed by the surveyor fell to almost 5% of the total loss without giving any cogent reasons and data in support of such a low assessment of loss.
All the three policies remained effective up to June 2015 on renewal and in time payment of premium. Hence claim was neither rejected nor paid. The parties after the intervention of the FIO office were brought to an agreeable settlement at Rs4 million. FIO finally issued order to respondent company to settle the claim by paying Rs4 million to the complainant within one month.
In yet another case, a widow Naheed Akhtar filed a complaint for non settlement of her husband death claim for Rs2.8 million.
After the death of her husband she lodged a death claim with the respondent company on the basis of entitlement that her husband was duly medically examined at the time of preparation of policy proposal form, but the respondent company repudiated the death claim by taking plea that the policy holder had disclosed only diabetes as his illness, whereas he died of heart failure due to hypertension and renal failure.
Eventually complainant widow approached FIO forum for the settlement of her claim.
After several hearings and detailed deliberations, both the parties agreed on the amount of Rs700,000/- after the intervention of FIO as full and final settlement of the death claim of the deceased policy holder.