The national consumer disputes redressal commission (NCDRC) has dismissed Canara HSBC Life Insurance Company’s appeal against an order directing it to pay the remaining ₹15 lakh accidental death benefit to the widow of a policyholder who died following electrocution. A bench comprising presiding member Dr Inder Jit Singh and member Shashi Nandkeolyar held that the insurer could not deny the additional benefit merely because the claimant did not produce a post-mortem report or first information report (FIR) when neither document existed in the case.
In
an order earlier this month, NCDRC said, "Even if it was necessary or mandatory to do a
post-mortem or to lodge an FIR, such a duty was cast on the concerned hospital or the doctor. If they have failed to discharge such a duty, the complainant cannot be blamed for such a lapse. No doubt, the submission of required documents is essential to enable the insurance company to consider the claim as per policy, however, if any such document does not exist, like in the present case, there is no
post-mortem report or FIR and the complainant is not at fault for the non-existence of such documents, the insurance company is not justified in rejecting the claim for such reasons."
"The facts and circumstances of the case and the evidence on record clearly indicate that it was a case of accidental death, and hence the complainants are entitled to full sum assured of ₹30 lakh and not only ₹15 lakh, which was even accepted by the insurance company. Hence, we find no illegality or material irregularity in the order of the Punjab state consumer disputes redressal commission. The complainants have discharged the burden of proving the death being accidental through cogent and reliable evidence in the form of medical records, death register and death certificate," the order said.
NCDRC found that medical records from a government hospital, the statutory death certificate and the hospital’s death register provided sufficient evidence that Lakhwinder Singh had died on 19 November 2021, following an electric shock. It upheld the state commission’s findings and dismissed the second appeal No.640 of 2026 filed by the insurer.
Policy Provided ₹30 Lakh for Accidental Death
Mr Singh had purchased a Canara HSBC Life Insurance policy under the 'POS-Easy Bima Plan-PPT-10' for a 20-year term beginning 19 April 2021. The policy carried a basic death benefit of ₹15 lakh, with an additional ₹15 lakh payable if the death was accidental, taking the total benefit to ₹30 lakh.
Mr Singh died on 19 November 2021. His widow, Muskan Kaur, informed the insurer that he had died due to an electric shock and sought the full amount payable under the policy.
Canara HSBC Life Insurance, however, paid only the basic ₹15 lakh death benefit. It maintained that the additional accidental-death benefit could not be considered because the claimant had not submitted documents, including the post-mortem report and police records.
The company had sought documents from Ms Kaur and subsequently communicated that the claim had been accepted for ₹15 lakh. The insurer treated that amount as full and final settlement unless the claimant protested within the stipulated period.
Insurer Relied on Policy Condition
The insurance company relied on Clause 17 of the policy, which sets out the documents required for processing death claims. These included the policy document, death certificate, identity and address proof, claim forms, medical records and, where applicable, a post-mortem or chemical viscera report. For unnatural or accidental deaths, the clause also referred to police records such as an FIR, panchnama, investigation report and final police report.
Canara HSBC Life Insurance argued that these documents were necessary to establish that Mr Singh’s death qualified as an accidental death under the policy.
The Ferozepur district consumer disputes redressal commission, however, rejected the contention and ordered the insurer to pay the remaining ₹15 lakh, along with 6% annual interest from 16 February 2023, and ₹5,000 as compensation for mental agony, harassment and litigation expenses.
The state commission subsequently dismissed the insurer’s appeal and upheld the district commission’s order.
During the hearing, NCDRC noted that the policy itself required a post-mortem or chemical viscera report only 'wherever conducted'. Since no post-mortem had been carried out, there was no such report for Ms Kaur to submit.
The commission also noted that the government hospital records recorded Mr Singh’s admission to the emergency ward at 5.30pm on 19 November 2021, in a gasping condition with a history of electrocution. His blood pressure and pulse were not recordable, he did not respond to CPR and he was declared dead at 5.40pm. The hospital records and death register recorded electric shock as the cause of death.
The commission said that if a post-mortem or FIR was required in the circumstances, the responsibility for taking those steps rested with the hospital or doctor concerned, and not with the claimant.
While claimants are required to provide documents available to them, an insurer cannot reject a claim because of documents that simply do not exist, NCDRC added.
Commission Rejects Insurer's Reliance on Earlier Case
Canara HSBC Life Insurance relied on an earlier NCDRC decision in Anju Goel vs Oriental Insurance Co Ltd, arguing that failure to produce documents establishing an accidental death justified denial of the additional insurance benefit.
NCDRC distinguished the circumstances, noting that in the earlier case there was no documentary evidence establishing that the insured had died in an accident. In the present matter, it said, there is government hospital documentation, a statutory death certificate and a death register supporting the claim.
NCDRC concluded that Ms Kaur had discharged the burden of proving accidental death through 'cogent and reliable evidence' and that the insurer was not justified in withholding the additional ₹15 lakh on the ground that the post-mortem report and FIR were unavailable.
Insurer Raised Fraud Allegations at Appeal Stage
The case took another turn when Canara HSBC Life Insurance, during proceedings before the state commission, alleged that Mr Singh might have been alive when the claim was lodged and that the death certificate could have been obtained fraudulently.
The company relied on an affidavit from an advocate, Varun Kumar Gupta, who claimed to have conducted an inquiry into the matter. The allegations included claims that Mr Singh and Ms Kaur did not live at the address mentioned in the policy and were not a married couple, and that the policy itself had been obtained through forged documents.
The state commission rejected the application, finding that the allegations were unsupported by cogent evidence. It also noted that Canara HSBC Life Insurance had already paid ₹15 lakh after investigating the claim and had not raised the fraud allegations when it filed its written reply before the district commission.
NCDRC agreed with that assessment. It noted that there was no evidence before it to suggest that Mr Singh was alive on 19 November 2021, or when the claim was lodged. In contrast, government hospital records, the statutory death certificate and the death register all recorded his death on that date.
The commission also pointed out that if the insurer suspected the medical records were forged or fabricated, it was for the insurer to establish that allegation. It further noted that the company had not taken steps to have the statutory death certificate modified or cancelled.
Finding no illegality or material irregularity in the state commission’s decision, NCDRC dismissed Canara HSBC Life Insurance’s second appeal. The commission held that the evidence on record left no doubt that the death was accidental and that Ms Kaur is entitled to the full ₹30 lakh sum assured, rather than the ₹15 lakh already paid by the insurer.
(Case No. NC/SA/640/2026 Date: 8 September 2026)
