Name, age mismatch blocks PMSBY claim, son wins

A man from Chhattisgarh has won a Rs 2.5 lakh claim from a consumer commission after an insurer rejected his deceased father's accidental death claim under the Pradhan Mantri Suraksha Bima Yojana (PMSBY). The Chhattisgarh State Consumer Disputes Redressal Commission overturned a previous ruling that dismissed the complaint and ordered the insurance company to pay the full sum, including compensation for mental anguish and legal fees.

PMSBY is an accidental death and disability insurance scheme for low-income workers, offering a Rs 2 lakh cover for a yearly premium of Rs 12 deducted from the subscriber's bank account. The deceased, a contractual laborer at Bhilai Steel Plant, had enrolled in the scheme and died in 2018 after falling from a height while working. His son, Shiva Singh, was the nominated beneficiary.

The insurance company rejected the claim in 2019 due to discrepancies in the deceased's name and age across various documents, including his death certificate, Aadhaar card, and bank records. The insurer argued that no affidavit or supporting proof was provided to establish the nominee's identity.

However, the state consumer commission examined the evidence and found that all documents consistently identified the deceased as Janak Singh, son of Laxman Singh, aged 51. The commission ruled that Janak Singh and Janak Ram Beldar were the same person and that the insurer was contractually obligated to honor the claim. It dismissed the technical grounds for rejecting the claim and held that consumer forums can adjudicate such matters when sufficient documentary evidence supports the claim.

The commission ordered the insurance company to pay Rs 2 lakh along with Rs 40,000 for mental agony and Rs 10,000 for litigation expenses within 60 days. The bank, Jila Sahkari Bank Maryadit, was absolved of liability, as its role was limited to deducting the premium and forwarding the claim to the insurer.