Case Review: Insurance
Summary of some of the decisions made by the Mediators on some of the complaints received by FMB.
This summary is for information only and should not be used for other purpose.
IMB/1755/L Whether Assured Suffers Total Permanent Disability
The insurers declined the assured's claim for Total Permanent Disability benefit on the ground that the assured did not suffer any physical disability apart from walking with a limp as a result of an accident on 23.2.2001.
It was observed that the assured suffered serious head injury in the accident. His physical movement may not be severely affected but the head injury had caused other disabilities. A specialist medical examination was carried out whereby it was reported that apart from limitation in movement, the assured suffered from headache, giddiness, loss of memory, slurred speech, tremor and unsteady gait. The doctor reported that the assured was unfit for any job due to his condition.
The insurers' decision was based merely on their investigation on the assured's physical ability / movement. But the insurers had failed to consider the various medical reports on the assured's mental disability due to his head injury. Upon being queried the insurers revised their decision and settled the claim.