He has never been to court in his life, but this welder from Kerala has fought a case all by himself to win compensation from insurance major Navi General Insurance Limited. Vishnu Raj, 31, of Vaikkom, Kottayam, who had studied only up to tenth grade, fought the case for an insurance claim after his left arm was amputated in an accident, causing him to lose his job as a welder.
He decided to argue the case all by himself because he didn’t have the money to engage a lawyer. Finally, his valiant effort to take on senior lawyers representing Navi General Insurance paid off when the Ernakulam District Consumer Disputes Redressal Commission gave a verdict favouring him.
The Commission directed Navi General Insurance to pay an insurance amount of Rs two lakh, which they had denied Vishnu Raj despite his repeated pleas after he lost his left hand in a bus accident.
The Commission, chaired by its president D B Binu, with members V Ramachandran and Sreevidhia T N, issued the order after Vishnu Raj successfully argued his case, presenting evidence and citing relevant sections of consumer law.
“I have never been to a court before. I decided to argue the case all by myself because I didn’t have the money to engage a lawyer. The officials at the Commission helped with case filing and other procedures,” Vishnu Raj told “Open Digest“.
Vishnu Raj moved the Commission after Navi General Insurance failed to comply with an insurance ombudsman order which directed the insurance company to settle the insurance claim amount for Vishnu Raj.
As per the case details, Vishnu Raj met with a bus accident on January 1, 2020, at Paravoor in Ernakulam. He lost his left upper limb in the accident and soon lost his job, unable to properly discharge his duties as a welder technician. As he had taken a home loan from DHFL Bank, which came along with a Standard Fire & Special Perils Policy and a Group Critical Illness Insurance with coverage spanning from December 30, 2017 to December 29, 2022, he applied for compensation under the Group Critical Illness Insurance Policy, specifically under Section B-ii, which covers loss of job.
Despite the severity of his condition and the evident loss of livelihood, the insurance company failed to respond to his claim application. The insurance company contended that the Group Critical Illness Insurance Policy was designed to provide indemnity to the policyholder if any of the illnesses specified in the policy occur and does not extend coverage to accidents or injuries resulting from road accidents. The company further submitted that though a loss of job was covered if it results from a critical illness as defined in the policy, the loss of an upper limb could not be categorized as a critical illness under the policy.
However, the Commission rejected the arguments of the insurance company, observing that “it is impossible to overlook the profound impact this tragic accident has had on a young life full of promise. At just 31 years old, a dedicated welder by profession, faced a life-altering event that not only took away his ability to work but also cast a shadow over his future prospects. The amputation of his left arm was not merely a physical loss but a devastating blow to his livelihood, which depended entirely on his skill and physical capability. As a welder, his hands were his tools, his means of earning a living, and securing a future for himself and his family. This sudden and severe setback has placed an overwhelming burden on him, both emotionally and financially.”
