Kathmandu. Although the body of a youth who went missing from a cliff was not found, the Nepal Insurance Authority (NEA) has decided to provide the claim amount to the family of the insured on the basis of the documents confirming his death.
Although the body of Bishnu Bahadur Bista, who was said to have gone missing after falling from a cliff, has not been found, the NRA has decided to provide Rs 1 million to Bista’s wife as the recommendation letter of the rural municipality.
Events
Bishnu Bahadur Bista had purchased Rs 1 million from Prime Life Insurance on November 3, 2017 for a period of three years. His wife Rojika Bista had filed a complaint at the Area Police Office and Rural Municipality stating that he had gone missing after falling into the river from a cliff at Lungri Rural Municipality-6 of Rolpa on September 29, 2019. Based on this petition, both the offices issued recommendations to confirm the disappearance of Bista.
Based on the documents and evidence issued by the same two offices, Rojika received Rs 7 lakh as relief from the Foreign Employment Board. The board paid Rs 7 lakh on the basis of the evidence, but the claim department of Prime did not accept it as evidence and refused to pay the claim.
Rojika, the wife of the insured, went to the door of the Insurance Authority (then Insurance Board) for justice after not getting the claim even after visiting the Prime Office repeatedly. She filed a complaint application (Ex.D.No. 501) on July 26, 2021, two years after her husband’s death, demanding Rs 1 million as insurance premium.
Hearing the complaint soon, the authority sought a written response from Prime Life. Instead of submitting a rational reason for rejecting the claim, the claims department submitted a written reply to the authority on October 26, 2021 seeking an opinion on whether to pay the claim on the basis of the available evidence. Prime Life, which was told not to give a claim to the insured, had gone wrong while writing a reply to the letter of the authority. It was clear that the insurer did not have any evidence to reject the claim in the context of Prime Life seeking the opinion of the authority.
Authority’s Decision and Decision
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The NRA ruled in favour of Rojika Bista on the basis of the evidence issued by the Area Police Office and the Rural Municipality Office confirming the death and the fact that the amount has been paid to the wife of the insured by the Foreign Employment Board as evidence.
A year after the complaint was filed, on August 22, 2022, the NRA dismisses the case, stating, “On the basis of the death of the insured Bishnu Bahadur Bista, it has also been found that the Foreign Employment Board has paid Rs 700,000 to the insured’s heir wife Rojika Bista.” As it does not appear to be justified and reasonable to deny the fact that the death of the insured was not found only on the ground and reason that the dead body of the insured was not found on the basis of the evidence provided by the authorized authorities regarding the death of the insured, therefore, the liability of the insured towards the death of the insured arises. Waits. ’
Path of Justice
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Rojika Bista would not have been able to claim Rs 10 lakh for her family if she was satisfied that the life insurance company did not pay the claim. Although he was late, he filed a complaint with the authority on the suggestion of the insurance agent, but the authority ruled in his favor and provided the insurance amount.
Sometimes, even when it seems that the claim is not available, the authority decides in the case of the insured on the basis of available facts, evidence, legal provisions, established precedents and principles of natural justice. Therefore, in recent times, insurance consumers have become aware to seek legal remedies through complaints.
