A Chhattisgarh man has won a Rs 2.5 lakh payout from a consumer commission after the insurer under the Pradhan Mantri Suraksha Bima Yojana rejected his deceased father's accidental death claim, citing mismatches in the name and age recorded across documents.
The Chhattisgarh State Consumer Disputes Redressal Commission, in an order pronounced on 11 August 2026, set aside an earlier district commission ruling that had dismissed the complaint, and directed the insurance company to pay the full insured sum of Rs 2 lakh along with Rs 40,000 as compensation for mental agony and Rs 10,000 towards litigation expenses.
What is PMSBY and who was insured?
The Pradhan Mantri Suraksha Bima Yojana is a government-backed accidental death and disability insurance scheme that offers a Rs 2 lakh cover for an annual premium of Rs 12, deducted directly from the subscriber's bank account. It is among the most accessible insurance schemes in India, designed specifically for low-income workers.
The deceased, a contractual labourer working at the Bhilai Steel Plant in Chhattisgarh, had enrolled in the scheme through his savings account at the Kodwa branch of Jila Sahkari Bank Maryadit. The annual premium of Rs 12 was deducted from his account on 31 May 2017, covering him from 31 May 2017 to 30 May 2018.
He died on 9 May 2018, within the coverage period, after falling from a height of 20 to 25 metres in the project area of the Bhilai Steel Plant. His son, Shiva Singh, was the nominated beneficiary.
Why was the PMSBY insurance claim rejected?
After the family submitted the claim, the insurance company rejected it on 20 September 2019, pointing to what it described as irreconcilable discrepancies across the deceased's documents.
The insurer noted that the deceased's age was recorded as 38 years in the death certificate and OPD report, 51 years in the post-mortem report, and 52 years in his Aadhaar card. On the name, the bank passbook listed the account holder as Janak Ram Beldar, while the death certificate, FIR, post-mortem report, and police investigation final report all referred to the deceased as Janak Singh, son of Laxman Singh.
The insurer argued that the nominee had failed to establish that Janak Singh and Janak Ram Beldar were the same person, and that no affidavit or supporting proof was furnished to the insurer at the time of the claim. On these grounds, it maintained the rejection was lawful and that no deficiency in service had occurred.
The district consumer commission accepted this position and dismissed the complaint, holding that the contradictions in records required a detailed trial beyond the scope of summary consumer proceedings.
Can name and age mismatch alone justify rejecting an insurance claim?
The state commission answered this directly. It examined the documents placed on record, including the police investigation final report, FIR, merg intimation, post-mortem report, and sworn affidavits from the deceased's son and wife.
All of these, the commission found, consistently identified the deceased as Janak Singh, son of Laxman Singh, aged 51, who died as a result of injuries sustained from a fall at the Bhilai Steel Plant project area. The commission noted that the sworn statements of the family members remained uncontroverted by the insurer, reinforcing the authenticity of the claim.
On the basis of this evidence, the commission ruled that Janak Singh and Janak Ram Beldar were one and the same individual. It held that once the insured's identity and accidental death are established through documentary evidence, the insurer is contractually liable to honour the claim.
The commission further ruled that the rejection of the claim on technical grounds of age and name variation was unjustified and amounted to deficiency in service. It also held that the district commission erred in dismissing the complaint on the premise that disputed facts required a detailed trial, stating that consumer forums are competent to adjudicate such matters when documentary evidence sufficiently proves the claim.
PMSBY Claim Rejected: What the commission ordered
The state commission set aside the district commission's dismissal order and directed the insurance company to pay the insured sum of Rs 2 lakh with interest at 6 per cent per annum from the date of claim repudiation until realisation, along with Rs 40,000 as compensation for mental agony and Rs 10,000 towards litigation costs.
The insurer must comply within 60 days of receiving the order. If it fails to do so, the entire amount will carry interest at 9 per cent per annum from the date of the order until full realisation.
The bank, Jila Sahkari Bank Maryadit, was absolved of liability. The commission accepted its position that its role was limited to deducting the premium and forwarding the claim to the insurer, and that it bore no responsibility for the assessment or settlement of the claim.
The full award is to be paid to Shiva Singh, the nominee. The deceased's wife and another son had already filed sworn no-objection statements, entitling Shiva Singh to receive the entire amount without dispute.
Check the case judgement here:
