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State Consumer Disputes Redressal Commission

Ajay Makhija vs B.M , The New India Insurance Co.Ltd. on 19 June, 2018

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izkIr gksrk Fkk ftldh HkjikbZ ds fy, vukosnd ftEesnkj gSA ifjoknh }kjk vukosnd ls vusdksa ckj laidZ fd;k x;k fdUrq vukosnd }kjk vkt fnukad rd ifjoknh dks mlds {kfrxzLr okgu dks uk rks lq/kjokdj fn;k x;k vkSj uk gh okgu dh {kfriwfrZ jkf'k iznku fd;k x;kA ifjoknh }kjk vius vf/koDrk ds // 3 // ek/;e ls vukosnd dks lwpuk izsf"kr fd;k x;k ftldk dksbZ tokc ugha fn;k x;k vkSj uk gh {kfriwfrZ iznku dh xbZ ftlds dkj.k ifjoknh dks ;g ifjokn ykus dh vko';drk iM+h gSA vr% ifjokn&i= esa of.kZr vuqlkj vuqrks"k fnykbZ tkosa 03- mRrjoknh@vukosnd dh vksj ls ftyk Qksje ds le{k fyf[kr dFku izLrqr djrs gq, ;g vfHkopu fd;k x;k gS fd ifjoknh dk iz'uxr okgu vukosnd ds ikl chfer gksus ds laca/k esa ifjoknh }kjk izLrqr ikWfylh ds lR;kiu ij lgh ikbZ xbZ] ijUrq vukosnd }kjk fdlh Hkh okgu dk chek fof'k"V 'krksZa ,oa fucZU/kuksa ds v/khu fd;k tkrk gS ftldk lexz ifjikyu fdlh Hkh nkf;Ro ds mn~Hkwr gksus ds fy, iwoZHkkoh 'krZ gksrh gSA dfFkr ?kVuk fnukad&29-12-2008 dh lwpuk ifjoknh }kjk 16 fnol Ik'pkr~ fnukad&14-01-2009 dks nh xbZ gS] tcfd fdlh Hkh okgu ds nq?kZVuk dh lwpuk chek daiuh dks rRdky fn;k tkuk vko';d gSA vukosnd dks lwpuk&i= }kjk fnukad&21-06-2013 dks vR;f/kd foyac ls izkIr gqbZ gSA ifjoknh }kjk izLrqr baVhes'ku fnukad&14-01-2009 ij vukosnd ds fdlh vf/kd`r O;fDr ds gLrk{kj ,oa lhy u gksus ls mDr nLrkost Lohdk;Z ugha gSA chek daiuh }kjk okgu Lokeh dks xkM+h dh ejEer Lo;a ds O;; ij djokus ,oa vf/kd`r losZ{kd }kjk losZ{k.k djokus ds Ik'pkr~ losZ{k.k fjiksVZ ds vk/kkj ij vkadfyr jde dh chek ikWfylh dh 'krksZa ds v/khu izR;kHkwfr dh tkrh gS vU;Fkk ugha] ijUrq mDr izdj.k esa okgu ds {kfrxzLr gksus dh lwpuk vR;f/kd foyac ls nh xbZ Fkh // 4 // blfy, chek daiuh mDr okgu dk LFky fujh{k.k rFkk losZ{k.k ugha djk ikbZ vkSj uk gh ifjoknh Lo;a }kjk xkM+h dh ejEer djokbZ xbZ gSA ,slh fLFkfr esa chek daiuh ifjoknh dks dksbZ Hkh {kfriwfrZ dh jkf'k dh vnk;xh gsrq nkf;rok/khu ugha gSA ifjoknh }kjk iz'uxr okgu dk mi;ksx O;olkf;d iz;kstu ds fy, fd;k tk jgk Fkk tcfd okgu futh okgu ds :Ik esa chfer Fkk blfy, okgu dk O;olkf;d mi;ksx chek 'krZ dk mYya?ku FkkA vukosnd }kjk lsok esa dksbZ deh ugha dh xbZ gSA ifjoknh] vukosnd ls dksbZ vuqrks"k izkIr djus dk vf/kdkjh ugha gSA vr% ifjoknh dk ifjokn lO;; fujLr fd;k tkosA 04- vihykFkhZ@ifjoknh dh vksj ls vius i{k leFkZu esa ftyk Qksje ds le{k iksLVy jlhn fnukad&18-06-2013 dh Nk;kizfr ¼,usD'pj&1½] vf/koDrk uksfVl fnukad&17-06-2013 dh Nk;kizfr ¼,usd'pj&2½] lfVZfQdsV vkWQ jftLVsª'ku dh Nk;kizfr ¼,usD'pj&3½] vkWVks xSl dk buokbZl fnukad&16-01-2007 dh Nk;kizfr ¼,usD'pj&4½] dksjk fMLpktZ OgkÅpj dh Nk;kizfr ¼,usD'pj&5½] baVhes'ku fnukad&14-01-2009 dh Nk;kizfr] eksVj nkok izi= dh Nk;kizfr] ba';ksjsal jlhn fnukad&09-12- 2008 dh Nk;kizfr ¼,usD'pj&6½ izkfIr Lohd`fr jlhn dh Nk;kizfr ¼,usD'pj&7½] chek ikWfylh dh Nk;kizfr ¼,usD'pj&8½ izLrqr fd;k gSA 05- mRrjoknh@vukosnd dh vksj ls vius i{k leFkZu esa ftyk Qksje ds le{k chek ikWfylh dh izekf.kr izfr ¼,usD'pj vksih&1½] baVhes'ku de losZ;j ,ykWVesaV jftLVj dh izekf.kr izfr ¼,usD'pj vksih&2½ rFkk // 5 // vukosnd }kjk Jh f'kf'kj HkaMkjdj vf/koDrk dks izsf"kr i= fnukad&08 tqykbZ 2014 dh Nk;kizfr ¼,usD'pj vksih&3½ izLrqr fd;k gSA 06- ftyk Qksje us mHk;&i{k dh vksj ls izLrqr vfHkopu ,oa nLrkosth lk{;ksa ds ifj'khyu ds Ik'pkr~ ifjoknh ds ifjokn dks fujLr fd;k gS ftlds fo:} ;g vihy gSA 07- vihykFkhZ@ifjoknh dh vksj ls milatkr gksus okys fo}ku vf/koDrk Jh vkj- ds- Hkkoukuh dk rdZ gS fd ifjoknh ek:fr osu ftldk fd iath;u dzekad&lh-th- 07 ,u@4071 gS] dk iathd`r Lokeh gS vkSj mDr okgu fnukad&09-12-2008 ls fnukad&08-12-2009 dh vof/k ds fy, vukosnd ds ikl chfer Fkk vkSj chek vof/k esa fnukad&29-12- 2008 dks okgu nq?kZVukxzLr gks xbZ Fkh ftldh lwpuk vukosnd dks nh xbZ Fkh vkSj vukosnd ds funsZ'k ij okgu dks x.kifr eksVlZ] th- bZ- jksM lqisyk] fHkykbZ esa ejEer ds fy, ys tk;k x;k Fkk] ijUrq vukosnd }kjk {kfriwfrZ dh jkf'k vnk ugha dh xbZ] tcfd ifjoknh }kjk mDr okgu dk O;kolkf;d mi;ksx fd;k tkrk Fkk ftlls ifjoknh dks 15]000@&¼iUnzg gtkj :Ik;s½ ekfld vk; gksrk Fkk vkSj blls ifjoknh dks {kfr gqbZ gS vkSj okgu dks lq/kkj djus esa Hkh ifjoknh dks vR;f/kd {kfr mBkuh iM+h gS vkSj yxHkx 1]00]000@&¼,d yk[k :Ik;s½ O;; djuk iM+k gS vkSj ifjoknh dks O;kolkf;d {kfr Hkh gqbZ gS] ijUrq bu lc rF;ksa dks /;ku fn, fcuk ftyk Qksje us =qfViw.kZ vkns'k ikfjr fd;k gS rFkk vukosnd }kjk dsoy foyac ds vk/kkj ij nkos dks fujLr dj fn;k x;k tks fd // 6 // =qfViw.kZ gSA vr% ifjoknh dh vihy Lohdkj fd;k tkos vkSj ftyk Qksje }kjk ikfjr vkyksP; vkns'k vikLr fd;k tkos vkSj ifjoknh dks ifjokn&i= esa of.kZr vuqlkj vuqrks"k iznku dh tkosA ifjoknh dh vksj ls vius rdZ ds leFkZu esa Om Prakash Vs. Reliance General Insurance & Anr. IV (2017) CPJ 10 (SC), dk voyacu fy;k gSA 08- mRrjoknh@vukosnd dh vksj ls milatkr gksus okys fo}ku vf/koDrk Jh f'kf'kj HkaMkjdj dk rdZ gS fd ikWfylh iSdst ikWfylh ¼izkbZosV Oghdy½ ds :Ik esa tkjh gqvk Fkk vkSj ifjoknh us Lo;a ;g Lohdkj fd;k gS fd mldk mi;ksx og O;kolkf;d iz;kstu ds fy, dj jgk Fkk tks fd chek 'krksZa dk Li"V mYya?ku gS rFkk ifjoknh dk ifjokn ifjlhek vof/k ls ckf/kr gSA ftyk Qksje us tks vkns'k ikfjr fd;k gS og iw.kZr% mfpr gS vkSj mlesa fdlh izdkj ds gLr{ksi dh vko';drk ugha gSA vr% ifjoknh dh vihy fujLr fd;k tkos vkSj ftyk Qksje }kjk ikfjr vkyksP; vkns'k ;Fkkor~ j[kk tkosA vukosnd dh vksj ls vius rdZ ds leFkZu esa Kandimalla Raghavaiah & Co. Vs. National Insurance Co. Ltd. & Anr. III (2009) CPJ 75 (SC), Suresh Kumar Vs. National Insurance Company Ltd. I (2013) CPJ 60 (NC), State Bank of India Vs. B. S. Agricultural Indutries (I) II (2009) CPJ 29 (SC), Jansatta Sahkari Awas Samiti Ltd. Vs. Kone Elevators India Pvt. Ltd. I (2016) CPJ 190 (NC), dk voyacu fy;k gSA // 7 // 09- geus mHk;i{k ds fo}ku vf/koDrkx.k dk rdZ Jo.k fd;k rFkk ftyk Qksje ds vfHkys[k ,oa vkyksP; vkns'k dk Hkh ifj'khyu fd;k x;kA 10- ifjoknh us ;g vfHkopu fd;k gS fd og okgu dzekad&lh- th- 07 ,u@4071 dk iathd`r Lokeh gS tks fd vukosnd ds ikl fnukad&09-12-2008 ls fnukad&08-12-2009 dh vof/k ds fy, chfer Fkk vkSj bl rF; dks vukosnd }kjk Lohdkj fd;k x;k gSA 11- ifjoknh ds vuqlkj fnukad&29-12-2008 dks nq?kZVuk dkfjr gqvk gS] ijUrq vukosnd dk ;g dguk gS fd bl nq?kZVuk dh lwpuk ifjoknh }kjk vR;f/kd foyac ls fn;k gS vkSj foyac ds laca/k esa dksbZ Li"Vhdj.k ugha gS rFkk ifjoknh us okgu dk mi;ksx O;kolkf;d iz;kstu ds fy, fd;k gS vkSj blfy, fujLr fd;s tkus ;ksX; gSA 12- vukosnd dh vksj ls chek ikWfylh ¼izn'kZ vks- ih-&1½ izLrqr fd;k x;k gSA bl chek ikWfylh esa Li"V :Ik ls mYysf[kr gS fd iSdst ikWfylh ¼izkbZosV Oghdy½ fnukad&09-12-2008 ds 12%33 cts tkjh fd;k x;k gSA bl izdkj Li"V gS fd okgu O;fDrxr mi;ksx ds fy, fy;k x;k FkkA 13- ifjoknh us vius ifjokn&i= dh dafMdk&5 esa ;g vfHkopu fd;k gS fd ifjoknh ds }kjk vius mDr okgu dk O;kolkf;d dk;Z gsrq mi;ksx fd;k tkrk Fkk ftlls ifjoknh dks 15]000@&¼iUnzg gtkj // 8 // :Ik;s½ ekfld vk; izkIr gksrk FkkA bl izdkj ifjoknh Lo;a us Lohdkj fd;k gS fd mlus okgu dk mi;ksx O;kolkf;d iz;kstu ds fy, dj jgk Fkk tcfd okgu dh chek ikWfylh izkbZosV okgu ds :Ik esa tkjh gqvk Fkk tks fd fuf'pr gh chek ikWfylh dh 'krksZa dk mYya?ku gSA 14- vukosnd dh vksj ls ;g crkus dk iz;kl fd;k x;k gS fd okgu ds nq?kZVuk dh lwpuk vR;f/kd foyac ls fn;k x;k Fkk vkSj tks fnukad&14-01-2009 dks nq?kZVuk dh lwpuk fn;s tkus dh ckr gS] ml ij chek daiuh ds fdlh vf/kd`r O;fDr dk gLrk{kj ugha gS vkSj uk gh lhy gS vkSj bl izdkj chek daiuh dks fof/kor~ lwpuk ugha fn;k x;k gS vkSj ,slh fLFkfr esa ifjoknh dks Om Prakash Vs. Reliance General Insurance & Anr. (Supra) ds U;k; n`"Vkar dk ykHk ugha feyrk gS rFkk nq?kZVuk fnukad&29-12-2008 dh gS vkSj ifjoknh us ;g ifjokn fnukad&31-07- 2013 dks lafLFkr fd;k gS tks fd ifjlhek vof/k ls ckf/kr gSA 15- Kandimalla Raghavaiah And Co. Vs. National Insurance Co. & Anr. (Supra) esa ekuuh; loksZPp U;k;ky; }kjk ;g fu/kkZfjr fd;k x;k gS fd%& "17. Section 24-A of the Act bars any fora set up under the Act, from admitting a complaint, unless the complaint is filed within two years from the date on which the cause of action has arisen. The provision expressly casts a duty on the Commission, admitting a complaint, to dismiss a complaint unless the complainant satisfies the District Forum, the State Commission or the National Commission, as the case may be, that the complainant had sufficient cause for not filing the complaint within the period of two years from the date on which the cause // 9 // of action had arisen. Recently, in SBI v. B.S.Agriculture Industries (I) this Court, while dealing with the same provision, has held: (SCC p. 125, paras 11-12) "11. ...It would be seen from the aforesaid provision that it is peremptory in nature and requires the consumer forum to see before it admits the complaint that it has been filed within two years from the date of accrual of cause of action. The consumer forum, however, for the reasons to be recorded in writing may condone the delay in filing the complaint if sufficient cause is shown. The expression, 'shall not admit a complaint' occurring in Section 24-A is sort of a legislative command to the consumer forum to examine on its own whether the complaint has been filed within the limitation period prescribed thereunder.

12. As a matter of law, the consumer forum must deal with the complaint on merits only if the complaint has been filed within two years from the date of accrual of cause of action and if beyond the said period, the sufficient cause has been shown and delay condoned for the reasons recorded in writing. In other words, it is the duty of the consumer forum to take notice of Section 24-A and give effect to it. If the complaint is barred by time and yet, the consumer forum decides the complaint on merits, the forum would be committing an illegality and, therefore, the aggrieved party would be entitled to have such order set aside.

18. The term "cause of action" is neither defined in the Act nor in the Code of Civil Procedure, 1908 but is of import. It has different meanings in different contexts, that is when used in the context of territorial jurisdiction or limitation or the accrual of right to sue. Generally, it is described as "bundle of facts", which if proved or admitted entitle the plaintiff to the relief prayed for. Pithily stated, "cause of action" means the cause of action for which the suit is brought, "Cause of action" is cause of action which gives occasion for and forms the foundation of the suit. (See Sidramappa v. Rajashetty.) In the context of limitation with reference to a fire insurance policy, undoubtedly, the date of accrual of cause of action has to be the date on which the fire breaks out."

// 10 // 16- H.P.State Forest Co. Ltd. Vs. M/s. United India Insurance Co. Ltd, 2009 AIR SCW 865, esa ekuuh; loksZPp U;k;ky; }kjk ;g fu/kkZfjr fd;k x;k gS fd%& "5. It is clear from the record that the timber had been washed away sometime in September 1988 and after prolonged correspondence, the respondent ultimately vide its communication dated 13th October, 1988 repudiated the appellant's claim. It is also clear from the counter-affidavit filed by the respondent that the appellant had, vide its letter dated 7th November, 1987, asked for insurance cover for a period of 8 months and that the period of one year fixed in the insurance policy was evidently a typographical mistake which had, in any case, been rectified in the records of the company on 17th December, 1987, that is long before the flood. The claim of the appellant that the respondent - company had, even after the 13th October, 1988, impliedly admitted its liability under the policy also appears to be incorrect as the surveyors had been appointed on the persistent demand of the claimant / appellant and the premium taken thereafter was only to make good the deficiency in the premium that had been paid for the policy for the period of eight months. It is therefore, apparent that as on the date of the flood, there was no insurance policy in existence or any commitment on behalf of the respondent to make the payment under the policy. We therefore, endorse the argument raised by the respondent that even accepting the case of the appellant at its very best that the period of limitation would be 3 years under Section 44 of the Limitation Act, the complaint would, even then, be beyond time, having been filed in April 1994." 17- Smita Madhav Patki Vs. National Insurance Co. Ltd. & Ors, I (2013) CPJ 331 (NC), esa ekuuh; jk"Vªh; vk;ksx }kjk ;g fu/kkZfjr fd;k x;k gS fd%& // 11 // "17. State Commission in its order has observed:

5. Cause of action for the insurance claim in question but arose on the death of late Madhav Patki and not on the date of repudiation of the insurance claim as alleged by the complainant. A useful reference can be made to the decision of the Apex Court in the matter of Kandimalla Raghavaiah & Co. v. National Insurance Co.

Ltd. and Others, 2009 CTJ 951 (SC) (CP). Insurance claim, thus, is preferred beyond the period of two years from the date of cause of action, supra and as such barred by limitation. There is no application for condonation of delay, admittedly, made.

6. Janata Personal Group Accident Policy is on record. Amongst other terms it also submitted as under:

"It is also hereby further expressly agreed and declared that if the Company shall disclaim liability to the insured for any claim hereunder and such claim shall not within 12 calendar months from the date of such ...have been made the subject of a suit in a Court of Law then the claim shall for all purpose be deemed ... been abandoned and shall not thereafter be recoverable hereunder."

7. As held by the Apex Court in the matter of Himachal Pradesh State Forest Co. Ltd. v. United India Insurance Co. Ltd, (2009) 2 SCC 252, though above referred clause in view of Section 28 of the Contract Act will not be acted upon for the curtailment of the period of limitation still the later part of it which refers to extension of the right itself unless exercised within specified time can be enforced. Therefore, since the claim was not made within 12 calendar months from the date of happening, the claim shall for all purposes be deemed to have been abandoned and is not recoverable after the expiry of the said period.

8. For the above said reasons, we find that no fault can be found with the impugned order resulting into dismissal of consumer complaint. Holding accordingly, we pass the following order."

// 12 //

18. National Flask Industries Ltd. vs. Dakshin Gujarat Vij Co. Ltd. & Ors., IV (2015) CPJ 566 (NC), esa ekuuh; jk"Vªh; vk;ksx }kjk ;g fu/kkZfjr fd;k x;k gS fd%& "23. ....... The cause of action will arise from the date of incident and not from the date, when the Insurance Company has given a decision on the complaint/claim. The complainant should have filed the complaint immediately, within two years and should have given the notice to the OPs, within the said two years, in order to file the complaint within time."

19. Ganpat Rama Madhavi Vs. New India Assurance Company Ltd., IV (2011) CPJ 210 (NC); esa ekuuh; jk"Vªh; vk;ksx }kjk ;g fu/kkZfjr fd;k x;k gS fd%& "If the Insurance Company had not repudiated claim and taken more than two years to take decision of claim, aggrieved insured could not have waited indefinitely and would have had to file consumer complaint from date of occurrence of peril. Period of limitation cannot be reckoned from the date of repudiation of claim. Complaint time barred."

20- ifjoknh ds vuqlkj mlus fnukad&18-06-2013 dks fof/kd lwpuk&i= izzsf"kr fd;k Fkk vkSj rc vukosnd }kjk ifjoknh dks vk'oklu fn;k x;k Fkk vkSj bl izdkj ifjoknh ds vuqlkj okn dkj.k fnukad&18- 06-2013 dks mRiUu gqvk gS tc uksfVl fn;k x;k gSA ifjoknh dk mDr rdZ Lohdkj fd;s tkus ;ksX; ugha gSA // 13 // 21- United Bank of India vs. Janata Paradise Hotel and Restaurant, IV (2014) CPJ 383 (NC), esa ekuuh; jk"Vªh; vk;ksx }kjk ;g fu/kkZfjr fd;k x;k gS fd%& "6.......... correspondence does not extend limitation, particularly, when first request for refund is made after claim became time-barred. In this matter, claim became time barred in the year 1995 and letter has been written on 18.11.2007. Complainant has not placed any letter from 1995 to 2007 and, thus claim being barred by limitation, learned District Form committed error in allowing complaint."

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