State Consumer Disputes Redressal Commission
Amritlal & Others vs Branch Manager & Anr. on 17 July, 2013
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION,
PANDRI, RAIPUR(C.G.)
Appeal No.FA/12/765
Instituted on : 22.12.2012
1. Amritlal, S/o Late Shri Ratan Saay,
2. Kamla Bai, W/o Shri Balak, D/o Late Shri Ratan Saay,
3. Santosh Kumar, S/o Late Shri Ratan Saay,
4. Abhisht Kumar, S/o Late Shri Ratan Saay,
All R/o : Village - Peepar Dand,
P.S. & Tehsil - Patna, District - Korea (C.G.) ... Appellants.
Vs.
1. Branch Manager,
The Oriental Insurance Company Limited,
Divisional Office, First Floor, Opp. Rajiv Plaza,
Rama Trade Centre, Near Bus Stand,
Bilaspur (C.G.).
2. General Manager, S.E.C.L. Baikunthpur Area,
Baikunthpur, District Korea (C.G.) ... Respondents.
PRESENT: -
HON'BLE SMT. VEENA MISRA, PRESIDING MEMBER
HON'BLE SHRI V.K. PATIL, MEMBER
HON'BLE MISS HEENA THAKKAR, MEMBER
COUNSEL FOR THE PARTIES: -
Shri Sanjay Tiwari, for appellants.
Shri P.K. Paul, for respondent No.1.
Shri O.P. Agrawal, for respondent No.2.
ORDER
Dated : 17/07/2013 PER: - HON'BLE SHRI V.K. PATIL, MEMBER This appeal has been filed by the appellants/complainants having been aggrieved by the order dated 30.11.2012 of District Consumer Disputes Redressal Forum, Korea, Baikunthpur (C.G.) (hereinafter called //2 // "District Forum" for short) in Complaint Case No.55/2012, whereby complaint of the appellants/complainants, alleging deficiency in service on the part of respondents towards non-payment of claim amount under Group Insurance Policy, has been dismissed.
2. Briefly stated facts of the case necessary for disposal of the appeal, as per averment of the complainants, are that his deceased father was insured under a Group Janta Personal Accident Policy which was taken out by deceased's employer OP-2/ S.E.C.L. with the OP-1 insurance company for Rs.5,00,000/- covering period 16.10.1999 to 20.04.2009 and premium thereof Rs.464/- was deducted from his salary. Complainant's father and mother both died together on 02.03.2002 due to lightening during rains while standing under a tree, intimation of which was given immediately to police and a case no. 09/2002 was registered and post mortem done. Intimation with documents was also given to OP-2/Employer on 06.04.2002 so as to get insurance claim. As per averment of the complainant, intimation was also given to OP-1/Insurance Company but no action was taken so again claim was filed with OP-1/Insurance Company but was of no avail. Notice sent through an advocate on 23.12.2012 was also not responded. Complainants filed consumer complaint alleging deficiency in service against OPs and prayed for seeking direction to OPs for payment for payment of sum assured Rs.5,00,000/- on the life of deceased employee and Rs. 1,00,000/- on the life of his spouse along with interest @ 12% p.a. also other relief, as may be deemed appropriate.
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3. OP-1/Insurance Company in its reply, while denying other averments of the complaint, averred that the complainant had not filed insurance claim with it and intimation about death of late Ratan Saay had also not been given within 15 days. No cause of action had arisen against OP-1/Insurance Company. OP-1/Insurance Company further averred that no intimation about the deceased was received from OP-2/employer also. OP-1 in its additional pleading averred that the Group Janta Personal Accident Insurance Policy was purchased by OP-2/SECL for its employees in terms of MOU between it and OP-2/SECL for period 16.10.1999 to 15.10.2009 and that the complainant was not eligible for claim there under, so prayed for dismissing the complaint.
4. OP-2/ Employer SCCL in its reply averred that it had taken out the Group Janta Personal Accident Insurance Policy for the benefit of its employees and premium was collected thereby and was remitted to the OP- 1/Insurance Company and OP-2 had neither acted as agent of the insurance company nor did collect any amount for such service. OP-2 averred that the complaint was barred by limitation so prayed for dismissing the complaint.
5. Learned District Forum after having perused the documents produced before it and heard arguments of parties dismissed the complaint on the ground that it was barred by limitation, hence having been aggrieved thereby the complainant filed this appeal.
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6. We have perused the documents on record and heard arguments advanced by the parties.
7. During proceedings at appellate stage, counsel for respondent- 2/Employer SECL has filed an application dated 21.05.2013 under Order 41 Rule 27 of CPC along with two documents which being relevant to decide the appeal, are taken on record.
8. Defence of the appellant/complainant is that subsequent to the death of his parents on 02.03.2002, after having performed the last rites he procured relevant documents and filed insurance claim with the respondents on 06.04.2002. Thereafter he had been pursuing the matter with the concerned offices of respondents and because of that action only he was provided claim form which was duly filled up, signed on 06.04.2002 and was filed with OPs but the claim was not settled and no intimation about it was given. Ultimately a notice through an advocate notice dated 06.08.2009 was sent to respondent-1/Insurance Company followed by reminder dated 09.09.2009. Appellant/Complainant contended that the cause of action against the respondents had been continuous and learned District Forum erred in its impugned order by dismissing his complaint, being barred by limitation.
9. We observe that as per documents on record both father & mother of the appellants died of accidental death on 02.03.2002 due to lightening during rains (documents P-2 to P-9 at page s.no.35 to 46).
//5 // Appellants/complainants had sent a letter dated 06.04.2002 to OP-2/employer intimating about the death of his parents along with relevant documents towards claim under Group Janta Personal Accident Insurance policy which was duly received by it with seal & initials of its official (document no.A-10 at page s.no.10). Copy of claim form dated 06.04.2002 which was a printed form of the insurance company, (document no. A-11 at page s.no.48) reveals the fact that claim form was issued to him by the respondent-1/Insurance company earlier to 06.04.2004. In view of the aforesaid documents, it is obvious that both the respondents had been given due intimation about the insurance claim. Aforesaid fact is further corroborated by the documents filed at appellate stage by respondent-2 whereby respondent-1 had sent a letter dated 19.02.2002 to OP-2/employer wherein it was clearly mentioned that OP-1 received intimation on 18.02.2002 about the death claim of the two deceased persons and he was asked to provide some relevant information & documents to process the claim further. As per another document filed at appellate stage, Respondent-2 had sent a letter dated 23/24.08.2002 to the complainant referring therein its earlier letter dated 31.07.2002 asking him thereby to comply some requisite information/ documents. From the foregoing it is well established that both the respondents were duly intimated about the insurance claim and since OP-1 / Insurance Company did not settle claim either by repudiation or payment then cause of action against it had been continuing. Learned counsel for the appellant relied upon case of Laxmi Bai & Ors Vs. ICICI Lombard General Insurance Co. Ltd. & Ors, III (2002) //6 // CPJ 507 (NC) whereby in para no.9 and onward Hon'ble National Commission in their order while referring about the very important pronouncement of Hon'ble Apex court, regarding cause of action and limitation with regard to section 24-A of Consumer Protection Act, held that cause of action remains continuous against the insurance company when it had already intimation about the claim but it kept it undecided. The same underlying principle is squarely applicable in the instant case also.
10. In the facts of the case and foregoing observation, the complaint of the appellants cannot be held to have been barred by limitation thus the impugned order being not sustainable is set aside. The appeal is allowed and the respondent no.1/ insurer is directed to pay Rs.5,00,000/- (Rs. Five Lacs only) to the appellants / complainants within a period of two months after the date of receipt of this order towards death claim of his father late Ratan Saay and Rs.1,00,000/- (Rs. One Lac only) towards that of his mother, after collecting indemnity bond from the legal heirs. Aforesaid amount shall be payable with interest @ 6% p.a. from the date of complaint. If the amount is not paid within stipulated period, interest @ 9% will be payable from the date of default. The insurer shall also be liable to pay Rs.3,000/- towards cost of proceedings throughout.
(Smt.Veena Misra) (V.K.Patil) (Ms. Heena Thakkar)
Presiding Member Member Member
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