State Consumer Disputes Redressal Commission
Smt.Kunti Bai vs B.M. Bhartiya Jeevan Bima Nigam & Ors. on 12 May, 2016
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i{kdkjksa ds vf/koDrk vihykfFkZuh dh vksj ls Jh jke ujs'k jkW;] vf/koDrkA mRrjoknh dzekad&1 dh vksj ls Jh ,- lh- feJk] vf/koDrkA mRrjoknh dzekad&2 dh vksj ls Jh vks- ih- vxzoky ,oa Jh ds- vkuankuh] vf/koDrkA vkns'k fnukad% 12@05@2016 }kjk%&ekuuh; U;k;ewfrZ Jh vkj- ,l- 'kekZ] v/;{k vihykfFkZuh@ifjokfnuh us ;g vihy /kkjk&15 miHkksDrk laj{k.k vf/kfu;e] 1986] ds varxZr ftyk miHkksDrk fookn izfrrks"k.k Qksje] // 2 // dksfj;k] cSdq.Biqj ¼N-x-½ ¼ftls vkxs laf{kIr esa **ftyk Qksje** lacksf/kr fd;k tk,xk½ ds ifjokn izdj.k dzekad&59@2015 Jherh dqUrh ckbZ fo:) 'kk[kk izca/kd] Hkkjrh; thou chek fuxe ,oa nks vU; esa ikfjr vkns'k fnukad&31-12-2015 ftlds }kjk vihykfFkZuh@ifjokfnuh ds ifjokn dks fujLr fd;k x;k gS] ls nqf[kr gksdj izLrqr fd;k gSA 02- vihykfFkZuh@ifjokfnuh dk ifjokn ftyk Qksje ds le{k laf{kIr esa bl izdkj jgk gS fd vihykfFkZuh@ifjokfnuh ds ifr Lo- /keZiky vk- jkepj.k dVdksuk dkWyjh ds varxZr dk;Zjr~ Fkk ftldh e`R;q dVdksuk dkWyjh esa M~;wVh ds nkSjku dk;Z djrs gq, fnukad&12-09-2010 dks ,l- Mh- ,y- e'khu ds pkyd }kjk ykijokghiwoZd pykrs gq, Lo- /keZiky dks nq?kZVuk dkfjr djus ds dkj.k gks xbZ ftldh lwpuk Fkkuk iVuk esa ntZ djkbZ xbZ Fkh ftldk vijk/k dz-&206@10 ntZ fd;k x;k FkkA vihykfFkZuh@ifjokfnuh ds ifr Lo- /keZiky us vius thoudky esa mRrjoknh dz-1@vukosnd dz-1 ds dk;kZy; ls chek ikWfylh dz; fd;k Fkk ftldk chek ikWfylh dzekad&378723179] 378723426] 378308419 ,oa 378135354 tks dze'k% 55]000@&¼ipiu gtkj :Ik;s½] 50]000@&¼ipkl gtkj :Ik;s½] 40]000@&¼pkyhl gtkj :Ik;s½ ,oa 50]000@&¼ipkl gtkj :Ik;s½ dk Fkk vkSj lHkh ikWfyfl;ka nq?kZVuk fgrykHk chek ikWfylh Fkh ftudh dVkSrh mRrjoknh dz-3@vukosnd dz-3 ds dk;kZy; }kjk gj ekg ,d lkFk mRrjoknh dz-1@vukosnd dz-1 ds dk;kZy; esa Hksth tkrh FkhA Lo- /keZiky us mDr lHkh chek ikWfyfl;ksa esa vihykfFkZuh@ifjokfnuh dks ukfeuh fu;qDr fd;k FkkA vihykfFkZuh@ifjokfnuh us vius ifr Lo- /keZiky dh e`R;q Ik'pkr~ lk/kkj.k ,oa nq?kZVuk fgrykHk jkf'k izkIr djus gsr q mRrjoknh dz-1@vukosnd dz-1 ds dk;kZy; esa vkosnu fn;k ftlds mijkar mRrjoknh dz-1@vukosnd dz-1 dk;kZy; }kjk dqN izi= iznku fd, x, ftls vihykfFkZuh@ifjokfnuh }kjk laiw.kZ :Ik ls iwjk dj ,oa // 3 // e`R;q izek.k&i=] izFke lwpuk&i=] uD'kk iapk;rukek] iksLV ekVZe fjiksVZ is'k dh Fkh ftldh ikorh mRrjoknh dz-1@vukosnd dz-1 }kjk iznku ugha fd;k x;kA mRrjoknh dz-1@vukosnd dz-1 }kjk lk/kkj.k chek/ku dk Hkqxrku o"kZ 2012 esa dj fn;k x;k ijUrq nq?kZVuk fgrykHk jkf'k vkt fnukad rd Hkqxrku ugha fd;k tk jgk gS vkSj nq?kZVuk fgrykHk dh jkf'k ds Hkqxrku esa vuko';d foyac dj lsok esa deh fd;k tk jgk gSA izFke lwpuk&i=] uD'kk iapk;rukek] iksLVekVZe fjiksVZ ,oa vafre tkap fjiksVZ ls lkQ izrhr gksrk gS fd e`rd /keZiky dh nq?kZVuk o'k e`R;q gqbZ gS ijUrq chek daiuh }kjk fnukad&25-09-2014 ,oa 17-11-2014 ds i= ds vuqlkj nq?kZVuk fgrykHk dh jkf'k dk bl vk/kkj ij Hkqxrku ugha fd;k tk jgk gS fd iqfyl vafre tkap fjiksVZ vkus ij gh fopkj fd;k tkosxkA ,slk dj chek daiuh }kjk vihykfFkZuh@ifjokfnuh dks feyus okyh jkf'k ds Hkqxrku esa vuko';d foyac fd;k tk jgk gSA chek daiuh ds i= fnukad&25-09- 2014 esa ikWfylh dzekad&378135354 dks dkykrhr ikWfylh ,oa ikWfylh dzekad&378308419 eas vafdr isa'ku vfrfjDr izhfe;e Hkqxrku u gksus ds dkj.k ns; ugha gksuk dgdj mDr nksuksa ikWfyfl;ksa dks vLohd`r dj fn;k gSA e`rd /keZiky }kjk vius thoudky esa yh xbZ leLr ikWfyfl;ka] ,l- bZ- lh- ,y- ds ek/;e ls dVkSrh dj ,d lkFk mRrjoknh dz-1@vukosnd dz-1 dk;kZy; essa Hksth tkrh Fkh tks lsyjh lsfoax Ldhe ds rgr Fkh rFkk ikWfylh dzekad&378135354 dh ekfld izhfe;e jkf'k&217@&¼nks lkS l=g :Ik;s½ e`rd /keZiky ds e`R;q ds iwoZ Hkh ,l- bZ- lh- ,y- }kjk dVkSrh dj mRrjoknh dz-1@vukosnd dz-1 ds dk;kZy; esa Hksth xbZ Fkh vkSj mRrjoknh dz-1@vukosnd dz-1 ds dk;kZy; }kjk mDr izhfe;e dh jkf'k dks Lohdkj Hkh fd;k x;k Fkk ,oa ikWfylh dzekad&378308419 tks fd nq?kZVuk fgrykHk jfgr ikWfylh Fkh] bu nksuksa ikWfyfl;ksa dks vLohdkj dj chek daiuh }kjk lsok esa deh dh xbZ gSA vihykfFkZuh@ifjokfnuh }kjk ijs'kku gksdj yxHkx ikap o"kksZa ckn vius vf/koDrk ds ek/;e ls iathd`r // 4 // oS/kkfud lwpuk fnukad&03-09-2015 dks Hksth xbZ fdUrq chek daiuh }kjk mDr lwpuk&i= dk tokc vkt fnukad rd ugha fn;k x;k vkSj u gh nq?kZVuk fgrykHk jkf'k e; C;kt Hkqxrku fd;k x;k gS ftlds dkj.k vihykfFkZuh@ifjokfnuh dks ;g ifjokn ykus dh vko';drk iM+h gSA vr% ifjokn&i= esa of.kZr vuqlkj vuqrks"k fnykbZ tkosA 03- mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 dh vksj ls ftyk Qksje ds le{k fyf[kr dFku izLrqr dj ;g vfHkopu fd;k x;k gS fd Lo- /keZiky us vius thou dky esa mDr of.kZr chek ikWfyfl;ka dz; dh FkhA bu lHkh ikWfyfl;ksa esa nq?kZVuk fgrykHk dh lqj{kk chek /kkjd dh ukSdjh ds nkSjku gqbZ nq?kZVuk dks NksM+dj vU; nq?kZVuk ls e`R;q gksus ij gh feyrh gSA mDr chek ikWfyfl;ksa ds fy, vihykfFkZuh@ifjokfnuh }kjk e`R;q nkok izLrqr dj lacaf/kr nkok QkeZ mRrjoknh dz-1@vukosnd dz-1 }kjk izkIr fd, x, FksA mRrjoknh dz-1@vukosnd dz-1 }kjk mDr chek ikWfyfl;ksa ds fy, lk/kkj.k e`R;q nkok jkf'k dk Hkqxrku dj fn;k gSA chek /kkjd dks;yk [knku esa ukSdjh djrk Fkk tks ,d tksf[ke ;qDr is'kk ¼Hazardous Occupation½ gS] vr% bu leLr ikWfyfl;ksa esa ikWfylh 'krZ ds vuqlkj dks;yk [knku tSls tksf[ke ;qDr is'kk ¼Hazardous Occupation½ esa d;Zjr~ O;fDr ds fy, muds O;olk;@ukSdjh ds nkSjku gqbZ nq?kZVuk ls tksf[ke lqj{kk iznku ugha dh tkrh gSA ,Q- vkbZ- vkj- ds vuqlkj chek /kkjd dh e`R;q [knku ds vanj M~;wVh ds nkSjku ,l- Mh- ,y- e'khu ls nq?kZVuk gksus ds dkj.k gqbZ gS] vr% bu lHkh ikWfyfl;ksa esa ukSdjh ds nkSjku dks;yk [knku esa gqbZ nq?kZVuk ds fy, nq?kZVuk fgrykHk nkok ns; ugha gSA chek daiuh }kjk lsok esa dksbZ deh ugha dh xbZ gSA vihykfFkZuh@ifjokfnuh fdlh Hkh izdkj dh nq?kZVuk nkok jkf'k ,oa vU; {kfriwfrZ jkf'k izkIr djus dh vf/kdkfj.kh ugha gSA ikWfylh 'krksZa ds vuqlkj ftu ikWfyfl;ksa esa Occupation Extra Premium fy;k tkrk gS mu ikWfyfl;ksa // 5 // esa tksf[ke;qDr is'kk ¼Hazardous Occupation½ esa dk;Zjr~ O;fDr ds fy, muds O;olk;@ukSdjh ds nkSjku gqbZ e`R;q ds fy, ek= ewy chek /ku dh lqj{kk iznku dh tkrh gS rFkk nq?kZVuk fgrykHk dh lqj{kk iznku ugha dh tkrh gSA blds vfrfjDr bl izdkj ds chek/kkjd dh e`R;q ;fn O;olk;@ukSdjh dh vof/k dks NksM+dj vU;= fdlh vU; [email protected] ls gqbZ gks rks mls leLr vfrfjDr izhfe;eksa ds pqdrk gksus ij tksf[ke ls lqj{kk iznku dh tkrh gSA bl izdkj Li"V gS fd Lo- /kjeiky dh e`R;q tksf[ke ;qDr is'kk ¼Hazardous Occupation½ easa dk;Zjr~ jgus ds nkSjku nq?kZVuk ls gqbZ gS] vr% ikWfylh 'krksZa ds vuqlkj nq?kZVuk fgrykHk nkok ns; ugha gSA vr% vihykfFkZuh@ifjokfnuh dk ifjokn lO;; fujLr fd;k tkosA 04- mRrjoknh dz-3@vukosnd dz-3 dh vksj ls ftyk Qksje ds le{k fyf[kr dFku izLrqr dj ;g vfHkopu fd;k x;k gS fd Lo- /keZiky vk- jkepj.k dVdksuk dkWyjh esa dk;Zjr~ Fkk vkSj mlds }kjk dz; dh xbZ chek ikWfylh dz-&378723179] 378723426] 378308419 ,oa 378135354 ds fy, dkexkj ds dk;Z ij mifLFkr jgus ij vkSj mldk osru cuus ij izhfe;e dh jkf'k dh dVkSrh dh tkdj mldk Hkqxrku lesfdr psd ds ek/;e ls mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 ds dk;kZy; dks fd;k x;k gSA bl izdkj mRrjoknh dz-3@vukosnd dz-3 us fu;ksDrk ds mRrjnkf;Roksa dk lE;d :Ik ls fuoZgu fd;k gSA dfFkr ikWfyfl;ksa dks ysdj chek/ku ,oa nq?kZVuk fgrykHk ds fy, mRrjoknh dz-3@vukosnd dz-3 dk dksbZ nkf;Ro ugha gSA dkexkj dk osru cuus ij le;kuqlkj izhfe;e jkf'k dh dVkSrh dj mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 ds dk;kZy; dks Hkstus dk gh mRrjnkf;Ro mRrjoknh dz-3@vukosnd dz-3 dk gS vkSj mRrjoknh dz-3@vukosnd dz-3 us fcuk fdlh deh'ku ds fu;ksDrk dh gSfl;r ls vius nkf;Roksa dk fuoZgu fd;k gSA mRrjoknh dz-3@vukosnd // 6 // dz-3 dks vuqfpr :Ik ls i{kdkj cuk;k x;k gSA mRrjoknh dz-3@vukosnd dz-3 }kjk dksbZ O;kolkf;d dnkpj.k vFkok lsok esa deh ugha dh xbZ gSA mRrjoknh dz-3@vukosnd dz-3 ds fo:} dksbZ okn dkj.k mRiUu ugha gqvk gS vkSj vihykfFkZuh@ifjokfnuh] mRrjoknh dz-3@vukosnd dz-3 ls dksbZ vuqrks"k izkIr djus dh vf/kdkfj.kh ugha gSA mRrjoknh dz- 3@vukosnd dz-3 fu;ksDrk gS vkSj og vius dkexkjksa ds osru ls chek izhfe;e jkf'k dh dVkSrh djus dh lqfo/kk fu%'kqYd :Ik ls miyC/k djkrk gS vkSj bls ysdj mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 ls vFkok dkexkj ls dksbZ deh'ku ugha ysrk gS blfy, izLrqr ifjokn mRrjoknh dz-3@vukosnd dz-3 ds fo:} izpyu ;ksX; ugha gSA dkexkj /keZiky vk- jkepju dk fu/ku fnukad&12-09-2010 dks gksuk crk;k x;k gS vkSj ;g ifjokn 05 o"kksZa Ik'pkr~ nkf[ky fd;k x;k gS vkSj foyac ds laca/k esa leqfpr Li"Vhdj.k ugha n'kkZ;k x;k gS blfy, ifjokn le; ckf/kr gksus ls fopkj ;ksX; ugha gSA vr% vihykfFkZuh@ifjokfnuh dk ifjokn lO;; fujLr fd;k tkosA 05- vihykfFkZuh@ifjokfnuh dh vksj ls vius i{k leFkZu esa ftyk Qksje ds le{k izFke lwpuk izfrosnu (Annexure A-1)] uD'kk iapk;rukek (Annexure A-2)] 'ko ijh{k.k ds fy, vkosnu fnukad&12-09-2010 ,oa 'ko ijh{kk izfrosnu (Annexure A-3)] lwpuk ds vf/kdkj ds rgr izLrqr vkosnu fnukad&24-06-2014 (Annexure A-4) dh QksVks dkih rFkk LVsVl fjiksVZ (Annexure A-5)] osru iphZ ekg uoacj 2009] ekpZ 2010 ,oa vizSy 2010 (Annexure A-6)] chek daiuh }kjk vihykfFkZuh@ifjofnuh dks izsf"kr i= fnukad&25-09-2014 ,oa 19-11-2014 (Annexure A-7 & 8) dk vly ,oa eq/kj dksfj;j dh jlhn fnukad&03-09-2015 ,oa vf/koDrk uksfVl fnukad&03-09-2015 (Annexure A-9) dh f}rh; izfr izLrqr fd;k gSA // 7 // 06- mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 dh vksj ls vius i{k leFkZu esa ftyk Qksje ds le{k fof/kd uksfVl dk tokc fnukad&20-10- 2015 (Annexure D-1) dh QksVks dkih] nq?kZVuk fgrykHk dk ifji= fnukad&17-12-2003 (Annexure D-2) dh izekf.kr izfr] izFke lwpuk&i= ,oa iksLV ekVZe fjiksVZ (Annexure D-3) dh QksVks dkih rFkk lwpuk ds vf/kdkj ds rgr nh xbZ tkudkjh fnukad&24-06-2014 dh QksVks dkih izLrqr fad;k gSA 07- ftyk Qksje us mHk;i{k }kjk izLrqr vfHkopu ,oa nLrkosth lk{; ds ifj'khyu Ik'pkr~ vkns'k ikfjr djrs gq, vihykfFkZuh@ifjokfnuh ds ifjokn dks fujLr fd;k gS] ftlds fo:) ;g vihy gSA 08- vihykfFkZuh@ifjokfnuh dh vksj ls milatkr gksus okys fo)ku vf/koDrk Jh jkeujs'k jkW; dk ;g rdZ gS fd vihykfFkZuh@ifjokfnuh ds ifr /keZiky us vius thoudky esa mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 ls ifjokn&i= esa of.kZr vuqlkj ikWfylh fy;k Fkk vkSj lHkh ikWfyfl;ka nq?kZVuk fgrykHk gsrq vkPNkfnr Fkh vkSj izfrekg izhfe;e dh jkf'k dVkSrh dj mRrjoknh dz-3@vukosnd dz-3 ds dk;kZy; }kjk mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 dks fn;k tkrk FkkA fnukad&12-09-2010 dks ,l- Mh- ,y- e'khu ds pkyu ds nkSjku Lo- /keZiky dh nq?kZVuk dkfjr gqbZ ftlds dkj.k ls mldh e`R;q gqbZ Fkh] ftldh lwpuk Hkh iqfyl Fkkuk iVuk esa ntZ djk;k x;k Fkk tgka vijk/k dzekad&206@10 varxZr /kkjk&304&, iathc} fd;k x;k Fkk vkSj pwafd e`rd /keZiky dh e`R;q nq?kZVukRed izd`fr dh Fkh blfy, vihykfFkZuh@ifjokfnuh nq?kZVuk fgrykHk dh jkf'k izkIr djus dh vf/kdkfj.kh gSA vihykfFkZuh@ifjokfnuh }kjk nq?kZVuk fgrykHk dh jkf'k // 8 // iznku fd;s tkus gsrq nkok izLrqr fd;k Fkk ijUrq dsoy fnukad&09-02- 2012 dks lk/kkj.k chek/ku dh jkf'k dk Hkqxrku fd;k x;k ysfdu nq?kZVuk fgrykHk dh jkf'k dk Hkqxrku ugha fd;k x;k vkSj fnukad&25-09-2014 dks vafre tkap izfrosnu dh ekax dh xbZ ftls izLrqr fd;k x;k Fkk] mlds ckn Hkh nkos dk fujkdj.k ugha fd;k x;k] ijUrq ftyk Qkssje us ;g ekurs gq, fd vihykfFkZuh@ifjokfnuh dk ifjokn ifjlhek vof/k ls ckf/kr gS] vihykfFkZuh@ifjokfnuh dk ifjokn fujLr fd;k x;k gSA ftyk Qksje dk mDr vkns'k =qfViw.kZ gSA pwafd i= fnukad&25-09-2014 ds }kjk iqfyl izfrosnu dh ekax dh xbZ Fkh blfy, okndkj.k mDr fnukad dks mRiUu gksxkA blfy, vihykfFkZuh@ifjokfnuh dk ifjokn ifjlhek vof/k ds Hkhrj gS vkSj ftyk Qksje dk vkns'k fujLr fd;s tkus ;ksX; gSA vr% vihykfFkZuh@ifjokfnuh dh vihy Lohdkj fd;k tkos vkSj ftyk Qksje ds vkns'k dks vikLr fd;k tkos vkSj vihykfFkZuh@ifjokfnuh dks ifjokn&i= esa of.kZr vuqlkj vuqrks"k iznku fd;k tkosA 09- mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 dh vksj ls milatkr gksus okys fo}ku vf/koDrk Jh ,- lh- feJk dk ;g rdZ gS fd ftyk Qksje dk vkns'k iw.kZr% mfpr gSA vihykfFkZuh@ifjokfnuh ds ifr dh e`R;q fnukad&12-09-2010 dks gqbZ FkhA vihykfFkZuh@ifjokfnuh ds ifr dh e`R;q ftl ifjfLFkfr esa gqbZ gS og ikWfylh ds vUnj vkPNkfnr ugha gS rFkk e`rd ladVkiu dk;Z esa fu;ksftr Fkk blfy, viotZu DykWl 85 ,oa 86 ds varxZr vkrk gS] blfy, vihykfFkZuh@ifjokfnuh {kfriwfrZ ikus dh vf/kdkfj.kh ugha gS vkSj ftyk Qksje dk vkns'k iw.kZr% mfpr gSA vr% vihykfFkZuh@ifjokfnuh dh vihy fujLr fd;k tkosA 10- mRrjoknh dz-3@vukosnd dz-3 dh vksj ls milatkr gksus okys fo}ku vf/koDrk Jh vks- ih- vxzoky ,oa Jh ds- vkuankuh us ftyk Qksje // 9 // }kjk ikfjr vkyksP; vkns'k dk leFkZu djrs gq, vihykfFkZuh@ifjokfnuh dh vihy dks fujLr fd;s tkus dk fuosnu fd;k gSA 11- 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;kA 12- ftyk Qksje us vius vkyksP; vkns'k dh dafMdk&14 esa ;g fu/kkZfjr fd;k gS fd **vihykfFkZuh@ifjokfnuh }kjk izLrqr LVsVl fjiksVZ esa ikWfylh dzekad&378135354 ds vuqlkj fnlacj 2000 ls flracj 2002rd 20 izhfe;e xSi gSA pwafd izhfe;e xSi gksus ls tks jkf'k bl ikWfylh ds en esa vnk dh xbZ gS og okilh ;ksX; ugha gSA ;fn ikWfylh ds xSi izhfe;e dks Hkjus ds ckn Hkh rhu o"kZ rd ugha pyh gks rks pqdrk jkf'k Hkh okilh ;ksX; ugha jgrh gS] blfy, izhfe;e xSi gksus ds ckn Hkh ;fn vkxs dh izhfe;e jkf'k nh tkrh gS rks mls fy;k tkrk jgrk gS] ftls vkxs fu;fer ugha fd;k x;k gS vkSj mlds Ik'pkr~ yxkrkj izhfe;e vnk djus ds dkj.k dkykrhr ikWfylh gksus ls dsoy pqdrk jkf'k tks tek dh xbZ gS mls gh okil fd;s tkus dk izko/kku gSA blfy, mDr ikWfylh ds en esa 28]897@&¼vV~BkbZl gtkj vkB lkS larkucs :Ik;s½ vnk fd;k x;k gS tks flracj 2020 rd 50]000@&¼ipkl gtkj :Ik;s½ ds fy, ikWfylh FkhA 'ks"k 03 ikWfyfl;ksa dk chek/ku dk Hkqxrku dj fn;k x;k gS vkSj blfy, 03 ikWfyfl;ksa dks Hkh fof/k vuqlkj nkos ds fujkdj.k dh fLFkfr esa lsok esa deh fd;k tkuk ugha dgk tk ldrk vkSj dkykrhr ikWfylh ls lacaf/kr nq?kZVuk fgrykHk dk nkok mfpr ugha gS vkSj mls fujLr fd;k tkuk lsok esa deh fd;k tkuk ugha dgk tk ldrkA** 13- ftyk Qksje us vius vkyksP; vkns'k dh dafMdk&15 esa ;g fu/kkZfjr fd;k gS fd **nq?kZVuk fgrykHk lfgr e`R;q nkok ds izdj.k dk // 10 // fujkdj.k ds Ik'pkr~ jkf'k dk Hkqxrku fnukad&09-02-2012 ls rhu ikWfyfl;ksa ds fy;s rFkk ,d ikWfylh dzekad&378135354 ds fy, fnukad&15-02-2012 ls okn dkj.k izkjaHk ekuk tk;sxk** vkSj blfy, vihykfFkZuh@ifjokfnuh dk ifjokn ifjlhek vof/k ls ckf/kr gSA 14- bl izdj.k esa vihykfFkZuh@ifjokfnuh us ;g Lohdkj fd;k gS fd mls fnukad&09-02-2012 vkSj fnukad&15-02-2012 dks jkf'k dk Hkqxrku gqvk gS ijUrq vihykfFkZuh@ifjokfnuh }kjk okn dkj.k fnukad&25-09- 2014 dks mRiUu gksuk crk;k x;k gSA vihykfFkZuh@ifjokfnuh dk mDr rdZ Lohdkj ;ksX; ugha gSA 15- Royal Sundaram Alliance General Insurance Company Limited vs. Rapeti Aruna, 2015 (4) CLT 86, esa ekuuh; jk"Vªh; vk;ksx }kjk ;g fu/kkZfjr fd;k x;k gS fd%& "6. In a recent authority titled as Dolphin Offshore Enterprises (India) Ltd. vs. United India Insurance Co. Ltd., SLP No.9307 of 2013, decided on 8.3.2013, the Supreme Court has held :
"We have heard learned counsel for the petitioner and perused the record. In our opinion, the reasons assigned by the State Commission and the National Commission for holding that the complaint was barred by time are correct. It is not in dispute that the claim made by the petitioner was repudiated by the respondent vide communication dated 30.10.2002 and the complaint was filed on 25.5.2008 i.e. after three years and five months of repudiation of the claim. Therefore, there is no escape from the conclusion that the complaint was barred by time. This view finds support from the judgment of this Commission in HUDA vs. B.K. Sood (2006) 1 SCC 164, SBI vs. B.S. Agricultural Industries (I) 2009 5 SCC 121, // 11 // Kandimala Raghavaiah vs. National Insurance Company (2009) 7 SCC 768 and V.N. Shrikhande (Dr.) Vs. Anita Sena Fernandes (2011) 1 SCC 53."
16. Kandimalla Raghavaiah And Co. Vs. National Insurance Co. & Anr., (2009) 7 Supreme Court Cases 768, 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 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 //
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."
17. H.P.State Forest Co. Ltd. Vs. M/s. United India Insurance Co. Ltd, 2009 AIR SCW 865, esa ekuuh; loksZP; U;k;ky; }kjk ;g fu/kkZfjr fd;k x;k gS fd%& // 13 // "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."
18. 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%& "17. State Commission in its order has observed:
// 14 //
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 // 15 // 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."
19- bl izdj.k esa mRrjoknh dz-3@vukosnd dz-3 us Li"V :Ik ls vfHkopu fd;k gS fd dkexkj /keZiky dh e`R;q fnukad&12-09-2010 dks gqvk gS vkSj ;g ifjokn 05 o"kksZa Ik'pkr~ nkf[ky fd;k x;k gS rFkk mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 us ;g crk;k gS fd vihykfFkZuh@ifjokfnuh dks lk/kkj.k chek/ku jkf'k dk Hkqxrku dj fn;k x;k gS vkSj vihykfFkZuh@ifjokfnuh ds vuqlkj mDr jkf'k dk Hkqxrku o"kZ 2012 esa dj fn;k x;k gS blfy, okn dkj.k Qjojh 2012 ftl fnu jkf'k dk Hkqxrku fd;k x;k gS vkSj vihykfFkZuh@ifjokfnuh ds vuqlkj 'ks"k jkf'k cdk;k gksuk crk;k x;k gS] ml fnu ls okndkj.k mRiUu gksrk gSA vihykfFkZuh@ifjokfnuh us ;g ifjokn 07-10-2015 dks lafLFkr fd;k gS tks fd nks o"kZ Ik'pkr~ gSA ,slh fLFkfr esa ftyk Qksje us tks ;g fu/kkZfjr fd;k gS fd vihykfFkZuh@ifjokfnuh dk ifjokn ifjlhek vof/k ls ckf/kr gS og iw.kZr% mfpr gSA 20- tgka rd fd e`R;q ;k nq?kZVuk fgrykHk dk laca/k gS] mRrjoknh dz- 1 ,oa 2@vukosnd dz-1 ,oa 2 dh vksj ls ;g crk;k x;k gS fd e`rd /keZiky dks;yk [knku esa ukSdjh djrk Fkk tks fd Hazardous Occupation Fkk vkSj Hazardous Occupation esa dk;Zjr~ O;fDr ds fy, muds O;olk;@ukSdjh ds nkSjku gqbZ nq?kZVuk ls tksf[ke dh lqj{kk iznku ugha dh tkrh gSA izFke lwpuk&i= ds vuqlkj e`rd dh e`R;q [knku ds vUnj // 16 // M~;wVh djrs le; gqvk gS blfy, nq?kZVuk fgrykHk dk nkok ns; ugha gSA vihykfFkZuh@ifjokfnuh dh vksj ls izFke lwpuk&i= izLrqr fd;k x;k gS] mlesa ;g mYysf[kr gS fd **e`rd /keZiky M~;wVh ij x;k Fkk] ,l- Mh- ,y- e'khu pkyd ds }kjk tl elhg ds }kjk ,l- Mh- ,y- e'khu dks rst o ykijokgh ls pyk dj ,DlhMsaV dj fn;k ftlls /kjeiky dh e`R;q gqvk gS** vkSj vkxs ;g Hkh mYysf[kr gS fd **/kjeiky dk lcc [knku esa dke ds nkSjku nq?kZVuk ds pksV ds dkj.k e`R;q gksuk crk;k x;k gSA** vihykfFkZuh@ifjokfnuh dh vksj ls uD'kk iapk;rukek izLrqr fd;k x;k gS rFkk uD'kk iapk;rukek esa Hkh mYysf[kr gS fd **e`rd dVdksuk dkWyjh esa [knku ds vanj M~;wVh dj jgk Fkk] M~;wVh ds nkSjku ,l- Mh- ,y- e'khu esa e`rd ds nc tkus ds dkj.k mlds nksuksa da/kk] lhuk] isV] nksuksa iSj] tka?k esa pksV yxk gS] isV dk vrM+h ckgj vk x;k gS mlh ls mldh ekSr gqbZ gSA** 21- mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 dh vksj ls ykbZQ ba';ksjsal dkiksZjs'ku vkWQ bafM;k dk ifji= izLrqr fd;k x;k gS vkSj bl ifji= ds lkFk vuqlwph Hkh fn;k x;k gS ftlds vuqlkj%& Clause FORM SHORT WHEN EFFECT ON CLAIM No NO DESCRIPTION APPLICABLE SETTLEMENTS Clause 3188 Exclusion clause Applicable to Double Accident 85 for Accident proposals where Benefit including benefit to persons the same is Extended permanent engaged in accepted with Disability benefit and hazardous occupational Disability benefit occupation extra. If no shall not be payable if occupational the death or disability extra is charged, of the life assured then this clause is shall take place as a not applicable result of accident while the life assured is engaged in the hazardous occupation // 17 // Clause Text Exclusion clause Applicable to If the death of the life 86 for basic death those proposals assured shall occur as cover to persons where clause 85 a result of or from engaged in is applied and life any cause arising out Hazardous assured do not of the life assured occupation but want to pay extra engaging in the who do not want premium on hazardous to pay occupation account of occupation, then extra hazardous basic sum assured is occupation. not payable, but the amount payable under the policy shall be limited to either.
1) a sum equal to the
total amount of
premiums (exclusive
of extra premiums)
paid under the policy,
without interest, less
any sums paid by the
corporation in respect
of bonuses in cash,
portions of sum
assured, or
2) the surrender value
of the policy,
whichever shall be
the greater but shall
not exceed in any
case the amount
which would
otherwise have been
payable at death.
DAB claim is also
not payable.
bl izdkj ;g Li"V gS fd e`rd /keZiky dh e`R;q Hazardous Occupation ds nkSjku dk;Z djrs le; gqvk gS vkSj pwafd etnwj dk dk;Z ds nkSjku gq, nq?kZVuk ds QyLo:Ik [knku ds vanj e`R;q gksus ij tc rd vfrfjDr jkf'k fu;ekuqlkj vnk ugha fd;k tkrk gS rc rd ?kkrd ifjladVe; LFkku ij dke djus okys O;fDr ds fy, nq?kZVuk fgrykHk dh ik=rk ugha jgrh gSA chek daiuh dh vksj ls tkjh ldqZyj // 18 // fnukad&17-12-2013 nLrkost dz-&Mh&2 ds vuqlkj dkWye uacj&85 ,oa 86 ds vuqlkj [knku etnwj (Hazardous Occupation) ds fy;s vfrfjDr izhfe;e fn;s tkus ij gh nq?kZVuk fgrykHk iznku fd;s tkus dk izko/kku fd;k x;k gSA tcfd e`rd /keZiky ds }kjk ,slh dksbZ vfrfjDr izhfe;e vnk ugha dh xbZ gS] blfy, /keZiky nq?kZVuk fgrykHk laca/kh ikWfylh ls vkPNkfnr ugha Fkk vkSj blfy, vihykfFkZuh@ifjokfnuh nq?kZVuk fgrykHk izkIr djus dh vf/kdkfj.kh ugha gS vkSj ,slh fLFkfr esa mRrjoknh dz-1 ,oa 2@vukosnd dz-1 ,oa 2 us vihykfFkZuh@ifjokfnuh ds nq?kZVuk fgrykHk ds nkos dks vLohdkj dj fdlh izdkj ls lsok esa deh ugha fd;k gSA 22- mijksDr foospuk ds ifjizs{; esa ftyk Qksje }kjk ikfjr vkyksP; vkns'k iw.kZr% mfpr gS vkSj mlesa fdlh izdkj dh vfu;ferrk ,oa voS/kkfudrk ugha gSA 23- vr% vihykfFkZuh@ifjokfnuh dh vksj ls izLrqr vihy lkjghu gksus ls fujLr fd;k tkrk gSA ftyk Qksje }kjk ikfjr vkyksP; vkns'k fnukad&31-12-2015 dh iqf"V dh tkrh gSA bl vihy dk O;; i{kdkj viuk&viuk ogu djsaxsA ¼U;k;ewfrZ vkj-,l-'kekZ½ ¼lqJh fguk BDdj½ ¼Mh- ds- iksn~nkj½ ¼ujsanz xqIrk½ v/;{k lnL; lnL; lnL;
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