State Consumer Disputes Redressal Commission
Principal Govt. Polytechnic For Women vs Reliance General Insurance Limited And ... on 28 August, 2012
BEFORE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM SOLAN, H
H.P. STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, SHIMLA.
First Appeal No.125/2011
Date
of Decision: 28.08.2012
Principal Govt. Polytechnic for
Women,
Kandaghat, District Solan, H.P.
..
Appellant
Versus
1. Reliance
General Insurance Limited,
Regional
Office, SCO 212-214,
Sector
34-A, Chandigarh,
Through
its Senior Manager.
2. Branch
Manager,
Reliance
General Insurance Co. Ltd.,
Rain Basera
Building, Khalini,
Shimla,
H.P.
3. Shri
Attar Singh son of Shri Ram Singh,
R/o Village Kather,
Near H.P. State
Electricity Board,
Sub
Division, P.O. Chambaghat,
District
Solan, H.P.
Respondents
Coram
Honble Mr. Justice (Retd.) Surjit Singh, President
Honble Mrs. Prem Chauhan, Member
Whether
approved for reporting?[1]
Yes.
For the
Appellant: Mr.
Vinay Verma, A.D.A.
For the
respondents No.1 & 2: Mr. Ratish
Sharma, Advocate
For the
Respondent No.3: Mr.
M.L. Sharma, Advocate
O R D E R:
Justice (Retd.) Surjit Singh, President (Oral) Appellant is aggrieved by the order dated 23.03.2011, of learned District Consumer Disputes Redressal Forum, Shimla, whereby a complaint, under Section 12 of the Consumer Protection Act, 1986, filed by respondent Attar Singh against it (the present appellant) and respondents No.1 and 2, i.e. Reliance General Insurance Limited, Chandigarh, through its Senior Manager and Branch Manager, Reliance General Insurance Company Limited, Khalini, Shimla, repectively, has been allowed and the appellant has been ordered to pay a sum of `2,00,000/- with interest at the rate of 9% per annum from the date of the complaint to the date of payment of the aforesaid amount of money, on account of insurance money and `3,500/-, as litigation expenses.
2. Smt. Kamlesh Kumari wife of respondent Attar Singh, hereinafter referred to as complainant, was employed as sweeper, in the college of appellant. Government of Himachal Pradesh introduced a scheme, in terms of which, all its employees were covered under a group insurance. Arrangement for group insurance had been made by the State Government with Reliance General Insurance Company Limited, respondent No.1 herein and hereinafter referred to as opposite party No.1. Certain amount of money was required to be deducted from the salary of the employees and deposited with the opposite parties No.1 and 2 towards the premium.
3. The scheme was initially started in November, 2006. It was for one year. It was extended by another year by issuance of a fresh circular and after renewal, it was to remain in force from 10.10.2007 to 09.10.2008.
Under this renewed policy/scheme, first instalment of premium was to be deducted from the salary for the month of October, 2007, payable on 01.11.2007. Premium was deducted from the salary of Kamlesh Kumari by the present appellant/opposite party No.3 and remitted to opposite parties No.1 and 2.
However, Kamlesh Kumari died in a bus accident on 01.11.2007 itself. Intimation of her death was given to the appellant/opposite party No.3 being her employer. Claim for insurance money was lodged with the opposite parties No.1 and 2 by the appellant on 13th August, 2008. Opposite parties No.1 and 2 repudiated the claim on the ground that under the scheme and the policy, intimation of death was required to be given to them within one month of the death and in this case, intimation was given about 10 months after the date of death.
4. Complainant being the husband of the deceased and also the nominee in the insurance cover filed a complaint, under Section 12 of the Consumer Protection Act, 1986, seeking issuance of a direction to the opposite parties, including the appellant for payment of insurance money with interest and also for damages and litigation expenses.
5. Complaint was contested by the opposite parties. Appellant in his reply pleaded that money was payable by opposite parties No.1 and 2, as deceased was insured with them. Opposite parties No.1 and 2 denied their liability, on the plea that intimation of death had been given to them about 10 months after Kamlesh Kumari actually died, though under the insurance scheme, intimation was required to be given within one month.
6. Learned District Forum concluded that the present appellant was responsible for delaying the intimation of death of deceased employee to opposite parties No.1 and 2. Learned District Forum further held that respondents No.1 and 2 having not been apprised of the death within one month, were not liable to pay the insurance money.
The present appellant having been held responsible for failure to inform opposite parties No.1 and 2 about the death within the prescribed time, was held guilty of deficiency in service and ordered to pay the insurance money with interest and litigation expenses, as aforesaid.
7. Appellants contention is that money is required to be paid by the opposite parties No.1 and 2, who have been impleaded as respondents No.1 and 2 in this appeal, because they had received the premium and the risk of the death of deceased employee was covered under the scheme.
8. We have heard learned counsel for the parties and gone through the record.
9. It is not denied by respondents No.1 and 2 that deceased was covered under the scheme. Also it is not in dispute that deceased died in a bus accident, a report about which accident was lodged with the police promptly and in the F.I.R. also, name of deceased is there. It is also not disputed that dead body of Kamlesh Kumari was subjected to post-mortem examination during the course of investigation of matter by the police and post-mortem report indicated that cause of death was injuries sustained in the accident. Copies of F.I.R. and post-mortem report are Annexure C-1 and C-2, respectively, on the record of learned District Forum.
10. Intimation of death of Kamlesh Kumari was given to the appellant promptly, because we find on record a letter dated 02.11.2007 written by the appellant to the Government, seeking release of ex-gratia money payable to the dependents of deceased Kamlesh Kumari. Said letter is Annexure R-3B. All the relevant papers, i.e. F.I.R., post-mortem report, legal heirs certificate etc. were available with the appellant, at-least by 17.11.2007 because on that date appellant addressed a letter Annexure C-4 to S.D.M., Kandaghat, with which letter he sent photostat copies of legal heirs certificate and death certificate to the said S.D.M. Appellant, however, did not inform the opposite parties No.1 and 2 about the death of Kamlesh Kumari within one month of her death. Explanation offered by him is that circular regarding scheme had been received by him from the Head of the Department on 29.08.2008 and that on the very next date, opposite parties No.1 and 2 were apprised of the accidental death of Kamlesh Kumari. There is an affidavit of the appellant to this effect.
11. Now, when it is established beyond doubt and is also not disputed by opposite parties No.1 and 2 that deceased Kamlesh Kumari had died on 01.11.2007, in a vehicular accident, merely for the reason that the appellant did not inform opposite parties No.1 and 2 about the death of Kamlesh Kumari within one month, cannot be a ground for repudiation of claim, especially when the scheme or the policy, nowhere provides that in case intimation was not given within one month, the insurer will not be liable to pay the insurance money. Delay in informing the insurer about the date of death, may be a good ground for repudiation of claim in a case where there is serious dispute creating reasonable doubt about the death or the cause of death of the insured person, but not in a case like the present one, where there is no dispute that the insured employee had died and her death was accidental.
12. As a result of the above stated position, we allow the appeal and modify the order of learned District Forum to the extent that instead of directing the appellant alone to pay the insurance money with interest, as ordered by learned District Forum, we direct opposite parties No.1 and 2, i.e. respondents No.1 and 2, herein, as also the appellant to pay insurance money of `2,00,000/- with interest and their liability shall be joint and several.
13. One copy of this order be sent to each of the parties, free of cost, as per Rules.
(Justice Surjit Singh) President (Prem Chauhan) Member August 28, 2012 *dinesh* [1] Whether Reporters of the local papers may be allowed to see the order?