State Consumer Disputes Redressal Commission
The Oriental Insurance Co.Ltd. Through ... vs Shiv Kumari & Ors. on 20 April, 2016
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miHkksDrk fookn Áfrrks"k.k vk;ksx] iaMjh] jk;iqj vihy Øekad% FA/2014/568 lafLFkr fnukad: 19.09.2014 nh vksfj;saVy ba';ksjsal daiuh fyfeVsM] }kjk e.My izca/kd] e.My dk;kZy;] fcykliqj jkek VªsM lsaVj] jktho Iyktk ds lkeus] cl LVS.M jksM fcykliqj ¼N-x-½ -----------------vihykFkhZ@vukosnd dz-1- fo:) 1- f'kodqekjh ifRu Lo- ;ksxs'oj ÅQZ tksxs'oj] mez yxHkx&40 o"kZ] is'kk x`g.kh] fuoklh xzke&cjkSa/kh] Fkkuk&HkVxkao] rglhy&HkS;kFkku] ftyk&lwjtiqj ¼N-x-½ ---------mRrjokfnuh dz-1@ifjokfnuh-
2- lc ,fj;k eSustj]
,l- bZ- lh- ,y- HkVxkao dkWyjh]
Fkkuk&HkVxkao]
rglhy o ftyk&lwjtiqj ¼N-x-½--mRrjoknh dz-2@vukosnd dz-2-
3- eq[; egkizca/kd]
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rglhy o ftyk&lwjtiqj ¼N-x-½--mRrjoknh dz-3@vukosnd dz-3- le{k% ekuuh; U;k;ewfrZ Jh vkj- ,l-'kekZ] v/;{k-
ekuuh; Jh Mh- ds- iksn~nkj] lnL;-
i{kdkjksa ds vf/koDrk vihykFkhZ dh vksj ls Jh f'kf'kj HkaMkjdj] vf/koDrkA mRrjokfnuh dzekad&1 vuqifLFkrA mRrjoknh dz-2 ,oa 3 dh vksj ls Jh vks- ih- vxzoky ,oa Jh ds- vkuankuh] vf/koDrkA vkns'k fnukad% 20@04@2016 }kjk%&ekuuh; U;k;ewfrZ Jh vkj- ,l- 'kekZ] v/;{k vihykFkhZ@vukosnd dz-1 us ;g vihy /kkjk&15 miHkksDrk laj{k.k vf/kfu;e] 1986] ds varxZr ftyk miHkksDrk fookn izfrrks"k.k Qksje] // 2 // ljxqtk&vfEcdkiqj ¼N-x-½ ¼ftls vkxs laf{kIr esa **ftyk Qksje** lacksf/kr fd;k tk,xk½ ds ifjokn izdj.k dzekad&2014@14 f'kodqekjh fo:) fn vksfj;saVy ba';ksjsal daiuh fyfeVsM }kjk e.My izca/kd ,oa nks vU; esa ikfjr vkns'k fnukad&24-07-2014 ftlds }kjk mRrjokfnuh dz- 1@ifjokfnuh ds ifjokn dks Lohdkj djrs gq, ;g vknsf'kr fd;k x;k gS fd%& **1- vukosnd dz-1 ,d ekg ds Hkhrj vkosfndk dks chek/ku dh jkf'k&5]00]000@&¼ikap yk[k :Ik;s½ lank; djsA pwafd vkosfndk }kjk vkns'k fnukad&07-09-2011 dk iw.kZ ikyu ugha fd;k x;k blfy, mDr jkf'k ij f}rh;
vkosnu@ifjokn izLrqfr fnukad&29-01-2014 ls 06 izfr'kr okf"kZd dh nj ls lk/kkj.k C;kt iw.kZ Hkqxrku frfFk rd vukosnd dz-1] vkosfndk dks iznku djsA 2- mijksDr jkf'k lank; ds nkf;Ro ls vukosnd dz-2 ,oa 3 dks mUeqDr fd;k tkrk gSA 3- bl ifjokn ds O;; vukosnd dz-1 Lo;a dk rFkk vkosfndk dk Hkh O;; 1]000@&¼,d gtkj :Ik;s½ ogu djsxk ftlesa vf/koDrk 'kqYd lekfgr gSA** ls nqf[kr gksdj izLrqr fd;k gSA 02- mRrjokfnuh dz-1@ifjokfnuh dk ifjokn ftyk Qksje ds le{k laf{kIr esa bl izdkj jgk gS fd mRrjokfnuh dz-1@ifjokfnuh ds ifr Lo- ;ksxs'oj] mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 ds v/khuLFk dY;k.kh dkWyjh ,l- Mh- ,y- gsYij ds in ij dk;Zjr~ FkkA Lo- ;ksxs'oj ds lsokdky ds nkSjku mldk 5]00]000@&¼ikap yk[k :Ik;s½ dk xqzqi turk ilZuy ,DlhMsaV ikWfylh ds rgr chek vihykFkhZ@vukosnd dz-1 // 3 // ds }kjk mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 ds ek/;e ls fd;k x;k Fkk ftldk ikWfylh dzekad&47@2000@00257 gS tks fnukad&16-10- 1999 ls 15-10-2009 rd dh vof/k ds fy, FkkA izhfe;e dh jkf'k mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 ds ek/;e ls Lo- ;ksxs'oj ds osru ls dVkSrh dj vihykFkhZ@vukosnd dz-1 dks fn;k x;k FkkA chek vof/k ds nkSjku Lo- ;ksxs'oj dh lM+d nq?kZVuk esa fnukad&10-04-2005 dks e`R;q gks xbZ vkSj e`R;q ds ckn mRrjokfnuh dz-1@ifjokfnuh tks fd ukfeuh gS] ds }kjk mDr chek ikWfylh dh jde 5]00]000@&¼ikap yk[k :Ik;s½ izkIr djus gsrq mRrjoknh dz-2@vukosnd dz-2 ds ikl Dyse QkeZ] chek izek.k&i=] e`R;q izek.k&i=] izFke lwpuk i=] exZ baVhes'ku rFkk lHkh vko';d dkxtkr ds lkFk fnukad&09-05-2005 dks tek dh rc mRrjoknh dz-2@vukosnd dz-2 ds }kjk dgk x;k fd vkidk Dyse QkeZ 'kh?kz gh vihykFkhZ@vukosnd dz-1 ds ikl Hkst fn;k tk,xk rFkk tYn ls tYn chek jkf'k 5]00]000@&¼ikap yk[k :Ik;s½ dk Hkqxrku dj fn;k tkosxk] ijUrq vkt frfFk rd chek jkf'k dk Hkqxrku ugha fd;k x;k gSA mRrjokfnuh dz-1@ifjokfnuh }kjk vukosndx.k ds ikl dbZ ckj tkdj chek jkf'k dk Hkqxrku djus dk fuosnu dh vkSj vafre ckj fnukad&04-06- 2009 dks vihykFkhZ@vukosnd dz-1 ds ikl xbZ rks vihykFkhZ@vukosnd dz-1 }kjk chek jkf'k nsus ls badkj dj fn;k x;k vkSj dgk x;k fd vki nwljk jkLrk ns[ksa ;k dksVZ&dpgjh tk ldrs gSaA mRrjokfnuh dz-1@ ifjokfnuh }kjk vius vf/koDrk ds ek/;e ls fnukad&16-06-2009 dks vukosndx.k dks uksfVl izsf"kr fd;k mlds ckn Hkh vukosndx.k }kjk chek jkf'k dk Hkqxrku ugha fd;k x;k ftlds dkj.k mRrjokfnuh dz- 1@ifjokfnuh dks ;g ifjokn ykus dh vko';drk iM+h gSA vr% ifjokn&i= esa of.kZr vuqlkj vuqrks"k fnykbZ tkosA // 4 // 03- vihykFkhZ@vukosnd dz-1 dh vksj ls ftyk Qksje ds le{k fyf[kr dFku izLrqr dj ifjokn&i= ds vfHkopukasa dks vLohdkj fd;k x;k gS vkSj ;g vfHkopu fd;k x;k gS fd e`rd dkWyjh esa dke djrk Fkk] dks izekf.kr fd;s tkus gsrq fdlh Hkh izdkj ds nLrkost miyC/k ugha djk;s x;s gSa vfirq e`rd dk dkWyjh esa LFkkbZ dkexkj gksuk ekU; ugha gSA chek ikWfylh izhfe;e dVkSrh izek.k&i= ds vHkko esa e`rd dk xzqi turk nq?kZVuk ikWfylh ds rgr chek gksuk ekU; ugha gSA mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 ds ek/;e ls vihykFkhZ@vukosnd dz-1 }kjk fdlh Hkh izdkj dh ikWfylh tkjh ugha dh xbZ gSA xzqi turk O;fDrxr nq?kZVuk chek ikWfylh vihykFkhZ@vukosnd dz-1 ls ,l- bZ- lh- ,y- fcykliqj }kjk dz; dh xbZ Fkh tks fd izdj.k esa vko';d i{kdkj gS vkSj mls i{kdkj cuk;s fcuk nkok pyus ;ksX; ugha gSA xzqi turk O;fDrxr nq?kZVuk chek ikWfylh] mldh 'krksZa ds rgr fnukad&08-03-2002 dks jn~n gks pqdh gSA ,slh fLFkfr esa chek vof/k vFkok 5]00]000@&¼ikap yk[k :i;s½ dk iz'u mRiUu ugha gksrk gSA chek ikWfylh vihykFkhZ@vukosnd dz-1 }kjk tkjh ugha dh xbZ gSA e`rd dh e`R;q fnukad&12-04-2005 dks gqvk gS ijUrq e`R;q dh lwpuk rFkk vko';d nLrkost] Dyse QkeZ] iqfyl isij] izFke lwpuk&i=] vafre izfrosnu] iapukek] e`R;q izek.k&i=] chek ikWfylh] osru ls chek izhfe;e dVkSrh izek.k&i= vFkok fdlh Hkh izdkj dk nLrkost mRrjokfnuh dz-1@ifjokfnuh }kjk vihykFkhZ@vukosnd dz-1 dks miyC/k ugha djk;s x;s gSaA ,slh fLFkfr esa izLrqr nkok pyus ;ksX; u gksdj fujLr fd;s tkus ;ksX; gSA mRrjokfnuh dz-1@ifjokfnuh }kjk vihykFkhZ@vukosnd dz-1 ds le{k e`rd dh e`R;q dh lwpuk vFkok fdlh Hkh izdkj dk nLrkost miyC/k ugha djk;k x;k gS tks mRrjokfnuh dz- 1@ifjokfnuh ds vfHkopu ls gh LFkkfir gSA mRrjoknh dz-2@vukosnd dz-2 dks Hkh mRrjokfnuh dz-1@ifjokfnuh }kjk fdlh Hkh izdkj ds nLrkost miyC/k ugha djk;s x;s gSa rFkk mRrjoknh dz-2@vukosnd dz-2 }kjk Hkh vihykFkhZ@vukosnd dz-1 dks fdlh Hkh izdkj dk nLrkost vFkok // 5 // e`rd ds e`R;q dh lwpuk ugha nh xbZ gSA mRrjokfnuh dz-1@ifjokfnuh }kjk l{ke U;k;ky; }kjk tkjh oS/k mRrjkf/kdkj izek.k&i= Hkh izLrqr ugha fd;k x;k gSA ,slh fLFkfr esa mRrjokfnuh dz-1@ifjokfnuh e`rd dh oS/k mRrjkf/kdkjh gksuk LFkkfir ugha gSA nq?kZVuk ds le; e`rd lweks okgu pkyu dj jgk Fkk vkSj e`rd ds ikl mijksDr okgu pkyu dk oS/k ,oa izHkkoh pkyu vuqKfIr i= ugha Fkk rFkk e`rd }kjk Lor% ykjokghiwoZd okgu pkyu ds dkj.k dfFkr nq?kZVuk gqbZ gSA ,slh fLFkfr esa e`rd gsrq nkok pyus ;ksX; ugha gSA vihykFkhZ@vukosnd dz-1 }kjk lsok esa dksbZ deh ugha dh xbZ gSA mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 }kjk fdlh Hkh izdkj dk izhfe;e vihykFkhZ@vukosnd dz-1 dks miyC/k ugha djk;k x;k gSA mRrjokfnuh dz-1@ifjokfnuh dk nkok vof/k ckg~; gSA mRrjokfnuh dz-1@ifjokfnuh] vihykFkhZ@vukosnd dz-1 ls fdlh Hkh izdkj dh jde izkIr djus dh vf/kdkfj.kh ugha gSA ftyk Qksje }kjk izdj.k dzekad&20@2010 f'ko dqekjh fo:) vkfj;saVy ba';ksjsal daiuh fyfeVsM esa fnukad&07-09-2011 dks vkns'k ikfjr fd;k x;k vkSj mRrjokfnuh dz-1@ifjokfnuh dk ifjokn] vifjiDo gS] vo/kkfjr fd;k x;k gS rFkk mRrjokfnuh dz-1@ifjokfnuh dks le;kof/k esa nLrkost chek daiuh dks miyC/k djk;k tkuk Fkk ijUrq laiw.kZ nLrkost chek daiuh dks miyC/k ugha djk;k x;kA bl izdkj mRrjokfnuh dz-1@ifjokfnuh }kjk iwoZ vkns'k dk ikyu ugha fd;k x;k gS rFkk orZeku ifjokn Hkh iwoZ ikfjr vkns'k ds ifjizs{; esa vof/k ckg~; gSA xzqi turk O;fDrxr nq?kZVuk ikWfylh fcykliqj ls tkjh dh xbZ Fkh rFkk mijksDr ikWfylh fujLrhj.k fcykliqj esa gqvk gS rFkk ikWfylh ls lacaf/kr leLr dk;Zokgh fcykliqj esa laikfnr gqbZ gS] vr% ftyk Qksje] ljxqtk&vfEcdkiqj dks izdj.k dh lquokbZ dk {ks=kf/kdkj izkIr ugha gSA ikWfylh ds 'krZ dzekad&5 ds rgr vihykFkhZ@vukosnd dz-1 }kjk mijksDr chek ikWfylh jn~n dj nh xbZ gS rFkk ikWfylh fnukad&08-03-2002 ls jn~n gks pqdh gS vkSj e`rd dh e`R;q ikWfylh jn~ndj.k ds Ik'pkr~ gqbZ gS] vr% e`rd dh e`R;q fnukad dks chek // 6 // ikWfylh izHkko'khy ugha Fkk bl dkj.k nkok pyus ;ksX; ugha gSA ikWfylh fujLrh ds Ik'pkr~ ikWfylh dh 'krZ dzekad&5 ds vuqlkj izksjsVk ds vk/kkj ij cps gq, o"kZ ds izhfe;e dks ,l- bZ- lh- ,y- dks okil fd;k tkuk Fkk ijUrq ,l- bZ- lh- ,y- }kjk ekuuh; mPp U;k;ky; N-x- esa fjV ;kfpdk dzekad&327@02 izLrqr fd;s tkus d dkj.k rFkk mijksDr fjV ;kfpdk ,l- bZ- lh- ,y- fo:) vksfj;saVy ba';ksjsal daiuh fyfeVsM esa LFkxu vkns'k fujLr djus ij chek daiuh }kjk izhfe;e dh 'ks"k jde&34]69]21]151@&¼pkSarhl djksM+ mugRrj yk[k bDdhl gtkj ,d lkS bD;kou :Ik;s½ dk psd dzekad&00776975 fnukad&28-03-2005 dks ,l- bZ- lh- ,y- dks okil ns fn;k x;k ftls ysus ls badkj djrs gq, chek daiuh dks okil Hkst fn;k x;kA ikWfylh 'krZ dh dafMdk&5 ds vuqlkj chek daiuh fdlh Hkh le; uksfVl nsdj ikWfylh dks jn~n dj ldrh gS ijUrq daiuh ml n'kk esa chekd`r O;fDr dks vafre nh xbZ izhfe;e jkf'k esa ls pkyw dkykof/k ds chrs le; dk vkuqikfrd izhfe;e ?kVkdj ykSVk nsxh] ,slk uksfVl Ik;kZIr le>k tkosxk] c'krsZ ,slh uksfVl daiuh dh iqLrd esa ml le; vafdr chekd`r O;fDr ds irs ij Mkd ls Hkstk x;k gks vkSj uksfVl ds ckor~ ;g le>k tk;sxk fd og chekd`r O;fDr dks ml le; izkIr gks x;k ftl le; lkekU; Mkd }kjk mls izkIr gks tkuk pkfg,A chek daiuh }kjk lafonk ds laiw.kZ fu;eksa ,oa 'krkZsa dk ikyu djrs gq, ikWfylh fujLr dh xbZ gSA ikWfylh fujLrh jk"VªO;kih uhfrxr~ fu.kZ; ds vk/kkj ij fd;k x;k gS ,slh fLFkfr esa ikWfylh fujLr fd;k tkuk mfpr gS ;k vuqfpr bldk fujkdj.k Qksje ds {ks=kf/kdkj eas ugha gS blfy, Qksje dks lquokbZ dk {ks=kf/kdkj ugha gSA vr% ikWfylh dk fujLrhdj.k dk iqu% foyksdu dk {ks=kf/kdkj ugha gSA mijksDr chek ikWfylh fujLrhdj.k dks ,l- bZ- lh- ,y- ds }kjk ekuuh; mPp U;k;ky; N-x- esa pqukSrh nh xbZ gS tks fd ;kfpdk dzekad&327@2002 yafcr gS vkSj ;kfpdk orZeku esa yafcr gksus ds dkj.k lcT;wfMl gksus ls izdj.k // 7 // dh lquokbZ dk vf/kdkj ftyk Qksje dks ugha gSA vr% ifjokn fujLr fd;k tkosA 04- mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 dh vksj ls ftyk Qksje ds le{k fyf[kr dFku izLrqr dj ;g vfHkopu fd;k x;k gS fd mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 lkÅFk bZLVuZ dksy QhYM~l fyfeVsM] daiuh vf/kfu;e ds rgr ,d jftLVMZ daiuh gS tks fd vihykFkhZ@vukosnd dz-1 ls vius fu;kstu easa dk;Zjr~ Jfedksa ds dY;k.k ds fy, xzqi turk ba';ksjsal ikWfylh fnykus esa mUgsa lg;ksx fn;k gS] blfy, bl mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 dk dksbZ nkf;Ro ugha gSA mrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 dk dk;Z O;kikj ba';ksajasl djus dk ugha gS] u gh vihykFkhZ@vukosnd dz-1 ls dksbZ deh'ku vFkok ykHk fy;k gS vkSj u gh og vihykFkhZ@vukosnd dz-1 ds izfrfuf/k ;k ,tsaV ds :Ik esa dk;Z fd;k gS vkSj u gh e`rd Jfed ls dksbZ jkf'k bl gsrq fy;k gSA blfy, mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 mfpr i{kdkj ugha gSaA mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 ,d lkoZtfud midze gS tks izhfe;e izkIr djus ds ckn lfVZfQdsV vkWQ ba';ksjsal izR;sd Jfedksa dks xzqi turk ilZuy ,DlhMsaV ikWfylh ua-& 47@200@00257 tkjh fd;k gS] ftldh 'krksZa ls vihykFkhZ@vukosnd dz- 1 focaf/kr gS vkSj mlds foijhr dgus dk vf/kdkj mls ugha gSA vihykFkhZ@vukosnd dz-1 ;fn ikWfylh 'krksZa ds foijhr dksbZ vU; vk/kkj ysrk gS rks og U;kl Hkax rFkk vuqca/k Hkax dk nks"kh gSA vihykFkhZ@vukosnd dz-1 ,d lkoZtfud midze gksus ds ukrs rFkk [;kfr izkIr chek daiuh gksus ds ukrs mldh xzqi turk ilZuy ,DlhMsaV ikWfylh ij fo'okl dj mDr ikWfylh izkIr fd;k x;k gS vkSj vc Jfed dh e`R;q gksus ds Ik'pkr~ vihykFkhZ@vukosnd dz-1 dh nkok jkf'k ds Hkqxrku djus dh ftEesnkjh ls cpus ds fy, dksbZ foijhr dFku ugha dj ldrkA vihykFkhZ@vukosnd dz-1 }kjk turk xqzi ilZuy ,DlhMsaV ikWfylh ds // 8 // laca/k esa vihykFkhZ@vukosnd dz-1 rFkk mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 dh tkudkjh esa ykus ij vihykFkhZ@vukosnd dz-1 ,oa mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 rFkk Jfed izfrfuf/k;ksa ds chp eseksjs.Me vkWQ v.MjVsfdax fnukad&06-09-1999 dks gqvk ftlds rgr 10 o"kksZa ds fy, ,l- bZ- lh- ,y- esa dk;Zjr~ Jfedksa dks nq?kZVuk ij {kfriwfrZ gsrq chek fd;k tkuk r; gqvkA mDr eseksjs.Me vkWQ v.MjVsfdax ds vuqlkj ;fn mlds 'krZ ij fdlh izdkj ds ifjorZu djus dh vko';drk gqbZ rks ,l- bZ- lh- ,y-] chek daiuh vkSj Jfed izfrfuf/k;ksa ds chp cSBdj fd;k tkosxkA bl izdkj vihykFkhZ@vukosnd dz-1 fdlh Hkh izdkj dh ikWfylh 'krksZa ij ifjorZu eseksjs.Me vkWQ v.MjVsfdax fnukad&06-09-1999 dh mDr 'krZ ds vuqlkj vius eu ls ugha dj ldrk vkSj og eseksjs.Me vkWQ v.MjVsfdax dh 'krksZa ls ikcan gS fdUrq vihykFkhZ@vukosnd dz-1 }kjk mDr 'krZ dk ikyu fd, fcuk chek ikWfylh dks fujLr djus dh lwpuk ,l- bZ-lh- ,y- dks fn;kA pwafd chek daiuh us Jfed izfrfuf/k ,oa ,l- bZ- lh- ,y- ds izfrfuf/k ds lkFk eseksjs.Me vkWQ v.MjVsfdax fnukad&06-09-1999 ds 'krZ dk ikyu ugha fd;k blfy, ,di{kh; :i ls chek daiuh dks ikWfylh fujLr djus dk vf/kdkj ugha gSA ,l- bZ- lh- ,y- }kjk ekuuh; NRrhlx<+ mPp U;k;ky; esa fjV ;kfpdk dzeakd&327@2002 izLrqr fd;k x;k gS tks vHkh fopkjk/khu gSA vihykFkhZ@vukosnd dz-1 }kjk NRrhlx<+ mPp U;k;ky; }kjk LFkxu vkns'k gVkus ds ckn chek izhfe;e dh 'ks"k jkf'k dk psd izsf"kr fd;k ftls mRrjoknh dz-2@vukosnd dz-2 }kjk vihykFkhZ@ vukosnd dz-1 dks okil ykSVk fn;k gSA esekssjs.Me vkWQ v.MjVsfdax fnukad&06-09-1999 ds 'krZ ds foijhr tkdj ikWfylh dh 'krksZa dk ikyu vihykFkhZ@vukosnd dz-1 }kjk ugha fd;k gSA chekd`r O;fDr dks ikWfylh fujLrhdj.k ds laca/k esa lwpuk nsus dh ftEesnkjh chek daiuh dh gSA mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 dks vuko';d :Ik ls i{kdkj // 9 // cuk;k x;k gSA vr% ifjokn] mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 ds fo:) fujLr fd;k tkosA 05- mRrjokfnuh dz-1@ifjokfnuh dh vksj ls vius i{k leFkZu esa ftyk Qksje ds le{k lfVZfQdsV vkWQ ba';ksjsal dk vly] izdj.k dzekad&20@2010 f'ko dqekjh fo:) fn vksfj;saVy ba';ksjsal daiuh fyfeVsM }kjk eaMy izca/kd ,oa nks vU; esa ikfjr vkns'k fnukad&07-09- 2011 dh izekf.kr izfr] fcy Hkqxrku i=d fnukad&04-10-2011 dk vly rFkk izFke lwpuk izfrosnu fnukad&15-04-2005] vafre izfrosnu dh QksVks dkih izLrqr fd;k gSA 06- vihykFkhZ@vukosnd dz-1 dh vksj ls vius i{k leFkZu esa ftyk Qksje ds le{k izdj.k dzekad&20@2010 f'ko dqekjh fo:) fn vksfj;saVy ba';ksjsal daiuh fyfeVsM }kjk eaMy izca/kd ,oa nks vU; esa ikfjr vkns'k fnukad&07-09-2011] bf'rgkj fnukad&07-06-2008] iz;k'k ,MojVkbZtj dk fcy fnukad&09-06-2008] chek daiuh }kjk ,l- bZ- lh- ,y- dks izsf"kr i= fnukad&28-03-2005] psd fnukad&28-03-2005] Hkqxrku@tujy okÅpj fnukad&28-03-2005] chek daiuh }kjk tkjh i= fnukad&09-03-2005 ,oa fnukad&06-03-2002] N-x- mPp U;k;ky; ds fjV ;kfpdk dzekad&327@2002 esa ikfjr vkns'k dh izfr] ikWfylh 'ksM~;wy rFkk turk O;fDrxr nq?kZVuk chek ikWfylh dh fu;e ,oa 'krZ dh QksVks dkih izLrqr fd;k gSA 07- mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 dh vksj ls vius i{k leFkZu esa ftyk Qksje ds le{k 'ko ijh{k.k ds fy, vkosnu fnukad&12- 04-2005] lfVZfQdsV vkWQ ba';ksjsal] lfoZl cqd] ifVZdqylZ vkWQ Qssfeyh rFkk uksfeus'ku QkeZ dh QksVks dkih izLrqr fd;k gSA // 10 // 08- ftyk Qksje us mHk;i{k }kjk izLrqr vfHkopu ,oa mRrjokfnuh dz- 1@ifjokfnuh ds ifjokn dks Lohdkj djrs gq, Åij dafMdk&1 esa of.kZr vuqlkj vuqrks"k iznku fd;k gS] ftlds fo:) ;g vihy gSA 09- vihykFkhZ@vukosnd dz-1 dh vksj ls milatkr gksus okys fo)ku vf/koDrk Jh f'kf'kj HkaMkjdj dk ;g rdZ gS fd ftyk Qksje }kjk ikfjr vkyksP; vkns'k =qfViw.kZ gSA ftyk Qksje us bl rF; dks /;ku ugha fn;k gS fd mRrjokfnuh dz-1@ifjokfnuh ds ifr e`rd ;ksxs'oj dh e`R;q fnukad&10-04-2005 dks gqbZ Fkh vkSj mRrjokfnuh dz-1@ifjokfnuh us igyk ifjokn 2010 esa lafLFkr fd;k Fkk tks fd ifjlhek vof/k ls ckf/kr Fkk rFkk mRrjokfnuh dz-1@ifjokfnuh }kjk dksbZ Hkh nLrkost miyC/k ugha djk;k x;k Fkk vkSj ftlds dkj.k ls izdj.k dk fujkdj.k ugha gks ldk Fkk vkSj mRrjokfnuh dz-1@ifjokfnuh us ;g ifjokn foyac ls lafLFkr fd;k gS] blh vk/kkj ij ifjokn fujLr fd;s tkus ;ksX; Fkk ijUrq ftyk Qksje us bl fcUnq ij fopkj u dj =qfViw.kZ vkns'k ikfjr fd;k gSA vr% vihykFkhZ@vukosnd dz-1 dh vihy Lohdkj fd;k tkos vkSj ftyk Qksje }kjk ikfjr vkyksP; vkns'k vikLr fd;k tkosA 10- mRrjokfnuh dz-1@ifjokfnuh f'kodqekjh uksfVl rkehyh ds ckn Hkh mifLFkr ugha gSA 11- mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 dh vksj ls milatkr gksus okys fo}ku vf/koDrk Jh vks- ih- vxzoky dk ;g rdZ gS fd ftyk Qksje us mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 dks tks mUeqDr fd;k gS og vkns'k iw.kZr% mfpr gS rFkk mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 dk dksbZ nkf;Ro ugha gSA vr% mRrjoknh dz-2 ,oa 3@vukosnd dz-2 ,oa 3 ds laca/k esa vihy fujLr fd;k tkosA // 11 // 12- 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 13- vihykFkhZ@vukosnd dz-1 dh vksj ls ifjlhek ds laca/k esa vk{ksi fd;k x;k gS] ml ij fopkj fd;k tk jgk gSA mRrjokfnuh dz-1@ ifjokfnuh us vius ifjokn&i= dh dafMdk&3 esa vfHkopu fd;k gS fd mlds ifr Lo- ;ksxs'oj dh lM+d nq?kZVuk esa fnukad&10-04-2005 dks ekSr gks xbZ Fkh vkSj mlh dafMdk dh mi dafMdk&c esa ;g Li"V vfHkopu dh gS fd **xzqi turk ilZuy ,DlhMsaV ikWfylh dh jde 5]00]000@&¼ikap yk[k :Ik;s½ izkIr djus ckor~ vukosnd dz-2 ds ikl Dyse QkeZ] chek izek.k&i=] e`R;q izek.k&i=] izFke lwpuk&i=] exZ baVhes'ku rFkk lHkh vko';d dkxtkr ds lkFk fnukad&09-05-2005 dks tek dh Fkh** rFkk mRrjokfnuh dz-1@ifjokfnuh dh vksj ls mlds }kjk iwoZ esa izLrqr ifjokn izdj.k dzekad&20@2010 f'kodqekjh fo:) fn vksfj;saVy ba';ksjsal daiuh fyfeVsM esa ikfjr vkns'k fnukad&07-09-2011 dh izfrfyfi izLrqr fd;k gSA blls Li"V gS fd mRrjokfnuh dz-1@ ifjokfnuh us iwoZ esa vihykFkhZ@vukosnd dz-1 ds fo:) ,d ifjokn izdj.k dzekad&20@2010 lafLFkr dh FkhA ftyk Qksje us vius mDr vkns'k esa fopkj.kh; fcUnq dzekad&1 ds laca/k esa ;g fu"d"kZ fudkyk Fkk fd mRrjokfnuh dz-1@ifjokfnuh] vihykFkhZ@vukosnd dz-1 dh **miHkksDrk** gS rFkk fopkj.kh; fcUnq dz-&2] D;k vukosndx.k us chek /kkjd ;ksxs'oj ÅQZ tksxs'oj dh nq?kZVukRed e`R;q ds laca/k esa chek/ku jkf'k&5]00]000@&¼ikpa yk[k :Ik;s½ ifjokfnuh dks iznk; u dj lsok esa deh fd;k gS\ bl laca/k esa ftyk Qksje us ifjokn izdj.k dzekad&20@2010 esa ikfjr vkns'k dh dafMdk&17 esa ;g fu"d"kZ fudkyk gS fd **vukosnd dz-1 dks nLrkost miyC/k djk;s tkus ds laca/k esa dksbZ ikorh izLrqr ugha dh gS** vkSj ;g fu"d"kZ fn;k gS fd 5]00]000@&¼ikap yk[k :Ik;s½ iznku u dj chek daiuh us lsok esa deh ugha fd;k gS] ijUrq // 12 // fopkj.kh; fcUnq dzekad&3 ,oa 4 esa ftyk Qksje us ;g fu/kkZfjr fd;k gS fd mRrjokfnuh dz-1@ifjokfnuh ds ifjokn dh lquokbZ dk {ks=kf/kdkj ftyk Qksje dks gS vkSj dafMdk&21 esa ;g vknsf'kr fd;k Fkk fd%& **21- bl izdkj mijksDr foospu ckn izkIr fu"d"kZ ds vk/kkj ij ;g ik;k tkrk gS fd ifjoknh dk orZeku ifjokn vifjiDo gS] vr% ifjoknh }kjk izLrqr ifjokn dks bl funsZ'k ds lkFk [kkfjt fd;k tkrk gS fd ifjoknh vkns'k fnukad ls 01 ¼,d½ ekg ds Hkhrj vukosnd dz-1 ds le{k Dyse QkeZ] iqfyl isij] izFke lwpuk&i=] vafre izfrosnu] iapukek] e`R;q izek.k&i=] chek ikWfylh] osru ls izhfe;e dVkSrh izek.k&i= izLrqr dj ikorh izkIr djs rFkk vukosnd dz-1 mDr Dyse QkeZ vkSj nLrkost izkfIr frfFk ls 01 ¼,d½ ekg ds Hkhrj ifjoknh ds chek nkos dk fujkdj.k djs] mlds@ifjoknh ds chek nkos ds fujkdj.k ls vlarq"V gksus ij ifjoknh fof/kor~ l{ke U;k;ky; ds le{k ifjokn izLrqr dj ldsxkA** 14- ftyk Qksje ds mDr vkns'k ds fo:) vihykFkhZ@vukosnd dz-1 }kjk dksbZ vihy ugha fd;k x;k Fkk vkSj ;g vk{ksfir ugha fd;k x;k Fkk fd mRrjokfnuh dz-1@ifjokfnuh dk ifjokn ifjlhek vof/k ls ckf/kr gS vkSj ,slh fLFkfr esa tcfd ftyk Qksje us ifjokn dks dafMdk&21 eas of.kZr funsZ'k ds vuqlkj mRrjokfnuh dz-1@ifjokfnuh dks okil fd;k Fkk vkSj mlds ifjizs{; esa mRrjokfnuh dz-1@ifjokfnuh }kjk nLrkost izLrqr fd;k x;k Fkk vkSj ,slk izrhr gksrk gS fd mRrjokfnuh dz-1@ifjokfnuh ds izdj.k dk chek daiuh }kjk dksbZ fujkdj.k ugha fd;k x;k gS vkSj bl ij mRrjokfnuh dz-1@ifjokfnuh us fnukad&29-01-2014 dks ;g f}rh; ifjokn ftyk Qksje ds funsZ'k ds ifjizs{; esa izLrqr fd;k gS] tcfd vihykFkhZ@vukosnd dz-1 }kjk mRrjokfnuh dz-1@ifjokfnuh ds nkos dk fujkdj.k ugha fd;k x;k gSA ,slh fLFkfr esa vc ;g ugha dgk // 13 // tk ldrk fd mRrjokfnuh dz-1@ifjokfnuh dk ifjokn ifjlhek vof/k ls ckf/kr gSA 15- vihykFkhZ@vukosnd dk ;g Hkh rdZ gS fd vihykFkhZ@vukosnd }kjk chek ikWWfylh dks fnukad&08-03-2002 dks fujLr dj fn;k x;k gS vkSj bl izdkj dksbZ lafonk vfLrRo esa ugha gS vkSj ,slh fLFkfr esa mRrjokfnuh@ifjokfnuh fdlh izdkj dh chek/ku izkIr djus dh vf/kdkfj.kh ugha gSA 16- New India Assurance Company Ltd. & Anr. vs. Manish Abhay Bedmutha & Anr., IV (2013) CPJ 303 (NC), esa ekuuh; jk"Vªh; vk;ksx }kjk ;g fu/kkZfjr fd;k x;k gS fd%& "21. Learned counsel for the petitioner has given three citations of the National Commission :
In the case of Ashok Jain v. Oriental Insurance Co. Ltd., I (2012) CPJ 150 (NC), wherein this Commission has observed that "it is thus clear that in cancelling the insurance policy in question, the Insurance Company needed to write to "the insured" and not to "the insured person". Perusal of the certificate of insurance shows that the State Bank of India Officers Association, Chjandigarh Circle was recorded as the "insured", whereas Adesh Kumar Jain was recorded as "the insured person". In other words, for cancellation of the policy it was sufficient for the Insurance Company to send notice only to the "insured", viz., the State Bank of India Officers Association, Chandigarh Circle. It is not in dispute that this was done by the Insurance Company. Hence, the contention of the learned Counsel for the petitioner is not valid and cannot be accepted."
In the case of Usha Sharma and Ors. V. New India Assurance Co. Ltd. And Ors., I (2012) CPJ 488 (NC), this Commission has held that "a perusal of the above condition // 14 // would show that the Insurance Company was within the right to cancel the policy in question at any time provided the written notice are sent to the policy-holders and the balance premium for the unexpired/uncovered policy period is returned to the insured. In the present case, as per condition No.5 of the insurance policy, the policy in question was cancelled by the Insurance Company and intimation was sent to the policy holder by registered letter. Cheque of Rs.601 towards balance premium was also returned to the insured. Public notice of cancellation was also given through newspapers and it was enough notice to the respondent regarding cancellation of the policy. Since, the policy was cancelled during the life time of the insured and due intimation was given to him along with cheque of balance premium, the Insurance Company was not liable to indemnify the complainants. Even the Hon'ble Supreme Court in the case of United India Insurance Co. v. Harcharan Chand Rai Chandan Lal, IV (2004) CPJ 15 (SC) = V (2004) SLT 876 and National Insurance Company v. Laxmi Narain Dhut, III (2007) CPJ 13 (SC) = IV (2007) SLT 102, has held that the policy is a contract between the parties and both the parties are bound by terms of contract".
In the case of Nand Kumari and Ors. V. Oriental Insurance Co. Ltd., I (2012) CPJ 357 (NC), the National Commission has held that "it is not in dispute before us that the policy could be cancelled at any time by the insurer as averred by the respondent in paragraph Nos.4 and 5 of its written version. The insured died on 22.7.2006. Policy had been cancelled by the respondent on 26.11.2000 and an intimation to the effect was sent to the insured by a registered letter addressed to him at the address given by him in the proposal form for obtaining the said policy. Intimation regarding cancellation was sent to the insured along with cheque of prorate premium drawn on Bank of India".
// 15 //
23. In view of the above, are of the view that the petition had cancelled the policy as per Clause No.5 of the terms and conditions of the policy which had been issued in favour of respondent No.2 even giving the reasons for cancellation of the policy. Respondent No.2 did not challenge the cancellation of the policy. Respondent No.2 also failed to the inform the individual beneficiaries including respondent No.1 of cancellation of the policy and failed to refund the prorate premium sent to them vide letter dated 6.9.2006. They thus denied the opportunity to the petitioner and her husband to avail of an alternate policy, if they so desired. Petitioner's husband Dr. Abhay Bansilal Bedmutha died on 14.10.2008. Hence, the revision petition is allowed and the order of the District Forum is modified to the extent that complaint /application of the complainant is admitted only against respondent No.2 who should pay the expenses of Rs.5,000 as also Rs.5.00 lakh with interest @ 9% per annum from the date 13.11.2006 till that period to getting the full amount. Similarly for the mental /psychological harassment the damages amount of Rs.10,000/- be given to the complainant within 30 days from the date of pronouncement of this order."
17- chek ikWfylh dh 'krksZa dks ns[kus ls ;g izdV gksrk gS fd chek daiuh fdlh Hkh le; fyf[kr esa lwpuk nsus ds Ik'pkr~ chek ikWfylh dks lekIr ;k fujLr dj ldrh gS ijUrq mlds fy, vko';d gS fd og chfer O;fDr dks fyf[kr esa lwpuk izsf"kr djs ijUrq bl izdj.k esa vihykFkhZ@vukosnd }kjk ,slk dksbZ Hkh nLrkost izLrqr ugha fd;k x;k gS ftlds ifjizs{; esa ;g izdV gks fd vihykFkhZ@vukosnd chek daiuh us chek ikWfylh dks fujLr djus dh O;fDrxr lwpuk chek /kkjd Lo- ;ksxs'oj dks mlds thoudky esa izsf"kr fd;k gksA tcfd vihykFkhZ@ vukosnd ds vuqlkj fnukad&08-03-2002 dks chek ikWfylh fujLr dj fn;k x;k Fkk vkSj Lo- ;ksxs'oj dh e`R;q fnukad&10-04-2005 dks gqbZ Fkh // 16 // ijUrq Lo- ;ksxs'oj dks chek ikWfylh fujLr fd;s tkus laca/kh dksbZ lwpuk izsf"kr fd;k x;k gks ,slk dksbZ nLrkost vihykFkhZ@vukosnd }kjk izLrqr ugha fd;k x;k gS vkSj ,slh fLFkfr esa ;g ugha dgk tk ldrk gS fd vihykFkhZ@vukosnd chfer jkf'k nsus ds fy, nkf;Rok/khu ugha gSA 18- vihykFkhZ@vukosnd dz-1 dh vksj ls ;g Hkh vk{ksi mBk;k x;k gS fd vihykFkhZ@vukosnd dz-1 }kjk lqlaxr nLrkost miyC/k ugha djk;k x;k Fkk blfy, nkos dk fujkdj.k ugha gks ldk gSA vihykFkhZ@vukosnd dk mDr rdZ Hkh Lohdkj ;ksX; ugha gSA mRrjokfnuh@ifjokfnuh us vius ifjokn&i= esa Li"V :Ik ls vfHkopu fd;k gS fd ftyk Qksje }kjk ifjokn izdj.k dzekad&20@2010 esa fn, x, vkns'k fnukad&07-09-2011 ds ifjizs{; esa laiw.kZ nLrkost vihykFkhZ@vukosnd ds le{k tek djk fn;k Fkk vkSj mlds ckn Hkh izdj.k dk fujkdj.k vihykFkhZ@vukosnd }kjk ugha fd;k x;k gS vkSj ,slh fLFkfr esa fuf'pr gh vihykFkhZ@vukosnd chek daiuh }kjk mRrjokfnuh@ifjokfnuh ds nkos dk fujkdj.k ugha dj lsok esa deh dks ifjyf{kr djrk gS vkSj bl laca/k esa ftyk Qksje us vius vkyksP; vkns'k dh dafMdk&14 eas tks fu"d"kZ fudkyk gS og iw.kZr% mfpr gS rFkk ftyk Qksje us vius vkns'k dh dafMdk&16 esa ifjlhek ds laca/k esa foLr`r foospu djrs gq, ;g fu/kkZfjr fd;k gS fd mRrjokfnuh@ifjokfnuh dk ifjokn ifjlhek vof/k ds Hkhrj gS ftlds laca/k esa bl vk;ksx }kjk Hkh Åij fujkdj.k fd;k x;k gS vkSj pwWafd mRrjokfnuh@ifjokfnuh ds ifr }kjk xzqi turk ilZuy ,DlhMsaV ikWfylh ds rgr ikWfylh izkIr fd;k Fkk vkSj ftldk chek/ku 5]00]000@&¼ikap yk[k :Ik;s½ Fkk rFkk mRrjokfnuh@ifjokfnuh ds ifr Lo- ;ksxs'oj dh e`R;q lM+d nq?kZVuk esa gqbZ Fkh ftldh iqf"V izFke lwpuk izfrosnu ,oa iqfyl }kjk rS;kj fd, x, QkbZuy fjiksVZ rFkk 'ko ijh{k.k izfrosnu ds ifj'khyu ls ;g Li"V gS fd e`rd dh e`R;q nq?kZVukRed izd`fr dk gS rFkk e`rd dk 'ko ijh{k.k djus okys fpfdRld us 'ko // 17 // ijh{k.k izfrosnu esa Li"V :Ik ls e`R;q dk dkj.k "Accidental in Nature"
fy[kk gS vkSj bl izdkj ;g Li"V gS fd e`rd dh e`R;q nq?kZVukRed izd`fr dk gSA 19- Lo- ;ksx'oj }kjk xqzi turk ilZuy ,DlhMsaV ikWfylh izkIr fd;k x;k Fkk vkSj mRrjokfnuh@ifjokfnuh f'kodqekjh mldh iRuh gS rFkk tks lfVZfQdsV vkWQ ba';ksjsal izLrqr fd;k x;k gS mlesa Name of Spouse esa f'ko dqekjh fy[kk gqvk gS vkSj bl izdkj mRrjokfnuh@ifjokfnuh f'ko dqekjh e`rd ;ksxs'oj dh ukfeuh gS vkSj mDr chek/ku mRrjokfnuh@ifjokfnuh izkIr djus dh vf/kdkfj.kh gS vkSj ftyk Qksje us tks fu"d"kZ fudkyk gS og iw.kZr% mfpr gS vkSj mlesa fdlh izdkj dh vfu;ferrk ,oa voS/kkfudrk ugha gSA 20- vr% vihykFkhZ@vukosnd dh vksj ls izLrqr vihy lkjghu gksus ls fujLr fd;k tkrk gSA ftyk Qksje }kjk ikfjr vkyksP; vkns'k fnukad&24-07-2014 dh iqf"V dh tkrh gSA bl vihy dk O;; i{kdkj viuk&viuk ogu djsaxsA ¼ U;k;ewfrZ vkj-,l-'kekZ ½ ¼ Mh- ds- iksn~nkj ½ v/;{k lnL;
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