State Consumer Disputes Redressal Commission
N I A Co vs Rani Devi on 19 July, 2017
Cause Title/Judgement-Entry STATE CONSUMER DISPUTES REDRESSAL COMMISSION, UP C-1 Vikrant Khand 1 (Near Shaheed Path), Gomti Nagar Lucknow-226010 First Appeal No. A/2012/270 (Arisen out of Order Dated in Case No. of District State Commission) 1. N I A Co a ...........Appellant(s) Versus 1. Rani Devi a ...........Respondent(s) BEFORE: HON'BLE MR. Raj Kamal Gupta PRESIDING MEMBER HON'BLE MR. Mahesh Chand MEMBER For the Appellant: For the Respondent: Dated : 19 Jul 2017 Final Order / Judgement RESERVED State Consumer Dispute Redressal Commission, Uttar Pradesh Lucknow Appeal No. 270 of 2012 New IndiaAssurance Company Ltd., .......Appellant Versus Smt. Rani Devi ......Respondent Present:- Hon'ble Sri Raj Kamal Gupta, Presiding Member.
Hon'ble Sri Mahesh Chand, Member.
Sri Ashish Kumar Srivastav, Learned Advocate for the Appellant.
None for the Respondent.
Date: 23-08-2017 Judgment
Sri Mahesh Chand,Member- This Appeal under section 15 of Consumer Protection Act,1986, has been filed by New India Assurance Company Ltd., Legal Hub, at 94, M.G.Marg, opposite Raj Bhawan, Lucknow against the order dated 15.12.2011, passed by learned District Consumer Dispute Redressal Forum, Gautam Budh Nagar, in complaint Case No 245/2010, Smt.Rani Devi vs New India Assurance Company Ltd.
Briefly the facts in this matter are that the Government of Uttar Pradesh launched a Group Personal Accident Policy for Farmers, in the name of Hon'ble Governor of Uttar Pradesh, covering all farmers of the state of U.P. in the age group of 12 to 70 years, both inclusive and whose names appear in the Khatauni Records of Uttar Pradesh as the owner of agricultural land in the state of Uttar Pradesh. If the farmer attains the age of 12 years he/she will be deemed to be covered from such date. But if a farmer attains the age of 70 years during the tenure of this policy, he/she will also remain covered till the end of the policy. This policy shall remain in force for a period of one year from 16thSeptember, 2005 to 15thSeptember, 2006. An agreement was signed between the Government of Uttar Pradesh and New India Assurance Company. All terms and conditions in detail were mentioned in this agreement. The Government paid the premium of Rs 10,75,00,000/- to the insurance company for all such farmers covered under the said scheme. In the instant matter the Complainant's husband Mr Nanak Chand Sharma, aged about 55 years, r/o Mohalla Manak Chowk, Town Jewar , District Gautam Budh Nagar was covered under this scheme. He was holding agricultural land in his village Jewar Bangar, District Gautam Budh Nagar. He was killed in a railway accident . The information of his death was sent to the District Magistrate, Gautam Budh Nagar who in turn after getting completed all formalities submitted the claim of Rs 100,000/- to the Appellant- the insurance company. The Respondent-Complainant visited the office of the Appellant as well as that of the District Magistrate to know about the fate of the claim application. But no communication was made to her about the disposal of the claim. As per her statement in the complaint, in the month of July 2009, She came to know from the office of the District Magistrate that the claim might have been rejected. The complainant stated in complaint that the cause of action arose in July, 2006 when she came to know about the result of the claim application.
Being aggrieved, the Complainant-the wife of the deceased, filed the complaint before the District Forum, Gautam Budh Nagar. The Appellant contested the complaint case and filed the written statement wherein the averments of the complaint were denied. In the written statement of the insurance company it was stated that the Appellant-insurance company repudiated the claim on the ground that it was not the case of accident but that of suicide. The suicide is not covered under the said policy. The other ground of repudiation was the claim was not filed within the stipulated time of 90 days, hence it was time barred.
The learned District Forum Gautam Budh Nagar, after hearing both the parties and going through the entire record and evidences on file, passed the impugned order and directed the Opposite Party to pay the sum of Rs100,000/- towards the insurance claim, along with interest @ 6% per annum on the awarded sum from the date of the filing the complaint case till the date of payment. The appellant was directed to pay a sum of Rs 1000/- as legal expenses also.
Being aggrieved with the impugned order dated 15.12.2011, the Opposite Party/Appellant have filed this Appeal. The notices were issued to the Complainant/Respondent but the respondent did not turn up to contest the appeal. The notice was deemed to be served as it did not return as unserved within the stipulated time.
The case was put up before this bench for hearing. Mr Ashish Kumar Srivastav, the learned counsel for the Appellant was present. Nobody was present from the Respondent's side. Heard the arguments of the learned counsel for the Appellant and perused the record on file. The main ground in the appeal is that it was not the case of accidental death but that of the suicide. It has also been stated in the grounds of appeal that the death of the respondent's husband Nanak Chand Sharma occurred on dated 15.3.2006 and the complaint was filed on 25.6.2010. Thus the complaint was time barred by limitation under section 24 of Consumer Protection Act, 1986 wherein it has been provided that the complaint should be filed within a period of two years from the date when cause of action arises. It has also been stated in the appeal that according to conditions of the policy, the claim should be processed by the insurance company within a period of 90 days. In the grounds of appeal it has also been stated that the claim was forwarded by the competent authority on dated 14.6.2006 and was received by the insurance company on 19.6.2006 which was beyond the stipulated time. The appellant's learned counsel assailed the impugned order on these grounds and alleged that the learned District Forum by ignoring all the facts passed the impugned order arbitrarily which is erroneous and unjustified. The appellant pleaded to set aside the impugned order.
There is no dispute that the complainant's husband deceased Nanak Chand Sharma was a farmer of village Jewar Banger and was resident of Town Jewar in District Gautam Budh Nagar. It is also admitted that Government of Uttar Pradesh had launched "Group Personal Accident Policy for Farmers"for the welfare of the farmers of the State Of Uttar Pradesh in collaboration the Appellant Insurance Company. The Government of Uttar Pradesh had paid a premium of Rs.10,75,00,000/- (Rupees Ten Crore Seventy Five Lakh Only) to the Appellant Insurance Company for and on behalf of the 2,50,00,000 farmers as is evident from the policy cover note No 420500/42/05/00000075 dated 15thSeptember 2010. It was valid for the period from dated 16th September 2005 to 15th September 2006. Since the deceased farmer's name was recorded in the agricultural records of the revenue department and was qualifying the other conditions to become entitled to get benefits of the said scheme. So he was also covered under the said scheme. This is also admitted that the complainant's husband Nanak Chand Sharma died of rail accident on dated 15.3.2006 during the validity period of the said Policy and his claim was forwarded by the office of the District Magistrate on dated 14.6.2006that was received in the office of the insurance company on dated 19.6.2006.
The appellant have filed so many annexures with the appeal. One annexure No. 4 is the copy of repudiation letter wherein it has been stated that the claim form should have been received within a period of 90 days. Since the claim was received after the time period, hence the claim is not maintainable. From the perusal of this letter it is apparent that this letter is undated. When it was issued to District Magistrate, Gautam Budh Nagar, is not clear. It is apparent that claim was sent by the District Magistrate just within 91 days. Nothing has been shown by the insurance company that if the claim is received after the stipulated period, the claim will be rejected. The directions in the scheme/policy to send the claims and dispose them within 90 days are there. But nothing is mentioned in the policy cover note that if the claim is received after the said stipulated period due to delay in transit or otherwise, the claim will not be accepted and rejected outright only on this count.
This appeal has been filed at delay of about 20 days. The delay condonation application has also been filed along with the affidavit wherein the reasons has been stated. From the perusal of the affidavit it is apparent that the delay appears to be due to routine procedural official lackluster style of functioning of babudom. Which is not very much convincing. If the appellant is not ready to grant a waiver of one day in filing the claim by the respondent-claimant or the District Authorities concerned then how they can expect the delay of 20 days on their part in filing the appeal to be condoned that too when the reason of condonation are not satisfactory. The State Government gave them the premium of more than Rupees 10 crore and the appellant is rejecting the claim of Rupees one lakh only of the poor farmer for a delay of one or two days only. This delay of one day was not on the part of the claimant but on the part of District Officials who were responsible for sending the claims to the insurance company. District Officials are always over burdened with so many public works and other duties and responsibilities including that of law & order. This fact should have been under consideration of the Appellant-Insurance Company. There is no evidence on the file that the respondent's husband committed suicide. It is mere imagination of the appellant and a lame excuse to reject the claim. There is no exclusion clause in the policy regarding death due to suicide. On this count also the claim should have not been rejected.
From perusal of the order of the learned District Forum it is apparent that they have thoroughly examined the scheme and passed a detailed order. The learned District Forum have not made any mistake in allowing the complaint. There is no need to interfere in the impugned order. The appeal deserves to be dismissed.
ORDER The Appeal is dismissed. The parties will bear their own costs. Let the copies of this order be made available to all concerned as per rules.
(Raj Kamal Gupta) (Mahesh Chand) Presiding Member Member S.k. st. ct-5 [HON'BLE MR. Raj Kamal Gupta] PRESIDING MEMBER [HON'BLE MR. Mahesh Chand] MEMBER