State Consumer Disputes Redressal Commission
Tulsi Ram Lauansi vs Icici Lombard Gic. on 27 February, 2016
M. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PLOT NO. 76, ARERA HILLS, BHOPAL (M.P.)
FIRST APPEAL No. 426 /2011.
DECIDED ON : 27.2.2016.
Tulsiram Lovansi,
s/o Shri Moolchand Lovansi,
r/o Gram Salkani, Janpad Panchayat
Obedulla Ganj, District Raisen
(Madhya Pradesh).
....APPELLANT.
VERSUS
ICICI Lombard & Anr.
....RESPONDENTS.
BEFORE:
HON'BLE SHRI JUSTICE RAKESH SAKSENA, PRESIDENT
HON'BLE SMT. NEERJA SINGH, MEMBER
COUNSEL APPEARING FOR THE PARTIES :
MS. MONA PALIWAL, LEARNED COUNSEL FOR APPELLANT.
SHRI ADITYA SHARMA, LEARNED COUNSEL FOR RESPONDENT NO.1.
NONE FOR RESPONDENT NO.2.
ORDER
The following order of the Commission was delivered by Rakesh Saksena, J. :
Appellant / complainant has filed this appeal against the order dated 1.11.2010 passed by District Forum, Raisen in complaint case No.38/2009 whereby the complaint filed by him has been dismissed.
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2. The case of the complainant, in nutshell is that he is the member of below poverty line family as such he is covered under the Vivekanand Group Insurance Scheme floated by the State Government. On 18.6.2006 his son Mukesh Kumar died in a road accident. First information report in that regard was lodged with the Police Station Obedullaganj District Raisen and a case under section 304-A, I.P.C. was registered. Under the aforesaid insurance scheme, complainant's insurance cover was in force, therefore, he was entitled to insurance amount of Rs.50,000/- on account of accidental death of his son. Complainant's claim was sent to respondent / Insurance Company through Chief Executive Officer, Janpad Panchayat along with the requisite documents, but it was not accepted and no amount was paid. Aggrieved by the act of respondent, complainant approached to District Forum for a direction to Insurance Company to pay the amount of Rs.50,000/- of compensation with interest.
3. Respondent no.2 / Nodal Officer despite service of notice remained absent.
4. Respondent no.1 / Insurance Company resisted the claim on the ground that according to conditions of the policy the claim of complainant could be honoured only if the intimation of the incident was sent to it through Nodal Officer within the limitation of 90 days from the date of accident. Since no intimation or any claim was received by the company, the company was not liable to pay any amount to the complainant.
5. Learned District Forum after perusal of record held that no document evidencing the presentation of claim of the complainant before the Insurance Company was on record, therefore the company committed no error in not making payment of the insured amount.
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6. We have heard learned counsel for the parties and perused the record.
7. In the conditions of the policy it has been prescribed that as soon as the claim is received by the Nodal Officer, after examining it, he shall forward the same to the District Representative of the Insurance Company directly after giving information of the same to Chief Executive Officer of District Panchayat. Learned counsel for the appellant failed to point out any document showing that the claim of complainant was ever forwarded to Insurance Company. From the impugned order it is seen that the complainant was afforded opportunity to adduce documents showing that respondent / Nodal Officer recommended and forwarded his claim to respondent / Insurance company, but he failed to do so. This indicates that the claim form of complainant was not certified or verified by the Nodal Officer. In such a situation, it could not be presumed that complainant filed his claim with the Insurance Company through the Nodal Officer. In such situation, no fault can be found with the Insurance Company in not making payment of insurance amount to the complainant.
8. In the above circumstances, we find no infirmity in the impugned order passed by the District Forum dismissing the complaint. The appeal being devoid of substance, is dismissed.
(Justice Rakesh Saksena) (Smt. Neerja Singh)
PRESIDENT MEMBER