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Showing contexts for: Group Insurance Policy in Smt. Sunita vs State & Ors on 5 September, 2016Matching Fragments
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1. The claim in the present writ petition is for release of compensation amount payable under the General Insurance Policy (Group Personal Accident Policy) on account of unnatural death of petitioner's husband along with interest for delayed payment.
2. The petitioner herein is a widow of late Sri Vinod Kumar, an employee of Department of Medical & Health. He being a State employee had subscribed to General Insurance Policy (Group Personal Accident Policy) (hereinafter referred as 'the Policy') and Insurance Certificate No.693918 was issued in his favour under the Rajasthan State Employees Insurance Rules, 1953. Regular deductions were made from his salary towards Group Personal Accident Policy. The husband of the petitioner expired on 12.11.2010 and as per Postmortem Report, the cause of death was stated to be "antemortem head injury". The petitioner thereafter submitted an application in the requisite format along with supporting documents. However, the claim of the petitioner came to be rejected by an order dated 11.03.2013. An appeal against the said order was preferred on 17.05.2013 before the Director, State Insurance & Provident Fund Department but the same was not taken up for consideration and is pending. On denial of release of benefits under the Scheme the petitioner approached the Consumer Forum by filing a Complaint under the provisions of Section 12 of the Consumer Protection Act, 1986. However, the said complaint was returned as not maintainable. Aggrieved against on account of denial of compensation, the present writ petition has been filed.
5. I have heard learned counsel for the petitioner and have perused the record of the case.
6. There is no doubt that the petitioner was a member of the Group Insurance Scheme, 1995. The said Scheme came to be introduced by the Government of Rajasthan for it employees in the Year 1995, with an object to provide social security to its employees and their wards in the event of death or disablement of its employees. As per the Policy in case a person insured sustained any bodily injury which arose solely and directly from an accident caused by external, violent and visible means, the compensation would be paid to the Insured Persons as specified in the Policy. In clause 4 of the Exceptions to the General Insurance Policy (Group Personal Accident Policy) it has been specified in that compensation shall not be payable under this Policy in respect of Death, injury or Disablement of the Insured Person: