State Consumer Disputes Redressal Commission
Parwati Thakur vs Golden Multi Services Club Ltd. on 24 October, 2008
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION
PANDARI, RAIPUR
Appeal No.231/08
Date of institution 10.04.08
Date of Order 24.10.08
Parwati Thakur,
W/o Lt. Adalat Singh Thakur,
R/o Kailash Nagar Ward No.2,
Behind Electricity Office, Lohar Road, Kawardha
Dist. KABEERDHAM (C.G.) ... Appellant.
Vs.
1. Golden Multi Services Club Ltd.
S.B. Mains - 16, R.M. Mukharjee Road,
CALCUTTA - 700 001
2. Divisional Manager, National Insurance Co. Ltd.,
Division - III, Shakespeare Sarani, 6th Floor,
CALCUTTA - 700 001
3. Khem Singh Sahu,
S/o Shri Saniram Sahu,
Kailash Nagar, Kawardha, Behind Muktidham,
Dist. KABEERDHAM (C.G.) ... Respondents.
COUNSEL FOR THE PARTIES : -
Shri K.K. Chandrakar, for Appellant.
Shri P.K. Paul, for respondent No.1.
None for respondent Nos. 2 & 3.
PRESENT : -
HON'BLE SMT. VEENA MISRA, MEMBER
HON'BLE SHRI V.K. PATIL, MEMBER
ORDER
PER: - HON'BLE SMT. VEENA MISRA, MEMBER This appeal under section 15 of the Consumer Protection Act, 1986 is directed against the order dated 10.03.08 passed in complaint case No.10/07 by District Consumer Disputes Redressal Forum, Kabirdham (hereinafter called the "District Forum" for short) whereby the complaint was dismissed.
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2. As per averments of the complaint the complainant's husband had obtained insurance from OP - 2 through OPs - 1 & 3 for a sum of Rs.50,000/- for the period from 23.05.04 to 22.05.14 under policy No.100300/42/04/820012. The complainant's husband Adalalt Singh died in an accident on 17.08.05. Complainant is the nominee under the policy hence she laid claim before the insurer / OP - 2 but the claim was repudiated on 04.05.06.
3. The OP - 1 admitted averments contained in the complaint and averred that the said OP received intimation regarding the death of the complainant's husband on 21.10.05, relevant documents were also handed over to the said OP on 24.11.05. Subsequently, after doing the needful, the OP - 1 had sent the said documents togetherwith letter dated 28.11.05 to the insurer / OP - 2. However, the police final report was sent to OP - 2 on 25.01.06. It was further averred in the written version that the insurer had repudiated the claim which was against terms of the policy. It was further averred that OP - 1 had repeatedly reminded the OP - 2 for deciding the claim of the complainant.
4. The insurer had averred in the written version that OP - 1 is a service club which had entered into an agreement with the insurer on // 3 // 14.04.04. The complainant had given intimation of her husband's death to OP - 1 after a period of 2 months and 9 days on 14.10.05. Thereafter the filled claim form was sent to the insurer after a period of 3 months and 10 days from the date of death of the insured which was violation of terms of the policy because as per the policy intimation regarding death was necessary to be given within a period of one month and claim was to be submitted within a period of 90 days. Since the claim was not preferred within time, it was closed as 'no claim' and complaint as such was liable to be dismissed.
5. In separate written version OP - 3 has averred that no cause of action ever arose in favour of the complainant against OP - 3. On receiving intimation regarding death of the complainant's husband the OP - 3 handed over the claim form to the complainant. The claim was to be paid by OPs - 1 & 2. There was no deficiency in service on part of OP - 3. Hence, the complaint may be dismissed against the said OP.
6. The District Forum came to the conclusion that neither the intimation regarding death was given within the stipulated time, nor the claim was filed within stipulated period, hence the complaint was dismissed.
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7. Final arguments heard, record perused.
8. Learned counsel for the appellant submitted that the husband of the complainant died within subsistence of insurance on 17.08.05 but the complainant was not aware of any policy in favour of her husband. While she was searching for papers relating to agriculture she came to know about the policy on 19.10.05 and she took the same to educated person of her village and through him intimated the OP - 1 on 21.10.05 regarding death of her husband and submitted all relevant documents on 24.11.05, which were in turn sent to OP - 2 on 28.11.05. Learned counsel further submitted that main purpose of obtaining insurance cover is that the family members of the insured would receive some financial assistance in case the insured dies but repudiation of claim simply on the ground of delay, is against the principles of natural justice. He further submitted that the complainant belongs to poor family and is an illiterate village woman. She was not aware of the policy as soon as she came to know about the policy, she took necessary steps to lay claim. The District Forum has erred in not considering the aforesaid facts. He submitted that in view of facts of the case order of the District Forum may be set aside and appeal may be allowed.
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9. Learned counsel for respondent No.1 submitted that respondent No.1 was only responsible for forwarding the documents and claim form received from the complainant to the insurer and had not committed any deficiency in service. It was the obligation of the insurance company to consider the claim. He further submitted that respondent No.1 had stated in the written version that the claim ought not to have been rejected simply on the ground of nominal delay. He has no objection if the claim of the complainant is allowed against the insurer.
10. None appeared for respondent Nos.2 & 3.
11. On perusal of complaint itself it appears that the complainant has put her thumb impression which clearly shows that she is an illiterate village woman. Admittedly, immediate intimation regarding death was not given to the insurer. Intimation to OP - 1 was given on 21.10.05 and necessary papers were handed over to OP - 1 on 24.10.05, hence there was obvious delay in giving intimation regarding death of the insured. As per terms of policy intimation of death is required to be given so that the insurer gets an opportunity to // 6 // verify whether the death has actually been caused due to accident or not. In the instant case it appears from FIR / document A-5 that the matter was reported to the police on 17.08.05 itself i.e. date of accident. Hence, even if the intimation regarding accident was not given to the insurer the fact of the accident is proved by document A-5 and we have no reason to disbelieve the aforesaid document.
12. So far as the question of delayed filing of claim form is concerned, it is noted that there was nominal delay of merely 10 days. We are of the opinion that in view of the fact that the complainant is an illiterate woman who was not aware of the policy in favour of her husband and who depended upon others for laying the claim, hence in the circumstances insurer ought to have considered the claim sympathetically and simply repudiating the claim on the basis of delay of 10 days does not appear to be proper. In the circumstance we are of the opinion that the complainant is entitled to claim amount as per policy.
13. Hence, the appeal is allowed. The order of the District Forum is set aside and it is directed that the insurer / OP - 2 shall pay a sum of Rs.50,000/- (Rs. Fifty Thousand) to the complainant with interest // 7 // @ 9% p.a. from the date of complaint within a period of 45 days from the date of this order, failing which interest @ 12% p.a. from the date of default shall also be payable. Besides this the OP - 2 / insurer shall also pay a sum of Rs.2,000/- (Rs. Two Thousand) towards cost of proceedings to the complainant.
(Smt. Veena Misra) (V.K. Patil)
Member Member