Back
2008(4) CPR 173
CHHATTISGARH STATE CONSUMER DISPUTES REDRESSAL COMMISSION, RAIPUR
Veena Misra and V.K. Patil, Members
Parwati Thakur —Appellant
versus
Golden Multi Services Club Ltd. and Divisional Manager, National
Insurance Co. Ltd. & Another —Respondents
Appeal No. 231 of 2008
Decided on 25.10.2008
Counsel for the Parties:
For the Appellant:Shri K.K. Chandrakar, Advocate.
For the Respondent No. 1:Shri P.K. Paul, Advocate.
For the Respondent Nos. 2 & 3: None.
IMPORTANT POINT
Repudiation of claim under Insurance policy on ground that intimation of accident wherein insured died was not given to insurance company within stipulated period in terms of policy would not be just and proper when police report was lodged regarding accident and FIR copy proved fact of accident.
Headnote:Consumer Protection Act, 1986—Sections 12 and 17—Insurance claim—Husband of complainant obtained policy for Rs. 50,000 for the years on 23.5.2004—He died in accident on 17.8.2005—Claim repudiated on ground that intimation of accident was not given within stipulated period in terms of policy and claim was also not filed within that period—District Forum dismissed complaint—Appeal—Intimation of accident was given to respondent on 21.10.2005 but policy report was lodged on date of accident itself—Fact of accident stood proved from copy of FIR and there was no reason to disbelieve the document—Delay in filing claim, which was required to be filed in 90 days, was only of 10 days—Claimant was an illiterate villager—Insurer ought to have considered the claim sympathetically and repudiation of claim on that ground was not proper—Complainant held entitled to policy amount with interest @ 9% p.a. from the date of complaint. (Paras 11 to 13)
Result: Appeal allowed.
Veena Misra, Member—This appeal under Section 15 of the Consumer Protection Act, 1986 is directed against the order dated 10.3.2008 passed in complaint case No. 10 of 2007 by District Consumer Disputes Redressal Forum, Kabirdham (hereinafter called the “District Forum” for short) whereby the complaint was dismissed.
2. As per averments of the complaint the complainant’s husband had obtained insurance from OP2 through OPs 1 and 3 for a sum of Rs. 50,000 for the period from 23.5.2004 to 22.5.2014 under policy No. 100300/42/4/820012. The complainant’s husband Adalat Singh died in an accident on 17.8.2005. Complainant is the nominee under the policy hence she laid claim before the insurer/OP2 but the claim was repudiated on 4.5.2006.
3. The OP1 admitted averments contained in the complaint and averred that the said OP received intimation regarding the death of the complainant’s husband on 21.10.2005, relevant documents were also handed over to the said OP on 24.11.2005. Subsequently, after doing the needful, the OP1 had sent the said documents together with letter dated 28.11.2005 to the insurer/ OP2. However, the police final report was sent to OP2 on 25.1.2006. 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 OP1 had repeatedly remained the OP2 for deciding the claim of the complainant.
4. The insurer had averred in the written version that OP1 is a service club which had entered into an agreement with the insurer on 14.4.2004. The complainant had given intimation of her husband’s death of OP1 after a period of 2 months and 9 days on 14.10.2005. 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 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 OP3 has averred that no cause of action ever arose in favour of the complainant against OP3. On receiving intimation regarding death of the complainant’s husband the OP3 handed over the claim form to the complainant. The claim was to be paid by OPs.1 and 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.
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 17.8.2005 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 19.10.2005 and she took the same to educated person of her village and through him intimated the OP1 on 21.10.2005 regarding death of her husband and submitted all relevant documents on 24.11.2005, which were in turn sent to OP2 on 28.11.2005. 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 repudiated 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 the facts of the case order of the District Forum may be set aside and appeal may be allowed.
9. Learned counse
