HIMACHAL PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION, SHIMLA
Surjit Singh, (Retd.) President and Mrs. Prem Chauhan, Member
Principal Government Polytechnic for Women Kandaghat, District Solan (H.P.) —Appellant
versus
Reliance General Insurance Ltd. —Respondent
First Appeal No. 125 of 2011
Decided on 28.8.2012
Counsel for the Parties:
For the Appellant: Mr. Vinay Verma, ADA.
For the Respondents No.1 and 2:Mr. Ratish Sharma, Advocate.
For the Respondent No.3:M.L. Sharma, Advocate.
IMPORTANT POINT
Death claim cannot be repudiated only on ground of delay in intimation.
Headnote:Consumer Protection Act, 1986—Sections 15 and 17—Insurance—Group Insurance—Repudiation of death claim on ground of delay in intimation—Appellant has been ordered to pay Rs.2,00,000 with 9% interest and Rs.3,500, as costs— cause of death was injuries sustained in the accident—Intimation of death was given to appellant promptly—Delay in informing insurer about date of death, may be a good ground for repudiation of claim in a case where there is serious dispute creating reasonable doubt about death or cause of death of insured person, but not in a case like present one, where there is no dispute that insured employee had died and her death was accidental—Respondents as also appellant directed to pay insurance money of Rs.2,00,000 with interest and their liability shall be joint and several—Impugned order modified. (Paras 9 to 12)
Justice (Retd.) Surjit Singh, President—Appellant is aggrieved by the order dated 23.3.2011, of learned District Consumer Disputes Redressal Forum, Shimla, whereby a complaint, under Section 12 of the Consumer Protection Act, 1986, filed by respondent Attar Singh against it (the present appellant) and respondents No.1 and 2, i.e. Reliance General Insurance Limited, Chandigarh, through its Senior Manager and Branch Manager, Reliance General Insurance Company Limited, Khalini, Shimla, respectively, has been allowed and the appellant has been ordered to pay a sum of Rs.2,00,000 with interest at the rate of 9% per annum from the date of the complaint to the date of payment of the aforesaid amount of money, on account of insurance money and Rs.3,500, as litigation expenses.
2. Smt. Kamlesh Kumari wife of respondent Attar Singh, hereinafter referred to as complainant, was employed as sweeper, in the college of appellant. Government of Himachal Pradesh introduced a scheme, in terms of which, all its employees were covered under a group insurance. Arrangement for group insurance had been made by the State Government with Reliance General Insurance Company Limited, respondent No.1 herein and hereinafter referred to as opposite party No.1. Certain amount of money was required to be deducted from the salary of the employees and deposited with the opposite parties No.1 and 2 towards the premium.
3. The scheme was initially started in November, 2006. It was for one year. It was extended by another year by issuance of a fresh circular and after renewal, it was to remain in force from 10.10.2007 to 9.10.2008. Under this renewed policy/scheme, first instalment of premium was to be deducted from the salary for the month of October, 2007, payable on 1.11.2007. Premium was deducted from the salary of Kamlesh Kumari by the present appellant/opposite party No.3 and remitted to opposite parties No. 1 and 2. However, Kamlesh Kumari died in a bus accident on 1.11.2007 itself. Intimation of her death was given to the appellant/opposite party No.3 being her employer. Claim for insurance money was lodged with the opposite parties No.1 and 2 by the appellant on 13th August, 2008. Opposite parties No.1 and 2 repudiated the claim on the ground that under the scheme and the policy, intimation of death was required to be given to them within one month of the death and in this case, intimation was given about 10 months after the date of death.
4. Complainant being the husband of the deceased and also the nominee in the insurance cover filed a complaint under Section 12 of the Consumer Protection Act, 1986, seeking issuance of a direction to the opposite parties, including the appellant for payment of insurance money with interest and also for damages and litigations expenses.
5. Complaint was contested by the opposite parties. Appellant in his reply pleaded that money was payable by opposite parties No.1 and 2, as deceased was insured with them. Opposite parties No.1 and 2 denied their liability, on the plea that intimation of death had been given to them about 10 months after Kamlesh Kumari actually died, though under the insurance scheme, intimation was required to be given within one month.
6. Learned District Forum concluded that the present appellant was responsible for delaying the intimation of death of deceased employee to opposite parties No.1 and 2. Learned District Forum further held that respondents No.1 and 2 having not been apprised of the death within one month, were not liable to pay the insurance money. The present appellant having been held responsible for failure to inform opposite parties No.1 and 2 about the death within the prescribed time, was held guilty of deficiency in service and ordered to pay the insurance money with interest and litigation expenses, as aforesaid.
7. Appellant’s contention is that money is required to be paid by the opposite parties No.1 and 2, who have been impleaded as respondents No.1 and 2 in this