CHATTISGARH STATE CONSUMER DISPUTES REDRESSAL COMMISSION
S.C. Vyas, President and V.K. Patil, Member
ORIENTAL INSURANCE COMPANY LTD. - Appellant
Versus
DEV KUNWAR AND ORS. - Respondents
Appeal No. FA/12/111
Decided on : 20-03-2012
Mr. P.K. Paul, Advocate, for the Appellant; None, for the Respondent
The policy remains in existence unless personal notice is given to the insured during his lifetime along with refund of pro rata premium, and the Insurance Company must provide evidence to show that the deceased was not insured.
Headnote:
Insurance - Personal Accident Policy - Interpretation of insurance coverage and cancellation of policy
Fact of the Case:
The complaint was allowed against the Insurance Company as it failed to prove that the deceased was not insured under the Group Janta Personal Accident Policy. The Insurance Company's defense of policy cancellation was not upheld by the court.
Finding of the Court:
The District Forum rightly allowed the complaint of the complainants as the Insurance Company failed to prove its defense. The court directed the District Forum to secure necessary indemnity bond or security bond from the complainants before disbursement of the award.
Issues: Interpretation of insurance coverage, proof of insurance, and cancellation of policy
Ratio Decidendi: The court held that unless personal notice is given to the insured during his lifetime along with refund of pro rata premium, the policy remains in existence and cannot be treated as cancelled. The Insurance Company failed to provide evidence to show that the deceased was not insured.
Final Decision: The appeal was dismissed, and the court directed the District Forum to secure necessary indemnity bond or security bond from the complainants before disbursement of the award.
ORDER
S.C. Vyas, President (Oral)- This appeal is directed against order dated 30.1.2012 of District Consumer Disputes Redressal Forum, Baikunthpur, Koria (C.G.) (hereinafter called "District Forum" for short), passed in Complaint Case No. 68/2009, whereby the complaint of the complainants, has been allowed against the Insurance Company.
2. This defence was raised by the appellant/Insurance Company before District Forum that deceased Shri Phool Say, was not insured by this Insurance Company, because the Insurance Certificate was not produced by the complainants and no list was brought on record by the employer/respondent No. 5 to show that name of the deceased was also figuring in that list.
3. We have gone through the pleadings of all parties.
4. The appellant/Insurance Company has provided insurance cover by way of Group Janta Personal Accident Policy to all permanent employees of respondent No. 5/S.E.C.L. The case of the complainants before District Forum was that Shri Phool Say was also a permanent employee of the S.E.C.L. The insurance premium was deducted from his salary and was paid to the Insurance Company, so he was insured and had died accidentally. The employer/S.E.C.L. has also supported this pleading. The Insurance Company has not brought any material on record to show that deceased was not insured or that no insurance premium was ever received by it for providing insurance cover to the deceased. The general plea was taken by the Insurance Company that insurance policy has already been cancelled by refunding amount of pro rata premium to the employer, but as per settled position of law, unless personal notice is given to the insured during his lifetime along with refund of pro rata premium, the policy remains in existence and cannot be treated as cancelled, so, District Forum has rightly observed that questioned policy was not cancelled and as the Insurance Company has not brought any material on record to show that deceased was not insured and all permanent employees of S.E.C.L were insured, so it can safely be presumed that deceased was also insured by the Insurance Company under Group Janta Personal Accident Policy after receiving premium.
5. The appellant/Insurance Company had ultimately failed to prove the defence raised by it before District Forum and District Forum, has rightly allowed the complaint of the complainants and we do not find any error in the order recorded by the District Forum.
6. Last contention of learned Counsel for the appellant/Insurance Company is that there is no material to show that complainants are the only legal heirs of the deceased. If the case is so, then for the purpose of securing the interest of the Insurance Company, necessary indemnity bond or security bond can be obtained by the Insurance Company from the complainants before making payment of the sum assured, as directed by the District Forum in execution case. District Forum will take care of this aspect of the matter and may pass suitable directions in execution case and will disburse the amount of the award to the complainants after receiving such indemnity bond and other security bond, as required by the Insurance Company under its rules and directed by the District Forum in execution case.
7. With these directions, the appeal having no substance, is dismissed in limine without any notice to the complainants and employer. No order as to the cost of this appeal.