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MAHARASHTRA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, MUMBAI
S.M. SHEMBOLE, K.B. GAWALI, UMA S. BORA, JJ.
Balu Waman Kadam – Appellant
Versus
ICICI Lombard General Insurance Co. – Respondent
F.A. No. 612 of 2009 in Complaint Case No. 78 of 2009
Decided On : 01-08-2013
Advocate Appeared:
For the Appellant : Mr. Anand Mamidwar.
For the Respondent: Mr. R.H. Dahat.
The court emphasized the importance of considering the complainant's submission of required documents and willingness to produce further documents in the context of an insurance claim.
Headnote:
Insurance Claim - Personal Accident Insurance Policy - The court directed the insurance company to reconsider the claim on production of required documents by the complainant.
Fact of the Case:
The complainant's mother held a personal accident insurance policy. After her death, the complainant submitted an insurance claim, which was repudiated by the insurance company due to alleged failure to produce required documents.
Finding of the Court:
The court found that the complainant had already submitted the required documents and was willing to produce any further required documents. The court directed the insurance company to reconsider the claim on production of the required documents.
Issues: Alleged deficiency in service by the insurance company, repudiation of the insurance claim, and the complainant's willingness to produce required documents.
Ratio Decidendi: The court's decision was influenced by the complainant's submission of the required documents and willingness to produce further documents, contrary to the insurance company's allegation of non-compliance.
Final Decision: The appeal was allowed, the impugned judgment and order were set aside, and the insurance company was directed to reconsider the claim within one month upon receipt of the required documents from the complainant.
ORDER :
1. This appeal is an exception to the judgment and order dated 31.7.2009 passed by District Consumer Forum, Aurangabad dismissing the consumer complaint No.781/2009. (For the sake of brevity appellant hereinafter referred as 'the complainant' and respondent as 'opponent Insurance Company').
2. With the consent of learned counsel for both sides we have decided to dispose of this appeal at the stage of hearing before admission.
3. The brief facts giving rise to this appeal are that: Deceased Nanubai mother of complainant Balu was farmers personal accident insurance policy holder. It was obtained by the State Government from the opponent Insurance Company. After the death of Nanubai her son complainant Balu submitted insurance claim with the opponent Insurance Company. However the claim came to be repudiated on the ground that requisite documents are not produced. Therefore complainant has filed the consumer complaint alleging deficiency in service on the part of opponent Insurance Company and claimed insurance amount of Rs.1 lakh with interest @ 18% p.a. and also claimed compensation of Rs.5000/-.
4. Opponent Insurance Company resisted the complaint by its written version contending inter-alia that it has rightly repudiated the claim as the complainant failed to produce documents inspite of issuance of letter dated 9.6.2006. Opponent Insurance Company also raised some other points and submitted to dismiss the complaint.
5. On hearing both sides, District Consumer Forum held that as the complainant failed to produce the documents Insurance Company has rightly repudiated the claim.
6. Feeling aggrieved by that judgment and order complainant has preferred this appeal.
7. We heard learned counsel for both sides, perused the copy of impugned judgment and order, copies of complaint, written version and other documents.
8. It is submitted by Shri.Mamidwar learned counsel for the complainant/appellant that the complainant had already produced entire documents along with claim form and same form was submitted to Tahasildar, Khultabad. It is further submitted that complainant never received any letter from opponent Insurance Company asking him to produce some documents. But opponent Insurance Company has falsely alleged that complainant failed to produce the documents. It is further submitted that now complainant is ready and willing to produce the required documents. Therefore we feel it just and proper to direct opponent Insurance Company to reconsider the claim on production of required documents by the complainant. Hence we are inclined to allow this appeal and pass the following order.
ORDER:
1. Appeal is allowed and impugned judgment and order is hereby set aside.
2. Opponent Insurance Company is directed to reconsider the claim of complainant within one month on receipt of required documents from complainant.
3. No order as to cost.
4. Copies of the judgment be issued to both the parties.
