IMPORTANT POINT
Claim – No claim should be disallowed purely on technical ground or in a mechanical manner; the insurance company should reject the claim only when the insurer finds that it was liable to be rejected, even after it had been submitted in time.

ORDER

Kumkum Rani, Judicial Member II—This appeal under Section 15 of the Consumer Protection Act, 1986 has been directed against the judgment and order dated 23.08.2018 passed by learned District Consumer Disputes Redressal Commission, Udhamsingh Nagar (hereinafter to be referred as “The District Commission”) in consumer complaint No. 43 of 2017, styled as Sh. Devnath and others Vs. The New India Assurance Company Limited and another, wherein and whereby learned District Commission was pleased to allow the consumer complaint filed by respondent Nos. 1 to 4 / complainants, by directing the appellant to pay to respondent No. 1 / complainant No. 1, an amount of Rs. 2,00,000/- along with simple interest @7% p.a. from the date of filing of the consumer complaint till payment as well as Rs. 20,000/- towards mental & financial agony and Rs. 5,000/- as cost of litigation.

2. The facts giving rise to the present appeal, in brief, are as such that on dated 04.07.2016, the deceased / insured late Ramakant (father of respondent Nos. 1 to 4 / complainants), was crossing Devaha River for approaching his agricultural field and in the process of crossing the river, he got drowned in the river and expired. The intimation of the accident was given to Majhola Khatima Sahkari Ganna Vikas Samiti Limited, who forwarded the same to the insurer on 20.09.2016, which was received in the office of the insurer on 26.09.2016. Even after the expiry of more than six months’, the insurer did not pay the insured amount, therefore, the complainants sent a legal notice dated 26.04.2017 through their Advocate. Even after expiry of 30 days’ from the date of receipt of the notice, neither the amount was paid by the insurer, nor reply was given. Hence, the consumer complaint was filed for the grant of reliefs mentioned in the consumer complaint.

3. The opposite party No.1 / appellant (insurance company) filed written statement before the District Commission and pleaded that the complainants had filed the consumer complaint for the death of their father without filing any insurance policy and verifying its efficacy as on the date of death of the deceased. It is also alleged in the written statement that the death of late Ramakant was alleged to have taken place while he was crossing Devaha River, but no proof as to the Postmortem Report, Panchnama, F.I.R. and copy of G.D. Entry has been filed to prove the accident and subsequent death of the deceased. It appears that late Ramakant had died due to his natural death and as an afterthought, with the sole intention to obtain illegal compensation from the insurance company, the complainants have got the documents fabricated, with the malafide intention to obtain claim. It is further averred that the intimation about the death of the deceased was given with delay, violating the terms and conditions of the insurance policy. Hence, the complainants are not entitled to get any amount and the consumer complaint is liable to be dismissed.

4. The opposite party No. 2 / respondent No. 5 (Majhola Khatima Sahkari Ganna Vikas Samiti Limited) has pleaded in their written statement filed before the District Commission that it is true that as per the record, the father of the complainants was a Member of the Samiti bearing Serial No. 134 and Code No. 2185. The information about the death of the deceased Ramakant along with 10 documents was given to the insurer, with a request to pay the insured amount. The said claim form was received by the office of the insurer on 26.09.2016. The Samiti has no concern with regard to payment of insured amount to the complainants, hence the consumer complaint is liable to be dismissed against opposite party No.2.

5. Learned District Commission, after hearing the parties and after taking into consideration the entire evidence and material available on record, passed the impugned judgment and order on dated 23.08.2018, wherein it has held as under:—

“(Matter in Other Language)”

6. On having been aggri