IN THE HIGH COURT OF RAJASTHAN
Dinesh Mehta, J.
United India Insurance Company Limited - Appellant
Versus
Narayani - Respondent
Civil Writ Petition No. 14601 of 2019
Decided On : 07-11-2019
Legal Services Authority Act, 1987 - Section 22-C - Repudiation letter - Accident - Apathetical attitude - Writ petition questioning legality and propriety of judgment and award - Claimant being hapless widow mother of deceased took some time to come out of shock and mourning, and when she was informed that her son was holding a Credit Card covered by a Group Insurance Policy taken by Jodhpur Central Cooperative Bank Ltd for its members she contacted the respondent Bank having taken a Group Insurance Policy on filed a claim Policy for accidental death - Held, It was duty of respondent Bank policy holder to lodge claim beneficiary or family member of insured cannot directly file a claim - It is difficult nay impossible for Bank to know that a particular member/ Credit Card holder has passed away and that too out of an accident of this Court having regard to nature of policy and considering fact that beneficiary or insured are members/ Credit Card holders stationed at remote corners condition itself is unconscionable - Same cannot be applied mechanically without going into reasons which has led to late intimation - In instant case since nothing has been brought on record which can even create a doubt about occurrence of accident this Court is of considered opinion that Insurance Company has committed an illegality in repudiating claim in relation to death of cloak of condition of Insurance Policy - Application Disposed of
JUDGMENT
Dinesh Mehta, J. - Reportable
1. The petitioner-Insurance Company has preferred the present writ petition questioning the legality and propriety of judgment and award dated 12.6.2019, passed by the learned Permanent Lok Adalat, Jodhpur, whereby a sum of Rs.5 lacs has been awarded in favour of the respondent no.1 with respect to a Group Insurance Policy, which had been taken by the respondent no.2- The Jodhpur Central Cooperative Bank Ltd for covering the risk of the insuredits members/Kissan Credit Card Holders.
2. The facts relating to the accident are harrowing; but the facts giving rise to this case are even more agonising- they showcase the apathetical attitude of the Insurance Companies.
3. On 31.1.2017 when Dungar Ram was traveling in a Bolero vehicle alongwith his family members, a truck collided with it, resulting in serious accident, in which almost all the passengers, being his close relatives got seriously injured. Sattu Devi W/o Prakash and Sagni D/o Dungar Ram (the deceased) died instantaneously; whereas Dungar Ram was seriously injured and was referred to MDM Hospital, Jodhpur. He remained hospitalized, fought till 9.2.2017 and ultimately lost the battle.
4. The claimant being hapless widow mother of the deceased Dungar Ram took sometime to come out of the shock and mourning, and when she was informed that her son was holding a Kissan Credit Card, covered by a Group Insurance Policy taken by the Jodhpur Central Cooperative Bank Ltd. for its members, she contacted the respondent Bank. The respondent Bank, having taken a Group Insurance Policy on 11.7.2016 filed a claim under the Policy for accidental death of Dungar Ram on 11.4.2017.
5. The petitioner - Insurance Company however repudiated the same vide its letter dated 7.12.2017, solely on account of the fact that the accident took place on 31.1.2017, whereas the intimation to the Insurance Company was given on 11.4.2017 (after 70 days). It will not be out of place to reproduce the contents of the repudiation letter dated 7.12.2017, which reads thus:
6. Respondent No. 1, the mother of the deceased - being nominee, thus approached Permanent Lok Adalat under Section 22-C of the Legal Services Authority Act, 1987 by way of filing a claim petition.
7. The petitioner - Insurance Company opposed the claim tooth and nail, with the plea that the claimant is not entitled for the benefits of the Group Insurance Policy, as the intimation of the accident was given after the prescribed of 30 days.
8. The learned Permanent Lok Adalat, after considering the facts and material available on record, allowed the claim petition filed by the respondent no.1 and awarded a sum of Rs.5 lacs being amount payable under the Group Insurance Policy; interest @ 9% upon such sum from 1.1.2018 and cost of Rs.10,000/-.
9. Mr. Jagdish Vyas, learned counsel for the petitioner - Insurance Company submitted that learned Lok Adalat has erred in passing the impugned award dated 12.6.2019 and directing the petitionerInsurance Company to pay the amount in pursuance of the Group Insurance Policy. Inviting Court's attention towards condition no.1 of the terms and condition of the Policy, he submitted that as per the condition no.1, the claimant was required to give intimation of the accident immediately, and in any case, within a maximum period of 30 days. According to him since neither any intimation of the accident was given to the petitioner - Insurance Company nor was the claim lodged within the stipulated period, the benefits of Insurance Policy cannot be extended, as the claimant failed to comply with the condition of the policy. The bone of contention- condition no.1 of the Policy is being reproduced hereinfra:
"1. Upon the happening of any event, which may give rise to claim under this Policy, written notice with full particulars must be given to the company immediately. In case of death, written notice also of the death must, unless reasonable cause is shown, be so given before internment, cremati
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