ORAL ORDER

PER: - JUSTICE GAUTAM CHOURDIYA, PRESIDENT

This appeal, filed under Section 41 of the Consumer Protection Act

2019 (hereinafter called “the Act” for short) is directed against order dated 23/08/2023 passed by District Consumer Disputes Redressal Commission, Raipur (C.G.) (hereinafter referred to as “District Commission” for short), in Complaint Case No.CC/2017/156, whereby the complaint of the respondent herein alleging deficiency in service against the opposite party / appellant herein by not settling her insurance claim in time, is partly allowed and the opposite party / appellant is directed to pay the complainant/ respondent within 45 days the amount of insurance claim Rs.2,00,000/- (Two Lacs) with interest @ 6% p.a. from the date of filing complaint i.e. 27.02.2017 till realization, Rs.5,000/- (Five

Thousand) as compensation for mental agony and Rs.5,000/- (Five Thousand) as cost of litigation. Feeling aggrieved the opposite party has approached this Commission by way of this appeal.

2. In nutshell the facts of the case are that the deceased husband of the complainant / respondent was registered owner of vehicle bearing registration No.CG-04-JC-9936 for which insurance cover under a package policy was obtained from the opposite party / appellant for the period between 14.08.2012 to 13.08.2013. On 16.12.2012, during subsistence of the insurance policy, when the vehicle was being driven by the deceased Jitendra Kumar Mehta, it met with an accident in which he sustained serious injuries in his head. He was brought to the hospital in unconscious condition. Subsequently he was referred to higher center Ram Manohar Lohia Hosptal New Delhi, where he remained admitted from 21.04.2013 to 13.05.2013, when he could not gain his consciousness, he was referred to Christian Medical College Vellore. In that hospital deceased Jitendra Kumar Mehta remained admitted from 22.05.2013 to 11.06.2013, where his exercises and physiotherapy was also done and was discharged. But he could not recover from the traumatic injuries and ultimately died on 23.05.2014. Claim case was filed before the Motor Accident Claims Tribunal but the same was dismissed holding the claim as P.A. Claim as the deceased was the owner and driver of the vehicle himself and he did not come in the category of a third person. As per averment of the complainant/ respondent the non-applicant impleaded in the claim case who is the opposite party / appellant insurance company in this case was fully aware of the entire facts regarding accidental death of the insured Jitendra Kumar Mehta, but they did not take any step for settlement of the claim, which amounted to deficiency in service on their part. Hence, complaint was filed before the District Commission seeking direction to the opposite party / insurance company for payment of personal accident death claim of Rs.2,00,000/- with interest @ 12% p.a., compensation for mental agony Rs.20,000/- along with cost of litigation and any other relief which the District Commission deems fit to award.

3. The opposite party / appellant in its written version except the admitted facts has denied all the adverse allegations leveled against. It was specifically denied that the deceased insured died as a result of accident. It was averred that the insured did not die as a result of accident, therefore neither information of his death was given nor any claim form was submitted before the insurance company by the complainant/ respondent, which was a mandatory condition as per the insurance policy but was not followed by the complainant / respondent. It was also averred that as no document and claim form was submitted before the insurance company within the proper and prescribed time, no cause of action arose to file the complaint, hence for the above reasons the complaint is liable to be dismissed with cost.

4. Learned District Commission after going through the record and considering the rival contentions of both parties observed that as a