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2007 DIGILAW 139 (CHH)

ORIENTAL INSURANCE CO. LTD. v. GEETO BAI

2007-02-19

R.S.AWASTHI, V.K.AGARWAL, VEENA MISRA

body2007
ORDER V.K. Agarwal, President:- 1. This appeal, under Section 15 of the Consumer Protection Act, (hereinafter called the 'Act' for short) is directed against the order dated 01.08 in complaint No. 123/2005 by District Consumer Disputes Redressal Forum, Bilaspur (hereinafter called the 'District Forum' for short) directing the appellant/ insurer to pay to the complainant/respondent a sum of Rs.5,00,000/- with interest @ 9 p.a .. Cost of Rs. 1,000/- was also awarded. 2. The facts not in dispute are that Shankar Singh, husband of the complainant/appellant was an employee of S.E.C.L. A Janata Personal Accident Insurance Policy (hereinafter referred to as "Janata Policy" for short) was issued in favour of the employees of S.E.C.L. by the appellant-insurer. The coverage of risk in the event of inter alia death in an accident was for the period from 16.10.1999 to 15.10.2009. It is further not in dispute that insured amount payable on the occurrence of such event was Rs.5,00,000/-. It is also not disputed that the complainant's husband, Shankar Singh died in a road accident on 13.10.2003. The claim preferred by the complainant was, however, repudiated by the appellant insurer by their letter dated 0 1.04.2003. 3. The complainant averred that since her claim was illegally repudiated by the letter dated 0 1.04.2003 by the appellant-insurer; therefore, she served a legal notice dated 23.08.2004 to the appellant-insurer and on getting no response thereof, she preferred complaint before the District Forum. She prayed that insured amount of Rs.5,00,000/- with interest and cost etc. be awarded in her favour. 4. Complaint was resisted by the appellant-insurer. It was averred that the intimation of the death of the insured was given to the appellant-insurer, after 4 months. It was further averred that the driving license of driver of the vehicle in which the deceased was traveling, was got renewed after insured's death. It was' also averred that the certificate of the deduction of premium from salary of deceased, was not produced by the complainant. Hence, the claim of the complainant respondent was repudiated by letter dated 01.04.2003. Therefore, there was breach of terms of policy. It was also averred that the complaint was barred by time. The appellant-insurer, therefore, averred that the complaint was liable to be dismissed. 5. The District Forum held that the complaint was within limitation. It was further held that the deceased held a proper license at the time of accident. Therefore, there was breach of terms of policy. It was also averred that the complaint was barred by time. The appellant-insurer, therefore, averred that the complaint was liable to be dismissed. 5. The District Forum held that the complaint was within limitation. It was further held that the deceased held a proper license at the time of accident. It was observed in the above context that it was also not conclusively proved that deceased was driving motor-cycle in question. The District Forum, therefore, allowed the complaint and directed the appellant-insurer to pay Rs.5,00,000/- with interest @ 9% p.a. and as also cost of Rs. 1,000/-. 6. Learned counsel for the parties were heard. Record perused. 7. The first contention raised by the learned counsel for the appellant was that the intimation about the death of the deceased-insured was given after 4 months of the event of the death. It appears from the material shown during the arguments that the complainant had submitted a letter dated 27.01.2000 to the employer-S.E.C.L., praying that the necessary actions regarding payment of the amount under the 'Janata Policy', be taken. It would, thus, appear that the complainant sent intimation about the death of her husband and had submitted an application in that regard to the employer. It also appears that later on, the employer S.E.C.L. belatedly sent the documents along with letter of the complainant, to the appellant-insurer. It, therefore, appears that the employer was partly responsible for the delay. Therefore, delay in sending intimation to the appellant/insurer, cannot be solely attributable to the complainant. Moreover, in the foregoing circumstances, delay can not also be said to be unduly long or without justification. 8. Moreover, it may be noticed that the accident has been reported with the Police and documents of police, including FIR, Post-Mortem Report etc. leave no scope of doubt that the deceased, Shankar Singh died in a road accident. Thus, though, it is true that under certificate of insurance issued by the appellant insurer, providing for claim procedure states that the death should have been reported within 15 days. However, the aforementioned condition of claim procedure, as above, could not be rigidly interpreted, so as to cause hardship to the complainant/respondent, who is a poor widow lady, who possibly did not know niceties of the procedure as mentioned in the certificate. Moreover, as also noticed the delay is also not inordinate. However, the aforementioned condition of claim procedure, as above, could not be rigidly interpreted, so as to cause hardship to the complainant/respondent, who is a poor widow lady, who possibly did not know niceties of the procedure as mentioned in the certificate. Moreover, as also noticed the delay is also not inordinate. Therefore, even if, the complainant/respondent did not prefer the claim within 15 days as provided in claim procedure in the certificate of insurance, it would not result in negation of her claim. The above contention raised by the learned counsel for the appellant, therefore, cannot be accepted. 9. Learned counsel for the appellant also submitted that this complaint has been filed after the period of limitation. It was submitted in the above context, that since the repudiation of the complainant's claim was made by letter dated 01.04.2003 by the appellant-insurer hence, the complaint filed on 18.05.2005 was barred by limitation having been filed, after two years. The District Forum in the impugned order has observed that since the complainant had served notice dated 23.08.2004 to the appellant-insurer, hence, the complaint is within limitation In our opinion, observation as above is not justified. It is clear that after repudiation of claim by the appellant-insurer the correspondence including the service of legal notice, would not give rise to fresh cause of action and would not extend it. 10. It may, however, be noticed in the above context that, the complainant/ respondent has admitted that the repudiation of her claim was made by the appellant insurer by letter dated 01.04.2003. The copy of the said letter is on record. It appears to have been sent by Registered Post as has been mentioned therein. However, no postal receipt or acknowledgment of the said repudiation letter dated 01.04.2003 has been placed on record, by the appellant-insurer. Obviously, even if, the repudiation was made by letter dated 01.04.2003, it would have taken some time to dispatch it by Registered Post and further some more time would have been taken in service thereof, on the complainant/respondent. We do not know when the letter of repudiation as above was actually served on the complainant/respondent. It would have been better to make specific averments regarding the communication of the letter of repudiation dated 01.04.2003. We do not know when the letter of repudiation as above was actually served on the complainant/respondent. It would have been better to make specific averments regarding the communication of the letter of repudiation dated 01.04.2003. However, even in the absence of the averments as above of the complainant respondent; it cannot be presumed that the said notice was served on the complainant/respondent, on the same date i.e. 01.04.2003. Therefore, it would appear that the said letter presumably must have been served on the complainant on 2nd or 3rd week of April, 2003. The complaint has been filed on 18.05.2005,. which thus, appears to be delayed by about a month. 11. It may again be stated that the complainant/respondent is illiterate widow of the deceased-insured. She does not understand basic requirements of law. The delay in filing the complaint is not inordinate. In view of the aforesaid circumstances of the delay in filing the complaint, deserves to be condoned. Accordingly, though we find that there is some delay of about a month in filing the complaint, the delay as above is condoned. 12. Learned counsel for the appellant also submitted that license held be deceased was renewed after his death. The District Forum dealt with the above aspect of matter in detail in the impugned order. However, we find that the above aspect of the matter is totally irrelevant and does not require any serious consideration. In fact, as would appear from the certificate of insurance issued by the appellant-insurer, the event of accidental death of the insured was covered, under the policy. Therefore, it is immaterial as to whether the license of the deceased was renewed after his death or before his death or was not in order, at the time of accident. Since, it appears that the deceased Shankar Singh died an accidental death; hence, the complainant/respondent is entitled to benefit under the policy. Hence, Complaint was rightly allowed by the District Forum. 13. Accordingly, we find no substance in this appeal. It is accordingly dismissed. The impugned order is affirmed. Appeal Dismissed.