NATIONAL INSURANCE CO LTD vs DHAYA DEVI

THIS appeal under Section 15 of the Consumer Protection Act, 1986 (for short "the Act of 1986") has been filed by the appellant-National Insurance Company Ltd. (opposite party No. 3 in the original complaint) against the order dated 24. 12. 2007 passed by the learned District Forum, Jodhpur in Complaint Case No. 457/2006 by which the complaint filed by the complainant-respondent No. 1 under Section 12 of the Act of 1986 was allowed against the appellant-Insurance Company in the manner that the appellant-Insurance Company was directed to pay to the complainant respondent No. 1 the sum insured under the group insurance policy to the tune of Rs. one lac along with interest @ 9% p. a. with effect from the date of filing claim till payment was made and the appellant was further directed to pay to the complainant respondent No. 1 a sum of Rs. 10,000 as compensation for mental agony and Rs. 1,500 as cost of litigation within 15 days from the date of order failing which the complainant respondent No. 1 would be entitled to get interest on that amount at the rate of 9% p. a. from the date of order till payment was made. The complaint against the respondent Nos. 2 and 3 employer was dismissed.

IT may be stated here that the complainant respondent No. 1 had filed a complaint under Section 12 of the Act of 1986 before the District Forum, Jodhpur against the appellant-Insurance Company and the respondent Nos. 2 and 3-JVVNL (RSEB) on 6. 6. 2006 stating inter alia that her husband Jagdish Kachhawaha (hereinafter referred to as the deceased) was employee in the RSEB Department (respondent Nos. 2 and 3) and deceased was member of group insurance policy which was taken by the respondent Nos. 2 and 3 employer from the appellant-Insurance Company for the period from 1. 6. 2001 to 31. 5. 2002 and as per the terms of the group insurance policy, if any employee, who was member of the group insurance policy, dies in an accident, the appellant-Insurance Company would pay a sum of Rs. one lac to his dependent or claimant. It was further stated in the complaint that deceased had sustained injuries due to electric current on 9. 3. 2002 for which mug FIR No. 1/02 was also lodged in the Police Station Pipar City, Jodhpur under Section 174, Cr. P. C. It was further stated in the complaint that deceased had died on 16. 3. 2002 and after the death of the deceasd, the complainant respondent No. 1 being wife and nominee of the deceased submitted a claim to the office of the respondents Nos. 2 and 3 employer in the month of March, 2002 and, therafter, the claim was forwarded by the respondent Nos. 2 and 3 to the appellant Insurance Company, but that claim was not settled by the appellant Insurance Company. Hence, the present complaint was filed. A reply was filed by the respondent Nos. 2 and 3 RSEB employer on 28. 8. 2006 in the manner that the claim, which was lodged by the complainant respondent No. 1 after the death of the deceased, was sent to the office of the appellant Insurance Company on 30. 3. 2002, but the appellant Insurance Company had not settled the claim. It was further replied that complainant respondent No. 1 should have also approached the office of the appellant Insurance Company. It was further replied that on the application of the complainant respondent No. 1 dated 30. 4. 2005, the matter was again taken up by the respondent Nos. 2 amd 3 with the appropriate authorities and claim was again sent by the respondent Nos. 2 and 3 RSEB-employer to the United India Insurance Co. Ltd. as in the year 2005, the agreement for group insurance policy was with the United India Insurance Co. Ltd. and since at the time of death of the deceased, the agreement for group insurance policy was with the appellant Insurance Company, therefore, the claim of the complainant-respondent No. 1 was sent to the appellant Insurance Company on 30. 3. 2002, but the appellant had not settled the claim for which the respondent Nos. 2 and 3 employer could not be held liable and liability should be imposed on the appellant Insurance Company. Hence, it was prayed that the complaint against the respondent Nos. 2 and 3 be dismissed.

A reply was also filed by the appellant Insurance Company on 28. 8. 2006 stating inter alia that no information of accident and claim of complainant respondent No. 1 was earlier received by the office of the appellant from the respondent Nos. 2 and 3 employer and, therefore, the question of settlement of claim does not arise at all and now the claim of the complainant respondent No. 1 is time-barred and, therefore, the same was not payable. Hence, it was prayed that the complaint be dismissed against the appellant.

AFTER hearing the parties, the learned District Forum, Jodhpur through order dated 24. 12. 2007 allowed the complaint of the complainant respondent No. 1 in the manner as indicated above holding inter alia: (i) That the death of the deceased, which had taken place on 16. 3. 2002, was accidental one. (ii) That the deceased was member of the group insurance policy. (iii) That as per the reply of the respondent Nos. 2 and 3 employer, it is evident that the claim of the complainant respondent No. 1 was sent by them to the appellant Insurance Company on 30. 3. 2002 and, therefore, the case of the appellant Insurance Company that it was not informed about the accident and it had not received any claim of complainant respondent No. 1 from the respondent Nos. 2 and 3, was not found acceptable by the learned District Forum. (iv) That there was no fault or delay on the part of the complainant-respondent No. 1 in submitting the claim. (v) That denial and non-settlement of claim of the complainant-respondent No. 1 by the appellant Insurance Company was not justified and it amounted to deficiency in service on the part of the appellant.

Aggrieved from the said order dated 24. 12. 2007 passed by the learned District Forum, Jodhpur, the appellant Insurance Company has preferred this appeal.

WE have heard the learned Counsel for the appellant and the learned Counsel for the complainant-respondent No. 1 and gone through the entire materials available on record. In this appeal, the following two contentions were raised by the learned Counsel for the appellant admitting the fact that htere was no dispute on the point that the death of the deceased was accidental one and he was member of the group insurance policy: (i) That the claim of the complainant-respondent No. 1 was time-barred. (ii) That awarding of compensation to the tune of Rs. 10,000 was not justified when interest has been awarded and further, interest must have been awarded and further, interest must have been awarded from the date of filing complaint and not from the date of lodging claim. Point No. 1 regarding delay

So far as the point of delay is concerned, in our considered opinion, since the deceased had died on 16. 3. 2002 and when the complainant respondent No. 1 had submitted the claim before the respondent Nos. 2 and 3 employer within time in the month of March, 2002 and, thereafter, the respondent Nos. 2 and 3 employer had sent the claim of the complainant-respondent No. 1 to the appellant Insurance Company through letter dated 30. 3. 2002, therefore, in these circumstances, if the claim was not settled between the parties, it could not be said that there was fault or delay or negligence on the part of the complainant respondent No. 1 in lodging the claim and the learned District Forum has rightly observed so. The findings and conclusions of the learned District Forum holding deficiency in service on the part of the appellant Insurance Company are based on correct appreciation of entire materials and evidence available on record and they do not suffer from any basic infirmity or illegality or perversity. Hence, no interference is called for with the same and this appeal on merits deserves to be dismissed. On Point No. 2 regarding compensation and interest

IN our considered opinion, looking to the entire facts and circumstances of the case, when interest has been awarded on the decretal amount, therefore, the learned District Forum was not justified in awarding compensation to the tune of Rs. 10,000 and that part of the impugned order awarding compensation of Rs. 10,000 is liable to be quashed and set aside and furthermore, interest must have been awarded on the decretal amount from the date of filing complaint and not from the date of lodging claim and to that extent, the impugned order is liable to be modified and this appeal, on point of compensation and date of commencement of interest deserves to be partly allowed. Accordingly, this appeal filed by the appellant is dismissed on merits. However, on point of compensation and date of interest, this appeal is partly allowed in the manner that that portion of the impugned order of the learned District Forum by which compensation to the tune of Rs. 10,000 was awarded, is quashed and set aside and, further, now the complainant respondent No. 1 would be entitled to get interest on the decretal amount with effect from the date of filing complaint and not from the date of lodging the claim as ordered by the learned District Forum and to that extent, on point of date of interest and compensation, the impugned order of the learned District Forum, Jodhpur dated 24. 12. 2007 stands modified. Appeal dismissed.