Oriental Insurance Co. Ltd. vs Nirmala Singh

THIS appeal, under Section 15 of the Consumer Protection Act, 1986, is directed against the order dated 19.7.2004 in Complaint No. 120/2003 by the District Consumer Disputes Redressal Forum, Sarguja, Ambikapur (hereinafter called the ''District Forum'' for short) directing the appellant to pay to the complainant/respondent No. 1 Rs. 25,000 with interest @ 9% per annum payable from 13.8.2003 as also Rs. 500 as cost of the complaint.

THE complainant averred that she was entitled to get the assured amount under the Women''s Welfare Insurance Policy issued by the respondent No. 1, as the husband of the complainant Pramod Singh died in an accident on 18.8.2002. It was also averred that the complainant approached the respondents to pay the amount under the policy. However, the same was not paid to them. Hence she filed complaint in the District Forum. The appellant/opposite party No. 1-Oriental Insurance Company averred that cheque of premium amount was received from Janpad Panchayat (which included premium amount paid by the husband of the complainant) on 18.10.2002, whereafter the policy under the Women''s Welfare Insurance Scheme was issued covering the risk from 15.1.2003 to 14.1.2004. It was averred that since the complainant''s husband died on 18.8.2002, that is prior to the date of coverage of risk, the complainant was not entitled to any relief.

It appears that the respondent No. 2 sent to the insurer the cheque of the premium of the complainant''s husband and others on 10.7.2002. It was averred that the claim form of the complainant was also forwarded to the respondent No. 3 on 28.2.2003. The respondent No. 2 averred that it did not commit any deficiency in service.

RESPONDENT No. 3 in its written version averred that, though the amount of cheque from Janpad Panchayat was received on 10.7.2002, but as other Janpad Panchayats had not sent the premium amount, therefore, the premium could not be sent earlier to the appellant/insurer; and was sent to the insurer/appellant on 20.1.2003. It was averred that the respondent No. 3 did not commit any deficiency in service. The District Forum held that the complainant was entitled to the assured amount, as the premium was paid on or before 10.7.2002. Accordingly, District Forum directed that appellant/insurer shall pay assured amount of Rs. 25,000 with interest, etc. as mentioned above.

ARGUMENTS of the learned Counsel for the parties heard. Record perused. The main contention of the appellant insurer was that as the amount of premium was received by it in January, 2003, Women''s Welfare Insurance Policy was issued covering the risk from 15.1.2003 to 14.1.2004. Since the death of the complainant''s husband had occurred earlier on 18.8.2002 prior to the issuance of policy; the complainant was not entitled to any benefit under the said policy. It may be noticed that the complainant and her husband resided in village Paraswarkala in Janpad Panchayat, Rajpur. The said Janpad Panchayat comes under the jurisdiction of District Panchayat, Sarguja. It would be clear from the documents placed on record of the District Forum, that premium amount was remitted by Gram Panchayat, Paraswarkala to Janpad Panchayat, Rajpur in the month of July, 2002. It further appears that the Janpad Panchayat, Rajpur also remitted the amount in the month of July, 2002, to District Panchayat, Sarguja. However, it appears from the letter of the District Panchayat Sarguja dated 7.11.2003 that the amount of premium received from Janpad Panchayat, Rajpur was not sent to the appellant/insurer, as the premium amount of other Janpad Panchayats was not received earlier. Ultimately, it was sent to the appellant/insurer on 15.1.2003 upon which it issued insurance policy. Unfortunately, memorandum of understanding between the Janpad Panchayat, District Panchayat or the appellant/insurer, as also the master policy have not been produced by the appellant, from which it could have been verified as to what was the exact terms of the policy under which it was issued. In any case, the appellant cannot deny that the premium amount was to be received in the manner described above i.e., Gram Panchayat was to collect and send it to Janpad Panchayat, which in turn was to send it to District Panchayat, which was required to send it to the insurer, Oriental Insurance Co. That being so, if the complainant or her husband paid the premium in the month of July, 2002 the rights of the complainant could not be adversely affected and prejudiced merely because the appellant insurer received the premium belatedly from District Panchayat, Sarguja. It also appears from the minutes of the meeting dated 22.6.2001 placed on the record of the District Forum, that the appellant/insurer company has agreed to continue the scheme under which the policy was initially issued without any break or interruption.

IN the foregoing circumstances, it is clear that the complainant or her husband Pramod Singh, having paid the premium amount for the insurance policy as above, prior to the death of the insured which was issued with the objective of welfare of the women; the benefit thereunder could not be denied to the complainant. As the premium was paid prior to the death of her husband; therefore, merely because premium was received by the appellant insurer later in Jan, 2003 would not imply that the complainant is not entitled to the benefit under the policy, as appears to be the stand of the appellant.

CONSEQUENTLY, the District Forum justifiably awarded the assured amount with interest, etc., by the impugned order. The impugned order does not call for any interference. Accordingly, this appeal has no substance. It is accordingly, dismissed. The impugned order is affirmed. The appellant shall bear its own cost of this appeal and shall pay that of the respondent No. 1 which is quantified at Rs. 1,000 (Rupees one thousand) only. Appeal dismissed.