Smt. Leela Devi vs State Of Raj. And Anr

Arun Monga, J

A hapless and helpless widow, exasperated after running from pillar to past, filed the instant petition way back in the year 2010 seeking benefit of Group Insurance policy of her deceased husband, benefit of which has not been given to her by the State Insurance and Provident Fund Department (respondent No.1). She lost her husband owing to an accident, while in harness, as he was serving as a Beldar in Public Health Engineering Department, Sub Division, Kankroli, Rajsamand (respondent No.2).

The facts of the case are self revealing and need no further explanation. It is borne out that petitioner has left no stone unturned for reimbursement of the insurance amount, but to no avail. The relevant factual narrative, as pleaded in the petition, is as follows:-

2.1 The petitioner's husband, a Beldar, was a member of Group Accident Insurance policy under State Insurance and Provident Fund Department. A regular deduction, under the head of insurance policy, was being carried out on a regular basis from his salary until his death. He met with an accident on 23.03.2008 which resulted in his untimely death. His widow applied for disbursement of amount due under group insurance policy. She was asked to supply some documents viz. copy of FIR qua accident (from concerned police station), Final investigation Report, Postmortem Report (from the concerned hospital) etc. Pertinently, death of her husband was never in dispute as her son was given Compassionate appointment by the employer Department.

2.2 Be that as it may, in compliance of the command of the department, the petitioner proceeded to get the requisite documents through her counsel from Police Station, Jawad, District Neemach (M.P.). However, since the widow is a resident of Nathdwara, District Rajsamand (Rajasthan) whereas, the accident took place at in Madhya Pradesh- Jawad, District Neemach, there was delay in obtaining the required documents for raising her claim under group insurance policy.

2.3 After she received the required documents on 30.06.2008, she moved the department claiming the due amount under the Group Insurance policy. The claim of the petitioner was rejected on the ground of delay. Hence, this petition.

The defence taken by the respondent No.1 in its reply is that the Assistant Engineer (respondent No.2) submitted claim along with all requisite supporting documents after a lapse of 1 year and 2 months.

3.1 Moreover, a perusal of the FR submitted along with the claim reveals that the petitioner died in the accident due to his own rash and negligent driving. The same is against the terms and conditions of the policy. Thus, the claim of the petitioner was rightly rejected.

The defence taken by the respondent No.2 in its reply is that as per the clause (5) of the policy (Annex.6) clearly provides that original proposal form be submitted latest by two months from the date of incident and all such documents be submitted latest by six months along with mentioning the reasons of delay, otherwise claim to be closed as "No Claim" and no claim would be entertained after six months. It is also stated in the reply that, had the claim been sought within time, the other documents could have been filed subsequently.

Having perused the pleadings and after hearing the rival contentions, it emerges that there is no dispute on two facts, i.e.

(i) that the petitioner was serving as Beldar at the time of his death and (ii) that his widow is entitled to the benefit of Group Insurance Policy.

Entire lis is qua the delay, stated to have been caused by the widow, in submitting the requisite documents, i.e. copies of FIR, FR, Postmortem Report etc.

Given the nature of documents/requisites, which the widow was supposed to provide, it is amply clear that the same could have been submitted only after being supplied by respective third parties in Madhya Pradesh i.e. the police station/trial court and/or the government hospital. It was thus beyond the control of the widow to submit the same within the stipulated time of six months.

It is also not in dispute that the aforesaid documents, as and when were made available, were immediately provided by the widow to the department. And yet, her claim was declined on the ground that she had since not submitted her claim within six months, therefore, she is not entitled to the benefits of the Group Insurance Policy.

I am of the view that the official respondents ought to have taken a rather sympathetic and humanitarian view. Indulging instead into hair splitting of the procedural rules amounts to defeating the very benevolent purpose of creating the group insurance policy.

As already noticed herein above, what makes the case even more curiouser is that the widow resides at Rajsamand in Rajasthan, whereas her husband died in an unfortunate road accident in Neemach in Madhya Pradesh where the FIR was lodged and subsequent proceedings before the jurisdictional court took place. Rajsamand to Neemuch is stated to be 172 kilometers and takes 3.5 hours one to reach one place to the other.

Needless to say, it was due to apathetic and over pedantic view of the department to prove the death of her husband (which stood duly acknowledged as son was given compassionate appointment), that the widow had to undergo the entire trouble of running back and forth between Rajsamand and Neemuch to get the requisite documents. Notwithstanding, when finally she obtained the same, the benefit thereof was declined on accont of delay. Not only that, it is not even the case of the respondents that the genuineness of the said documents is disputed. It is only on the technical ground that the same were submitted after six months, the claim of the widow was rejected.

Trite it may sound but the intent of creating the stipulated time period to submit the documents is that there is no delay in providing the funds, so that the family does not have to suffer the financial ignonimity and sheer immediate penuiary on the demise of its sole earning member. But the said intent has been given a complete short shrift by the official respondents while denying the claim of the petitioner.

As an upshot, the order/communication dated 26.10.2009 (Annex.7) and quashed and set aside. The respondents are directed to verify the documents submitted by the petitioner within a period of two months from today and process her claim. If the same are found in order, the amount payable to her on the death of husband be disbursed to her with interest as per the applicable insurance rules. The interest shall be calculated w.e.f. 30 days after the submission of the requisite documents by the petitioner till the actual date of payment.

The petition stands allowed accordingly.

All pending application(s), if any, shall also stand disposed of.