This revision petition has been filed by the petitioners Branch Manager, Reliance Nippon Life Insurance Co. Ltd. and anr. against the order dated 18.09.2018 of the State Consumer Disputes Redressal Commission, Madhya Pradesh, (in short ‘the State Commission’) passed in Appeal no.2467 of 2013.

2.      Brief facts of the case are that the respondent/complainant’s sister Smt Shiv Kumari Avwadhiya (deceased) had availed a Life Insurance Policy bearing no. 17686425 on 09.08.2010 for basic sum assured of Rs.10,00,000/-. On 25.03.2012 the policyholder died suddenly due to cardiac arrest. After the death of the policyholder, the respondent presented the death certificate and Xerox copy of the policy to the petitioner/OP for the claim amount.  As per the instruction of OP, the respondent sent a written application for the claim on 17.05.2012 along with other documents but opposite parties failed to pay the claim amount to the respondent.  The respondent filed the complaint before District Forum for deficiency in services on the part of the petitioner. District Forum vide its order dated 12.08.2013 allowed the complaint against opposite parties with the cost of Rs. 20,000/-. District Forum directed opposite party No.1 to pay the amount of Rs.10,000/- as compensation to the complainant. District Forum further directed opposite party no.2 to pay the insurance claim amount of Rs.10,00,000/- along with interest @ 10% p.a. from 3 months after the claim date, within 4 months from this order.

3.      Aggrieved with the above order of the District Forum, the opposite parties/petitioners filed an appeal before the State Commission, which was dismissed vide its order dated 18.09.2018.

4.      Hence, the opposite parties have filed the revision petition before this commission. 

5.      Heard the learned counsel for the petitioners and the respondent in person.  Learned counsel for the petitioners stated that the complainant never submitted the insurance claim in the claim form to the Insurance Company.  In the written statement filed before the District Forum, it was clearly stated that the complainant may be asked to submit the claim before the Insurance Company so that proper decision may be taken by the Insurance Company.  However, the District Forum passed the final order allowing the complaint and directed the Insurance Company to pay the insurance amount of Rs.10,00,000/- along with 10% p.a. interest.  The same plea was taken in the appeal filed before the State Commission, but the State Commission also did not consider this vital aspect.  The role of the Forum starts if there is any deficiency on the part of the opposite parties.  However, in the present case, no deficiency can be attributed to the opposite party Insurance Company because the Insurance Company could not get any opportunity to take a decision on the claim of the complainant.

6.      In response to the arguments of the learned counsel for the petitioners, the respondent stated that the death certificate along with application was sent to the local office of the Insurance Company.  All the documents were sent by registered post, but the same were refused by the employees of the Insurance Company.  Thus, there was no alternative but to file a consumer complaint before the District Forum.  District Forum after being convinced allowed the complaint.   The State Commission has also concurred with the order of the District Forum. Against the concurrent finding of the fora below, the scope under the revision petition is quite limited and facts cannot be reassessed. Both the fora below have allowed the genuine claim of the complainant and therefore, no interference is required by this Commission.

7.      I have carefully considered the arguments advanced by both the parties and have examined the record.  Even, if the petitioners had taken the plea before the District Forum that claim was not submitted in the required form along with documents but, when District Forum finally allowed the complaint, it is not clear as to why the opposite parties did not prefer the appeal on substantive grounds.  The Insurance Company had got enough time to have the matter investigated and based on that investigation they should have either decided the claim or should have contested the case.  The District Forum and the State Commission have given clear finding that the documents were sent to the Insurance Company, but the same were refused as evidenced by the remark on the envelope.  Against the concurrent finding by the fora below in respect of the fact that the Insurance Company refused to take the documents sent by the complainant, this Commission has very little choice to reverse this finding.  Moreover, petitioners have not filed any such evidence which could help such reversal of finding.

8.      The petitioner Insurance Company is litigating this case at the third stage and still no substantive objection has been raised against the claim.  There was enough time for the Insurance Company to have investigated the matter and if there was anything against the claim, the Insurance Company should have come out with those facts.  When the Insurance Company refused to take cognizance of the claim submitted by the complainant and also refused to accept the documents sent by the complainant, the complainant had no choice but to approach the District Forum.  As there is no substantive objection from the side of the Insurance Company in respect of the insurance claim, I do not find any opportunity to interfere in the approval of claim by the fora below.  However, I feel that the interest awarded by the District Forum is on a higher side and accordingly, it is reduced to 6% p.a. from 10% p.a. as awarded by the District Forum and concurred by the State Commission.

9.      Based on the above discussion, the orders of the fora below are upheld except that the Insurance Company shall pay interest @6% p.a. on the insurance amount of Rs.10,00,000/- from the date of order of the District Forum till actual payment instead of 10% as allowed by the District Forum. As the interest has been provided on the insurance amount, no separate compensation is required.  Accordingly, the order of Rs.10,000/- as compensation is set aside. This order be complied by the petitioners/Opposite parties within a period of 45 days from the date of receipt of this order.