Per Shri S.R. Khanzode, Hon’ble Presiding Judicial Member This appeal takes an exception to an order dated 20/09/2001 passed in consumer complaint No.765/2000, Mr.Anandrao M. Katrut V/s. The Branch Manager, The New India Assurance Co. Ltd., by District Consumer Disputes Redressal Forum, Kolhapur (‘the Forum’ in short). 2. The deficiency in service is alleged against the Insurance Company for arbitrary repudiating the insurance claim under the Workmen’s Compensation Insurance Policy taken by the complainant relating to the death of one of worker on 20/05/1998. The claim was repudiated on the ground that on the date of event there was no valid insurance policy and as such there arise no question either to consider or sanction the insurance claim. The Forum did not accept the case of the Insurance Company and partly allowed the consumer complaint and directed Insurance Company to pay `2,03,850/- as compensation along with interest covering insurance claim, further directed to pay compensation of `5,000/- towards mental torture, and `1,000/- as costs. Feeling aggrieved thereby, this appeal is preferred by org. opponent/Insurance Company. 3. We heard Mr.M.M. Mahajan, Advocate for the appellant/Insurance Company and Mr.Mahesh Subramaniam, Advocate for the respondent/complainant. 4. Referring to the various documents, particularly, to the various policies which were taken right from the year 1990-91, it is submitted that the policy prior to the event was taken and it was issued on 14/05/1997 for the period 11/05/1997 to 10/05/1998 and thereafter, next policy was issued on 22/05/1998 covering the period 25/05/1998 to 24/05/1999 and therefore, on the date of the death which took place on 20/05/1998, there was no insurance existing. 5. It is the contention of the complainant that right from the beginning i.e. from year 1990-91 they were regularly paying the premiums, but it is the Insurance Company which was not regular in issuing the policy, particularly about mentioning the date of commencement of the insurance. In fact all the while they paid premiums in time and it is always a case of renewal of the insurance policy which was initially taken in the year 1990-91. It is tried to be submitted on behalf of the appellant/Insurance Company that on each occasion there is a fresh proposal form taken from the insured and fresh policies were thereafter issued. When we asked the Learned Counsel for the Insurance Company, what is the case pleaded by the Insurance Company and what evidence is adduced on behalf of Insurance Company and whether their such case reflects from the repudiation letter dated 26/09/2000; Learned Counsel for the Insurance Company tried to bring to our notice the various policies issued from time to time and particularly, harping upon the reference to the fluctuating number of workers to whom the risk was covered. It is his submission that since, while issuing each policy for each year, there is a risk cover for different number of workmen and for different amount of risk cover, the Insurance Company must have got filled fresh proposal forms on each occasions and such change status is, per se, reflected in the each policy issued. However, there is no such document on record to show that any fresh proposal form was taken from the insured on each occasion. It is the case of the complainant/insured that no fresh proposal form was filled in. It is a case of renewal after ensuring payment of premium in time. Therefore, burden is heavily lies on the Insurance Company to show that on each occasion each policy is fresh policy and not a renewal of the policy. From the record available and also considering the case pleaded on behalf of the Insurance Company which stated while recounting facts in the impugned order, we find that the line of argument which is taken by Learned Counsel of the appellant while explaining the documents in respect of fresh proposal vis-à-vis each policy is a fresh policy and not a policy as a case of renewal, finds no support from the written version too and to substantiate their such case. 6. For the reasons stated above, we find that the Insurance Company failed to discharge its burden to justify its repudiation. We find no reason to take a different view than what has been taken by the Forum. We hold accordingly and pass the following order :- -: ORDER :- 1. Appeal stands dismissed. 2. No order as to costs. 3. Copies of the order be furnished to the parties. Pronounced Dated 10th April 2012. |
