Present (1) Nisha Nath Ojha,
District & Sessions Judge (Retd.) President
(2) Smt. Karishma Mandal,
Member
Date of Order : 25.06.2018
Nisha Nath Ojha
- In the instant case the Complainant has sought for following reliefs against the Opposite party:-
- To direct the opposite parties to pay the Policy amount of Rs. 2,00,000/- with 12% interest till the payment.
- To direct the opposite parties to pay Rs. 1,00,000/- as Compensation as well as Litigation costs.
- Brief facts of the case which led to the filing of complaint are as follows:-
The complainant has asserted that his father took a policy through opposite party no. 3 and as such certificate was issued to his father vide annexure – 1. The father of the complainant namely Parmanand Prasad Yadav died on 19.09.2004 in a road accident due to grevious injury caused by auto rikshaw at Bailey Road, Patna for which a FIR was lodged by traffic police vide traffic P.S. case no. 241 dated 18.09.2004 U/s 279, 338, 304(a) of IPC. Complainant thereafter intimated the opposite party no. 1 on 05.10.2004 about the death of his father and received claim form from the office of opposite party no. 2 and thereafter the complainant submitted the claim form with relevant documents to opposite party no. 3 vide annexure – 2. Opposite party no. 2 after receiving the claim of the complainant refused to entertain the claim on the ground that the claim was submitted after delay of 4 months 1 day as will appear from annexure – 3. When the complainant approached to opposite parties with a prayer to entertain his claim then opposite party no. 2 requested opposite party no. 3 to consider the claim of the complainant vide annexure – 4.
The grievance of the complainant is that uptill now no reply has been receiving after the letter contained in annexure – 4.
On behalf of opposite party no. 3 and 4 written statement has been filed, In Para – 7 of the written statement the opposite party no. 3 and 4 has stated that insurance company Ltd. (opposite party no. 1) has repudiated the claim on the ground of delayed intimation and delayed submission of papers vide letter dated 22.09.2005 against which a representation has been made by the complainant and these opposite parties have requested the opposite party no. 1 to reconsider and review the claim for settlement.
On behalf of opposite party no. 1 and 2 a written statement has been filed admitting the genuineness of annexure – 1. In Para – 7 and 8 of the written statement the following facts have been mentioned, “that it is specifically submitted that as per terms and conditions of the policy, the claimant is required to submit mandatorily the claim within 90 days from the date of accident and /or date of loss of sight or amputation.”
“that however in the instant case, the complainant submitted the relevant, claim after a lapse of 4 months and 1 day of the date of accident. Under the circumstances the opposite party no. 1 and 2 (national Insurance Company Ltd.) had no option than to repudiate the claim of the complainant (nominee under the policy) and intimated to this effect vide its letter dated 22.09.2005 ( annexure – 3) of the complaint petition as “no claim”.”
In Para – 10 of the written statement the opposite party no. 1 and 2 have asserted following facts, “that it is submitted that the complainant did not submit the required document viz – c.c. of FIR, charge sheet, post mortem report, death certificate income certificate etc. till date and without these document it is not proved that the death was accidental.”
No rejoinder have been filed on behalf of complainant and as such we have no option but to pass order after going through complaint petition as well as written statement filed by opposite parties.
It is the case of the complainant that his father died on 19.09.2004 and from annexure – 2 it transpires that his claim form with seven documents were forwarded by opposite party no. 3 and 4 to opposite party no. 1 and 2 on 17.01.2005. there is no explanation as to why such a long delay has been made in submitting the form opposite party no. 3 and 4. However from perusal of annexure – 4 as well as Para – 7 of the written statement of opposite party no. 3 and 4 it appears that a representation is pending before higher authority for reconsidering the claim of the complainant with sympathy.
Unfortunately there is no explanation on behalf of complainant with regard to delay in filing the claim application.
We find that there is no whisper about the disposal of the representation filed by the complainant.
For the reason stated above we direct the opposite party no. 1 and 2 to pass appropriate order on the representation of complainant contained in annexure – 4 of the complaint petition and if the aforesaid representation is not available in the office of opposite party no. 1 and 2 then opposite party no. 1 and 2 may obtain the copy of the same from opposite party no. 3 and 4 or the complainant and pass appropriate order within the period of three months from the date of filing of aforesaid representation of the complainant failing which opposite party no. 1 and 2 will pay Rs. 50/- ( Rs. Fifty only ) to the complainant for delay in passing order.
For the reason stated above this complaint stands disposed of with the aforementioned direction.
Member President
