Date of filing : 28-10-2008 Date of order : 02-04-2009 IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD CC.218/08 Dated this, the 2nd day of April 2009 PRESENT SRI.K.T.SIDHIQ : PRESIDENT SMT.P.RAMADEVI : MEMBER SMT.P.SHYMALADEVI : MEMBER 1. T.A. Jayasree 2. Neerja (Rep.by 1st complainant) 3. Bharathi (All are R/at Thimiri analakkat Illam, Kunhippara, } Complainants Po.Kodakkad, Hosdurg Taluk, Kasaragod.Dt) (Adv. M.Purushothaman, Hosdurg) The National Insurance Company Ltd, Rep.by it’s Branch Manager, Branch olffice, } Opposite party V.V.Road, Mandya (Exparte) O R D E R SRI.K.T.SIDHIQ, PRESIDENT The complainants 1 to 3 are the legal heirs of deceased Narayanan Nambooiri who was an insured under the Janatha Personal Accident Policy issued by the opposite party. The policy descriptions are as follows: Policy No. : 602401/47/98/9603467 Period of insurance : 9-2-1999 to 8-2-2011 Premium : Rs.300/- Sum assured : Rs.1,00,000/- (Rupees one lakh only) 2. While the policy was active, Sri.Narayanan Namboodiri expired on 1-4-02 in a railway accident. Though a claim with all the relevant documents was preferred by the complainants it was not honoured. Alleging deficiency in service on opposite party this complaint is filed claiming the sum insured i.e. Rs.1,00,000/-with interest and cost. 3. The opposite party National Insurance Co.Ltd and appeared through counsel and sought time for version, later not turned up or filed version. Complainants have not adduced any oral evidence. The documents produced by the complainants were marked as Exts A1 to A9. The counsel for the complainant heard. 4. Ext.A1 is the copy of certificate of death issued in respect of the death of the insured Narayanan Namboodiri. Ext.A2 is the copy of the Janatha Personal Accident Policy. Ext.A3 is the lawyer notice issued to opposite party No.2 calling upon the opposite party to settle the claim of the complainants. Exts A8 and A9 are the letters issued by opposite party to the Ist complainant asking her to produce documents to process the claim. 5. It is the case of the complainants that even after submission of all the records demanded by the opposite party the claim in respect of the death claim benefits of the insured is kept in abeyance without assigning any reason. 6. As held by our Hon’ble Apex Court the non-settlement of an insurance claim within 2 months of the submission of the claim itself is a deficiency in service. In this case there is no contra evidence is forthcoming to prove that the claim processing is attained its finality. Hence it cannot be considered that the complaint is barred by limitation also. The settled position of law is that the limitation in respect of an insurance claim runs from the date of rejection/repudiation of claim. As the claim is neither repudiated or rejected this complaint is well within the period of limitation and hence the complaint is maintainable. 7. The non settlement of the insurance claim of the complainants in respect of the death of Narayanan Namboodiri is a deficiency in service of the opposite party and therefore the opposite party is liable to pay the sum assured to the complainants. 8. As per the Janatha Personal Accident policy if the insured sustain any bodily injury resulting solely and directly from accident caused by outward violent visible means thus the company shall pay to the insured. If such injury shall within 12 calendar months of its occurrence be the sole and direct cause of the death of the insured the capital sum insured stated in the schedule the amount payable under this clause shall be paid to the Nominee shown in the schedule. 9. The capital sum shown in the schedule is Rs.1,00,000/- as per Ext.A2 policy. The nominee of the deceased insured is the complainant No.1. Therefore the complaint is allowed and the opposite party is directed to pay Rs. 1,00,000/- (Rupees one lakh only) to the Ist complainant being the nominee of the insured, towards the settlement of claim arising out of the Janatha Personal Accident Policy issued by the opposite party with interest @ 9% from the date of complaint till payment. Opposite party further directed to pay Rs.2000/- towards the cost of these proceedings. Time for compliance 30 days from the date of receipt of copy of order. Sd/- Sd/- Sd/- MEMBER MEMBER PRESIDENT Exts A1. Photocopy of certificate of death of P.Narayanan A2. Photocopy of policy certificate A3. 19-6-08 copy of lawyer notice. A4. Postal acknowledgement card A5. 2-1-06 representation made by Ist complainant. A6. 2-9-08 ,, A7. 8-9-05 Photocopy of legal heir certificate A8. 19-7-02 communication sent by OP to complainant. A9. 20-11-08 Photocopy of communication sent by OP to complainant. MEMBER MEMBER PRESIDENT Pj/
......................K.T.Sidhiq
......................P.P.Shymaladevi
......................P.Ramadevi | | 
