10-09-2015 - The reasons for delay in disposal of this appeal can be seen from the order sheet.

1.     Due to long and uncertain period of absence of the Members, single member bench of President is functioning in their absence, in view of the order of Hon’ble National Commission in Revision Petition No. 4434 of 2014, in the matter of Mr. Netaji Surrendra Mohan Nayyar -vs- Citibank; and the judgement passed by Hon’ble Kerala High Court in the W.P. (C) No. 30939 of 2010 (N) P.K. Jose -vs- M. Aby & ors.

2.       Inspite of fixing this case for passing ex- parte order, nobody appears on behalf of the respondents.

3.       Heard learned counsel for the appellant.

4.       This appeal has been filed along with petition for condoning the long delay of about eight months in filing this appeal.

          Though, the grounds are not satisfactory for condoning the long delay but in the interest of justice it is condoned.

5.       On merits, learned counsel for the appellant assailed the impugned judgement on various grounds. He submitted that the complainant had submitted incomplete claim form through O.P. 3 & O.P.4 – Golden Trust Financial Services (for short G.T.F.S). The complainant also did not file certified copy of F.I.R. and Final Form submitted by the police.

6.       It appears that R-1- complainant, being the nominee of her deceased-husband late Mohan Prasad Mathuri, filed the present complaint, claiming the insured amount on the ground that her husband was murdered on 13.9.2004, during the subsistence of ‘Janta Personal Accident Policy’ from 23.5.2000 to 22.5.2015. He was murdered by unknown criminals while driving his truck. She made a claim on 9.10.2004 with documents-policy certificate, F.I.R., death certificate etc. The Insurance Company issued a letter dated 19.1.2005 regarding the claim which she complied by submitting the required documents. Once again on 9.9.2006 through G.T.F.S. she furnished the claim and the papers, but inspite of repeated requests and reminders, the insurance claim was not paid, which amounted to rejection.

7.       According to the Insurance Company, the complainant submitted incomplete claim form in the last week of September, 2006, through G.T.F.S.

8.       From the letter dated 20.9.2006 issued by G.T.F.S., it is clear that the claim form and required documents were filed by the complainant.

9.       It appears that Section II of the claim form was to be filled up by the hospital authority, but as the insured died on the spot, no medical treatment was given to him in the hospital, and therefore such column was blank. Therefore, it is wrong on the part of the Insurance Company to say that the claim form was not duly filled up. The Insurance Company did not produce anything to show that it issued any letter to the complainant repudiating the claim on the ground of non supply of documents. It also did not produce anything to show that the deceased was responsible for his murder.

10.     The learned District Forum rightly held that the complainant sent all the documents and claim papers to the Insurance Company but it did not settle the claim, which certainly amounted to deficiency in service. Accordingly, it directed the Insurance Company to pay Rs. 1 lac being the sum assured, along with Rs. 20,000/- as compensation for mental agony and physical harassment and also Rs. 5000/- as litigation cost to the complainant within two months of the order, failing which, the complainant was made entitled to realize the said amounts with interest @ 9% P.A. from the date of the order till the date of realization through the process of law.

11.     After hearing learned counsel for the appellant and carefully going through the records, it is clear that no grounds are made out for interference with the impugned judgement.

Accordingly, this appeal is dismissed. 

   Issue free copy of this order to all concerned for information and needful.

             Ranchi,

     Dated: 10-09-2015