Maharashtra

StateCommission

A/10/749

ICICI LOMBARD GENERAL INSURANCE CO LTD - Complainant(s)

Versus

SMT ASHWINI VIJAY HANKARE - Opp.Party(s)

NIKHIL MEHTA

13 May 2013

ORDER

BEFORE THE HON'BLE STATE CONSUMER DISPUTES REDRESSAL
COMMISSION, MAHARASHTRA, MUMBAI
 
First Appeal No. A/10/749
(Arisen out of Order Dated 19/04/2010 in Case No. 1548/09 of District Sangli)
 
1. ICICI LOMBARD GENERAL INSURANCE CO LTD
ZENITH HOUSE KESHWRAO KHADKE MARG MAHALAXMI MUMBAI
MUMBAI
MAHARASHTRA
...........Appellant(s)
Versus
1. SMT ASHWINI VIJAY HANKARE
KAREWADI TALUKA KAVATHEMAHAKAL
SANGLI
MAHARASHTRA
2. KABAL INSURANCE SERVICE PVT LTD
101 SHIVAJI NAGAR 3 RD FLOOR NEAR MANGLA TALKIES PUNE
PUNE
MAHARASHTRA
3. THE STATE MAHARASHTRA
THROUGHT DIST COLLECTOR
SANGLI
MAHARASHTRA
...........Respondent(s)
 
BEFORE: 
 HON'BLE MR. Dhanraj Khamatkar PRESIDING MEMBER
 HON'BLE MR. Narendra Kawde MEMBER
 
PRESENT:NIKHIL MEHTA, Advocate for the Appellant 1
 Mr.Santosh Patil, Advocate, proxy for Ms.Archana Pise, Advocate for the Respondent No.1.
ORDER

Per Mr. Narendra Kawde - Hon’ble Member:

 

1.                 This appeal takes an exception to an order dated 19.04.2010 in Consumer Complaint No.1548/2009 (Smt.Ashwini Vijay Hankare V/s. ICICI Lombard General Insurance Company Limited & Ors.) passed by the District Consumer Disputes Redressal Forum, Sangli.  The District Forum while holding deficiency in service against the Appellant/Opponent No.1 Insurance Company allowed the consumer complaint filed by the present Respondent No.1/original Complainant and directed the Appellant/Opponent No.1 to pay an amount of `1,00,000/- together with interest @9% per annum effective from 06.12.2005. The District Forum also granted ancillary reliefs of `5,000/- on account of mental agony and `3,000/- towards costs of litigation.  All these amounts were directed to be paid within a period of 30 days.  Aggrieved with the impugned order the Appellant/Opponent  No.1 filed this appeal on the ground that the District Forum overlooked the point of delay in preferring the insurance claim and without taking into account the provisions of the claim of insurance extended to the farmers allowed the consumer complaint and passed the impugned order with directions as narrated hereinabove. 

 

2.                 Contention of Appellant/Opponent is that  incidence of accidental death of the insured late Sanjay Vijay Hankare, under the policy occurred on 15.04.2005.  However, the claim was preferred by the Complainant beyond the period of 90 days from the date of cause of action i.e. date of death, therefore, the claim was rejected by letter dated 6th December, 2005.

 

3.                 Heard Mr.Nikhil Mehta, Advocate for the Appellant/Opponent No.1 Insurance Company and Mr.Santosh Patil, Advocate, proxy for Ms.Archana Pise, Advocate for the Respondent No.1..

 

4.                 There is no dispute regarding the insurance cover extended and the policy obtained by the Government of Maharashtra with benevolent objective to extend insurance cover to the eligible farmers to the tune of `1,00,000/- each against various conditions.  The policy covers accidental death of a farmer and on account of such calamity amount of `1,00,000/- is payable to the legal heirs of the insured.  During the validity period of said insurance policy Shri Sagar Vijay Hankare, the farmer died on 15.04.2005 in an accident.  The Insurance Company repudiated the claim on the ground that the claim was not lodged within a stipulated period of 90 days from the date of accident.  Aggrieved thereby the Respondent/Complainant preferred the consumer complaint before the District Forum which was decided and the impugned order was passed as narrated in the opening paragraph, supra. 

 

5.                 We have perused the record placed before us.  The benevolent scheme of extending benefits of insurance to the farmers provides for information of incidents to the Government officials, responsible for implementation of scheme including the village Talathi, who works under the Tahsildar of a Taluka.  There is statement in the complaint made by the Complainant stating that the incidence of death was reported to village Talathi in the month of May, 2005, i.e. immediately after the occurrence of death on 15.04.2005.  The statement is supported by an affidavit of the Complainant reiterating the said facts.  All the required documents for settlement of claim viz. the 7/12 extract of the ownership of land, spot panchanama, F.I.R., death certificate, post mortem report were submitted.  However, it appears that the concerned Tahsildar of the jurisdiction has submitted the insurance claim late to the Opponent Insurance Company, after receipt of the same from Village Talathi (to whom an intimation was given by the Complainant immediately after the date of death of the insured) and therefore, the Appellant/Opponent Insurance Company repudiated the claim as according to them it was not preferred within a period of 90 days from the date of incidence.  Considering noble objective of the Government to extend insurance cover to the eligible farmers an intimation to the Government functionary well in time i.e. well before 90 days, was enough to meet the requirement of the scheme.  Therefore time should commence to run from the date of intimation of accidental death to Village Revenue Officer i.e. Talathi.  This State Commission has taken consistent stand that time limit prescribed for submission of claim is not mandatory and it is mere directory in nature as held in ICICI Lombard General Insurance Co. V/s. Sindhubai Khanderao Khairnar in F.A. No.1009/2007 (M.A. No.1350/2007) on 07.01.2008.  This fact should have been considered by the Insurance Company before rejecting the claim.  There is no reason to disbelieve the statement made by the Respondent/Complainant in the complaint on affidavit supporting her contention that within a period of one month the incidence of death was notified to the concerned village Talathi.  As against this there is no rebuttal whatsoever on record.  Additionally it has to be noted that failure to observe time limit does not empower the Insurance Company to foreclose the claim.   There is no other grievance made out by the Appellant/Opponent insurance Company.  The District Forum has scrutinized the claim of the Complainant and arrived at correct conclusion and passed the impugned order holding deficiency in service against the Appellant/Opponent.  There is no reason to disturb the impugned order passed by the District Forum.  We hold accordingly and pass the following order:

O  R  D  E  R

 

Appeal stands dismissed.

 

No order as to costs.

 

Inform the parties accordingly.

 

Pronounced on 13th May, 2013.

 

 
 
[HON'BLE MR. Dhanraj Khamatkar]
PRESIDING MEMBER
 
[HON'BLE MR. Narendra Kawde]
MEMBER

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