Tripura

StateCommission

RP/1/2016

The Administrative Officer National Insurance Company Ltd. - Complainant(s)

Versus

Smt. Rani Bala Debnath & 3 Others. - Opp.Party(s)

Mr. A.Nandi

20 May 2016

ORDER

 

STATE CONSUMER DISPUTES REDRESSAL

COMMISSION,

TRIPURA

 

APPEAL CASE No.RP/01/2016

 

1. Senior Divisional Manager,

The National Insurance Company Ltd.,

Division No.3,

8, India Exchange Place (Ground Floor),

Kolkata-700001, West Bengal.

Represented by its Administrative Officer,

Divisional Office, Agartala

 

                   ….    ….    ….    ….    Appellant/Petitioner.

 

                   Vs

 

1. Smt. Rani Bala Debnath,

W/o Late Manmohan Debnath

 

2. Sri Babulal Debnath alias Babul Debnath,

S/o Late Manmohan Debnath

Both are residing at Paschim Ghilatali,

P.S. Kalyanpur, Dist.Khowai, Tripura.

1.  

                              ….    ….    ….    ….    Respondents/Opposite Parties.

 

3. Golden Trust Financial Service

Paradise Chowmuhani,

P.S. West Agartala, Dist. Tripura West.

Represented by its Brach Manager.

 

4. The Branch Manager,

Golden Trust Financial Service

Paradise Chowmuhani,

P.S. West Agartala, Dist.Tripura West

                              ….    ….    ….    ….    Pro-Opposite Parties.

 

 

PRESENT

 

HON’BLE MR.JUSTICE S.BAIDYA,

PRESIDENT,

STATE COMMISSION

 

MRS. SOBHANA DATTA,

MEMBER,

STATE COMMISSION.

 

MR.NARAYAN CH. SHARMA,

MEMBER,

STATE COMMISSION.

 

For the Appellants             :         Mr. Ashish Nandi, Adv.

For the Respondent nos.3 & 4 :   Mr. Sudipta Sekhar Debnath, Adv.

Date of Hearing       :         30.04.2016 & 10.05.2016.

Date of delivery of Judgment:   20.05.2016 

 

 

J U D G M E N T

 

S. Baidya, J,

This revision petition filed on 02.02.2016 by the petitioner-revisionist, the National Insurance Company Ltd. under section 17 (1) (b) of the Consumer Protection Act, 1986 is directed against the Order dated 22.12.2015 passed by the Ld. District Consumer Disputes Redressal Forum (in short District Forum), West Tripura, Agartala, in case No.CC-40/2015 whereby the Ld. District Forum rejected the application of the present petitioner filed challenging the maintainability of the complaint petition being barred by law of limitation before the Ld. District Forum.

2. The case of the petitioner, as narrated in the revision petition, in brief, is that the complainants, the opposite party nos.1 & 2 herein, lodged the complaint under section 12 of the Consumer Protection Act, 1986 to entertain the claim for realization of insured money in the capacity as legal heir and nominee due to premature death of Manik Debnath, the son of opposite party no.1 and the brother of opposite party no.2 arising out of a drowning  incident taken place on 08.07.2006 who was the holder of Janata Personal Accidental Policy no.100300/47/01/9600022/3/96/30052 issued by the petitioner.  
3. It has been alleged that the nominee of the deceased i.e. O.P.no.2 made a claim before the Insurance Authority and it is their allegation that the Insurance Authority have failed to entertain the claim.
4. It has also been alleged that the proforma opposite party nos.3 & 4 are the corporate agent of the petitioner and as such, the complainants submitted their claim with all necessary documents into the office of the opposite party nos.3 who initiated the claim, but that too without any result. The complainant made several visits into the office of the petitioner and the proforma of opposite parties, but no tangible result was achieved.
5. It has also been alleged that the opposite party no.2 made a complaint before the Insurance Ombudsmen at Guwahati Centre and the said Authority though directed to settle the disputes along with interest, but the same could not be fulfilled on the ground of suppression of material fact by the complainant and finally, the petitioner Insurance Company by its letter dated 22.08.2011 repudiated the claim in question mainly on the ground that the insured was suffering from Epilepsy and also on the ground that there was no accident caused by external visible violent means and does not come within the purview of the scope of the policy and that result was communicated to the present opposite party nos.1 & 2 by the petitioner vide letter dated 22.08.2011.
6.    It has also been alleged that the opposite party nos.1 & 2 after receipt of the letter of repudiation remained silent for a period of more than 3 (three) years without challenging the letter of repudiation and thereafter on 16.08.2014 the opposite party no.2 served a notice for settlement of claim of his deceased brother against which the petitioner Insurance Company by its letter dated 15.09.2014 answered the allegation made in the letter dated 16.08.2014 denying the obligation to make payment of claim mentioning their earlier stand taken in the letter of refusal dated 22.08.2011 and then the opposite party nos.1 & 2 lodged the complaint petition before the Ld. District Forum on 06.04.2015 after almost 9 years from the date of the first cause of action.
7. It has also been alleged that pursuant to the notice, the present petitioner National Insurance Company Ltd. submitted written statement and also filed an application challenging the maintainability of the claim with the plea of time barred as per section 24 A of the C.P. Act.
8. It has also been alleged that the Ld. District Forum after hearing opined that the claim is maintainable by the impugned order and thereby being aggrieved and dissatisfied, the petitioner has preferred the instant revision petition on the grounds that the Ld. Forum has exceeded the jurisdiction vested upon it by entertaining a time barred claim as per provision of section 24 A of the C.P. Act, that the Ld. Forum failed to exercise its judicial mind and as such, arrived at a favourable finding for the complainant while passing the impugned order dated 22.12.2015 which is against the law of limitation for entertaining a complaint and as such, it is not sustainable in the eye of law and is liable to be set aside and hence, the instant revision petition has been filed.  

 

 

Points for Consideration

9. The points for consideration are (i) whether the Ld. District Forum was proper, legal and justified in passing the impugned order holding that the claim is maintainable and (ii) whether the impugned order can be sustained in the eye of law.

Decision with Reasons     

10. Both the points are taken up together for the sake of convenience and brevity.
11. At the outset, it is found necessary to mention that the present opposite party nos.1 & 2 who are the complainants in the Ld. Forum did not turn up to contest the revision petition, in spite of service of notices upon them.  
12. It is a revision case. In a revision case, only the propriety, legality and justifiability of the order under challenge requires to be adjudicated.
13. As per complaint filed under section 12 of the C.P. Act, 1986, the insured Manik Debnath who was the holder of Janata Personal Accident Insurance Policy bearing no.100300/47/01/9600022/03/96/30052, died on 08.07.2006 due to accidental drowning. It also appears that the complainant no.2 Babulal Debnath lodged the claim no.14-003-0031/09-10 before the Insurance Ombudsman at Guwahati Centre. It further appears that Insurance Ombudsman by its order dated 20.07.2009 directed the insurance company to complete the process of settlement of the claim. It further appears from paragraph-6 of the complaint that the insurance company vide letter dated 22.08.2011 repudiated the claim in question mainly on the ground that the deceased insured was suffering from Epilepsy and also on the ground that there was no accident caused by external visible violent means and as such, it does not come within the purview of the scope of the policy. The complaint further states that the complainant no.2 on 16.08.2014 submitted application before the National Insurance Company, the petitioner herein, requesting to settle the claim and the insurance company by letter dated 15.09.2014 finally repudiated the claim of the complainants and finding no alternative, the complainant thereafter lodged the complaint with the Ld. District Forum.
14. The Ld. Counsel for the petitioner submitted that the Ld. District Forum has taken 15.09.2014 as the date of repudiation of the claim of the complainants finally. He also submitted that the Ld. District Forum also held that the complaint under section 12 of the C.P. Act has been filed by the present respondent nos.1 & 2 before the Ld. District Forum on 29.04.2015 which is well within the period of two years from 15.09.2014 as per section 24 A of the C.P. Act, 1986. He also submitted that on the basis of that finding, the Ld. Forum held the complaint maintainable. He also submitted that this finding of the Ld. Forum is against the spirit of law enunciated in section 24 A of the C.P. Act and as such, it cannot be accepted and the impugned order should be set aside as the complaint was lodged before the Ld. Forum beyond the statutory period of two years as provided under section 24 A of the said Act.
15. We find that there involves a question whether accidental death by drowning without any external visible violent means can be considered as an accident as provided in the said Janata Personal Accident Insurance Policy. From the policy itself it appears that the said policy covers the risk of accidental death/loss of limbs/permanent total disablement. It further appears from the order of the Insurance Ombudsman passed on 20.07.2009 that the said authority directed the insurance authority to settle the claim holding that the documents produced before it prove the death of the insured due to drowning which appears to be in accidental nature and such kind of death is covered under the policy. It also transpires from the said order that the insurance company was a party to that proceeding and did not challenge the findings of the Insurance Ombudsman before any higher authority. That being the position, it can be said without any hesitation that the National Insurance Company, the petitioner herein, accepted the death of insured Manik Debnath due to drowning as an accidental death. Therefore, we are inclined to hold that the death of the insured Manik Debnath was an accidental death and comes within the purview of the said Janata Personal Accident Insurance Policy.     
16. Admittedly, Manik Debnath, the deceased insured died on 08.07.2006. It means that the claim of the nominee of Manik Debnath under that policy becomes due on the expiry of 08.07.2006. It also transpires that the Insurance Ombudsman passed the judgment and award dated 20.07.2009 directing the insurer i.e. National Insurance Company Ltd. to complete the process of settlement of the claim in question. It further appears from paragraph-7 of the complaint that the Insurance Company by letter dated 22.08.2011 repudiated the claim in question, whatever may be the ground of repudiation. Going through the said letter of repudiation dated 22.08.2011 we do not find anything to believe and hold that the Insurance Company admitted at any point of time the claim of the complainants. It further appears from the said letter of repudiation that the repudiation of claim of the complainants was conclusive and final.
17. It also appears that the complainant no.2 after the expiry of further three years from the date of said repudiation of the claim submitted an application before the present petitioner on 16.08.2014 re-agitating for early settlement of claim and the insurance company by its reply dated 15.09.2014 informed the complaint no.2 Babulal Debnath that the claim of the complainant was repudiated and the said repudiation of claim was informed to them vide letter dated 22.08.2011.
18. Section 24 A of the C.P. Act reads as follows:-
    •  

(2) Notwithstanding anything contained in sub-section (1), a complaint may be entertained after the period specified in sub-section (1), if the complainant satisfies the District Forum, the State Commission or the National Commission, as the case may be, that he had sufficient cause for not filing the complaint within such period:

Provided that no such complaint shall be entertained unless the National Commission, the State Commission or the District Forum, as the case may be, records its reasons for condoning such delay.”  

19.    The section 24 A of the C.P. Act, 1986 provides that the Ld. Forum, the State Commission or the National Commission shall not admit a complaint unless it is filed within two years from the date on which the cause of action has arisen. The claim of the complainants has become due on the death of the insured Manik Debnath who died on 08.07.2006. The claim of the complainants has been repudiated by the present petitioner National Insurance Company vide letter dated 22.08.2011 which is the date of accrual of the cause of action. So, the complainants ought to have filed the complaint before the District Forum within 22.08.2013 which is within two years from the date of accrual of the cause of action i.e. from 22.08.2011, but the complainants lodged the complaint before the Ld. District Forum on 29.04.2015 which is more than three years after the accrual of the cause of action.
20. The application dated 16.08.2014 submitted by the complainant no.2 Babulal Debnath before the insurance company is nothing, but an attempt, according to us, to get the period of limitation to file the complaint extended, but the letter dated 15.09.2014 of the insurance company referring to the letter of the respondent no.2 dated 16.08.2014 is also nothing, but a mere reply and the same cannot be treated under any stretch of imagination as a letter of repudiation of claim which was made practically vide letter dated 22.08.2011 and as such, the reply letter of insurance company dated 15.09.2014 did not give any fresh cause of action for lodging the complaint which has already been barred under section 24 A of the C.P. Act.
21. Going through the impugned order dated 22.12.2015, we are of the view that the Ld. District Forum failed to appreciate this position of law and wrongly held the complaint maintainable.
22. In view of the above, we are also of the view that the Ld. District Forum was not proper, legal and justified in passing the impugned order holding a time barred complaint maintainable and as such, the impugned order cannot be sustained in the eye of law and is liable to be set aside and the revision petition, therefore, should be allowed.
23. In the result, the revision petition succeeds. The impugned order dated 22.12.2015 passed by the Ld. District Forum, West Tripura, Agartala in case No.CC-40/2015 stands set aside. The complaint lodged by the complainants- respondent nos.1 & 2 herein, under section 12 of the Consumer Protection, Act, 1986 before the Ld. District Forum and registered as CC-40/2015, being time barred, is not legally maintainable and as such, the said complaint is dismissed.
24. Let a copy of the judgment and the record of the Ld. District Forum be transmitted to the Ld. Forum forthwith for information and necessary action.

 

 

MEMBER State Commission Tripura

MEMBER State Commission Tripura

PRESIDENT State Commission Tripura