Per Mr.B.S.Wasekar, Hon’ble President
1) The present complaint has been filed by the complainant under section 12 of the Consumer Protection Act, 1986. According to the complainant, Late Mr.Shetty Jagannath Badiya was her husband. Her husband paid premium of Rs.6,000/- to the opponents and took policy No.47/140200/338 valid from 29th April, 1999 to 28th April, 2011 i.e. for twelve years for the sum of Rs.10 Lakhs. Membership certificate No.NI/021/501 JP 0022105 for membership No.NI/021501/03/7030 valid upto 28th April, 2011 was issued by the opponents. Copy of insurance policy is produced on record. Late Mr.Shetty nominated the complainant being the legally wedded wife. As per policy, 100% sum was assured in case of death in accident. Husband of the complainant met with accident on 2nd March, 2011 while driving Tavera Car No.MH-04-CD-4768 at Chinchoti Bhiwandi Road. He sustained head injuries. He was admitted in the hospital at Vasai. While he was under treatment, he died on 8th March, 2011. F.I.R. was lodged at Manikpur Police Station on 8th March, 2011. Police made investigation. Postmortem was conducted. The complainant submitted claim to the opponents. The opponents repudiated the claim vide letter dated 8th December, 2011 on the ground that power of attorney given to M/s.Winner Capital to issue policies had been revoked with effect from 1st May, 1999. It was published in news paper dated 13th December, 2002. Policy was issued prior to 1st May, 1999 i.e. on 29th April, 1999. Therefore, the policy was valid. In spite of several correspondence, the opponents refused to satisfy the claim. Therefore, the complainant has filed this complaint for recovery of insurance claim amount of Rs.10 Lakhs with 18% interest. She has also claimed compensation of Rs.3 Lakhs for mental torture and mental agony and cost of proceeding Rs.10,000/-.
2) The opponents were duly served but remained absent the complaint was proceeded ex-parte against them.
3) The complainant filed affidavit of evidence and produced the copies of documents on record. On perusal of certificate of insurance, policy was issued in the name of husband of the complainant w.e.f.29th April, 1999 till 28th April, 2011 i.e. for twelve years. The complainant has produced copy of premium payment receipt and care card which was valid upto 28th April, 2011. According to the opponents as per correspondence, all policies issued by M/s. Winner Capital had been revoked w.e.f. 1st May, 1999. Policy was issued in the name of complainant’s husband on 29th April, 1999 i.e. prior to 1st May, 1999. Therefore, the ground of repudiation is not proper. Once the premium is received and policy is received, the opponents are bound to satisfy the claim, if other conditions are fulfilled. In this case, policy was valid till 28th April, 2011. Husband of the complainant wet with an accident on 2nd March, 2011 and died on 8th March, 2011 i.e. during policy period. The complainant has produced copies of F.I.R., P.M. and police investigation papers. On perusal of it, it is clear that husband of the complainant died due to the accident. The complainant is the nominee. She is legally wedded wife of deceased. Therefore, she is entitled for the insurance claim.
4) Copies of complaint and other documents were served on the opponents. The opponents did not bother to attend the Forum and file their reply. The submission of the complainant remained unchallenged. Documents on record are sufficient to prove the claim of the complainant. Therefore, the complainant is entitled for the insurance claim i.e. Rs.10 Lakhs with interest at the rate of 9% per annum from the date of filing of this complaint i.e. 14th February, 2013 till its realization. The complainant has produced correspondence on record. The opponents failed to satisfy the claim thereby the complainant suffered from mental agony. Therefore, the complainant is entitled for the compensation. We think compensation of Rs.10,000/- will suffice the purpose. Besides this the complainant is entitled for the cost of this proceeding Rs.5,000/-. Hence, we proceed to pass the following order.
O R D E R
1) Complaint is allowed.
2) The opponents are directed to pay Rs.10 Lakhs (Rs.Ten Lacks Only) with interest at the rate of 9% per annum to the complainant from the date of filing of the complaint i.e. 14th February, 2013 till its realization.
3) The opponents are also directed to pay to the complainant Rs.10,000/- (Rs.Ten Thousand Only) towards compensation for mental agony and Rs.5,000/- (Rs.Five Thousand Only) towards cost of the proceeding.
4) The above order shall be complied with within a period of one month from today.
5) Copies of this order be sent to the parties free of cost.
Pronounced dated 19th March, 2014
