BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION.
KAMRUP
C.C.No.70/2019
Present:
I) Shri A.F.A.Bora, M.Sc.,L.L.B.,A.J.S(Rtd.) -President
II) Smti Archana Deka Lahkar,B.Sc.,L.L.B. -Member
III) Shri Tutumoni Deva Goswami, B.A.L.L.B. -Member
Smti Minati Debnath - Complainant
Wife of Late Sujit Debnath
Resident of Saraighat Nagar,
P.O. Pandu,
P.S.Jalukbari, District ; Kamrup,(M),Assam
Pin-781012.
-vs-
The Regional Head Office of the Tata AIG - Opposite party
General Insurance Co,Ltd., Guwahati
Represented by the Regional General Manager
Of TATA AIG GENERAL INSURANCE CO.LTD.
3rd Floor, Mayur Gardens. G.S.Road, ABC, Guwahati,
Assam-781005
Appearance
For the complainant:- Ismail Hoque Learned advocates .
For the opp. party:- Sri Utpal Kr.Dutta Learned advocate
Judgment and Order
1) This is an order and judgment arising out of a petition No. 497/21 filed under order XII- Rule -6 C.P.Code stating that the complainant categorically admitted their liability to make payment of claim amounting to Rs.15,00,000/- which has not been released as personal accident benefit to the complainant . It is mentioned that same claim has been categorically admitted by the opp.party in their w.s. and as such further proceeding is not necessary. It has been further mentioning in the petition that opp.apry admitted the bonafide claim, but raise a dispute on payment of interest amount upon the principal amount. The complainant again made an reference of the provision 14 of the Insurance Regulation and Development authority of India (Protection of policy Holder’s Interest ) Regulation 2017. The entire provision of 14 with Sub-Rule 1 & 2 has been placed for reference.
2) At the same time claim has been made for interest which is above 2% interest on bank rate upon principal amount from the date of ready for payment of the claim . Against the aforesaid claim made by the complainant the opp.party filed a written objection stating that the complainant has filed this petition only to get interest from the insurance company unlawfully after her claim was approved by the company. It has been stated that the claim of Rs.15,00,000/- is ready for payment without any interest if complainant withdraw her complaint petition. It is further mentioned that the written statement was filed on 29.12.20 and complainant instead of filing the evidence delayed the matter with an intention to get higher rate of interest on the approved amount of Rs.15,00,000/-.
3) It is specifically mentioned by the opp.party that provision 14 of Insurance Regulatory Development Authority Regulation 2017 is applicable at Life Insurance Policy only and not for general Insurance policy. According to the opp.party the policy concerned is not a life Insurance policy .
4) In such a situation it is mentioned in the objection petition that complainant mentioning the Regulation of Life Insurance Company wants to mislead the commission for unlawful gain. The opp.party therefore raise the objection to dismiss the petition filed by the complainant and pass such other order.
5) The first question that has brought to our notice is that whether claim is in respect of a life insurance policy or General Insurance Policy. The opp.party in their written statement clearly admitted that they are ready to pay an amount of Rs.15,000,00/- only and the same was conveyed to the complainant prior to filing the complaint petition but same could not be paid due to non-co-operation of the complainant . We have given a anxious note of the fact that the procedure adopted by the Insurance company is in respect of the death of the insured . The opp.party stated that the complainant failed to withdraw her complaint inspite of offering Rs.15,000,00/-to the complainant on humanitarian ground . The opp. party filed written statement on 29.12.20 i.e. the day of admitting the claim and we do not like to make any discussions about further Rules of Life Insurance Policy or General Insurance policy etc. The opp.party again reiterated that there was no deficiency in service.
6) Having heard both the learned counsels we had taken notice of order XII Rule 6 of C.P.C. By following the spirit of the above provision of C.P.C. , we finally decided to draw a judgment in the aforesaid matter .
7) The fact of the complainant is that her husband namely Sujit Debnath was a registered owner of a motor cycle vide registration no. AS-17-H- 2573 which was insured by the opp.party Insurance company vide policy No. 0189354138. The policy was issued in the name of Sujit Debnath the husband of the complainant . The wife is a nominee of her husband and the said policy covered against personal Accident benefit of Rs.15,000,00/- towards the owner cum driver of the insured motor cycle. Complainant husband died due to an accident and accordingly F.I.R. was lodged . Complainant ‘s husband died on 15.7.2019 and she lodged a claim of personal accident benefit before the opp.party company.
8) The claim was for Rs.15,000,00/- with an interest at the rate of 18% per annum from the date of accident as well as for another amount of Rs.30,000/- as cost of the proceeding. Having such claim by the complainant the opp party company approved the claim of the complainant amounting Rs.15,,000,00/- for the death of the insured disputing the interest on the said amount of Rs.15,000,00/- . We have decided the dispute by following the spirit of Order XII Rule 6 C.P.C which read as under-
Judgment on admissions- (1) Where admissions of fact have been made either in the pleading or otherwise, whether orally or in writing , the court may at any stage of the suit, either on the application of any party or of its own motion or without waiting for the determination of any question between the parties , make such order or give such judgment as it may think fit, having regard to such admissions.
(2) Whenever a judgment is pronounced under sub-rule (1), a decree shall be drawn up in accordance with the judgment and the decree shall bear the date on which the judgment was pronounced.
9) The interest rate of 18% as claimed by the complainant in the complaint petition is now become irrelevant as we propose to follow the Rule 14 of the Insurance Regulatory and Development Authority of India (Protection of policy holders’ interest) Regulations 2017. There is no dispute regarding delay of settlement of the claim and our considered view is to follow the provision Rule 14, 3 (iii) which read as under
“ If a claim is ready for payment , but the payment cannot be made due to any reasons of proper identification of the payee, the life insurer shall pay interest on the claim amount at the bank rate from the date on which claim is ready for payment.”
10) In our present case in hand there is no specific evidence of refusing the insured amount by the claimant, but at the same time for non-submission of some documents and pending of the complaint , it is claimed that insurer is unable to make the insured amount on the date of admitting the same by way of submitting written statement on 29.12.2020 . As such , by adopting the procedure of provision 14 (2)(III) of Insurance Regulatory and Development Authority of India Regulations 2017, we may order the payment of interest for the insured amount at the bank rate i.e. @ 3.5% per annum from the date of admitting the claim by the opp.party till the payment.
11) The opp.parties are directed to make the payment within 45 days from the date of receipt of the order to the tune of Rs.15,000,00/- (Rupees fifteen lakh)only as admitted insured amount with the interest @ 3.5% per annum from the date of admitting the claim till realization .
Accordingly case is disposed off on contest.
Given under our hand and seal of the District Commission, Kamrup, this the 6th day of December 2021.
Dictated and corrected by me
( Shri A.F.A.Bora )
President ,
District Consumer Commission, Kamrup
( Shri A.F.A.Bora )
President
District Consumer Commission, Kamrup
( Smti Archana Deka Lahkar )
Member
District Consumer Commission,Kamrup
( Shri Tutumoni Deva Goswami )
Member
District Consumer Commission,Kamrup
Typed by me
( Smt Juna Borah )
Stenographer,
District Consumer Commission, Kamrup
