National Insurance Co. Ltd vs Chhabubai

This revision is directed against the order of the State Commission, Maharashtra dated 29.3.2017.

Briefly stated, facts relevant for the disposal of the revision petition are that the respondent filed a consumer complaint on the allegation that her husband was a farmer and owner of gut No.75. He was member of respondent/opposite party No.3 society. Opposite party No.3 society had obtained a group personal accident insurance policy in respect of its members trough respondent/opposite party No.2 bank. The policy was valid from 25.2.2014 to 24.2.2017.

According to the complainant her husband died because of fatal accident on the night intervening 24/25th February, 2014 at around 3 am. Intimation of accident was given to the police, FIR was registered against the driver of the car which caused accident and post-mortem examination of the deceased was done. The insurance claim submitted by the petitioner, however, was repudiated by the petitioner insurance company. Feeling aggrieved, the petitioner filed the consumer complaint.

The petitioner/opposite party on being served filed a written statement denying the allegations of deficiency in service.

The District Forum on consideration of pleadings and the evidence allowed the complaint and directed the petitioner insurance company to pay to the complainant the insured amount under the insurance policy within 30 days, failing which it was ordered that the amount shall carry 6% interest from the date of filing of the complaint i.e. 4.6.2015. Besides compensation of Rs.3,000/- was awarded on account of mental harassment.

The petitioner being aggrieved of the order of the District Forum approached the State Commission in appeal. The State Commission on re-appreciation of evidence concurred with the finding of the District Forum and dismissed the appeal.

Learned counsel for the petitioner has contended that the impugned orders of the Fora below are against the facts. It is submitted that the Fora below have failed to appreciate that the premium for the insurance cover was received by the bank after the death of the husband of the petitioner, therefore, the deceased husband of the petitioner was not covered under the group insurance policy. In support of his contention, learned counsel for the petitioner insurance company has drawn my attention to the copy of the letter dated 25.2.2014 addressed by the Manager of opposite party No.2 bank to the Branch Manager of opposite party No.1 insurance company as also the death certificate of the husband of the complainant.

Learned counsel for the respondent/complainant on the contrary has argued in support of the impugned order.

I have considered the rival contentions and perused the material on record. Perusal of the letter dated 25.2.2014 addressed by the opposite party No.2 bank to the petitioner insurance company would show that vide said letter insurance premium for 1,15,738/- farmer members to the tune of Rs.98,95,599/- was sent to the petitioner insurance company vide demand draft No.423399 dated 25.2.2014 with a list of members. As the demand draft was issued on 25.2.2014, obviously it must have been issued during the banking hours i.e. after 10.00 am in the morning of 25.2.2014.

Perusal of the copy of the provisional death information report given by the Government Medical College & Hospital, Latur would show that husband of the complainant died because of the fatal injuries on 25.2.2014 and his post-mortem examination was conducted in the morning of 25.2.2014 between 6.40 am to 7.40 pm i.e. much prior to the banking hours. Thus, it is evident that the bank draft for payment of premium for the insurance policy was issued after the death of the husband of the complainant. Therefore, it cannot be said that he was covered under the subject insurance policy premium of which was paid vide bank draft after the death. The Fora below have failed to take notice of the aforesaid facts. Therefore, their orders cannot be sustained.

In view of the discussion above, I allow the revision petition, set aside the orders of the Fora below and dismiss the complaint.