VINOD KUMAR NAGRATH vs UNITED INDIA INSURANCE CO LTD

FIRST Appeal No. 376 of 1993 has been filed against the order dated 9th July, 1993 of the State Consumer Disputes Redressal Commission, Delhi in Case No. 477/92. The Appellant herein was the Complainant before the State Commission.

THE facts of the case are in narrow compass. The Complainant purchased Personal Accident Insurance Policy for the period 30.10.1991 to 29.10.1992. According to the terms of the policy, the respondent was liable to pay Rs. 1500/ - per week to the Complainant on account of his total temporary disablement, medical expenses and losses suffered by him. The Complainant while driving a truck was hit by another truck on 18.12.1991 and received numerous serious injuries. After the accident he remained in various nursing homes for treatment. He wrote various letters and sent the bills of his treatment and medicines to the respondent for payment, but those have not been paid. The Complainant claimed an amount of Rs. 1,62,500/ - towards expenses for treatment (Rs. 25,000/ -), total temporary disablement at the rate of Rs. 1500/ - per week (Rs. 37,500/ -) and damages, compensation for mental pain and agony and financial loss on account of the recovery proceedings with regard to truck having been initiated by the Delhi Financial Corporation (Rs. 1,00,000/ -). The complaint was contested by the Respondent who pleaded held that (i) it took some time to settle the claim as the matter was investigated from Surveyors, Investigators, Doctors etc., (ii) the claim was settled by them at Rs. 46,338/ - which however, was declined by the Complainant and (iii) the Respondent was not concerned with or liable for payment of the instalment for the truck of the Complainant. The State Commission, after going through the affidavit of the Complainant in support of his claim, details of bills paid by him to the nursing home and cash memos for medicines etc. observed that they found no cogent ground to accept the plea of the Respondent that the Complainant was entitled to Rs. 46,338/ -. The Commission held that the Complainant was entitled to a payment of Rs. 33,750/ - towards total disability and Rs. 21,855/ - towards nursing home and medical bills with interest at 18 per cent per annum and computed the total amount including interest as Rs. 61,250/ -. The Commission directed the Respondent to pay to the Complainant this amount with interest @ 18% per annum from the date of the complaint till the date of payment within a period of three months and also costs of Rs. 2,000/ -.

THE Appellants main contention in his Appeal is that the Respondent did not make the payment of weekly instalments of Rs. 1500/ - promptly nor did they make payment of expenses incurred by him. Consequently, he had to bear the nursing home and related expenses and he could not make the payments of instalments in time to the Delhi Financial Corporation which had financed the purchase of his vehicle. The Delhi Financial Corporation passed recovery orders against the Appellant on 27.7.1992 and the Appellant had to be in jail from 26.5.1993 to 7.6.1993 for default in payment. The Appellants grievance is that the State Commission has not given compensation for losses and mental strain undergone by him in not getting timely payment from the respondent.

WE have heard the Counsel and gone through the records. We find that the State Commissions directions to the Respondent to pay an amount of Rs. 61,250/ - with interest at the rate of 18% per annum from the date of the complaint till the date of payment and costs is just and fair. We also agree with the finding of the State Commission that the payment of instalment by the Complainant to the Delhi Financial Corporation is not directly but remotely connected with the liability of the Complainant to pay the instalment amount. At the same time, we find that there has been hesitancy on the part of the Respondent to settle the claim of the policy although the intimation about the accident which took place on 18th December, 1991 was given by the Appellant almost immediately after the accident (through his letter of 19th December, 1991 and the claim from submitted by him on 7th February, 1992. The doctor deputed by the Respondent also visited the Appellant in the nursing home immediately after the accident. However, it was left to the Complainant to issue a notice to the Respondent on 8th October, 1992 about the non -payment of his claim and, it was only after the complaint was filed that the Respondent offered vide their letter dated 14th December, 1992 a payment of Rs. 46,338/ - by way of settlement of the claim which is less than the entitlement as per the State Commission. In the light of these facts and circumstances, we are of the view that the Appellant was put to avoidable strain and tension due to this attitude of the Respondent whereas the purpose of taking such insurance is only to secure against such contingency. We, therefore, direct the Respondent to pay an amount of Rs. 5,000/ - to the Complainant as compensation for mental agony. The order of the State Commission in respect of other directions will stand confirmed. The appeal is partly allowed. There is no order as to costs.