Smt. Sharadabai Prakash Bhosale Vs. General Manager Icici Lombard General Insurance Company Ltd. - Court Judgment

S. R. Khanzode, Presiding Judicial Member

[1] This appeal filed by the Appellant/original Complainant, Smt. Sharadabai Prakash Bhosale (hereinafter referred to as ‘the Complainant takes an exception to an order dated 18/9/2009 passed by the District Consumer Disputes Redressal Forum, Sangli (hereinafter referred to as ‘the Forum for the sake of brevity) in Consumer Complaint No.475 of 2008, Smt. Sharadabai Prakash Bhosale Vs.  General Manager, ICICI Lombard General Insurance Company Ltd. and Another.  It is the case of alleged deficiency in service on the part of the Respondent No.1/original Opponent No.1, ICICI Lombard General Insurance Company Ltd. (hereinafter referred to as ‘the Insurance Company for the sake of brevity) for not considering the insurance claim that arose on the accidental death of Mr. Sachin Bhosale, who was the son of the Complainant, which occurred in a truck accident on 6/3/2006.  Insurance claim was made under the ‘Cultivators Personal Accident Policy which was taken by the Government of Maharashtra for the benefit of cultivators in the State.  The claim was processed through the Respondent No.2/original Opponent No.2, Tahsildar who forwarded the papers to the Insurance Company on 4/6/2006.  However, the since the claim was not considered (neither repudiated nor accepted), a consumer complaint was filed on 7/5/2008.  The Forum partly allowed the consumer complaint and instead of granting compensation of Rs.1,00,000/- to the Complainant under the insurance policy, proceed further to direct the Insurance Company to pay to the Complainant an amount of Rs.7,000/- by way of compensation besides costs of Rs.3,000/-.  Thus, not satisfied with the impugned order the Complainant preferred this appeal.

[2] It may be pointed out at the outset that the Insurance Company has not preferred any appeal challenging the impugned order and thus, acquiesced with the impugned order.

[3] Heard Adv. Nagesh Chavan on behalf of the Complainant and Adv. Nikhil Mehta on behalf of the Insurance Company.

[4] It is the submission of the Insurance Company that Late Mr. Sachin Bhosale was not a ‘cultivator and as such, was not entitled for the benefit under the insurance policy.  It also submitted that since the claim was not made within a period of sixty days from the event of death of Late Mr. Sachin Bhosale, it could not have been entertained.  Further, it is also submitted that the consumer complaint was barred by limitation since it was filed after lapse of a period of two years from the date of death of Late Mr. Sachin viz. 4/3/2006.

[5] According to the Complainant, Late Sachin was very much a ‘cultivator and entitled to benefit under the insurance policy due to his accidental death.  The claim was also processed through concerned Tahsildar and it was forwarded to the Insurance Company within time on 4/6/2006.  As far as limitation is concerned, it is submitted that Insurance Company neither allowed the claim nor repudiated the same and, therefore, it cannot be said that the consumer complaint is filed beyond the prescribed period of limitation under Section 24-A of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act for the sake of brevity).

[6] As far as objection relating to the fact that insurance claim was not processed within a period of sixty days, the statement dated 5/7/2008 of the Respondent No.2/original Opponent No.2, Tahsildar filed in the consumer complaint itself shows that after the papers were received from the claimant (viz. the Complainant) upon verifying the same, they forwarded the papers to the Insurance Company on 4/5/2006 i.e. well within sixty days from the death of Late Mr. Sachin which occurred on 6/3/2006.  Apart from that Insurance Company failed to show that if the claim is not made within a period of sixty days, it cannot be entertained or right of the claimant would get forfeited.  Therefore, submission to his effect on behalf of the Insurance Company is devoid of any substance.

[7] As far as submission of the Insurance Company that the consumer complaint is barred by limitation, we are afraid that since they failed to consider and repudiate the insurance claim, the limitation would not go.  Useful reference on the point can be made to a decision of the National Commission in First Appeal No.50 of 2012 (In the matters of M/s. Manali Gold Vs.  Oriental Insurance Company Ltd.) decided on 19/9/2012 (Quorum Mr. Justice Ashok Bhan, President and Mrs. Vineeta Rai, Member).

[8] The Complainant categorically stated that her son, Late Mr. Sachin Bhosale was a ‘cultivator.  This particular statement made in the complaint is not specifically denied but it is only stated by the Insurance Company that they have no personal knowledge that Late Mr. Sachin was an agriculturist.  In this background, the Complainant also relied upon her own affidavit dated 24/10/2008 wherein it was specifically alleged by her that Late Mr. Sachin was a ‘cultivator and an agricultural land was standing in his name at the time of his death and since their territory was a drought affected area, Late Mr. Sachin was required to work as a ‘cleaner obviously in addition to his cultivation.  This particular evidence goes un-rebutted. ‘7-12 Extract on the record does establish the fact that Late Mr. Sachin was a small agricultural land-holder at Village Kawathe-Mahankal.  Under the circumstances, we do not subscribe to the reasoning given by the Forum holding that Late Mr. Sachin was not a ‘cultivator and, therefore, on his accidental death insurance cover as per the policy was not available to him.  Thus, we find that the act of the Insurance Company not to either consider the claim or repudiate the same establishes deficiency in service on the part of the Insurance Company and the Complainant is entitled to compensation of Rs.1,00,000/- i.e. sum equivalent to the amount payable under the insurance policy on the accidental death of Late Mr. Sachin.  We do not wish to disturb the compensation awarded on account of mental torture and cost

For the reasons stated above, we hold accordingly and pass the following order:-

ORDER

Appeal is allowed

Impugned order dated 18^th September, 2009 passed by the District Consumer Disputes Redressal Forum, Sangli in Consumer Complaint No.475 of 2008 is hereby modified and in addition to the compensation and costs awarded, the Respondent No.1/original Opponent No.1, ICICI Lombard General Insurance Company Ltd., is further directed to pay to the Appellant/original Complainant, Smt. Sharadabai Prakash Bhosale, an amount of Rs.1,00,000/- payable under the insurance policy.  This amount shall be paid within a period of sixty days from today (since the order is passed in open Court in presence of learned advocates representing the parties) and failing which this amount shall carry interest @ 21% p.a., till its realization.Insurance Company to bear its own costs and shall pay to the Appellant/original Complainant, an amount of Rs.5,000/- as costs of this appeal.