Full Judgment
The petitioner before this Court, a person belonging to the Scheduled Tribe and who also belongs to the weaker section of the society, has filed this present petition for issuance of an appropriate writ, order or direction directing the respondents to grant the petitioner the Insurance amount on account of death of his wife during pregnancy. Petitioner has enclosed a certificate issued by the Sarpanch, Shujalpur as Annexure P/1 dt. 18/5/07 which certifies that the petitioner is a Tribal and his name finds in the list of person belonging to Below Poverty Line. It has been further stated in the writ petition that the petitioner's wife, as she was expecting a child, was brought for delivery to the Primary Health Centre, Polay Kalan, Distt. Shajapur, however, the Doctors at the Primary Health Centre refused to admit the lady and she was brought to MY Hospital, Indore on 14/8/06. It has been further stated that the petitioner's wife expired on 19/8/06 and a certificate was issued by the Municipal Corporation, Indore on 12/7/07. The certificate also reflects that the death took place on 19/8/06 at MY Hospital, Indore. Petitioner has further stated that the petitioner immediately submitted an application to the authorities for grant of Insurance amount and as the Insurance amount was not paid to the petitioner on account of death of his wife, he has approached this Court.
A reply has been filed on behalf of respondent No.6 - Insurance Company and learned counsel for the respondent No.6 has vehemently argued before this court that the writ petition is not maintainable as the petitioner is having an alternative remedy. The second ground argued before this Court is that the claim was not submitted in time by the petitioner and therefore keeping in view the Insurance Policy, the question of making payment to the petitioner does not arise. Learned counsel for the respondent Insurance Company has also argued before this court that earlier also a writ petition was preferred and this Court while passing an order dt. 27/8/08 in WP No. 4345 / 2008 has dismissed the writ petition as premature and has observed that the petitioner has not served a notice of demand to the concerned authorities. Learned counsel for the respondent Insurance Company has prayed for dismissal of the present writ petition also.
Learned Government Advocate for the respondent State has argued before this court that the claim of the petitioner was forwarded to the Insurance Company on 5/9/08 and the Insurance Company has not paid the amount in question to the petitioner. The respondents have also stated that the Insurance Claims are forwarded to the Insurance Company within a period of 3 months and claims forwarded beyond a limit of 90 days are rejected by the Insurance Company. The respondent State has also prayed for dismissal of the writ petition.
Heard learned counsel for the parties at length and perused the record. The matter is being disposed of at the admission stage itself with the consent of the parties.
The petitioner before this court is admittedly a member of Scheduled Tribe and a person who belongs to the weaker section of the society. His name finds place in the list of persons, as per the Survey of the people who are living Below the Poverty Line. It is also an admitted fact that the wife of the petitioner, as she was expecting a child, was initially brought to the Primary Health Centre, Polay Kalan, Distt. Shajapur, and thereafter she was admitted in MY Hospital, Indore on 14/8/06. It is also an admitted fact that the wife of the petitioner expired on 19/8/06. The certificate which has been issued by the Municipal Corporation, Indore is dated 12/7/07, meaning thereby, the death certificate was issued after almost an year by the Municipal Authorities in the matter. Delay in issuance of death certificate cannot be attributed to the petitioner. In the present case, the State of Madhya Pradesh has issued executive instructions after taking a policy decision on 19/5/06 and 'Vijaya Raje Janani Kalyan Bima Yojana' has been framed by the State Government. Under the 'Vijaya Raje Janani Kalyan Bima Yojana', the amount is paid to the pregnant ladies who are covered under the Scheme and on account of death because of pregnancy, a sum of Rs.50,000/- is payable. The Scheme further reveals that the United India Insurance Co. Ltd., has entered into an agreement with the State of Madhya Pradesh and is accepting premium from the State of Madhya Pradesh to pay the amount as per the Scheme. It has not been denied before this Court that the United India Insurance Co. Ltd., has received premium from the State of Madhya Pradesh. The respondent United India Insurance Co. Ltd., has denied the claim on the ground that the same was not forwarded to them within time. Learned Counsel for the Insurance Company has informed this Court from the original record that a sum of Rs. 4.00 crores have been paid by the State Government on 12/5/06 and the policy is being renewed every year by paying such a huge premium.
In the present case, the petitioner is a Tribal and he cannot be blamed for not forwarding the claim in time to the Insurance company. The policy issued by the Insurance Company has been executed by the Commissioner, Health, State of Madhya Pradesh and it was the duty of the MY Hospital to forward the claim of the petitioner in time. The policy is very much in existence as it has been renewed every year and merely because the claim was not submitted in time, the claim cannot be turned down specially when the Insurance Company has received a premium of Rs.4.00 crores and is receiving premium every year.
Not only this, this Court has carefully gone through the death certificate issued by the Municipal Authorities and the Municipal Authorities have issued a death certificate after a lapse of about 1 year. In the State of Madhya Pradesh large number of tribals are illiterate, they are not aware of their rights and therefore it is the duty of the authorities to ensure implementation of the Schemes formulated by the State Government. This Court is of the considered opinion that in the peculiar facts and circumstances of the case the petitioner is certainly entitled for the amount under the Rural Special Contingency Policy . The earlier writ petition was disposed of on 27/8/08 as the petitioner at that point of time has not approached the authorities, however, now the record reveals that the petitioner has approached the authorities and his case cannot be thrown out on the ground of alternative remedy available to the petitioner, and therefore, keeping in view the peculiar facts and circumstances of the case the United India Insurance Co. Ltd., is directed to process the claim of the petitioner as it is an admitted fact that his wife expired on account of pregnancy complications on 19/8/06 and as death certificate is on record, the Insurance Company is directed to release the amount as per the Insurance Policy executed between the State of Madhya Pradesh and the Insurance Company. Not only this, the petitioner shall also be entitled for interest @ 12% p.a., The aforesaid exercise of making payment be concluded within a period of 60 days from the date of receipt of certified copy of this order.
With the aforesaid, this petition stands allowed. No order as to costs.