Suryapet: District Consumer Disputes Redressal Commission at Nalgonda has asked New India Assurance Company to reimburse a policy amount of Rs five lakh to the wife of a lorry driver who died in the accident.
Badhe Jyothi, resident of Ramachandrapuram Village of Nadigudem Mandal, Suryapet District, and wife of deceased lorry driver Badhe Madhu. He was a member of Telangana Transport Drivers and Non-Transport Auto Drivers, Home Guards and Journalists Social Security Scheme, 2015.
Under the scheme, the state government provided Group Personal Accident Policy to the members of Telangana Transport Drivers and Non-Transport Auto Drivers for an assured sum of Rs.5,00,000.
On August 28, 2018, the deceased Badhe Madhu loaded a lorry with cement and proceeded to Vemulawada. On reaching near Bharat Petrol Pump, Hasanparthy Village in Warangal district, another lorry coming from the opposite direction rammed into his truck. Madhu suffered multiple injuries and died on the spot. The accident was reported to the Police, Hasanparthy, who registered a case under section 304-A and 337 of IPC.
Due to the untimely death of the deceased, Badhe Jyothi was in shock and ill health and could not send the claim form along with relevant documents to The Assistant Motor Vehicle Inspector, Transport Department, Suryapet district within the stipulated time.
The complainant approached the Assistant Motor Vehicle Inspector and submitted her claim form on April 8, 2019, along with all relevant documents. The vehicle inspector sent the claim form along with relevant documents to New India Assurance Company Limited for settlement.
The insurance company sent a claim repudiation letter on a flimsy ground that the complainant has failed to submit their claim form within the stipulated period of 30 days from the date of the accident, as such there was a delay of 150 days.
The complainant approached the insurance company several times, but to no avail.
The Insurance Company filed a written version in the commission, denying all the averments of the complaint.
"As per the policy conditions, Assistant Motor Vehicle Inspector, Transport Department, Suryapet district and The Commissioner, Transport Department, Khairatabad, Hyderabad have to submit the claim form and relevant documents within 150 days from the date of the accident, whereas the claim form and relevant documents were received by them on April 8, 2019, which is 170 days after cutoff. We returned the claim form and relevant documents to Commissioner, Transport Department and repudiated the claim as there is no cause of action and the complainant is not entitled to any compensation," said the insurance company.
The company said the complainant is not a consumer as per Consumer Protection Act, as they have not paid the premium to the insurance company. The company said the Telangana government is the consumer and it has to file the case. The Forum has no jurisdiction to entertain the complaint and hence it may be dismissed.
After observing all the documents and evidence, the Commission observed that as per Circular issued by Insurance Regulatory and Development Authority (IRDA), the delay in intimation or submission of documents due to unavoidable circumstances should not prevent settlement of genuine claims.
"In the present case, the complainant could not send the claim form and documents within the stipulated period due to shock and ill health on account of the sudden and untimely death of her husband in the road accident. As the insurance company repudiated the genuine claim of the complainant, there is a deficiency in service on the part of the insurance company," said the commission.
The commission directed the insurance company to pay the complainant, an amount of Rs.5,00,000 covered under Telangana Transport and non-Transport Auto Drivers, Home Guards, and Journalists Social Security Scheme, 2015 with the interest of 9 percent from the date of filing of the complaint till realization. It also asked to pay Rs.3,000 towards costs of litigation.