ICICI LOMBARD GENERAL INSURANCE CO. LTD. Vs. SINDHUBHAI KHANDERAO KHAIRNAR
MAHARASHTRA STATE CONSUMER DISPUTES REDRESSAL COMMISSION
ICICI LOMBARD GENERAL INSURANCE CO. LTD.
SINDHUBHAI KHANDERAO KHAIRNAR
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(1.) This appeal filed by I.C.I.C.I. Lombard General Insurance Co. Ltd./org. opposite party in Consumer Complaint No. 125/2006 is directed against the order dated 29.12.2006 passed by District Forum, Nashik, whereby the Forum below directed the Insurance Company to pay the sum assured to the org. complainant. Insurance Company has taken exception to this order and has come up in appeal.
(2.) THERE is delay of 192 days in filing the appeal. Therefore, appellant has filed an application for condonation of delay. In para 3 of the application, it is stated that the certified copy is received on 29.12.2006. However, it was not traceable or lost. There is inordinate delay in filing the appeal. Inordinate delay of 192 days is not at all satisfactorily explained. We are, therefore, not inclined to condone the delay. Prayer for condonation of delay stands rejected.
(3.) BY way of abundant precaution, we examined the correctness of the order. The State of Maharashtra taking into consideration plight of poor Agriculturists introduced an insurance scheme. This scheme is known as "Agriculturist Accident Insurance Policy" (Shetkari Apghat Vima Yojana) in 2005. As per the said scheme, the claim was to be submitted to Tahsildar in case of accidental death of an Agriculturist. Village Revenue Officer was also involved in the said scheme. The Tahsildar is to verify as to whether particular person is eligible for grant of insurance amount. After receipt of particulars from the Village Revenue Officer, Tahsildar is to submit the claim directly to ICICI Lombard General Insurance Co. Ltd., Mumbai. The Government prescribed the procedure for verification and submission of claim form to the Insurance Company. In case of disability, the agriculturist was required to produce certificate of Doctor from Primary Health Centre/Civil Surgeon. Timelimit is also prescribed for submission of the said claim. The beneficiary was required to open an account in District Central Co -operative Bank. Tahsildar is to communicate the particulars of the bank account of the beneficiary to the Insurance Company. Insurance Company is supposed to credit the amount strictly in the bank account of the beneficiary.
Mr. Khanderao Krishna Khairnar was insured under the "Agriculturist Accident Insurance Policy" (Shetkari Apghat Vima Yojana). He met with an accident on 4.6.2005. He was admitted in Civil Hospital, Nashik. He had head injury. Accident was reported to the Satara Police Station. Necessary information was transmitted to Tahsildar, Satara. After following the procedure, the claim was submitted to the Insurance Company. Insurance Company rejected the claim on the ground that the claim papers were submitted after 110 days instead of 60 days after the death. The Insurance Company rejected the claim on the following terms and conditions: "5. Policy related terms and conditions
(i) Upon the happening of any event, which may give rise to a claim under the policy written notice with full particulars must be given to the company immediately. In case of death, written notice must be given before internment, cremation and in any case, within 60 days after the death, unless reasonable cause is shown. In the event of loss of sight or amputation of limbs, written notice thereof must be given within one month after loss of sight or amputation.";
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