Decided on August 29,2008

Urmila Shivajirao Patil Respondents


- (1.) THIS appeal is directed against the award passed by District Consumer Forum Nashik in consumer complaint No. 100/2007 decided on 14.11.2007 whereby O.P./Insurance Company has been directed to pay an amount of Rs. 5 lakh to the complainant with interest @ 18% p.a. and also to pay Rs. 10,000 towards compensation and Rs. 5,000 towards cost.
(2.) THE facts to the extent material may be stated as under: The complainant is the mother of Rajesh Shivajirao Patil. He was member of the Nashik Merchant Co -op. Bank. The O.P. No. 1/New India Assurance Co. had evolved a scheme of insurance for personal accident covering all the members of the Nashik Merchant Co -op. Bank. The complainant had taken insurance cover under the Group Insurance Scheme of the O.P./Insurance Company. He had paid premium amount through the Bank. Under the said policy, the Insurance Company agreed to pay 5 lakh to the legal heirs in case the member of the Bank dies in an accident. On 18.10.2004 son of the complainant by name Rajesh Patil died in the accident. She filed claim petition along with all the papers with the Insurance Company. But the claim was repudiated on the ground that the policy has been cancelled by the Insurance Company as per condition No. 5 of the policy and therefore nothing was payable under the said policy. She therefore filed consumer complaint and claimed Rs. 5 lakh towards the insurance claim.
(3.) O .P. No. 1/Insurance Company filed written statement and pleaded that there has been delay of 210 days in filing consumer complaint. The Insurance Company however admitted that the complainant s son had taken insurance cover being member of the Nashik Merchant Co -op. Bank. He had taken the policy. The Company admitted that the son of the complainant expired on 18.10.2004 in the accident and claim was preferred by the complainant, but it had repudiated the claim on the ground that with effect from 4.6.2002 the said policy has been cancelled. This was intimated to the Bank on 20.5.2002. However, while cancelling the policy, pro rata premium amount paid by the bank was not refunded and therefore to surmount technical difficulty in the month of September 2006, the Insurance Company had returned the amount of premium to the Nashik Merchant Co -op. Bank and therefore all the policies of the Nashik Merchant Co -op. Bank stood cancelled and nothing was as such payable to the complainant on account of her son s death due to the accident. O.P. No. 2 also filed written statement and pleaded that O.P. No. 1/Insurance Company cancelled policy ex parte and proportionate refund of premium was sent back to it in September, 2006. But the accident in question took place on 18.10.2004 and therefore according to the O.P. No. 2, O.P. No. 1/Insurance Company cannot avoid payment of assured sum to the complainant.;

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