SANJIV MISHRA Vs. ORIENTAL INSURANCE COMPANY LIMITED

JUDGEMENT

(1.) THIS complaint under Section 17 read with Section 12 of the Consumer Protection Act, 1986 , has been filed by the complainants, the legal representatives of the deceased J.K. Mishra, praying that the respondent be directed to pay to them Rs. 5 lacs as assured amount under the Group Janta Personal Insurance Policy, (hereinafter called the Janta Policy for short).

(2.) THE substance of the averments in the complaint is that J.K. Mishra was an employee as Master Operator -cum -Assistant Roller in the Bhilai Steel Plant. While he was in service, he obtained a Group Janta Policy No. 152501/47/99/00176, as a member of the Indian National Trade Union Congress ( INTUC for short). The complainants are the sons of deceased insured J.K. Mishra. The said policy covered the risk from 9.1.1999 to 8.1.2011 and in the event of death of the insured in accident, assured sum of Rs. 5 lacs was payable thereunder. It was further averred that the insured J.K. Mishra died on 1.2.1999 in an accident while on duty. It was further averred that complainants through their Counsel s letter dated 22.12.2000, approached the opposite party/insurer for payment of assured amount under the Janta Policy, but the said claim was not settled. Hence, they filed the present complaint.

(3.) THE complaint was resisted by the opposite parties/insurer. In its written version, it was denied that the deceased J.K. Mishra obtained policy from the opposite party/insurer. It was averred that Janta Policy No. 176/1999 was issued in favour of INTUC for the benefit of its members and the premium of the said policy was payable after deduction from the salary of the employees who were members of the INTUC. It was also averred that the policy was issued on 9.1.1999 for some of the members whose premium was received by then, and thereafter, some other members, whose premium was received later, were also included under the said policy, from the date of receipt of their premium. It was further averred that though in the policy document, the period of coverage of risk was mentioned as per certificate given to the INTUC, the coverage of the risk of the members, in fact, commenced from the date premium was received from them. It was further averred that as the premium relating to deceased J.K. Mishra was received on 15.3.1999, the risk on his life, commenced on 15.3.1999, and since J.K. Mishra had died on 1.2.1999, the risk of his life, was not covered by the policy. It was, therefore, averred by the opposite party insurer, that the complainants are not entitled to any benefit under the policy. It was also averred that the policy was cancelled on 26.11.2001, the intimation whereof, was sent to INTUC by the opposite parties, by their letter dated 20.12.2001. It was further averred that complainant never preferred any claim before the opposite parties. Hence, the complainants were not entitled to any relief in the said policy.