ORIENTAL INSURANCE CO. LTD. Vs. TARA

JUDGEMENT

(1.) This revision petition is directed against the order of Rajasthan State Consumer Disputes Redressal Commission, Circuit Bench at Jodhpur (in short, "State Commission") dated 11.7.2013 whereby State Commission allowed the appeal No.05/2012 of the respondent/complainant and set aside the order of the District forum and directed the petitioner/opposite party to pay a sum of Rs.1 lakh with interest @ 9% thereon from the date of filing of the complaint till its realization of the amount and also to pay litigation cost of Rs.5,000/-.

(2.) Briefly put facts relevant for the disposal of the revision petition are that the respondent/complainant filed a consumer complaint in District Forum, Pali alleging that her late husband, Ramesh Kumar obtained Janta Personal Accident Insurance Cover for sum assured of Rs.1 lakh on payment of premium of Rs.240/-. The insurance cover was effective from 19.05.2006 till mid night of 18.05.2011. It is the case of the petitioner that on 25.06.2006 the car of the insured collided with a train at the railway crossing resulting injuries on his backbone, chest and left thigh. The insured remained under treatment for those injuries till his death on 26.07.2007. It is further alleged that because of death of her husband, the complainant went into shock. When the complainant recovered from the shock, she checked the documents of her husband and came across the cover note. Thus, the complainant submitted the insurance claim. The petitioner / opposite party, however vide letter dated 15.07.2008 repudiated the claim. It is alleged by the complainant that insurance policy was never provided by the petitioner opposite party and that repudiation of claim amounts to deficiency in service.

(3.) The petitioner opposite party resisted the complaint. It was alleged that the complaint was rightly repudiated because no proof was produced by the respondent complainant that cause of death of the injured was the injuries suffered in the accident. The petitioner also took the plea that repudiation was justified in view of the terms and conditions of the insurance policy.