Before the District Consumer Disputes Redressal Forum, Mandi, H.P.



Complaint Case No.263/2008

Date of Institution 8-9-2008

Date of Decision 13-3-2009





1.Rita Devi wife of Sh. Paras Ram

2.Master Dinesh aged two yeas minor son of Sh. Paras Ram

3.Kumari Kalpana aged 4 years minor daughter of Sh. Paras Ram



Both minors through their mother and natural guardian and next f friend Smt. Rita Devi, complainant No.1.

All residents of village Bobar , Tehsil Sunder Nagar, District Mandi, H.P.



…Complainants





V/S



ICICI Lombard General Insurance Ltd through its General Manager Zenith House Keshavrao Marg, Opp. Race Course Mahalazmi Mumbai-400034

…..Opposite party





For the complainant Sh.Rajinder Kumar , Advocate

For the opposite party Sh. Sandeep Bhardwaj, Advocate



Complaint under Section 12 of the

Consumer Protection Act, 1986.



ORDER.

This order shall dispose of a complaint under Section 12 of the Consumer Protection Act, 1986( hereinafter referred to as the “Act”) instituted by the complainant against the opposite party. The case of the complainants are that they are widow, minor son and minor daughter, respectively of late Sh. Paras Ram who died on 12-5-2007 in an accidental death. As per the complainants, Sh. Paras Ram purchased an ICICI Lombard Travel Insurance from the opposite party in the sum of Rs.5,00,000/- vide policy number 4041/363127/00/000 and during the course of employment he sustained injuries to his stomach. However, he ultimately died on 12-5-2007 after receiving treatment from various hospitals. As per the complainant the matter was reported to the opposite party and claim was filed but the same has not been settled .

2 The opposite party had filed reply wherein it has been stated that the matter was never reported to the opposite party and no claim was filed. It has further been averred that the complaint had been pre-maturely filed.

3. We have heard the ld. counsel for the parties and have also gone through the entire record . From the perusal of the record it revealed that the complainant alongwith the complaint has not filed treatment record of deceased Sh. Paras Ram and in relief para insurance amount has not been specifically mentioned by them . In preliminary objection No.1, the opposite party No.1 had stated that the complaint has been pre-maturely filed. Para No.1 of the complaint is reproduced below:-

“That there is no deficiency in service on the part of the replying respondent therefore this complaint is not maintainable and deserves to be dismissed. It is submitted that the complainant never intimated to the opposite party about the alleged accident. No claim was lodged by the complainant with the opposite party. The complainant has played fraud upon the opposite party/ respondent by stating that the matter was reported to the opposite party and the claim was filed . The respondent / opposite party never received information regarding the claim and never failed to settle it. Had the respondent got the information regarding the claim, the respondent would definitely have opened the file and have looked into the matter. Even if the complainant happens to lodge the claim with the respondent , the matter can be looked into and process can be initiated for the settlement of the claim. It is further submitted that the complaint has been prematurely filed therefore it deserves to be dismissed .

4 There is no material on record to suggest that the complainants have lodged the claim with the opposite party However, in view of the stand taken by the opposite party in the reply,in our opinion at this stage no further orders are required to be passed in the present complaint except to direct the complainants to lodge the claim with the opposite party. Hence, the complainants are directed to lodge the claim with the opposite party within a period of 15 days from the receipt of the copy of the order and the opposite party shall decide the claim of the complainant within 60 days thereafter However, the complainant is at liberty to file fresh complaint on the same cause of action in case their claim is repudiated by the opposite party or not settled within the stipulated period. The complaint is disposed of accordingly.

5 Copy of this order be supplied to the parties free of cost as per Rules.

6 File, after due completion be consigned to the Record Room.

Announced

13-3-2009 (Sushil Kukreja ) President