Guwahati Ombudsman Centre
Case No.11/003/0059/08-09
Smt. Bindu Barman
Vs
National Insurance Co. Ltd.
Policy No. 100300/42/04/8200012
Award dated – 22.10.2008
The Complainant’s husband procured the above policy from the National Insurance Co. Ltd. covering the period from 01.08.2004 to 31.07.2009. The Insured died on 06.11.2006 due to injuries sustained in a motor vehicle accident on 05.11.2006 involving vehicle No. AS – 01 AA / 5462. The claim lodged with the Insurer was repudiated treating the claim as “No Claim” due to non submission of death intimation and relevant documents within specified time. Being aggrieved, the Complainant approached this forum for redressal of her grievances. The copy of the letter of repudiation of the claim shows that the Insurer treated the claim as “No Claim” due to non giving information within 30 days and non submission of papers / documents within 90 days from the date of the death of the Insured as required. In the policy condition, it is clearly mentioned that written notice of death intimation is to be given to the Company within one calendar month after death of the Insured but that stipulated period of one month can be relaxed in case where reasonable cause can be shown. So, strict compliance of the said condition is not a must in deserving cases.
During hearing the Insurer remained absent. The Complainant stated in her statement as well as in the P-Forms that the fact of existence of the policy was not known to her even long after the death of her husband and she came to know about it later on from the Agent and immediately thereafter, she informed the Insurer and submitted the claim along with the relevant documents. This proves that due to her ignorance about the existence of the policy, she was not in a position to intimate the death to the Insurer in time. The Complainant appears to be not intentionally delaying the matter rather it was due to circumstances beyond her control. Repudiation of the claim only on the ground of non submission of the death intimation / documents in time appears to be not justified.
The Insurer was directed to settle the claim.
