Punjab

Sangrur

CC/185/2016

Ajaib Singh - Complainant(s)

Versus

Authrised Signatory - Opp.Party(s)

05 Sep 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.

 

                                                               

                                                Complaint No.  185

                                                Instituted on:    22.01.2016

                                                Decided on:       05.09.2016

 

1.Ajaib Singh son of Mukhtiar Singh;

2.Surjit Kaur wife of Ajaib Singh son of Mukhtiar Singh;

3.Ramandeep Kaur widow of Jasvir Singh son of Ajaib Singh;

4.Lovepreet Kaur minor daughter of Jasvir Singh;

5.Sahij Singh minor son of Jasvir Singh both under guardianship of their mother Ramandeep Kaur;

All residents of Village Laddi, Tehsil and District Sangrur;

                                                        …Complainants

                                Versus

1.     The Union of India Department of Finance, New Delhi through its authorised signatory (Notice not issued to OP No.1).

2.     Punjab and Sind Bank, Main Branch Sangrur through its Manager.

3.     The General Manager, Punjab and Sind Bank, Head Office, Rajendra Place, New Delhi-110 001 through its authorised signatory.

4.     The New India Assurance Company Limited, E-9, 2^nd Floor, Connaught House, Connaught Place, New Delhi-110 001 through its authorised signatory.

5.     The New India Assurance Company Limited, Sangrur through its Divisional Manager.

                                                        ..Opposite parties

 

For the complainant  :       Shri Davinder Sharda, Adv.

For OPs No.2&3       :       Shri N.S.Sahni, Adv.

For OPs No.4&5       :       Shri Ashish Garg, Adv.

 

Quorum:   Sukhpal Singh Gill, President

                K.C.Sharma, Member

                Sarita Garg, Member

 

Order by : Sukhpal Singh Gill, President:

 

1.             Shri Ajaib Singh along with other  complainants (referred to as complainant in short) have preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that Jasvir Singh son of complainant number 1 opened a saving bank account with the OP number 2 under which he was insured for Rs.2,00,000/- under policy number 42150103004448253  under Pardhan Mantri Suraksha Bima Yojna.  It is further in the policy that a sum of Rs.2,00,000/- was payable to the nominee in case of accidental death of the insured.  All the complainants are the legal heirs of the deceased Jasvir Singh (referred to as DLA in short).

 

2.             The case of the complainants is that the DLA on 10.7.2015 at about went to outside the house at about 8.30 PM and suddenly fell in the pond, where he died due to drowning, as such he was immediately taken to Sibia Hospital, Sangrur, where he was declared dead.  It is further stated that after the last rites, the DDR number 30 dated 5.8.2015 was recorded at PS Sadar Sangrur regarding the accidental death of the DLA.  Further case of the complainant is that thereafter the claim was lodged with the insurance company for payment of Rs.2,00,000/- and further submitted the documents to Punjab and Sind Bank such as original DDR, death certificate, certificate of doctor, certificate of panchayat etc, who forwarded the documents to the insurance company.  But, the insurance company repudiated the claim of the complainants on the grounds that the claim has been lodged after a delay of one month and there is no DDR/FIR and post-mortem report of the DLA, as such the claim of the complainant was repudiated. Thus, alleging deficiency in service on the part of the OPs, the complainant has prayed that the OPs be directed to pay to the complainants an amount of Rs.2,00,000/- along with interest @ 18% per annum  and further claimed compensation and litigation expenses.

 

3.             In reply filed by the OPs number 2 and 3, it is admitted that the DLA had an account and was insured under the Pradhan mantra Suraksha Bima Yojna.  It is further admitted that after the death of the DLA, the complainant number 1 submitted the application dated 6.8.2015, which was forwarded to the insurance company on the same day along with the documents. It is further stated that the complainant also got served the legal notice dated 19.10.2015, which was duly replied vide letter dated 3.11.2015. Any deficiency in service on the part of the Ops number 2 and 3 has been denied.

 

4.             In reply filed by OPs number 4 and 5, it is stated that the OP number 4 issued a personal accident insurance policy in favour of the Punjab and Sind Bank for the period from 1.6.2015 to 31.5.2016 subject to the terms and conditions and an amount of Rs.2,00,000/- in case of accidental death was payable. It is further admitted that the OP number 5 received a letter dated 6.8.2015 from Punjab and Sind Bank regarding the death of Jasvir Singh along with the letter, but no FIR and post-mortem report of the DLA was produced, as both the documents were required to process the claim and without these documents, the claim cannot be processed.  It is further stated that the  death took place on 10.7.2015, but the DDR was registered on 5.8.2015 after 25 days from the alleged accidental death.  It is further averred that FIR and post-mortem report were the mandatory documents for the claim under PMSBY scheme, as such, it is stated that the claim has rightly been repudiated.

 

5.             The learned counsel for the complainant has produced Ex.C-1 affidavit, Ex.C-2 copy of account pass book, Ex.C-3 copy of legal notice, Ex.C-4 to Ex.C-8 copies of postal receipts, Ex.C-9 copy of DDR, Ex.C-10 copy of panchayat resolution, Ex.C-11 copy of medical certificate, Ex.C-12 copy of death certificate, Ex.C-13 copy of reply dated 3.11.2015, Ex.C-14 copy of reply dated 17.9.2015, Ex.C-15 copy of acknowledgment, Ex.C-16 copy of affidavit of Ajaib Singh, Ex.C-17 copy of postal receipt, Ex.C-18 copy of aadhar card of Jasvir Singh, Ex.C-19 copy of voter card and. closed evidence. On the other hand, the learned counsel for the OP number 2and 3 has produced Ex.OP2&3/1 affidavit, Ex.OP2&3/2 copy of letter dated 6.8.2015, Ex.OP2&3/3 copy of letter dated 26.8.2015 and closed evidence. The learned counsel for OP number 4&5 has produced Ex.OP4&5/1 copy of policy, Ex.OP4&5/2 copy of claim procedure, Ex.OP4&5/3 terms and conditions and Ex.OP/4&5/4 affidavit and closed evidence.

 

6.             We have carefully perused the complaint, version of the opposite parties, evidence produced on the file and written submissions and also heard the arguments of the learned counsel for the parties. In our opinion, the complaint merits dismissal, for these reasons.

 

7.             It is an admitted fact that the DLA was insured with the OPs number 4 and 5 through OPs number 2 and 3 under the Pradhan Mantri Suraksha Bima Yojana, a copy of which on record is Ex.OP4&5/1 and an amount of Rs.2,00,000/- was payable in case of accidental death of the insured.  It is further an admitted fact that the DLA died on 10.7.2015 after drowning in the pond at about 8.30 PM.  To support the allegations in the complainant, the learned counsel for the complainant has referred to the sworn affidavit of the complainant Ex.C-1, a panchayat certificate Ex.C-10 and copy of death certificate Ex.C-12.  Ex.C-14 is the copy of repudiation letter dated 17.9.2015 issued by the Ops number 4 and 5 on the ground that ‘FIR and post-mortem report have not been provided till date’.   As such, the learned counsel for the complainant has vehemently contended that the complaint be allowed and the claim be got paid from the insurance company.

8.             On the other hand, the learned counsel for the Ops number 4 and 5 has contended vehemently that the complainants have miserably failed to submit the documents, such as, copy of DDR and copy of post-mortem report, which is very necessary for the settlement of the claim and has further referred to the document Ex.OP4&5/2 i.e. claim procedure under Pradhan Mantri Suraksha Bima Yojana (PMSBY).  A bare perusal of the clause 5 of the claims procedure mentions as “The claim form shall be supported, in case of death of the insured, by the Original FIR/Panchnama, Post Mortem Report and Death Certificate and in case of permanent disablement by original FIR/Panchnama and a Disability Certificate issued by a Civil Surgeon. A discharge certificate in the enclosed formal shall also be submitted by the claimant/nominee”.  To support these allegations, the affidavit of Shri M.C.Dhawal, Sr. Divisional Manager Ex.OP4&5/4 is also on record.  The complainants have produced on record the copy of DDR dated 5.8.2015, which is on record as Ex.C-9, but no copy of FIR and post-mortem report has been produced on record by the complainants.  There is no explanation from the side of the complainants that if the DLA had died an accidental death by drowning in the pond, then why they did not got conducted the post-mortem on the dead body of the DLA and why they did not lodge the FIR of the same immediately with the police, more so when it is the condition of the policy for settlement of the claim in case of accidental death.   In the circumstances, we feel that the complainants have miserably failed to produce these documents, such as, copy of FIR and post-mortem report, as such, we find that there is no illegality in repudiating the claim of the complainants vide letter dated 17.09.2015 by the Ops number 4 and 5, a copy of which on record is Ex.C-14.

 

9.             In view of our above discussion, we find no merit in the complaint and the same is dismissed.  However, the parties are left to bear their own costs. A  copy of this order be issued to the parties free of cost. File be consigned to records.

                Pronounced.

                September 5, 2016.

                                                        (Sukhpal Singh Gill)

                                                           President

 

 

                                                              (K.C.Sharma)

                                                                Member

 

 

                                                                (Sarita Garg)

                                                                    Member