THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMRITSAR
Consumer Complaint No. 620 of 2014
Date of Institution : 27.11.2014
Date of Decision : 12.08.2015
Smt.Narinder Kaur daughter of Late Sh. Dalbir Singh, resident of Village & Post Office Thothian Tangra,District Amritsar
...Complainant
Vs.
Bajaj Allianz General Insurance Company Limited having registered office at GE Plaza, Airport Road, Yerwada,Pune-411006 (Maharashtra) through its Regional Officer
Bajaj Allianz General Insurance Company Limited, SCO No.31, K.K.Towers, District Shopping Complex, Ranjit Avenue,Amritsar through its Branch Manager/Principal Officer
....Opp.parties
Complaint under section 12/13 of the Consumer Protection Act, 1986
Present : For the complainant : Sh. A.K.Vermani,Advocate
For the opposite parties : Sh.R.P.Singh,Advocate
Quorum : Sh. Bhupinder Singh, President ,Ms. Kulwant Bajwa,Member &
Sh.Anoop Sharma,Member
-2-
Order dictated by :-
Bhupinder Singh, President
1 Present complaint has been filed by Narinder Kaur under the provisions of the Consumer Protection Act alleging therein that her father Dalbir Sing got policy bearing No. OG-10-1210-6401-00000439 on 18.6.2009 from the opposite party with date of commencement 9.6.2009 upto 8.6.2014 i.e. for five years , with sum assured Rs. 10 lacs. The complainant submitted that Sh.Dalbir Singh insured met with a road side accident on 9.6.2011 . He was taken to Apex Hospital, Batala Road, Amritsar but he could not survive and expired in the hospital. The matter was reported to the police of P.S. Verka, who recorded DDR No. 350-SE dated 9.6.2011. After the death of Dalbir Singh, the other family members of the deceased had lodged the claim with the opposite party, but the opposite party delayed the disposal of the claim under one pretext or the other . Complainant through her counsel also served legal notice upon the opposite party dated 13.11.2014 to settle the claim, but opposite party did not pay any heed to the request of the complainant. Alleging the same to be deficiency in service , complaint was filed seeking directions to the opposite parties to pay the insured amount of Rs. 10 lacs alongwith interest @ 18% p.a.. Compensation of Rs. 2,00,000/- alongwith litigation expenses were also demanded .
2. On notice, opposite party appeared and filed written version in which it was submitted that claim case of the complainant was repudiated vide letter dated 5.9.2014 which was duly received by the complainant. Thereafter the complainant requested for reconsideration of her claim case regarding death of DLA Dalbir Singh, On reconsidering the request made by the complainant, again the claim case of the complainant was repudiated and she was informed regarding the repudiation of the claim vide letter dated 26.11.2011 . In this case the complainant provided three certificates from the hospital, one is dated 9.6.2011 in which the statement showing that patient was admitted with the alleged history road side accident and it was mentioned in the certificate that the patient died at 11.15 p.m on 9.6.2011. Thereafter one other certificate was given by the hospital dated 19.10.2011 in which the doctor states that it was a known case of road side accident and patient expired in the hospital due to head injury and cardiac arrest and it was also stated therein that the dead body of the patient was handed over to head constable for medical procedure and one other certificate without date was also provided in which it has been stated that the patient was presented in critical internal body and head injury. So from all these certificates there is a discrepancy in the statements that when the dead body was handed over to the constable for medico legal purpose why the postmortem was not conducted which creates suspicion and shows that the death was not caused due to accident. It was also stated in the certificate issued by the hospital dated 9.6.2011 that at 11.15 p.m on 9.6.2011 Dalbir Singh died and on the other hand on the request letter of police official dated 9.6.2011 the doctor is giving the remarks that the patient is unfit to make any statement and time was marked as 12.15 a.m dated 10.6.2011. The post mortem of the dead body was not intentionally conducted , inspite of the fact that the body was handed over to Head Constable for medico legal purpose and in the majornama dated 10.6.2011 it has been stated that the body of Dalbir Singh has been kept in mortuary of Dhilwan Hospital. It was submitted that when the body has been kept in mortuary and no postmortem has been conducted, which shows that the intention of the complainant was malafide and the postmortem was not intentionally got conducted. It was submitted that as the complainant has breached the terms and conditions of the policy, as such the claim has rightly been repudiated vide letter dated 5.9.2011 and the same was reconsidered on the request of the complainant and again the same was repudiated vide letter dated 26.11.2011.
3. Complainant tendered into evidence policy Ex.C-1, legal notice Ex.C-2, original postal receipts Ex.C-3 and C-4, affidavit of Sh.Manjinder Singh Son of Mohan Singh Ex.CW1/A, copy of DDR Ex.C-5, affidavit of Ms.Harjinder Kaur Ex.CW2/A, affidavit of the complainant Ex.CW3/A.
4 Opposite parties No.1 & 2 tendered affidavit of Navjeet Singh Ex.OP1/A, copy of policy Ex.OP2, letter dated 10.6.2011 Ex.OP3, repudiation letter dated 26.11.2011 Ex.OP4, repudiation letter dated 5.9.2011 Ex.OP5.
5. We have carefully gone through the pleadings of the parties, arguments advanced by the ld.counsel for the parties and have appreciated the evidence produced on record by both the parties with the valuable assistance of the ld.counsel for the parties.
6. From the record i.e. pleadings of the parties and the evidence produced on record by both the parties , it is clear that Dalbir Singh, father of complainant got policy bearing No. OG-10-1210-6401-00000439 Ex.C-1 on 18.6.2009 from the opposite party with date of commencement 9.6.2009 upto 8.6.2014 i.e. for five years , with sum assured Rs. 10 lacs. The complainant submitted that Sh.Dalbir Singh insured met with a road side accident on 9.6.2011 . He was taken to Apex Hospital, Batala Road, Amritsar but he could not survive and expired in the hospital. The matter was reported to the police of P.S. Verka, who recorded DDR No. 350-SE dated 9.6.2011. The doctors have also issued certificate in this regard. The complainant alongwith other LRs of DLA Dalbir Singh lodged claim with the opposite party regarding the accidental death of DLA Dalbir Singh, but the opposite party did not decide the claim case of DLA Dalbir Singh. The complainant served legal notice dated 11.11.2014 Ex.C-2. But even then the opposite party did not pass any order on the claim case of the complainant. Ld.counsel for the complainant submitted that all this amounts to deficiency of service on the part of the opposite party qua the complainant.
7. Whereas the case of the opposite party is that the complainant has concealed the material facts from this Forum. The claim case of the complainant was repudiated vide letter dated 5.9.2014 Ex.OP5 which was duly received by the complainant. Thereafter the complainant requested for reconsideration of her claim case regarding death of DLA Dalbir Singh . On reconsidering the request made by the complainant again the claim case of the complainant was repudiated and she was informed regarding the repudiation of the claim vide letter dated 26.11.2011 Ex.OP4. Thereafter the complainant never approached the opposite party. The claim case of the DLA Dalbir Singh was repudiated on the ground that the complainant has failed to prove on record that DLA expired due to road side accident . The complainant provided three certificates from the hospital, one is dated 9.6.2011 in which it was submitted that the patient was admitted with the alleged history of road side accident and the patient died at 11.15 p.m on 9.6.2011. Thereafter another certificate was given by the hospital dated 19.10.2011 in which doctors stated that it was a known case of road side accident and patient expired in their hospital due to head injury and cardiac arrest. The dead body of the patient was handed over to head constable for medical procedure. Third certificate without date was also produced by the complainant which was allegedly issued by the hospital in which it has been stated that the patient was present in critical internal body injury and head injury. All these medical certificates Ex.C-5/2 , C-5/1 and Ex.OP1 are contradictory to each other. The dead body was handed over to the Head Constable for medico legal purpose , why postmortem of the DLA Dalbir Singh was not got conducted. Further in the certificate issued by the hospital dated 9.6.2011 , it has been stated that at 11.15 p.m on 9.6.2011 Dalbir Singh expired . On the other hand on the request letter of the police official dated 9.6.2011 the doctor is giving remarks that the patient is unfit to make statement and the time was marked at 12.15 a.m dated 10.6.2011. All this shows that these documents have been manipulated with ulterior motive, in the majornama Ex.C-6 dated 10.6.2011 produced by the complainant, it has been stated that the body of Dalbir Singh was kept in mortuary of Dhilwan Hospital, then why the postmortem of the dead body was not got conducted which shows malafide intention of the complainant. The DDR recorded by the policy in the DDR register i.e. DDR No. 350 dated 9.6.2011 is highly doubtful and it shows that there was some other material written there which was rubbed and the present DDR has been recorded. Even the date of that entry has been changed from 11.6.2011 to 9.6.2011 . Ld.counsel for the opposite party submitted that all this shows that opposite party has rightly repudiated the claim of the complainant and the complaint of the complainant is totally barred by limitation because the claim of the complainant was repudiated finally by the opposite party vide letter dated 25.11.2011 Ex.OP4,whereas the present complaint has been filed on 27.11.2014 i.e. after a lapse of a period of more than 3 years. Ld.counsel for the opposite party submitted that there is no deficiency of service on the part of the opposite party qua the complainant.
8. From the entire above discussion, we have come to the conclusion that Dalbir Singh,DLA obtained insurance policy Ex.C-1 from the opposite party for the period from 9.6.2009 to 8.6.2014 (for five years) with sum assured Rs. 10 lacs. Policy was covering case of accidental death , permanent total disability or permanent partial disability. The complainant submitted that DLA Dalbir Singh met with road side accident on 9.6.2011 and he was immediately taken to Apex Hospital, Batala Road,Amritsar. Matter was reported to police of P.S. Verka. Resultantly DDR No.350 dated 9.6.2011 was recorded. Unfortunately Dalbir Singh expired in the hospital and the doctors issued certificate Ex.CW5/1 and CW5/2. We have perused the entire documents produced on record by the complainant particularly DDR No. 350 dated 9.6.2011 of P.S.Verka. This Forum called the DDR register of P.S. Verka which is on record. From the perusal of DDR No. 350 dated 9.6.2011, it appears to the naked eyes that some other material was written against this entry which was rubbed and the present DDR regarding Dalbir Singh has been written later on. Even the date of this DDR was earlier 11.6.2011 which was also rubbed and changed to 9.6.2011. So this DDR is totally doubtful and as such cannot be believed. Moreover, in this DDR there is no mention about any road side accident nor there is any mention about the injuries on the body of Dalbir Singh. In this DDR it has been written that the heirs of Dalbir Singh wanted to get the dead body of Dalbir Singh without postmortem. So the base of this whole process i.e. DDR regarding the death of Dalbir Singh is not believable as highly doubtful. Rather it proves that this document has been created after tampering with the record of DDR register of P.S. Verka. The complainant has also produced on record Majornama dated 10.6.2011 in which it has been mentioned that Dalbir Singh was travelling in car No. PB-02-BB-5935 and it met with an accident with car No. PB-02-BJ-4792 which was being driven by Rajwinder Singh, as a result of which Dalbir Singh died. The dead body of Dalbir Singh was kept in Dhilwan Mortuary. The son of Dalbir Singh has stated on telephone that he does not want to proceed against any person regarding the death of Dalbir Singh as they have no suspicion against any person.
9. From these documents , it is clear that Dalbir Singh has expired but there is no proof on record that what was the cause of death of Dalbir Singh ? The complainant could not produce any evidence regarding the accident between two cars as alleged in the Majornama. Moreover, the none of the witnesses of this Majornama, was the witness of the accident nor the complainant could produce any document that the cars involved in the aforesaid accident were got repaired or were taken into possession by the police as the complainant party had informed the police and it was a police case in which death of a person is involved. Moreover, the dead body of Dalbir Singh was taken into police possession. It was the duty of the police to get done the postmortem of the dead body to find out the real cause of death of Dalbir Singh, DLA. Moreover, under general procedure as well as instructions only Magistrate particularly Sub Divisional Magistrate is competent to release the dead body to the heirs without postmortem. S.I of police is not competent to hand over the dead body of a person died in road side accident to the legal heirs and that too without getting the postmortem done on the dead body that is why the cause of death could not be made known and it remained doubtful.
10. Apart from this as per complainant's version Dalbir Singh injured (DLA) was immediately taken to Apex Hospital, Batala Road,Amritsar and he remained admitted there for some time. But no MLR of the injured/deceased was conducted by the doctors of the said hospital,Amritsar. Rather it was the duty of the doctors of Apex Hospital to find out the injuries, nature of injuries on the body of the injured/deceased. Moreover, it was the duty of the hospital to inform the police that they have received an injured person who had suffered serious injuries as a result of road side accident. But the Apex Hospital authorities did not inform the police . The patient i.e. DLA Dalbir Singh remained admitted for some time in Apex Hospital,Amritsar but no treatment was done by Apex Hospital nor any record of Apex Hospital has been produced by the complainant to prove the date, time of admission of Dalbir Singh in Apex Hospital and what treatment was given by the doctors to Dalbir Singh at Apex Hospital, what were the injuries on the body of
Dalbir Singh , what was their nature and what efforts the authorities of Apex Hospital,Amritsar have made to save the life of Dalbir Singh .Rather the conduct of the Apex Hospital authorities is totally doubtful. They had issued the certificates Ex.CW5/1 and Ex.CW5/2 without any record of the hospital. Both these certificates are highly doubtful. In certificate Ex.CW5/1 the doctors of Apex Hospital have stated that Dalbir Singh was brought to this hospital on 9.6.2011 in very serious condition with alleged history of road side accident. Patient came in gasping condition. The blood pressure and pulse was unrecordable . He was intubated and started on SIMV mode on ventilator . Cardio Pulmonary resuscitation was done, but no response was done. D/C cardioversion was also done. But no such record has been produced by the complainant. No doubt the complainant has examined Tarsem Singh Manager of Apex Hospital, Batala Road, Amritsar as CW5 but he too did not brought any record of Apex Hospital pertaining to Dalbir Singh. He only stated that he has been shown two certificates issued by Apex Hospital authorities i.e. certificates Ex.CW5/1 and CW5/2. This witness even failed to identify the signatures of any doctor on certificate Ex.CW5/2. In certificate Ex.CW5/2 no diary number, no date has been mentioned. Even from statement of this witness the certificate Ex.CW5/2 is also highly doubtful. Even the opposite party produced on record certificate issued by Apex Hospital authorities dated 19.10.2011 Ex.OP1. But this witness also stated that he cannot tell that Ex.OP1 has been issued by Dr. Saurabh or not. So this witness could not bring any record of Apex Hospital pertaining to admission, discharge, treatment of DLA Dalbir Singh at Apex Hospital,Amritsar nor he could produce the record pertaining to these three certificates issued by Apex Hospital authorities i.e. Ex.CW5/1, Ex.CW5/2 and Ex.OP1. As per the only certificate which was proved by this witness CW5 Tarsem Singh i.e. certificate Ex.CW5/1 the patient DLA Dalbir Singh expired on 9.6.2011 at 11.15 p.m., whereas the opposite party has produced on record a request made by the police to the doctors of Apex Hospital dated 9.6.2011 Ex.OP3 on which the doctors have written that the patient is unfit to record his statement at 12.15 a.m on 10.6.2011 which shows that DLA Dalbir Singh was still alive on 10.6.2011 at 12.15 a.m and this document also make the only certificate proved by Tarsem Singh CW5 i.e. Ex.CW5/1 highly doubtful. Further, the DDR No. 350 dated 9.6.2011 Ex.CW4/1 states that on 9.6.2011 the legal heirs of Dalbir Singh approached the police to hand over the dead body of Dalbir Singh without postmortem which means that the patient Dalbir Singh, DLA had already expired on 9.6.2011 . So all this makes the documents produced by the complainant highly doubtful rather the same have been prepared later on to create evidence that Dalbir Singh had expired due to road side accident and this Forum is of the opinion that the complainant has failed to prove on record that Dalbir Singh, DLA had expired as a result of road side accident because no DDR of the accident has been recorded, no treatment record of the patient at Apex Hospital has been produced. No MLR regarding the injuries, if any on the person DLA Dalbir Singh has been produced by the complainant nor any postmortem on the dead body of the injured/DLA Dalbir Singh has been got conducted. There is no proof regarding any road side accident. So the opposite party was justified in repudiating the claim of the complainant regarding the death of DLA Dalbir Singh.
11 Further, the opposite party has repudiated the claim case of the complainant vide letter dated 5.9.2011 Ex.OP5 . On the request of the complainant regarding reconsideration of the claim case, the opposite party reconsidered the case and again repudiated the claim of the complainant vide letter dated 25.11.2011 i.e. finally the claim case of DLA Dalbir Singh was repudiated by the opposite party on 25.11.2011, whereas the present complaint has been filed by the complainant on 27.11.2014 i.e. after a lapse of a period of more than three years. No application for condonation of delay has been made by the complainant nor the complainant could put forward any reason to condone the delay in filing the complaint. Ld.counsel for the complainant submitted that the complainant served legal notice upon the opposite party dated 11.11.2014 Ex.C-2 , so the cause of action accrued afresh to the complainant on 11.11.2014. This plea of the Ld.counsel for the complainant is not tenable because the period for filing the complainant had already expired on 25.11.2013. The legal notice issued after one years of the expiry of the limitation period does not create new cause of action to the complainant. As such, we hold that the present complaint is also barred by limitation.
12. In view of the entire above discussion, we hold that complaint is without merit and the same is hereby dismissed with no order as to costs. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Forum.
12.8.2015 ( Bhupinder Singh )
President
( Kulwant Kaur Bajwa) (Anoop Sharma)
/R/ Member Member
