Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 41
Instituted on : 21.01.2020.
Decided on : 04.05.2023.
Geeta age 45 years w/o Sh. Kamaljeet R/o H.No.1180, Ward No.5, Ladhot Road, Shakti Nagar, District Rohtak.
………..Complainant.
Vs.
- Bajaj Allianz General Insurance Company Ltd., Block no.4, 7th Floor, DLF Towers, 15 Shivaji Marg Moti Nagar, New Delhi 110015 through its Branch Manager.
- LIC Housing finance Ltd. Office at 1st Floor, Naraina Complex, New Chotu Ram, Rohtak through its branch Manager.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
DR.VIJENDER SINGH, MEMBER
Present: Sh.S.K.Hooda, Advocate for the complainant.
Sh. Puneet Chahal, Advocate for opposite party No.1.
Opposite party No.2 exparte.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case as per the complainant are that her husband had taken the house loan for a sum of Rs.1350000/- from opposite party No.2 and the same was insured with opposite party no.1 vide policy no.06-19-1135-8428-00000049 w.e.f. 26.12.2018 to 25.12.2021. The husband of complainant had deposited all the house loan inallments with the opposite party No.2 within time till his death and after his death complainant Geeta is depositing the installments on time. The husband of complainant had expired on 06.08.2019 and as per policy opposite arty No.1 is liable to pay the insured amount i.e. Rs.1350000/- to he complainant being nominee of the policy. The complainant applied for the insurance claim alongwith requisite documents but the opposite party no.1 refused to pay the same. The act of opposite parties is illegal and amounts to deficiency in service. Hence this complaint and it is prayed that opposite party No.1 may kindly be directed to pay an amount of Rs.1350000/- alongwith interest, compensation and litigation expenses as explained in relief clause. .
2. After registration of complaint, notices were issued to the opposite parties. Opposite party No.1 in its reply has submitted that the answering opposite party had issued a policy no.OG-19-1135-8428-00000049 for the period 26.12.2018 to 25.12.2021 in the name of inured namely Mr. Kamaljeet and the said policy is subjected to its terms, conditions and limitations thereof. It is further submitted that the insurance policy only covers accidental death but Kamaljeet did not had an accidental death. The answering respondent insurance company is not liable to pay any claim. On merits it is denied that opposite party No.1 is liable for insurance amount of Rs.1350000/- to the complainant being nominee of the policy. All the other contents of the complaint were stated to be wrong and denied and opposite party No.1 prayed for dismissal of complaint with costs. However, notice issued to opposite party no.2 received back duly served. But none appeared on behalf of opposite party no.2 and as such opposite party No.2 was proceeded against exparte vide order dated 11.03.2020 of this Commission..
3. Ld. counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, documents Ex.C1 to Ex.C8 and has closed his evidence on dated 11.02.2021. Ld. counsel for the opposite party no.1 has tendered affidavit Ex.RW1/A, documents Ex.R1 to Ex.R2 and closed his evidence on dated 08.09.2021.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. In the present case, grievance of the complainant is that after the death of her husband, she had filed a death claim with the opposite party No.1 but the opposite party no.1 refused to pay the same. To prove the same, ld. counsel for the complainant has placed on record policy documents Ex.C1, account statement Ex.C2, death certificate issued by the Govt. of Haryana Ex.C3, OPD Card Ex.C7 and death certificate issued by the Hospial Ex.C8. As per OPD card Ex.C7 dated 05.08.2019, insured Kamaljeet suffered from chest pain. As per death certificate Ex.C8 issued by Sungflag hospital dated 06.08.2019, the patient Kamaljeet died due to heart attack. On the other hand, contention of ld. counsel for the opposite party no.1 is that the insurance policy only covers accidental death but Kamaljeet did not had an accidental death. Opposite party No.1 has placed on record policy documents Ex.R1, as per which only accidental death is covered under the policy. We have minutely perused the Section 1 of the policy: “Death”, as per which it is submitted that : “If during the Policy period, the insured person sustains accidental bodily injury which directly and independently of all other causes results in Death of the inured person within twelve months from the date of accident, then the company agrees to pay the sum insured stated in the respective section of the policy schedule to assignee, as the case may be.”. But in the present case, the death is due to heart attack and not due to accident. Hence the same is not covered under the policy and therefore the complainant is not entitled for any relief as per terms and conditions of the policy. As such present complaint stands dismissed with no order as to costs.
6. Copy of this order be supplied to both the parties free of costs.
File be consigned to the record room after due compliance.
Announced in open court:
04.05.2023
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Nagender Singh Kadian, President
………………………………..
Tripti Pannu, Member.
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Vijender Singh, Member.
