Punjab

Moga

CC/16/146

Tarjinder Singh - Complainant(s)

Versus

Bajaj Allianz General Insurance Co. Ltd. - Opp.Party(s)

Sh. Manvinder Singh Sagoo

08 Feb 2017

ORDER

THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MOGA.

 

 

                                                                                      CC No. 146 of 2016

                                                                                      Instituted on: 05.09.2016

                                                                                      Decided on: 08.02.2017

 

Tarjinder Singh s/o Jagdev Singh s/o Karnail Singh, aged about 24 years, Village Khosa Kotla, Khosa Raandhir, Moga.

                                                                                ……… Complainant

 

Versus

1.       Bajaj Allianz General Insurance Company Ltd. GE Plaza, Airport Road, Yerawada, Pune- 411014.

 

2.       Bajaj Allianz General Insurance Company Ltd. SCO- 147-147, 6^th Floor, Feroze Gandhi Market, Bhai Bala Chowk, Ludhiana.

 

3.       Bajaj Allianz General Insurance Company Ltd.1^st Floor above Maharashtra Bank, Near I.T.I. G.T. Road, Moga.

 

4.       Manager, Axis Bank, G.T. Road, Moga.

                                                                           …….. Opposite Parties

 

 

Complaint U/s 12 of the Consumer Protection Act, 1986.

 

 

Quorum:    Sh. Ajit Aggarwal,  President

                   Smt. Vinod Bala, Member

                   Smt. Bhupinder Kaur, Member

 

Present:       Sh. Manvinder Singh Saggo, Advocate Cl. for complainant.

                   Sh. Jasvinder Singh, Advocate Cl. for opposite party nos.1 to 3.

                   Opposite party no.4 ex-parte.

 

ORDER :

(Per Ajit Aggarwal,  President)

 

1.                Complainant has filed the instant complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as the "Act") against Bajaj Allianz General Insurance Company Ltd. GE Plaza, Airport Road, Yerawada, Pune and others (hereinafter referred to as the opposite parties) directing them to pay claim of Rs.10,00,000/- alongwith interest @ 18% per annum from the date of death of the father of the complainant vide policy no.OG-12-1213-6401-00001107 towards accidental death of insured alongwith with all other bonus and benefits accrued on the policy. Further opposite parties may be directed to pay Rs.50,000/- as damages alongwith litigation expenses and typing charges Rs.25,000/- to the complainant or any other relief which this Forum may deem fit and proper be granted alongwith future interest.

2.                Briefly stated the facts of the case are that father of the complainant has purchased the policy bearing no.OG-12-1213-6401-00001107 of Bajaj Allianz General Ins. Co. Ltd. at Moga office for Rs.10,00,000/- and nominated the complainant being nominee of the policy. All the premiums were upto date and had been duly paid by the father of the complainant to the insurance company till his death. Before issuance of the policy all the formalities had been completed by opposite parties. Unfortunately, the father of the complainant, who was hale and hearty met with an accident on 03.06.2013 at 10.30 am when he was fell down on the road from the trolly and the tyre of the trolly was passed over the body of the father of the complainant and he was died at the spot. For this accident police report was lodged and post-mortem of the body of the father of the complainant was got conducted in the civil hospital, Moga. Intimation of the said accident was duly given to opposite parties and original policy alongwith other documents also sent to the opposite parties. The opposite parties asked for various documents, which were duly supplied by the complainant. Thereafter the complainant received letter of opposite parties on 25.10.2013, vide which, they demanded various documents, which were duly sent to them, after that they demanded schedule J form and income tax return, which had no relevancy with the claim. The complainant many times approached to opposite parties for the settlement of the claim, but to no effect. However, they started lingering the matter and preparing bogus letters documents and notices with a purpose to grab the amount of the policy. All the documents required by the opposite parties were made available to them whenever they required. The complainant had spent huge amount and wasted his precious time by completing the formalities of opposite parties. The complainant also approached the local office at Moga and Ludhiana office various times, but all in vain. The opposite party no.4 is the authority agent of opposite party nos.1 to 3. Being the agent of opposite party nos.1 to 3, opposite party no.4 persuaded the father of the complainant and he got issued policy on behalf of opposite party nos.1 to 3. It is a settled law that the agent is always liable for the act of his master and being the agent opposite party no.4 is also liable jointly and severally for the reimbursement and payment of policy to the complainant. The services of opposite parties are deficient one and due to the act of opposite parties the complainant has suffered great mental tension and harassment. Hence this complaint.

3.                Upon notice, opposite party nos.1 to 3 appeared through counsel and filed written reply taking preliminary objections that the complaint is not maintainable; that the complaint is premature, as the claim has not been repudiated; that the claim is subject to want of certain documents for processing the claim, which the complainant has failed to supply and thus there is no cause of action; the said policy clearly provides the conditions to pay a claim. Relevant Condition is as follows:

2 (e) You or someone claiming on your behalf must promptly give us the documentation and other information we ask for to investigate the claim or our obligation to make payment for it.

 

                   Thus, the complainant has breached the conditions of the said contract of insurance by not providing the requisite documents; that the claim is barred by limitation as the alleged accident occurred on 03.06.2013. The relevant condition clearly states as follows:-

2 (a) You or someone claiming on your behalf must inform us in writing immediately and in any event within 30 days.

 

                   The complainant had admittedly taken an accidental insurance policy from opposite party no.1 and as per settled terms and conditions the same is valid only, if the information given/disclosed in the policy by the insured is correct and if the same is found to be false, then in that case the insurer is at liberty to repudiate the claim. Three letters dated 10.10.2013, 25.10.2013 and 08.11.2013 were sent to the complainant, but to no effect, as the information and documents sought were not submitted by the complainant. Finally the opposite party nos.1 to 3 were not left with any alternative except to close the claim and claim closure letter dated 17.10.2016 was sent to complainant. In the entire complaint there is no averment made qua deficiency of service against the opposite party nos.1 to 3 and it being so no cause of action has arisen for filing of the present complaint, which deserves to be dismissed out rightly; that the complainant has not approached this Forum with clean hands, rather he has wilfully concealed the material and patent facts from this Forum while filing the present complaint which ipso-facto disentitles the complainant to seek any relief against opposite party. On merits, it is admitted to the extent that the complainant lodged the claim of insurance with opposite party nos.1 to 3 for the insurance claim of deceased Jagdev Singh being his nominee, but the complainant has failed to give required documents for the settlement of the claim. Three letters were written to him for providing the same, failing which the claim was closed. All other allegations made in the complaint have been denied and a prayer for dismissal of the complaint with special costs has been made.

4.                Notice issued for the service of opposite party no.4 duly served. But despite that none appeared on its behalf. As such, opposite party no.4 was proceeded against ex-parte.

5.                In order to prove the case, complainant tendered in evidence copies of documents Ex.C-1 to Ex.C-20 and his duly sworn affidavit Ex.C-21 and closed the evidence. 

6.                On the other hand, opposite party nos.1 to 3 tendered in evidence duly sworn affidavit of Sh. Navjeet Singh, Authorized Signatory, Bajaj Allianz General Insurance Co. Ltd. Ex.OP-1,2,3/1 alongwith copies of documents Ex.OP-1,2,3/2 to Ex.OP-1,2,3/10 and closed the evidence.

7.                We have heard ld. counsel for the parties and have very carefully gone through record placed on file.

8.                Ld. counsel for the complainant argued that father of the complainant had purchased insurance policy of Bajaj Allianz General Ins. Co. Ltd. for Rs.10,00,000/- and appointed the complainant as nominee in the said policy. All premiums were duly paid by the father of the complainant to the insurance company till his death. Before issuance of the policy all the formalities had been completed by opposite parties. Unfortunately, the father of the complainant met with an accident on 03.06.2013 at 10.30 am when he was fell down on the road from the trolly and the tyre of the trolly was passed over the body of the father of the complainant and he was died at the spot and police report was lodged regarding the accident and post-mortem of the body of the father of the complainant was also got conducted in the civil hospital, Moga. Intimation of the said accident was duly given to opposite parties. The original policy alongwith other requisite documents were also submitted with opposite parties. Despite that opposite parties asked for various documents, which were duly supplied by the complainant time to time. Thereafter the complainant received letter of opposite parties on 25.10.2013, vide which, they demanded various documents, which were duly sent. After that they demanded schedule J farm and income tax return, which has no relevancy with the claim. The opposite parties lingering the matter and preparing bogus letters, documents and notices with a purpose to grab the amount of the policy, despite supplying all the documents required demanded by the opposite parties. The complainant approached the local office at Moga and Ludhiana office various times and requested them to make the payment of the claim, but all in vain. The opposite party no.4 is the authority agent of opposite party nos.1 to 3. Being the agent of opposite party nos.1 to 3, opposite party no.4 persuaded the father of the complainant and he got issued policy on behalf of opposite party nos.1 to 3. As such, opposite party no.4 being the agent of opposite party nos. 1 to 3 is also liable for the reimbursement and payment of policy to the complainant. For not making the payment of claim, amounts to deficiency in service and trade mal practice on the part of opposite parties. Hence the present complaint may be accepted and opposite parties may be directed to make the payment of claim alongwith compensation and litigation costs.

9.                In rebuttal, ld. counsel for opposite party nos.1 to 3 argued that the complaint is premature, as the claim has not been repudiated. Further the claim is subject to want of certain documents for processing the claim, which the complainant failed to supply. Thus, the complainant breached the conditions of the contract of insurance by not providing the requisite documents. He argued that the claim is barred by limitation as the alleged accident occurred on 03.06.2013. However, the complainant intimated the opposite parties about the accident on dated 26.08.2013. The complainant had admittedly taken an accidental insurance policy from opposite party no.1 and as per settled terms and conditions the same is valid only, if the information given/disclosed in the policy by the insured is correct and if the same is found to be false, then in that case the insurer is at liberty to repudiate the claim. Three letters dated 10.10.2013, 25.10.2013 and 08.11.2013 were sent to the complainant demanding requisite documents, but complainant failed to supply the same. As the information and documents sought were not submitted by the complainant, as such, opposite party nos.1 to 3 were not left with any alternative except to close the claim. Thus, they closed the claim of the complainant and claim closure letter dated 17.10.2016 was sent to complainant. The present complaint may be dismissed with costs.

10.              We have thoroughly gone through the file, evidence and arguments lead by ld. counsel for the parties. The case of the complainant is that father of the complainant had purchased an insurance policy from opposite parties securing his life and in this policy the complainant was appointed as nominee. The father of the complainant paid all the premiums due towards the policy. On 03.06.2013, the father of the complainant met with an accident and died on the spot. The complainant lodged the claim with opposite parties and completed all the formalities for the settlement of claim. But opposite parties did not pay the insurance amount to him, rather complainant received a letter dated 25.10.2013, vide which, opposite parties demanded various documents, which had no relevancy with claim. He approached to opposite parties many times with a request to settle his claim, but they lingered the matter on one pretext or the other. On the other hand, ld. counsel for opposite parties admitted that father of the complainant was insured with them and they received claim from the complainant regarding the death of insured. He argued that the complainant had not completed all the formalities for the processing of his claim and also not submitted the required documents with opposite parties. Without submission of required documents, they are unable to settle the claim of the complainant. They issued various letters to complainant to submit requisite documents, but complainant failed to supply the same. Due to non submission of requisite documents they cannot settle the claim of the complainant. As such, the present complaint is premature. During the course of arguments, they stated that they are still ready to settle the claim of the complainant, subject to submission of requisite documents.

11.              We have heard both the parties. Now, it is admitted case of the complainant that father of the complainant was insured with opposite parties and complainant lodged the claim regarding the death of his father. The only plea of the opposite parties is that they were ready to settle the claim of the complainant, but it is the complainant, who failed to submit requisite documents with them for the settlement of the claim. But, however, they are still ready to settle the claim of the complainant, subject to deposit of requisite documents.

12.              In view of the above discussion, the present complaint is hereby disposed of with the direction to complainant to submit the requisite documents with opposite parties, which are necessary for the settlement of claim within 15 days from the date of receipt of copy of this order. The opposite parties are further directed to settle the claim of the complainant within 45 days from the receipt of requisite documents, which are required for the settlement of the claim of the complainant. However, the complainant is at liberty to file fresh complaint on the same cause of action, if he does not feel satisfied with the decision of opposite parties. Copy of this order be supplied to the parties, free of costs. File be consigned to record room.

Announced in Open Forum.

Dated: 08.02.2017.

 

                               (Bhupinder Kaur)                 (Vinod Bala)         (Ajit Aggarwal)

                                           Member                             Member                President