Punjab

Sangrur

CC/565/2014

Ramandeep Kaur - Complainant(s)

Versus

Bharti AXA Gen. Ins. - Opp.Party(s)

Shri R.K. Khilpa

17 Apr 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.

       

                                               

                                                Complaint No.    565

                                                Instituted on:      23.09.2014

                                                Decided on:       17.04.2015

 

 

Ramandeep Kaur widow of late Shivcharan Singh son of Chand Singh, resident of Village Panwan, Sub Tehsil Bhawanigarh, District Sangrur.

                                                        …Complainant

                                Versus

 

1.             Bharti AXA General Insurance Company Limited, Unit No.6-7, 3^rd Floor, Kunal Tower, Mall Road, Ludhiana through its Regional Manager.

2.             The Fatehgarh Bhadson Cooperative Agricultural Service Society Ltd. Sub Tehsil Bhawanigarh, District Sangrur through its Secretary/President.

3.             The Sangrur Central Cooperative Bank Limited,  Head Office, Patiala Gate, Sangrur through its Branch Manager.

                                                        …Opposite parties

 

For the complainant    :       Shri R.K.Khipla, Advocate.

For OP Number 1       :       Shri G.S.Shergill, Advocate.

For OP Number 2       :       Shri Ashish Grover, Advocate.

For OP Number 3       :       Shri Tomesh Sharma, Advocate.

 

 

 

 

Quorum:    Sukhpal Singh Gill, President

                K.C.Sharma, Member

                Sarita Garg, Member

 

Order by : Sukhpal Singh Gill, President.

 

1.             Smt. Ramandeep Kaur complainant (referred to as complainant in short) has preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that her husband, namely, Shri Shivcharan Singh was the member of OP number 2 and was having an account number 452 in the Kissan Credit Card. It is further averred that OP number 2 got insured the society members with the OP number 1  and the OP number 1 accordingly issued insurance policy number 10671461 for the period from 1.10.2011 to 30.09.2012 and an amount of Rs.50,000/- was payable in case of accidental death of any member of the society.

 

2.             The case of the complainant is that on 18.12.2011, the husband of the complainant Shri Shivcharan Singh met with an electric shock while he was starting his motor in the fields and ultimately died in an accidental death.  It is further averred that on 3.3.2012, the complainant went to OP number 3 and submitted her claim and other documents for further onward submission to OP number 3. It is further averred that OP number 2 sent all the documents to OP number 3 vide endorsement number 12763 dated 3.3.2012.  It is further averred that despite repeated visits of the complainant to the OPs, nothing has been paid and as such the complainant has alleged deficiency in service and unfair trade practice on the part of the Ops and has prayed that the  OPs be directed to pay to the complainant an amount of Rs.50,000/- under the policy in question along with interest @ 18% per annum from the date of death of Shivcharan Singh till payment and further pay to the complainant an amount of Rs.30,000/- for mental tension and harassment and Rs.20,000/- as litigation expenses.

 

3.             In reply filed by Op number 1,  preliminary objections have been taken up on the grounds that the present complaint is hopelessly barred by time as it has been filed on 23.09.2014 after the lapse of two years and 9 months from the date of death and no claim was lodged under policy number 10671461, that the complainant has not come to the Forum with clean hands and has suppressed true and correct fact from this Forum, as the claim was lodged under policy number 10596000 vide claim number C0191105 and an amount of Rs.1,00,000/- as claim has already been paid.  It is further stated that the complainant has not lodged any claim. On merits, it has been denied that late Shri Shivcharan Singh was the member of OP number 2 having KCC card bearing number 452. However, it has been admitted that OP number 3 took the group personal accident insurance policy bearing number 10671461 for its 1,13,163 KCC account holders having a sum assured of Rs.50,000/- each and the policy was valid for the period from 29.09.2011 to 28.09.2012. It is further stated that the complainant lodged the claim under policy number 10596000 with a delay of 45 days for an amount of Rs.1,00,000/- under saving bank account number 884.  However, any deficiency in service on the part of the OP has been denied.

4.             In reply filed by OP number 2, legal objections are taken up on the grounds that the complaint is not maintainable, that the complainant has no cause of action to file the present complaint and that this Forum has got no jurisdiction to try and decide the present complaint. On merits, it is admitted that Shri Shivcharan Singh was the member of the society and the OP number 2 sent the list of members from 1.10.2011 to 30.09.2012 to OP number 3 after deducting amount of Rs.5/- from each of the member of the society.  It is denied that the complainant ever approached OP number 2.  However, it is stated that if any liability arises, then the claim is payable by OP number 1 only.

 

5.             In reply filed by OP number 3, it is admitted that the insurance policy bearing number 10671461 was issued for the period from 1.10.2011 to 30.09.2012 for Rs.50,000/- as accidental death claim to the legal heirs of the society member/policy holder.  It is further admitted that OP number 3 forwarded the claim file to OP number 1 for the settlement of the claim of the complainant vide endorsement number 12763 dated 3.3.2012. The remaining allegations of the complainant have been denied in toto.  

 

6.             The learned counsel for the complainant has produced Ex.C-1 affidavit, Ex.C-2 copy of legal notice, Ex.C-3 to Ex.C-5 postal receipts, Ex.C-6 copy of PMR, Ex.C-7 copy of statement of complainant, Ex.C-8 copy of DDR, Ex.C-9 copy of inquest report, Ex.C-10 to Ex.C-11 copy of voter ID card, Ex.C-12 copy of letter dated 3.3.2012, Ex.C-13 copy of pass book of KCC account of Shivcharan Singh, Ex.C-14 copy of reply to legal notice, Ex.C-15 copy of death certificate, Ex.C-16 copy of insurance policy and closed evidence. On the other hand, the learned counsel for OP number 1 has produced Ex.OP1/1 affidavit, Ex.OP1/2 copy of policy, Ex.OP1/3 copy of letter, Ex.OP1/4 copy of claim form, Ex.OP1/5 copy of terms and conditions and closed evidence. The learned counsel for OP number 2 has produced Ex.OP2/1 affidavit, Ex.OP2/2 copy of reply of legal notice. The learned counsel for OP number 3 has  produced Ex.OP3/1 affidavit and closed evidence.

 

7.             We have carefully perused the complaint, version of the opposite parties and heard the arguments of the learned counsel for the parties. In our opinion, the complaint merits acceptance, for these reasons.

 

8.             In the present case the grievance of the complainant is that OP number 1 did not pay the insurance claim amount of Rs.50,000/-  under policy number 10671461 on account of accidental death of Shri Shivcharan Singh, who died on 18.12.2011 as he was a member of Kissan Credit Card scheme.  On the other hand, the stand of the OP number 1 in its written reply is that the complainant never lodged the claim under policy number 10671461 for payment of Rs.50,000/-, as such, the question of payment of the claim to the complainant does not arise at all.   The learned counsel for OP number 1 has further contended that the OP number 1 has already paid the claim amount of Rs.1,00,000/- to the complainant under policy number 10596000 vide claim number C0191105. 

 

9.             The learned counsel for the complainant has contended vehemently that she lodged the claim with the OP number 1 through OP number 3 on 3.3.2012 and the OP number 3 further forwarded the claim amount to OP number 1, as is evident from the copy of despatch register Ex.OP3/2 at serial number 12763.  The fact that the OP number 3 lodged the claim with the OP number 1 on account of death of Shri Shiv Charan Singh under KCC account number 452 is also evident from the copy of registered letter sent to OP number 1 vide letter dated 8.3.2012, a copy of which on record is Ex.C-12.  Ex.C-12 further clearly reveals that the OP number 3 lodged the claim under policy number 10671461, which clearly falsifies the stand of the OP number 1 that the complainant never lodged the claim with the Op number 1.  As such, we are of the considered opinion that the complainant has lodged the claim with the OP number 1 through OP number 3 on 3.3.2012. 

 

10.            Further the complainant has produced on record a lot of documents to show that Shri Shivcharan Singh died in an accidental death due to electric shock as is evident from the  copy of post-mortem report, Ex.C-1, copy of DDR Ex.C-8 and report of death, Ex.C-9.   We may mention here that the OP number 3 has already admitted and paid the claim amount of Rs.1,00,000/- under policy number 10596000 on account of accidental death of Shri Shivcharan Singh. As such, we feel that the complainant has clearly proved on record that the claim under policy number 10671461 was duly lodged with the OP number 1 and the OP number 1 is deficient in service by not settling and paying the claim amount of Rs.50,000/- to the complainant on account of accidental death of her husband Shri Shivcharan Singh.

 

11.            The objection taken by the Op number 1 that the complaint is time barred is also not tenable, as it has been clearly proved on record that the claim was lodged with the Op number 1 under the policy on 3.3.2012, as such, the cause of action is continuing one, as the OP number 1 did not settle the claim of the complainant. As such, we feel that the complaint of the complainant is fully maintainable. 

 

12.            The insurance companies are in the habit to take these type of projections to save themselves from paying the insurance claim. The insurance companies are only interested in earning the premiums and find ways and means to decline claims. The above said view was taken by the Hon’ble Justice Ranjit Singh of Punjab and Haryana High Court in case titled as New India Assurance Company Limited versus Smt. Usha Yadav and others 2008(3) R.C.R. 9 Civil) 111.

 

13.            In view of our above discussion, we allow the complaint and direct OP number 1 to pay to the complainant an amount of Rs.50,000/- along with interest @ 9% per annum from the date of filing of the present complaint i.e. 23.09.2014 till realisation.  OP number 1 is further directed to pay to the complainant an amount of Rs.10,000/- on account of consolidated amount of compensation for mental tension and litigation expenses.

 

14.            This order of ours be complied with within a period of thirty days of its communication.   A copy of this order be issued to the parties free of cost. File be consigned to records.

                Pronounced.

                April 17, 2015.

                                                        (Sukhpal Singh Gill)

                                                           President

 

 

                                                              (K.C.Sharma)

                                                                Member

 

 

                                                                (Sarita Garg)

                                                                    Member