Order by:
Smt.Aparana Kundi, Member.
1. The complainant has filed the instant complaint under section 35 of the Consumer Protection Act, 2019 on the allegations that on the allurement of Opposite Party, the son of the complainant namely Darshan Singh purchased policy from the Opposite Party bearing No.502-1811707 commencing from 16.03.2020 for sum assured of Rs.25,20,194/- against paid up premium of Rs.14,133/- per month. In this policy, the complainant was the registered nominee of the life assured. Unfortunately, on 26.03.2020 life assured died due to heart attack leaving behind his widow and two children, mother and father. After the death of the life assured, the complainant applied for the death claim of the life assured and provided all the relevant information as well as documents as raised by the Opposite Party, but the Opposite Party vide letter dated 31.03.2021 illegally and wrongly rejected the claim of the complainant by leveling false objections regarding impersonation and tampering of documents, whereas thee is no impersonation and tempering of documents as alleged by the Opposite Party. Thereafter, the complainant made so many visits to the office of the Opposite Party to pay the death claim under the policy, but the Opposite Party refused to admit the rightful claim of the Complainant. Vide instant complaint, the complainant has sought the following reliefs.
- The Opposite Party may be directed to pay the claim amount of Rs.25,20,194/- to the complainant under the policy alongwith interest @ 18% per annum and also to pay Rs.2 lakhs on account of compensation for causing her mental tension and harassment besides Rs.33,000/- as costs of litigation or any other relief to which this District Consumer Commission deem fit may please be granted to the Complainant, in the interest of justice and equity.
Hence, the Complainant has filed the present complaint for the redressal of her grievances.
2. Opposite Party appeared through its counsel, but failed to file the written reply within the stipulated period as required under the Consumer Protection Act, 2019 despite availing sufficient opportunities of more than 45 days from the date of service. In this regard, Hon’ble Supreme Court in complaint titled as New India Assurance Co. Ltd. Vs Hilli Multipurpose Cold Storage decided on 4th March, 2020 has held that the District Forum (now Commission) has no power to extend the time for filing the response to the complaint beyond the period of 15 days in addition to 30 days as envisaged under section 13 of Consumer Protection Act, 1986 (now under section 38 (2) of the Consumer Protection Act, 2019 and the commencing point of limitation of 30 days u/s 13 of the Act would be from the date of receipt of notice accompanied with the complaint by the Opposite Party. In view of this, we do not possess any power to give further time period after completion of 15 days in addition to 30 days as envisaged under section 13 of Consumer Protection Act, 1986 (now under section 38 (2) of the Consumer Protection Act, 2019. As such written reply submitted by the Opposite Parties was ordered to be placed on record and however, it is not considerable as referred above.
3. In order to prove his case, the complainant has tendered into evidence the copies of documents Ex.C1 to Ex.C4 and affidavit of complainant Ex.5 and closed his evidence.
4. On the other hand, Opposite Party also tendered into evidence the affidavit of Sh.Mitesh Pabari, Manager Legal Ex.OP1/1 alongwith copies of documents Ex.OP1/2 to Ex.OP1/5 and closed the evidence on behalf of Opposite Party.
5. We have heard ld.counsel for the parties and also gone through the documents placed on record.
6. During the course of arguments, the complainant has mainly reiterated the facts as narrated in the complaint. We have perused the rival contentions of the parties and also gone through the record on file. The main contention of the complainant is that son of the complainant namely Darshan Singh purchased policy from the Opposite Party bearing No.502-1811707 commencing from 16.03.2020 for sum assured of Rs.25,20,194/- against paid up premium of Rs.14,133/- per month. In this policy, the complainant was the registered nominee of the life assured. Unfortunately, on 26.03.2020 life assured died due to heart attack leaving behind his widow and two children, mother and father. After the death of the life assured, the complainant applied for the death claim of the life assured and provided all the relevant information as well as documents as raised by the Opposite Party, but the Opposite Party vide letter dated 31.03.2021 illegally and wrongly rejected the claim of the complainant by leveling false objections regarding impersonation and tampering of documents, whereas thee is no impersonation and tempering of documents as alleged by the Opposite Party.
7. Bare perusal of the policy in question Ex.C2 shows that the life assured purchased the policy on 16.03.2020 for a sum of Rs.25,20,194/- with monthly premium of Rs.14,133.83 paisa for Premium Payment Term of 10 years under the Insurance Plan Bharti Axa Life Shining Star Plan. It is the case of the complainant that on 26.03.2020, Life assured died, copy of death certificate is placed on record as Ex.C3 i.e. after 10 days from the issuance of the policy in question. The ground of the repudiation of the claim by the Opposite Party is that claim of the complainant is repudiated on the ground of policy cancellation as Impersonation and Tampering of documents. Perusal of the record shows that the life assured was in a young age of 33 years and the complainant has failed to convince this District Consumer Commission regarding the death of life assured in his very younger age due to heart attack because the life assured was died within a very short span of 10 days of purchasing the policy of very heavy sum assured. In the present case, there are some serious issues of impersonation, forgery, fabrication and such serious allegations requires proper trial by Civil/ Criminal court and the evidence has to be taken which is not possible in a summary trial and that intricate questions of law and facts are involved in the present complaint which requires voluminous documents and evidence for determination which is not possible in the summary procedure under the Consumer Protection Act and appropriate remedy, if any, lies only in the Civil Court. So for the proper adjudication and to prove the authenticity of these documents placed on record by the complainant for claiming the insurance amount, we feel that there is requirement of elaborated evidence both oral and documentary and as such it is only civil court of competent jurisdiction which can try and decide the present complaint. The complaint cannot be decided by this District Consumer Commission in a summary manner.
8. In view the aforesaid facts and circumstances, we are of the view that intricate questions of law and facts are involved in the present complaint which require voluminous documents and evidence for determination which is not possible in the summary procedure under the Consumer Protection Act and appropriate remedy, if any, lies only in the Civil Court. Not only this, the nature of the dispute, in the present complaint, is squarely covered by the law laid down by their lordships of the Hon'ble Supreme Court in various judgements. Further in case Oriental Insurance Company Ltd. Vs. Munimahesh Patel 2006(IV) CPJ page 1, wherein the Hon'ble Supreme Court has held that :-
“Proceedings before the commission are essentially summary in nature and adjudication of issues which involve disputed factual questions should not be adjudicated. It is to be noted that commission accepted that insured was not a teacher. Complainant raised dispute about genuineness of the documents (i.e. proposal forms) produced by the appellant.”
Their lordships have further held that :-
“The nature of the proceedings before the commission as noted above, are essentially in summary nature. The factual position was required to be established by documents. Commission was required to examine whether in view of the disputed facts it would exercise the jurisdiction. The State Commission was right in its view that the complex factual position requires that the matter should be examined by an appropriate court of Law and not by the Commission.”
A similar view has been taken by the Hon'ble National Consumer Disputes Redressal Commission in 1(2004) CPJ page 101 wherein it has been held by the Hon'ble National Commission in a revision petition titled as R.D. Papers Ltd. Vs. New India Assurance Co. Ltd. & Ors. in para No.7 of the judgement which reads as under:-
“After going through the complaint and the written version, it appears to us that the complaint raises complicated questions of facts which cannot be decided by us in our summary jurisdiction.”
9. Keeping in view the aforesaid facts and circumstances of the case, the instant complaint is not maintainable in this District Consumer Commission for its proper adjudication and the same stands dismissed. However, the complainant can get redressal of her grievance from the Civil Court/ or any other competent authority, in accordance with law, for which the time spent before this District Commission shall stand excluded under Section 14 of the Limitation Act in the light of the judgment of the Hon'ble Supreme Court in case titled 'Lakshmi Engineering Works vs PSG Industrial Institute reported in 1995(3) SCC 583'. However, keeping in view the peculiar circumstances of the case, the parties are left to bear their own costs. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room.
Announced in Open Commission.
Dated:29.11.2022.
