DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION FAZILKA.
R.B.T. C.C. No. 98 of 2023
Original C.C. No. 282 of 2021
Date of Institution: 05.07.2021
Date of Decision: 12.03.2024
Sarbjeet Kaur W/o Banta Singh aged 41 years R/O Village Pakan, Tehsil and District Fazilka. Ph. No.98155-00170.
...Complainant
Versus
- Branch Manager, United India Insurance Company Limited, Branch Mall Road, Ferozepur.
- The Divisional Manager, United India Insurance Company Limited, SCO No.72, Second Floor, Phase-9, Mohali.
...Opposite Parties.
Complaint under Section 35 of the Consumer Protection Act, 2019.
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Quorum: Sh. Vishal Arora, President.
Sh. Raghbir Singh Sukhija, Member.
Smt. Tajinder Kaur, Member.
Present: Sh. M.S.Chahal, Advocate, Counsel for Complainant.
Sh. A.K.Sharma, Advocate, Counsel for Opposite Parties.
ORDER
(Vishal Arora, President:)
Initially, the present complaint was preferred by complainant at District Consumer Commission, Ferozepur U/s 35 of the Consumer Protection Act, 2019 seeking directions to opposite parties to pay to the complainant a sum of Rs.5,00,000/- as death claim of deceased Banta Singh along with interest @ 12% per annum besides Rs.50,000/- as compensation for mental tension, agony & harassment and litigation expenses to the tune of Rs.10,000/-. The present complaint has been received by transfer to District Consumer Commission, Fazilka for disposal vide order dated 17.04.2023 passed by the Hon’ble State Commission, Punjab, Chandigarh.
2. Briefly stated, the case of complainant is that she is widow of deceased Banta Singh S/o Sher Singh and Punjab Government launched Bhagat
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Puran Singh Sehat Bima Yojna for the welfare of beneficiary of said scheme. Her husband died in the vehicular accident and in this regard DDR No.19 dated 26.09.2018 was registered at Police Station Sadar, Malout, District Sri Muktsar Sahib. It has been pleaded that said Banta Singh had availed one insurance policy under Bhagat Puran Singh Sehta Bima Yojna through smart card bearing no. 9364-8000-3430-3503-0 and the complainant number of times visited the office of opposite parties with a request to settle the claim of her husband and also submitted claim with all required documents to the Opposite parties, but all in vain. Due to act and conduct of the opposite parties, the complainant is suffering from mental tension, agony and harassment. Pleading deficiency in service on the part of opposite parties, the complainant has prayed for acceptance of the present complaint.
3. The Counsel for complainant was heard with regard to admission of the complaint and vide order dated 12.07.2021, complaint was admitted and notice was ordered to be issued to the opposite parties.
4. Upon notice, opposite parties have appeared and filed their joint written reply to the complaint raising certain preliminary objections inter alia to the effect that complainant has suppressed true and material facts from this Commission. The complainant neither intimated nor lodged
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any claim with the Insurance Company and the present complaint is pre-mature as the death claim was neither registered on 104 PHSC helpline nor in the office of United India Insurance Company. It has been pleaded that the complainant has no locus standi to file the present complaint and the same is groundless, unsustainable and abuse of process of law. It has been averred that the present complaint is false, frivolous and vexatious and the complainant is estopped by its own act and conduct to file the present complaint.On merits, the preliminary objections have been reiterated and the other allegations of the complaint have been denied and the opposite parties have prayed for dismissal of the present complaint.
5. Ld. Counsel for complainant has tendered into evidence affidavit of complainant Ex C-1, Copies of, post mortem report Ex C-2, smart card Ex C-3, death certificate Ex C-4, general diary details Ex C-5, aadhar card of complainant Ex C-6, aadhar Card of deceased Banta Singh Ex C-7, letter dated 27.05.2022 received from O.P. Ex C-8, postal receipt dated 07.06.2022 Ex C-9, DDR Ex C-9 (A), Form No.25-35(O) including proceedings U/s 174 Cr. P.C Ex C-10 and medical bills Ex C-11. Ld. Counsel for opposite parties has tendered into evidence affidavit of Sh.Bhushan Kumar Goyal, Divisional Manager, United India Insurance Company as Ex O.P’s-1 and closed evidence.
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6. We have heard the learned counsel for the parties and have also carefully gone through the record. The learned counsel for complainant and opposite parties have argued on the same lines as per their respective pleadings.
7. That the main plea put forward by the Ld. Counsel for the opposite parties is that the complainant neither intimated nor lodged any claim with the Insurance Company and the present complaint is pre-mature as the death claim was neither registered on 104 PHSC helpline nor in the office of United India Insurance Company.
However, perusal of the file reveals that opposite party No.2 insurance company at Mohali had issued a letter bearing reference no. DOM:2019/5120 dated 27.05.2022 Ex C-8 to complainant confirming the receipt of claim of complainant under Bhagat Puran Singh Sehat Bima Yojna Scheme Card No.9364 8000 3430 3503 0 and demanded documents mentioned at Sr. No.3,10 & 11 of the said letter. The complainant has also placed on record the said documents demanded by opposite party no.2 in the said letter as Ex C-9 (A), Ex C-10 and Ex C-11 along with postal receipt dated 07.06.2022 Ex C-9 regarding sending the said documents to opposite
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party insurance company on 07.06.2022 after receipt of letter dated 27.05.2022. But till date it has been a period of more than 1 ½ years but admissibility of claim of the complainant has not been decided by opposite parties for which they are liable to pay suitable compensation to the complainant for inordinate delay, mental harassment and litigation expenses.
8. In view of what has been discussed above, the present complaint stands disposed off with consolidated compensation of Rs.8000/- to be paid by opposite parties to the complainant with a direction to the complainant to again supply above said documents to opposite party no.2 insurance company by registered post within a period of 30 days from the date of receipt of certified copy of this order. And opposite party No.2 insurance company will decide the admissibility of claim of the complainant within a further period of 45 days from the date of receipt of said documents from the complainant. In case, the admissibility of claim is not decided within stipulated period of 45 days, then opposite party no.2 insurance company shall be liable to pay to the complainant Rs.300/- per day for the period of delay. If the complainant is dissatisfied with the decision taken by the insurance company, then the complainant will be at liberty to file a fresh
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complaint on the same cause of action. The present complaint is disposed off accordingly.
ANNOUNCED IN THE OPEN COMMISSION:
12th Day of March, 2024
(Vishal Arora)
President
(Raghbir Singh Sukhija)
Member
(Tajinder Kaur )
Member
