Punjab

Faridkot

CC/21/141

Surjeet Kaur - Complainant(s)

Versus

Branch Manager UIIC - Opp.Party(s)

Gurpreet Singh

12 Sep 2024

ORDER

  DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, FARIDKOT

 

Complaint No. :        141  of 2021

Date of Institution:      21.09.2021

Date of Decision:        12.09.2024

 

Surjeet Kaur aged about 69 years wife of Amar Singh son of Eshar Singh r/o Village Sandhwan, Tehsil and District Faridkot.

...Complainant

Versus

1. Branch Manager, United India Insurance Company Ltd., Branch, Near Punjab and Sind Bank, The Mall Road, Faridkot.
2. The Divisional Manager, United India Insurance Company Ltd., SCO No. 72, Second Floor, Phase-9, Mohali.

.....Opposite Parties

Complaint under Section 35 of the

Consumer Protection Act, 2019.

 

Quorum: Sh Rakesh Kumar Singla, President,

               Smt Param Pal Kaur, Member.

 

Present: Sh Gurpreet Singh, Ld Counsel for complainant,

              Sh Atul Gupta, Ld Counsel for OPs,

 

(Rakesh Kumar Singla, President)       

ORDER

                                        Complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against OPs seeking directions to OPs to make payment of Rs.5 lacs on account of

cc no. - 141 of 2021

 

death of her husband against insurance policy and for further directing OPs to pay Rs.50,000/- as compensation for harassment, inconvenience, mental agony besides litigation expenses of Rs.10,000/.

2                                     Briefly stated, the case of the complainant is that Amar Singh husband of complainant was insured under Bhagat Puran Singh Health Insurance Scheme and he paid Rs.30/-to OPs. He was issued card no.0304 5000 2836 4609, 8 and as per Insurance Policy in question,  in the event of death of head of family, family is entitled for sum of Rs. 5 lacs. It is further submitted that during the subsistence of policy in question, husband of complainant died in a motor vehicle accident on 14.10.2018 in respect of which, FIR No.95 dated 15.10.2018 was got registered in Police Station Sadar, Kotkapura District Faridkot. Thereafter, complainant contacted OPs and filed claim regarding death of her husband and prayed for making payment of death claim, but they did not pay even a single penny on account of insurance claim for the death of her husband. Complainant made several requests to OPs to make payment of genuine insurance claim, but all in vain, which amounts to deficiency in service. They have caused unnecessary harassment to her by not paying the genuine  claim on account of death of her husband and this act of OPs amounts to trade mal practice and deficiency in service and it has caused harassment and mental agony to complainant for which she has prayed for directions to OP to pay Rs.50,000/-as compensation

 

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alongwith Rs.10,000/-as cost of litigation besides the main relief. Hence, the present complaint.

3                                               The counsel for complainant was heard with regard to admission of the complaint and vide order dated 29.09.2021, complaint was admitted and notice was ordered to be issued to the opposite parties.

4                                                On receipt of the notice, OPs filed written statement taking preliminary objections that complainant is not their consumer and there is no relationship of consumer or service provider between complainant and answering OPs and there is no privity of contract between complainant and answering OPs. No cause of action arises against answering OPs. Moreover, no immediate information regarding death of Amar Singh insured was given to them thereby preventing them to gather first hand information, which is a violation of terms and conditions of the policy in question and therefore, present complaint is liable to be dismissed. It is averred that complaint involves complex questions of law and facts, which require voluminous evidence and it can not be decided by this Forum having limited jurisdiction and limited time span and therefore, it is liable to be referred to competent Civil Court.  No proper particulars of insurance have been produced on record either by complainant or by other OPs. It is averred that answering OP has numerous regional offices, divisional and branch officers and it is not possible for them to locate the insurance particulars without supplying

cc no. - 141 of 2021

the said documents and therefore, insurance of alleged deceased is denied. Further averred that complainant has no locus standi to file the present complaint as she is not the nominee as alleged and all the legal heirs of the deceased have not been mentioned in complaint. It is alleged that complainant was required to produce succession certificate before the Commission and moreover, deceased husband of complainant was not insured with OPs and thus, no liability in respect of payment of insurance claim attaches with answering OPs. However, on merits, OPs have denied all the allegations of complainant regarding accident, death or post mortem of her husband being wrong and incorrect and it is reiterated that there is no deficiency in service on their part and made prayer for dismissal of complaint with costs. However, OPs admitted before the Commission that said scheme was launched by Punjab Government and answering Ops were running the same, but it is denied that deceased husband of complainant ever purchased the policy in question or he ever paid the premium amount of Rs.30/-. It is further averred that neither complainant informed them about death of Amar Singh nor she ever approached them for obtaining insurance claim. Complainant did not give them immediate intimation in respect of accident and death of deceased Amar Singh thereby preventing them to gather first hand information regarding death of husband of complainant. It is contended that complainant had not lodged any claim during the currency of policy on 104 Government Helpline, rather directly filed the present complaint after

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the period of limitation and prayed for its dismissal being time barred. Answering OPs have been investigating the matter and thus, complaint in hand is premature and is liable to be dismissed. It is totally denied that husband of complainant was covered under Policy in question and therefore, she is not entitled to claim any compensation for death of her husband. All the other allegations are denied being wrong and incorrect and it is further averred that there is no deficiency in service on the part of answering OPs. Prayer for dismissal of complaint with costs is made.

5                                           Parties were given proper opportunities to prove their respective case. Ld Counsel for complainant tendered in evidence affidavit of complainant as Ex.C-1 and documents Ex C-2 to Ex C-7 and then, closed the evidence.

6                                       In order to rebut the evidence of the complainant, Ld Counsel for OPs tendered in evidence affidavit of Raghunandan Bansal as  Ex OP-1, document Ex OP-2 and then, closed the same on behalf of OPs.

7                                              We have heard the learned counsel for the parties and have very carefully gone through the affidavits and documents on the file.

8                                                         From the careful perusal of evidence on record, documents and pleadings put forward by complainant as well as OPs, it is observed that case of the complainant is that Amar

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Singh husband of complainant was insured with OPs against policy in question. Said Amar Singh died in a vehicular accident on 14.10.2018 and after his death, complainant lodged claim with OPs, but despite repeated requests, OPs did not make a single penny on account of death of insured Amar Singh. On the other hand, plea taken by OP-1 and 2 is that complainant has not produced succession certificate before them to prove that she is entitled to relief sought by her. As per OPs, complaint filed by complainant is time barred as death of insured Amar Singh occurred on 14.10.2018, whereas complainant has filed the present complaint after a long span of limitation period and it is time barred. Another plea taken by OPs is that at the time of said accident, deceased was not enrolled and covered under the policy in question as he never paid Rs30/-to OPs. OPs have prayed for dismissal of complaint with costs.

 9                              From the careful perusal of complaint filed by complainant, it is transpired that complainant has not specified the period of insurance and ld counsel for complainant has also not produced any documentary evidence to prove the fact that death of husband of complainant occurred during the subsistence period of insurance policy in question. Nowhere in the entire complaint and during the proceedings of whole case, neither complainant nor his counsel uttered a single word about subsistence period or the period during which husband of complainant was insured with them.  Thorough scrutiny of entire evidence

 

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and documents placed on record, also does not help in bringing on record the validity of insurance period. Counsel for complainant has nothing to contradict this point.

 10                                   From the above discussion and keeping in view the documents placed on record, it is noticed that there is no doubt regarding the fact that deceased Amar Singh was insured with OPs, but it is also brought on record that death of Amar Singh husband of complainant occurred on 14.10.2018, but his wife has filed the present complaint on 21.09.2021 after about 3 years of his death and it is time barred as it is filed much beyond the limitation period of two years. Moreover, ld counsel for complainant has nothing to place on record to contradict the allegations of OPs that present complaint is time barred. Even no application or condonation of delay is brought on record by complainant. As complainant has failed to prove her case, therefore, complaint in hand is hereby dismissed.          

11                               However, in peculiar circumstances of the case, there are no orders as to costs. Complaint could not be decided within stipulated period due to heavy pendency of work and incomplete quorum.   Copy of the order be supplied to parties free of cost as per law. File be consigned to the record room.

Announced in Commission

Dated: 12.09.2024

       (Param Pal Kaur)         (Rakesh Kumar Singla)             

                                      Member                          President