Haryana

Karnal

CC/210/2021

Smt. Poonam Devi - Complainant(s)

Versus

Cholamandlam Ms General Insurance Company Limited - Opp.Party(s)

Sunil Rana

13 Nov 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                        Complaint No. 210 of 2021

                                                        Date of instt.09.04.2021

                                                        Date of Decision:13.11.2024

 

Smt. Poonam Devi wife of late Shri Lakhvinder Singh, resident of house no.352, Kheda Ke pass, Gagains, District Karnal.

                                               …….Complainant.

                                              Versus

1.     Cholamandlam MS General Insurance Company Ltd. registered

office 2^nd floor Dare house 2 N.S.C. Bose Road, Chennai-600001.

 

2.     Cholamandlam MS General Insurance Company Ltd. SCO no.193 Sector-12, Karnal through its Branch Manager.

 

                                                                    …..Opposite Parties.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

 

Before   Shri Jaswant Singh……President.     

              Ms. Neeru Agarwal…….Member

      Ms. Sarvjeet Kaur…..Member

 

 Argued by: Shri Sunil Rana, counsel for the complainant.

                    Shri Naveen Khetarpal, counsel for the OPs.

 

                     (Jaswant Singh, President)

ORDER:   

                

              The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that Lakhwinder Singh husband of complainant had purchased one new Maruti car bearing registration no.HR-91AA-4306. At the time of purchasing the said car, the official of the OPs got the aforesaid car insured with the OPs and also insure the life of husband of complainant as well as his family member under the policy Chola Credit Linked Group Personal Accident Insurance upto the amount of Rs.4,50,000/-. The official of the OPs had received the premium of Rs.2626/- from the husband of the complainant. After receiving the aforesaid premium the OPs issued the policy, vide certificate no.2884/00015077/008670/000/00, loan account no.XVFPKAL00003139217, valid from 20.08.2019 to 19.08.2022. At the time of issuance of the aforesaid policy, the official of the OPs assured the complainant that the life of husband of complainant including all the family members have been insured. The official of the OPs further told her husband that in case of any mishappening would be caused with him during the insurance period, they would pay Rs.4,50,000/- on account of accidental death and the loan amount if remained due at that time the same would also been waived off. The husband of complainant died on 28.06.2020 and dead body of the husband of complainant was found on bank/patri of canal at village Budanpur, District Karnal. In this regard, the police of Police Station Sadar, Karnal lodged the DDR no.018 dated 28.06.2020. The postmortem of the deceased was also conducted in Civil Hospital, Karnal, vide PMR no.AV/73/2020 dated 29.06.2020. After this incident, the complainant being widow of Lakhwinder Singh, lodged the claim with the OPs with regard to death of her husband.  The complainant and her family were fully dependent upon the income of Lakhvinder Singh. The OPs without going to the facts of the case knowingly and intentionally rejected the claim of complainant, vide letter no.19.03.2021 on the false and frivolous ground. Due to this act and conduct of the OPs, complainant has suffered mental pain, agony and harassment as well as financial loss.  In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence complainant filed the present complaint seeking direction to the OPs to pay Rs.4,50,000/- on account of death of her husband alongwith interest @ 24% per annum from the date of accident till its realization, to pay Rs.2,00,000/- as compensation for causing mental pain, agony and harassment etc.

2.             On notice, OPs appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that insured died on 28.06.2020 and dead body of the insured as found on the bank/patri of canal at village Budanpur District Karnal, thereafter DDR was lodged. However, from the documents furnished by the complainant (Forensic Report) confirms that insured consume alcohol at the time of accident, which constitutes gross violation of terms and conditions of the policy. As per Exclusion no.6, which reads as under:-

“The policy does not provide benefits for any death occurred in consequence of the insured being under the influence of alcohol or drugs unless administered on the advice of a physician.”

                The claim of the complainant is not maintainable, as per terms and conditions of the policy and settled law, so same has been repudiated and was communicated to the complainant, vide repudiation letter dated 19.03.2021. There is no deficiency in service and unfair trade practice on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of RC Ex.C1, copy of insurance policy Ex.C2, copy of DDR Ex.C3, copy of PMR Ex.C4, copy of rejection letter dated 19.03.2021 Ex.C5, copy of Aadhar card of Poonam Ex.C6, copy of Inquest report Ex.C7, copy of statement of account Ex.C8, copy of death certificate Ex.C9, copy of aadhar card of Riya Ex.C10, copy of aahdar card of Aditya Ex.C11, copy of insurance policy of HDFC Life Ex.C12 and closed the evidence on 22.08.2022 by suffering separate statement.

5.             On the other hand, learned counsel for the OPs has tendered into evidence affidavit of Sujeet Kumar Sahu, Deputy Manager Legal Ex.RW1/A, copy of rejection letter dated 19.03.2021 Ex.R1, copy of terms and conditions of the policy Ex.R2 and closed the evidence on 23.10.2023 by suffering separate statement.

6.             We have heard the learned counsel for the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that husband of complainant Lakhwinder Singh (since deceased) purchased a new car and got financed with the Cholamandlam Finance Company. Husband of the complainant also purchased Accidental Death Policy under the sum insured of Rs.4,50,000/- from the OPs. Insured was expired on 28.06.2020 accidently.  A DDR no.018 dated 28.06.2020 was lodged. The postmortem of the deceased was also conducted in Civil Hospital, Karnal. The complainant being widow of Lakhwinder Singh, lodged the claim with the OPs  and submitted all the required documents but OPs did not pay the claim and repudiated the same, vide letter dated 19.03.2021 on the false and frivolous ground. Due to this act and conduct of the OPs, complainant has suffered mental pain, agony and harassment and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OPs, while reiterating the contents of written version, has vehemently argued that the insured died on 28.06.2020 and dead body of the insured was found on the bank of canal at village Budanpur District Karna. From the documents furnished by the complainant confirms that insured consumed alcohol at the time of accident, which constitutes gross violation of terms and conditions of the policy, so claim of complainant was rightly repudiated by the OPs and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, Lakhwinder Singh (since deceased) purchased a Chola Credit Linked Group Personal Accident Insurance Policy from the OPs. It is also admitted that the sum insured under the policy is Rs.4,50,000/-.

11.           Before going into the merits of the case, firstly we decide the complaint filed by the complainant is maintainable or not?

12.           As per insurance policy Ex.C2, the financer is the nominee under the policy. During the course of evidence, complainant tendered her affidavit Ex.CW1/A. As per contents of the said affidavit, the deceased is having parents and two minor children but the present complaint has been filed by the complainant only without impleading the other legal heirs of deceased. The complainant is window of deceased does not mean that she is alone entitled for the benefit of policy, if payable, rather all the legal heirs of deceased/ insured are entitled for the benefits of the policy. The complainant has not impleaded the other legal heirs of the deceased/ insured for the reason best known to her. In the present situation, the possibility for depriving the rights of other legal heirs from the awarded amount cannot be ruled out.

13.           Thus, in view of the above discussion, the present complaint is not maintainable and same deserves to be dismissed and same is hereby dismissed. However, complainant and other legal heirs of the deceased are at liberty to file a fresh complaint on the same cause of action, if so desired. In view of the law laid down by Hon’ble Supreme Court of India, in Laxmi Engineering Works Versus PSG Industries Institute (1995) 3 SCC 583, the complainant and legal heirs of deceased would be entitled to get the benefit of provisions of Section 14 of the Limitation Act, to exclude the period spent in prosecuting the present complaint, while computing the period of limitation prescribed for filing complaint before the competent court of law. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:13.11.2024                                                                     

                                                                President,

                                                   District Consumer Disputes

                                                   Redressal Commission, Karnal.

 

                  (Neeru Agarwal)              (Sarvjeet Kaur)

                         Member                             Member