PER:
Charanjit Singh, President
1 The complainant has filed the present complaint by invoking the provisions of Consumer Protection Act under Section 35 against the opposite parties on the allegations that the complainants are legal heirs of deceased Harjinder Singh being, the complainant No. 1 is widow and complainant No. 2 is son. On 2.1.2020 deceased Harjinder Singh had road accident. The tempo traveler came from behind which was being driven by some unknown person who was driving the Tempo traveler very rashly and recklessly and hit the bike of Harjinder Singh. The left leg of Harjinder Singh had broken due to fall on the road and got many occult injuries. The said driver ran away with Tempo Traveler from the spot. Harjinder Singh was admitted to the Guru Nanak Dev Multi- speciality Hospital Tarn Taran after arranging the vehicle. Thereafter Harjinder Singh shifted to Fortis Hospital Amritsar. The said incident was witnessed by Shamsher Singh. On 3.1.2020 F.I.R No. 02/2020 under section 279, 338, 337, 427 I.P.C has been registered in respect of unfortunate incident at Police Station Sadar of District Tarn Taran and Shamsher Singh is an author of above said F.I.R. Thereafter Harjinder Singh died on 12.01.2020 in Fortis Hospital during treatment. The opposite party No 4 is bank institution and provides banking services to the public as per their requirement. During his life time the deceased Harjinder Singh had opened an account bearing No. 14281050055625 in the bank of opposite party No. 4 and at the time of opening the account the opposite parties had issued master Card “easy shop” bearing Number 5264 1901 3399 2171. The opposite party No. 4 being agent of opposite parties No. 1 to 3 also did insurance policy bearing No. 2999201790009102000 on the basis of master card. At the time of issuing the above said master card the opposite parties had given assurance of services of insurance. The deceased Harjinder Singh had availed the services rendered by the opposite parties during his life time, hence, the opposite parties rendered their services and the complainant is the consumer of the opposite parties. The original policy cover is in the possession of opposite parties as handed with claim application. After the death of Harjinder Singh, the complainant being legal heir has approached many times to the opposite party no. 2 to claim accidental insurance of the complainant vide letter dated 5.1.2022 by stating that “As per verification it is noted that insured was under influence of heroin during incident, Hence this claim is not admissible”, whereas as per post mortem report of the deceased Harjinder Singh cause of death is “ the cause of death in this case in my opinion is Polytrauma specially injury No. 5 which leads to the lungs injury with Septicemia which is vital organ which is sufficient to cause death in ordinary course of nature. The above said condition is highly arbitrary. The complainant has prayed the following relieves.
- Direction may kindly be issued to the opposite parties to accept the accidental claim id RR-CS20-10045862 and policy No. 2999201790009102000 of deceased Harjinder Singh and Rs.30 Lacs may kindly be released in favour of complainants being legal heir.
- The opposite parties may kindly be directed to pay compensation of Rs. 50,000/- and Rs. 50,000/- as litigation expenses on account of mental and physical harassment and on account of negligent service may also be awarded to the complainant in the interest of justice.
Alongwith the complaint, the complainant has placed on record affidavit of Bhupinder Kaur Ex. C-1, Self attested copy of FIR Ex. C-2, Self attested copy of death certificate Ex. C-3, Cancelled cheque Ex. C-4, Self attested copy of Master Card Ex. C-5, Self attested copy of repudiation letter dated 5.1.2022 Ex. C-6, Self attested copy of Post Mortem report Ex. C-7.
2 Notice of this complaint was sent to the opposite parties and opposite parties No. 1 to 3 appeared through counsel and filed written version by interalia pleadings that the complainants have concealed the true and material facts from the knowledge of this Commission, therefore, they are not entitled for any claim. After receiving the claim documents for reimbursement from the complainant, the opposite parties No. 1 to 3 verified the same with regard to coverage as per terms and conditions of the policy and as per primary scrutiny of the said documents, it reveals that the complainant was under influence of heroin during incident, therefore, claim is not admissible as per Section 5(5) of the policy. “Person being under the influence of alcohol or drugs or narcotics unless professionally administered by a physician or unless professionally prescribed by and taken in accordance with the directions of a Physician.” In view of the facts mentioned above the claim was repudiated and intimation in this regard was given to the complainant vide letter dated 5.1.2022. In the death summary of Fortis Escort Hospital it has been specifically stated that the insured was addicted to Heroin. As per the questionnaire to the doctor who had treated he insured when he was first admitted to Guru Nanak Dev Super Specialty Hospital, the insured was under the influence of heroin at the time of accident, therefore, the complainants are not entitled for any claim in view of the terms and conditions of the policy and the claim has been rightly repudiated. Harjinder Singh was insured for the period of 19.5.2019 to 18.5.2020 under Policy No. 2999201790009102000 under the Group Personal Accident Insurance policy by the opposite parties No. 1 to 3 for benefits as detailed in coverage details of the policy subject to conditions and exclusions of the Policy wordings. The benefits under the policy are governed by the terms and conditions of the policy and the liability of the opposite party is limited to the insured perils occurring within the policy period subject to conditions and exceptions as mentioned in the terms and condition of the policy. The complainant lodged claim under the Group Personal Accident Policy claiming benefits of Accidental Death bearing claim No. RR-CS20-100445862. In the death summary of Forties Escort Hospital, it has been specifically stated that the insured was addicted to Heroin. As per the questionnaire to the doctor who had treated the insured when he was first admitted to Guru Nanak Dev Super Specialty Hospital, the insured was under the influence of Heroin at the time of accident. Both the parties are bound with the terms and conditions of the policy, which are duly supplied to the complainant and no claim can be passed beyond the terms and conditions of the policy. As per the terms and conditions of the policy, the company shall not be liable to pay anything in case the insured person suffers an injury while he is under the influence of alcohol or drugs or narcotics. Relevant condition is quoted herein below:-
“General Exclusions
The company shall not be liable to pay any benefit in respect of any insured person:
5 For bodily injury or sickness sustained or suffered whilst the insured person is or as a result of the insured person being under the influence of alcohol or drugs or narcotics unless professionally administered by a Physician or unless professionally prescribed by and taken in accordance with the directions of a Physician.”
The complainants are not entitled for any claim in view of the terms and conditions of the policy and the claim has been rightly repudiated. The present complaint has been filed without any cause of action against the opposite parties No. 1 to 3, therefore, the present complaint is liable to be dismissed. The complainants are estopped by their own act and conduct from filing the present complaint. The complainants have no locus standi to file the present complaint. The opposite parties No. 1 to 3 have denied the other contents of the complaint and prayed for dismissal of the same. Alongwith the written version, the opposite parties No. 1 to 3 have placed on record affidavit of Manoj Prajapati, Manager Claims Legal Ex .OP1,2,3/1 attested self copy of Power of attorney/Authority letter Ex. OP1,2,3/2, self attested copy of policy Ex.OP1,2,3/3, self attested copy of terms and conditions Ex. OP1,2,3/4, self attested copy of death summary issued by Fortis Escort Hospital Ex. OP1,2,3/5, self attested copy of progress notes of Fortis Escort Hospital Ex OP1,2,3/6, self attested copy of treatment record of Guru Nanak Dev Super Specialty Hospital Tarn Taran Ex.OP1,2,3/7, self attested copy of questionnaire Ex. OP1,2,3/8, self attested copy of repudiation letter dated 5.1.2022 is Ex.OP1,2,3/9.
3 The opposite party No. 4 appeared through counsel and filed written version by interalia pleadings that the complaint under the reply is not maintainable and is liable to be dismissed as the complainant has attempted to misguide and mislead this commission. The complaint is not maintainable and is liable to be dismissed as no cause of action ever arose in favour of complainant and against the opposite party No. 4 to file the present complaint and hence, the complaint under reply is an abuse of the process of law and as such the same is liable to be dismissed exemplary cost. The complainant has created a false story in his complaint to mislead this commission by concocted and distorting the facts and circumstances of the complaint. The present complaint is not maintainable in the present form as no compliance under Section 35(1)(c) of the Consumer Protection Act has been made by the complainants by taking permission from this commission to file a joint complaint. The deceased Harjinder Singh being account holder of opposite party NO. 4 had a road accident and on 3.1.2020 an FIR No. 02/20 U/s 279, 338, 337, 427 IPC was registered at Police Station Sadar of District Tarn Taran. Thereafter, Harjinder Singh died on 12.1.2020 in Forties Escort Hospital. During the life time of Harjinder Singh, he had opened an account bearing No. 14281050055625 with the opposite party No. 4 Bank and at the time of opening the said account, the opposite party No. 4 had issued Master Card ‘Easy Shop’ bearing No. 5264190133992171 and opposite party No. 4 being the agent of opposite parties No. 1 to 3 did an insurance policy bearing No. 2999201790009102000 on the basis of said Master Card. After the death of DLA, the complainants lodged the claim and the same was repudiated by opposite party No. 2 vide letter dated 5.1.2022 on the ground that as per verification, it was found that insured was under influence of drugs i.e. heroin during the incident, hence the claim is not admissible. The DLA was having a savings account with the opposite party No. 4 bearing No. 142810500556625 and he also applied for the master card and accordingly master card bearing No. 5264190133992171 was issued to DLA. Through the said card, Harjinder Singh was insured by opposite parties No. 1 to 3 under Policy No. 2999201790009102000 under the Group Personal Accident Insurance Policy. After the death of the DLA, the complainants lodged the claim with the opposite party No. 4. The opposite party No. 4 further forwarded the documents and lodged the claim with the opposite parties No. 1 to 3. The opposite party No. 4 received a claim reputation letter dated 30.12.2020 whereby the opposite parties No. 1 to 3 repudiated the claim on the ground that the DLA was under influence of heroin when met with the accident. The opposite parties No. 1 to 3 repudiated the claim as per the policy terms and conditions. The opposite party No. 4 has no role to play in adjudicating whether the claim is accepted or denied. It is the sole prerogative of the opposite parties No. 1 to 3 therefore, the claim is liable to be dismissed qua the opposite party No. 4. There is neither any deficiency in service nor unfair trade practice on the part of the opposite party No. 4. The present complaint has been filed by the complainants just to harass and humiliate the opposite party No. 4. The present complaint is false, frivolous and vexatious besides being devoid of any merits and has been filed with a view to malign the credential & reputation of opposite party No. 4 with dishonest intentions to detriment the opposite party No. 4 to the illegal advantage to the complainant. The opposite party No. 4 has denied the other contents of the complaint and prayed for dismissal of the same. Alongwith the written version, the opposite party No. 4 has placed on record affidavit of Harwinder Singh Ex. OP4/1, copy of authority letter Ex. OP4/2, Copy of claim repudiation letter Ex. OP4/3.
4 We have carefully gone through the record and heard Ld. counsel for complainant and opposite parties and written arguments filed by the opposite parties No. 1 to 3.
5 Ld. counsel for the complainant contended that the complainants are legal heirs of deceased Harjinder Singh. On 2.1.2020 deceased Harjinder Singh had road accident. The tempo traveler came from behind which was being driven by some unknown person who was driving the Tempo traveler very rashly and recklessly and hit the bike of Harjinder Singh. The left leg of Harjinder Singh had broken due to fall on the road and got many occult injuries. The said driver ran away with Tempo Traveler from the spot. Harjinder Singh was admitted to the Guru Nanak Dev Multi- specialty Hospital Tarn Taran after arranging the vehicle. Thereafter Harjinder Singh shifted to Fortis Hospital Amritsar. The said incident was witnessed by Shamsher Singh. On 3.1.2020 F.I.R No. 02/2020 under section 279, 338, 337, 427 I.P.C has been registered in respect of unfortunate incident at Police Station Sadar of District Tarn Taran and Shamsher Singh is an author of above said F.I.R. Thereafter Harjinder Singh died on 12.01.2020 in Fortis Hospital during treatment. He further contended that the opposite party No 4 is bank institution and provides banking services to the public as per their requirement. During his life time the deceased Harjinder Singh had opened an account bearing No. 14281050055625 in the bank of opposite party No. 4 and at the time of opening the account the opposite parties had issued master Card “easy shop” bearing Number 5264 1901 3399 2171. The opposite party No. 4 being agent of opposite parties No. 1 to 3 also did insurance policy bearing No. 2999201790009102000 on the basis of master card. He further contended that at the time of issuing the above said master card the opposite parties had given assurance of services of insurance. After the death of Harjinder Singh, the complainant being legal heir has approached many times to the opposite party No. 2 to claim accidental insurance of the complainant vide letter dated 5.1.2022 by stating that “As per verification it is noted that insured was under influence of heroin during incident, Hence this claim is not admissible”, whereas as per post mortem report of the deceased Harjinder Singh cause of death is “ the cause of death in this case in my opinion is Polytrauma specially injury No. 5 which leads to the lungs injury with Septicemia which is vital organ which is sufficient to cause death in ordinary course of nature and complainant prayed that the present complaint may be allowed.
6 Ld. counsel for the opposite parties No. 1 to 3 contended that the claim is not admissible as per Section 5(5) of the policy. “Person being under the influence of alcohol or drugs or narcotics unless professionally administered by a physician or unless professionally prescribed by and taken in accordance with the directions of a Physician.” In view of the facts mentioned above the claim was repudiated and intimation in this regard was given to the complainant vide letter dated 5.1.2022. In the death summary of Fortis Escort Hospital it has been specifically stated that the insured was addicted to Heroin. He further contended that as per the questionnaire to the doctor who had treated he insured when he was first admitted to Guru Nanak Dev Super Specialty Hospital, the insured was under the influence of heroin at the time of accident, therefore, the complainants are not entitled for any claim in view of the terms and conditions of the policy and the claim has been rightly repudiated. Harjinder Singh was insured for the period of 19.5.2019 to 18.5.2020 under Policy No. 2999201790009102000 under the Group Personal Accident Insurance Policy by the opposite parties No. 1 to 3 for benefits as detailed in coverage details of the policy subject to conditions and exclusions of the Policy wordings. The benefits under the policy are governed by the terms and conditions of the policy and the liability of the opposite party is limited to the insured perils occurring within the policy period subject to conditions and exceptions as mentioned in the terms and condition of the policy. The complainant lodged claim under the Group Personal Accident Policy claiming benefits of Accidental Death bearing claim No. RR-CS20-100445862. In the death summary of Forties Escort Hospital, it has been specifically stated that the insured was addicted to Heroin. As per the questionnaire to the doctor who had treated the insured when he was first admitted to Guru Nanak Dev Super Specialty Hospital, the insured was under the influence of Heroin at the time of accident. Both the parties are bound with the terms and conditions of the policy, which are duly supplied to the complainant and no claim can be passed beyond the terms and conditions of the policy. As per the terms and conditions of the policy, the company shall not be liable to pay anything in case the insured person suffers an injury while he is under the influence of alcohol or drugs or narcotics. In view of the facts mentioned above the claim was repudiated and intimation in this regard was given to the complainant vide letter dated 5.1.2022. Ld. counsel for the opposite parties relied upon Export Credit Guarantee Corpn of India Ltd. Vs M/s Garg Sons International, Oriental Insurance Co. Ltd. Vs Sony Cheriyan AIR 1999 SC 3252, Polymat India P. Ltd. Vs National Insurance Co. Ltd. AIR 2005 SC 286, M/s Sumitomo Heavy Industries Ltd. Vs Oil & Natural Gas Company, AIR 2010 SC 3400; Rashtriya Ispat Nigam Ltd. Vs M/s Dewan Chand Ram Saran AIR 2012 SC 2829, Suraj Mal Ram Niwas Oil Mills (P) Ltd. Vs United India Insurance Co. Ltd. 2010 SCC Online SC 1148, Deokar Exports Pvt. Ltd. Vs New India Assurance Company Ltd. AIR 2009 SC 2026, United India Insurance Company Ltd. Vs Harchand Ram Chandan Lal (2004) 8 SCC 644, Aman Kapoor Vs National Insurance Co. Ltd. and Ors 2017 (3) CPJ Page 319 (NC), SGS India Vs Dolphin International Ltd. LL 2021 SC 544, Ravneet Signh Vs KLM Royal Dutch Airlines (2000) 1 SCC 66, Indigo Airline Vs Kalpana Rani Debbarma (2020) 9 SCC 424
7 Ld. counsel for the opposite party No. 4 contended that the present complaint is not maintainable and is liable to be dismissed as the complainant has attempted to misguide and mislead this commission. The complaint is not maintainable and is liable to be dismissed as no cause of action ever arose in favour of complainant and against the opposite party No. 4 to file the present complaint and hence, the complaint under reply is an abuse of the process of law and as such the same is liable to be dismissed exemplary cost. The complainant has created a false story in his complaint to mislead this commission by concocted and distorting the facts and circumstances of the complaint. The present complaint is not maintainable in the present form as no compliance under Section 35(1)(c) of the Consumer Protection Act has been made by the complainants by taking permission from this commission to file a joint complaint. He further contended that the deceased Harjinder Singh being account holder of opposite party No. 4 had a road accident and on 3.1.2020 an FIR No. 02/20 U/s 279, 338, 337, 427 IPC was registered at Police Station Sadar of District Tarn Taran. Thereafter, Harjinder Singh died on 12.1.2020 in Forties Escort Hospital. During the life time of Harjinder Singh, he had opened an account bearing No. 14281050055625 with the opposite party No. 4 Bank and at the time of opening the said account, the opposite party No. 4 had issued Master Card ‘Easy Shop’ bearing No. 5264190133992171 and opposite party No. 4 being the agent of opposite parties No. 1 to 3 did an insurance policy bearing No. 2999201790009102000 on the basis of said Master Card. After the death of DLA, the complainants lodged the claim and the same was repudiated by opposite party No. 2 vide letter dated 5.1.2022 on the ground that as per verification, it was found that insured was under influence of drugs i.e. heroin during the incident, hence the claim is not admissible. The DLA was having a savings account with the opposite party No. 4 bearing No. 142810500556625 and he also applied for the master card and accordingly master card bearing No. 5264190133992171 was issued to DLA. Through the said card, Harjinder Singh was insured by opposite parties No. 1 to 3 under Policy No. 2999201790009102000 under the Group Personal Accident Insurance Policy. He further contended that after the death of the DLA, the complainants lodged the claim with the opposite party No. 4. The opposite party No. 4 further forwarded the documents and lodged the claim with the opposite parties No. 1 to 3. The opposite party No. 4 received a claim reputation letter dated 30.12.2020 whereby the opposite parties No. 1 to 3 repudiated the claim on the ground that the DLA was under influence of heroin when met with the accident. The opposite parties No. 1 to 3 repudiated the claim as per the policy terms and conditions. The opposite party No. 4 has no role to play in adjudicating whether the claim is accepted or denied. There is neither any deficiency in service nor unfair trade practice on the part of the opposite party No. 4 and prayed that the present complaint may be dismissed.
8 The combined and harmonious reading of documents and record is going to prove that deceased Harjinder Singh obtained an insurance policy from the opposite parties No. 1 to 3 and same is not disputed between the parties and it is also not disputed that on 2.1.2020 accident of Harjinder Singh took place. A FIR No. 2/2020 Under Section 279, 338, 337, 427 IPC was registered at Police Station Sadar of District Tarn Taran. Mr. Harjinder Singh i.e. deceased was died on 12.1.2020 during the treatment at Guru Nanak Dev Multispecialty Hospital Tarn Taran. The claim was lodged with the opposite parties Nos. 1 to 3 and same was repudiated by the opposite parties No. 1 to 3 vide repudiation letter dated 5.1.2022 Ex. C-6 on the ground that, As per verification, it is noted that insured was under influence of heroin during incident. No indemnity is available hereunder and no payment will be made by the Company for any claim directly or indirectly caused by , based on, arising out of or however attributable to any of the following: Whilst under the influence of intoxicating liquor or drug; as per police charges or proved medically. But we are not agreed with the version of the opposite parties No. 1 to 3 while repudiating the claim because Harjinder Singh was under the influence of Heroin during the incident, as neither proved by the police charges nor proved medically. A FIR was lodged with the police Station Tarn Taran whereby it was mentioned in the said FIR that the deceased was driving a motorcycle and a tempo traveler came from back side in rash and negligent manner, resultantly, the deceased Harjinder Singh suffered a lot of injuries and during the course of treatment, he died in Guru Nanak Dev Multispecialty Hospital Tarn Taran, hence, the version of opposite parties is not proved in police charges because in the FIR, it is nowhere mentioned that the deceased was under the influence of Heroin and he was driving the motorcycle in a rash and negligent manner.
9 Secondly, the opposite parties No. 1 to 3 have also miserably failed to prove medically that deceased Harjinder Singh was under the influence of Heroin at the time of accident. The opposite parties No. 1 to 3 have placed on record Ex. OP1 to 3/5 i.e. death summary whereby in the column of diagnosis it has been written road side accident with Polytrauma “left side rib fractures, scapula fracture and fracture distal femur, whereas during the course of hospital, it has been written that the patient is known Heroin addict admitted in ER at 07:53 pm. On 08/01/20 with C/o Road side accident on 2.1.2020 at 4.00 pm. H/o chest truma, multiple rib fracture with haemopneumothrox left side and cause of death has been mentioned in the death summary that road side accident with Polytrauma with cardio-respiratory arrest. Moreover, the post mortem report also corroborates the same version. Now it is beyond imagination how the hospital has come to the conclusion that the patient was known heroin addict, who had informed the doctor that the deceased was a Heroin Addict and whose instance the doctor has come to the conclusion that the deceased was a known case of Heroin addiction. Whereas in the column of course in the hospital what was the necessity for the doctor to write that the patient is heroin addict.
10 Moreover, in the post mortem report cause of death is mentioned as road side accident with Polytrauma with cardio-respiratory arrest which has no relation with the cause of death and Heroin addiction. There is no nexus between the cause of death and alleged addiction of drug. Moreover, if the deceased was a drug addict then why it has not been mentioned in the post mortem report. Moreover, there no dope test was conducted to reach the conclusion that the deceased was under the influence of Heroin at the time of accident.
11 The deceased was hit by a tempo traveler which has been clearly mentioned in the FIR report and deceased was not negligent in driving his vehicle. No affidavit has been placed on record of any treating doctor who suggests that the deceased was a Heroin drug addict. In the absence of affidavit of the treating doctor, the plea taken by the opposite parties No. 1 to 3 have no relevance. Reliance in this connection has Manikant Vs. New India Assurance Co.Ltd. 1(2012) CPJ 88 (NC) of the Hon’ble National Commission wherein it has been held that the surveyor did not appear in court and subject himself to cross examination nor was any affidavit filed by him to prove his report . Producing a document in court does not by itself constitute proving the document. It has to be backed by credible evidence. In the instant case, no evidence was led to prove the surveyor’s report in the absence of which the surveyor’s report has little evidentiary value.
12 The opposite party has placed on record only one document i.e. death summary Ex. OP 1 to 3/5, wherein it has been alleged that Patient a known heroin addict admitted in ER ……. The opposite party has to place on record a conclusive document to prove their contention that where and when he has taken the alleged treatment of Heroin Addiction.. In this regard, a reference can be made to the judgment of the Hon'ble National Commission in Revision Petition No. 200 of 2007 "Mr. Satinder Singh versus National Insurance Co. Ltd." decided on 24.1.2011 wherein it has been observed that "recording of history of patient in the above stated manner does not become a substantiate piece of evidence and convincing evidence be brought on record that complainant was aware of preexisting disease.". Further it has been observed by the Hon'ble National Commission in its judgment IV (2008) CPJ 89 (NC) "Life Insurance Corporation of India & Ors. Versus Kunari Devi" that history recorded in the hospital bed head ticket is not to be taken as evidence as Doctor recording history not examined and suppression of disease not proved.
13 Furthermore, It is usual with the insurance company to show all types of green pastures to the customer at the time of selling insurance policies, and when it comes to payment of the insurance claim, they invent all sort of excuses to deny the claim. In the facts of this case, ratio of the decision of Hon’ble Apex Court in case of DharmendraGoel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation. This ‘take it or leave it’, attitude is clearly unwarranted not only as being bad in law, but ethically indefensible. It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. In similar set of facts the Hon’ble Punjab & Haryana High Court in case titled as New India Assurance Company Limited Vs. Smt.UshaYadav& Others 2008(3) RCR (Civil) Page 111 went on to hold as under:-
“It seams that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy. The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5000/- for luxury litigation, being rich.
Moreover, the authorities relied by the opposite parties No. 1 to 3 are not applicable to the present case.
14 The opposite party has failed to prove on record that at the time of accident deceased was under influence of heroin and said accident was taken place due to consumption of Heroin.
15 From the above said decision we have come to the conclusion that the claim of the complainant has been wrongly repudiated by the opposite party Nos. 1 to 3 as they have miserably failed to prove on record that the complainant was drug addicted.
16 During the course of arguments, Ld. counsel for the complainant has placed on record document of HDFC Bank of salary account offer to employees of Punjab State Govt. in which it is specifically mentioned in Para No. 2 as follows:-
“Accidental death cover of Rs. 30 Lakhs (free of cost) (No swipe condition required for both the insurance)”
17 In light of the above discussion, the complaint succeeds and the same is hereby allowed with costs in favour of the complainant. The opposite Parties Nos. 1 to 3 are directed to make the insurance claim of Rs. 30 Lakhs to the complainants. The complainant has been harassed by the opposite parties No. 1 to 3 unnecessarily for a long time. The complainant is also entitled to Rs. 50,000/- as compensation on account of harassment and mental agony and Rs 21,000/- as litigation expenses. Opposite Parties No. 1 to 3 are directed to comply with the order within one month from the date of receipt of copy of the order, failing which the complainant is entitled to interest @ 9% per annum, on the awarded amount, from the date of complaint till its realisation. The present complaint against the opposite party No. 4 is dismissed. The complainants are entitled to the awarded amount as follows:-
Bhupinder Kaur : 50%
Manpreet Singh Bhullar : 50%
Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Commission. Copies of the order be furnished to the parties as per rules. File is ordered to be consigned to the record room.
Announced in Open Commission
16.05.2024
