BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, KAITHAL.

Complaint no.283/12.

Date of instt.: 06.11.2012. 

                                                 Date of Decision: 16.10.2015.

Angrejo Devi aged 46 years, wife of late Karambir Singh son of Suraj Bhan, resident of Village Rohera, Tehsil and District Kaithal.

                                                        ……….Complainant.      

                                        Versus

1. Haryana Gramin Bank, Kaithal, through its Branch Manager.

2. Bajaj Allianz, Life Insurance Company Ltd., G.E. Plaza, Airport Road Yerwada, Pune-411006, through its Branch Manager.

..……..Opposite Parties.

COMPLAINT UNDER SEC. 12 OF CONSUMER PROTECTION ACT, 1986.

Before:           Sh. Jagmal Singh, President.

                        Sh. Rajbir Singh, Member.

     Smt. Harisha Mehta, Member.

Present :        Sh. Sunder Singh Malik, Advocate for complainant.

Sh. R.K.Nagpal, Advocate for the opposite party.No.1.

Sh. C.S.Kala, Adv. for Op No.2.

                       ORDER

(JAGMAL SINGH, PRESIDENT).

                       The complainant has filed the present complaint under Section 12 of Consumer Protection Act, 1986, with the averments that the husband of complainant namely Sh. Karambir Singh got himself insured with the Op No.2 through Op No.1 vide registration No.0119486435, Membership No.9995061299 and application No.HGB025108 dt. 23.01.2009.  It is alleged that on 03.08.2011, Sh. Karambir Singh, husband of complainant died due to heart attack which is a natural death.  Information regarding death was given to the Ops.  It is further alleged that the complainant applied for necessary compensation with the Ops but the Ops failed to pay the same.  This way, the Ops are deficient in service.  Hence, this complaint is filed.   

2.     Upon notice, the opposite parties appeared before this forum and filed written statement separately.  Op No.1 filed written statement raising preliminary objections with regard to maintainability; cause of action; locus-standi; jurisdiction.  There is no deficiency in service on the part of answering Ops.  On merits, it is stated that the husband of complainant Sh. Karambir Singh never got himself insured with the Op No.2 through Op No.1.  The other contents of complaint are denied and so, prayed for dismissal of complaint.    

3.     Op No.2 filed written statement raising preliminary objections with regard to maintainability; cause of action; locus-standi; that the complaint of the complainant against the answering Op No.2 is hopelessly pre-mature as no intimation of alleged death of Mr. Karambir was ever given to the answering respondent either by the complainant or the policy-holder as required under the terms and conditions of the Certificate of Insurance & Group Master policy administered by the Haryana Gramin Bank.  Thus, the respondent insurance company had no opportunity to examine the admissibility of death claim under the policy as per the terms and conditions of the contract of insurance; that no cause of action has arisen in favour of the complainant against the Op No.2 as the alleged death of Mr. Karambir was never intimated to the answering Op and no proof of death and other mandatory claim papers/documents/requirements were ever submitted by the complainant to enable the respondent insurance company to ascertain the bonafides of the claim.  There is no deficiency in service on the part of answering Op.  On merits, the contents of complaint are denied and so, prayed for dismissal of complaint.    

 4.    In support of his case, the complainant tendered in evidence affidavit Ex.P4 and documents Ex.P1 to Ex.P3 and closed evidence on 12.02.2014.  On the other hand, the Op No.1 tendered in evidence affidavit Ex.RW1/A and closed evidence on 28.04.2015.  Op No.2 tendered in evidence affidavit Ex.RW2/A and documents Ex.R1 to Ex.R2 and closed evidence on 26.05.2015.  

5.     We have heard ld. counsel for both the parties and perused the case file carefully and minutely and have also gone through the evidence led by the parties.

6.     Ld. Counsel for the complainant argued that the husband of complainant namely Sh. Karambir Singh got himself insured with the Op No.2 through Op No.1 vide registration No.0119486435, Membership No.9995061299 and application No.HGB025108 dt. 23.01.2009.  The said Karambir Singh died on 03.08.2011 due to heart attack, which is a natural death.  He further argued that the complainant is nominee of insured Karambir Singh (since deceased).  He also argued that after the death of Karambir Singh, the complainant applied for necessary compensation with the Op No.2 but the Op No.2 failed to pay the same.  On the other hand, ld. Counsel for Op No.2 argued that the complaint against the Op No.2 is pre-mature as no intimation of alleged death of Karambir Singh was given.  He did not deny the factum of insurance but he argued that the complainant has not given the intimation within 180 days of the death.  So, he violated the terms and conditions of the insurance policy.  He further argued that the contract of insurance was entered into between the parties Haryana Gramin Bank and the answering Op No.2 under Group Master Policy No.0119486435 and no contract was entered into between the complainant and Op No.2.  Ld. Counsel for Op No.1 argued that the branch of Haryana Gramin Bank, Kaithal was not in existence at the time when the insurance policy was issued and the insurance policy has been issued through Haryana Gram Bank, Rajound.  So, the Op No.1 has no connection with the case.

7.     From the facts and circumstances of the case, we are of the considered view that from the copy of policy Ex.P1, it is clear that Karambir Singh was insured with the Op No.2 through Haryana Gramin Bank, Rajound.  As per complaint, the information regarding death of her husband was given to representatives of the Ops but according to Op No.2, no intimation was given within 180 days from the date of death as per terms and conditions of the policy.  The husband of complainant got insurance policy through the Haryana Gramin Bank and he was a member of Group Insurance but the complainant may not be known about the terms and conditions of the insurance policy.  The factum of insurance has not been denied by the Op No.2.  When the husband of complainant got the insurance policy, wherein the complainant is the nominee, so, she is entitled for the insurance amount.

8.     Therefore, in view of above discussion, we allow the complaint qua Op No.2 and direct the Op No.2 to make the payment of insured amount i.e. Rs.1,25,000/- to the complainant after getting completed its formalities and further to pay Rs.2200/- (Two thousand and two hundred) as lump sum compensation on account of harassment, mental agony and costs of litigation charges.  The complainant is directed to complete the formalities of Op No.2.  Thereafter after the completion of formalities by the complainant, the order be complied within 30 days, failing which, the complainant shall be entitled interest @ 8% p.a. on the awarded amount from the date of commencement of this order till its payment.  A copy of this order be sent to both the parties free of costs.  File be consigned to the record room after due compliance.

Announced.

Dt.16.10.2015.

                                                                (Jagmal Singh),

                                                                President.

                (Harisha Mehta),     (Rajbir Singh),       

                        Member.         Member.