Punjab

Fatehgarh Sahib

CC/61/2016

kushalya Devi - Complainant(s)

Versus

HDFC Bank LTD. - Opp.Party(s)

Sh. Ram Gopal Sharda

01 Sep 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FATEHGARH SAHIB.

                      Consumer Complaint No.61 of 2016

                                                            Date of institution:  09.06.2016                                   

                                                           Date of decision  :   01.09.2017

 

1.           Kushalya Devi aged 62 years widow of Sh. Mange Ram Sharma,
2.           Pankaj Sharma, aged 22 years son of Sh. Mange Ram Sharma,

Both resident of H.No.29, Sec 5-C, New Shastri Nagar, Mandi  Gobindgarh, Tehsil Amloh, District Fatehgarh Sahib.

 

……..Complainants

Versus

 

1. HDFC Bank Ltd., branch Mandi Gobindgarh, Tehsil Amloh, District Fatehgarh Sahib, through its Manager.
2. HDFC Bank Ltd., HDFC Bank House, Senapati Bapat Marg, Lower Parel(West) Mumbai-400013 through its directors.
3. HDFC ERGO General Insurance Company Ltd., Customer Service Office, 6^th Floor, Leela Business Park, Andheri Kotla Road, Andheri East, Mumbai, through its director.
4. HDFC ERGO General Insurance Company Ltd., First Floor, HDFC House, 165-166, Backway Reclamation, H.T.Parekh Marg, Church Gate, Mumbai.

 …..Opposite Parties

Complaint under Section 12  of the Consumer Protection Act 1986.

 

Quorum

Sh. Ajit Pal Singh Rajput, President                                

 Sh. Inder Jit, Member     

                                               

Present :        Sh. R.G.Sharda, counsel for complainant.

                      Sh. B.S.Randhawa, Adv.Cl. for OPs No.1 & 2

                      Sh. Sumit Gupta, Adv.Cl. for OPs No. 3 & 4.

ORDER

By Ajit Pal Singh Rajput, President.

                      Complainants, Kushalya Devi and Pankaj Sharma,  both resident of H.No.29, Sec 5-C, New Shastri Nagar, Mandi  Gobindgarh, Tehsil Amloh, District Fatehgarh Sahib, have filed this complaint against the Opposite parties (hereinafter referred to as “the OPs”) under Section 12 of the Consumer Protection Act. The brief facts of the complaint are as under:

2.                   Sh. Mange Ram Sharma, husband of complainant No.1 and father of complainant No.2, had expired on 22.07.2015. After the death of Late Sh. Mange Ram, the complainants came to know that he had availed a loan facility from OP No.1 against the Car bearing No.PB48C-9514. At the time of availing the loan facility, OP No.1 induced the husband of complainant No.1 that they can secure the four wheeler loan through insurance policy from their allied concern i.e. OP No.2 and also induced him to pay the premium of the said policy. OP No.1 assured that in case of any mis-happening, the loan will remain secure to the extent of outstanding at the time of such mis-happening. On believing their representations to be true and correct late Sh. Mange Ram Sharma agreed to pay one time premium amount of Rs.5493/- regarding the said policy to OP No.2 through OP No.1. OP No.2 issued policy bearing No.295020857400400000 dated 19.09.2014 w.e.f 19.09.2014 to 18.09.2018. At the time of death of the husband of complainant No.1, the said policy was  in force and is still in force. The complainants after the death of late Mange Ram Sharma, time and again visited the office of OP No.1 and requested to lodge claim with OP No.2, since OP No.1 is the agent of OP No.2, but they are putting off the matter on one pretext or the other and pressurized the complainants through other legal notices to deposit the dues, rather than claiming the same from OP No.2.  Thereafter, the complainants as per the requirement, lodged the claim of the said policy with OP No.2 but both the OPs in connivance with each other and with malafide and dishonest intention had repudiated the claim lodged by the complainants on flimsy grounds without verifying the facts and investigating the matter. The complainants also served legal notice on the OPs but in vain. The act and conduct of the OPs amounts to deficiency in service on their part. Hence, this complaint for directing the OPs to pay the outstanding amount of Rs.190191.66 paise as on 08.02.2016, being principal amount along with interest and bank charges upto date, besides Rs.50,000/- as compensation for mental and physical torture, harassment and mental agony, Rs.5,000/- as litigation expenses.

3.                   The complaint is contested by the OPs. In reply to the complaint, OPs No.1 & 2, who filed joint written reply, raised certain preliminary objections, inter alia, that the complainant is not a consumer within the meaning of Section 2(1)(d) of the Consumer Protection Act 1986; the present complaint is not maintainable before this Forum, as the vehicle in question was being used by the borrower for his business/commercial purpose and the present complaint is false, frivolous and vexatious, thus liable to be dismissed under Section 26 of the Consumer Protection Act. As regards the facts of the complaint, OPs No.1 & 2 stated that they have settled both the loan accounts of the vehicle in question with the complainants by giving huge amounts of waivers. In loan account No.29735081, an amount of Rs.2,07,183.33 paise was outstanding but the same was settled in 1,21,500/- and in the other loan account No.17535702 an amount of Rs.11,492/- was outstanding and the same was settled in Rs.8,500/-. Neither any claim has been lodged with OPs No.1 & 2, nor they have repudiated the claim as alleged, rather OPs No.3 & 4 have repudiated the claim. OPs No.1 & 2 are bank, who had given the finance to Late Mange Ram Sharma and being banker is duty bound to recover the finance amount. OPs No.1 & 2 have nothing to do with claim of the complainants. There is no deficiency in service on their part. After denying the other averments made in the complaint, OPs No. 1 & 2 prayed for dismissal of the complaint.

4.                   In reply to the complaint OPs No.3 & 4 raised certain preliminary objections, inter alia, that the present complaint is false, frivolous, vague and vexatious in nature; the complaint is devoid of any material particulars and has been filed merely to harass and gain undue advantage and unjustified money from the OPs and the present complaint is liable to be dismissed due to mis-joinder of necessary parties. As regards the facts of the complaint, the deceased Mr. Mage Ram Sharma had availed Sarv Suraksha Policy from OPs No. 3 & 4, vide policy number 2950200857400400000 and the policy was issued subject to the terms and conditions mentioned therein. The claim was lodged by the widow of the insured, claiming benefits under Critical Illness cover under the policy as the insured had suffered Heart Attack. Thereafter, the claim was processed as per norms and terms and conditions of the policy and it was found that the insured had unfortunately suffered with heart attack on 22.07.2015 and died on the same day. However, for a claim under Critical Illness to be admissible, the insured person has to survive for a period of 30 days from the date of diagnosis of any Critical Illness as listed under the policy.  Since the losses claimed under critical illness are not covered as per the above policy wording, therefore the claim of the complainant was repudiated vide letter dated 07.01.2016 as per terms and conditions of the policy.  The present complaint is filed praying for outstanding loan amount which is payable under Credit Shield coverage of the policy. It is further stated that the claim under Credit Shield was never lodged but it is an afterthought. However, the claim under Credit Shield cover of the policy is applicable only in case of accidental death. The claim of the complainants has been rightly repudiated by the OPs. Hence, there is no deficiency in service on their part. After denying the other averments made in the complaint, OPs No.3 & 4 prayed for dismissal of the complaint.

5.                   In order to prove their case, the complainants tendered in evidence affidavit of Pankaj Sharma Ex. C-1, attested copies of documents Ex. C-2 to Ex. C-10, legal notice Ex. C-11, postal receipts Ex. C-12 to C-15, reply to legal notice Ex. C-16, affidavit of  Kushalya Devi, Ex. C-17 and closed the evidence. In rebuttal OPs No.1 & 2 tendered in evidence affidavit of Deepdepinder Singh Assistant Manager Ex. OP1/1, true copies of documents i.e. power of attorney Ex. OP1/2, statement of account Ex. OP1/3 and Ex. OP1/4 and closed the evidence. OPs No. 3 & 4 tendered in evidence affidavit of Pankaj Kumar Ex. OP3/1, true copy of terms and conditions Ex. OP3/2,  copy of repudiation letter Ex. OP3/3, copy of claim form Ex. OP3/4, copy of adhaar card Ex. OP3/5, copy of death certificated Ex. OP3/6, copy of death summary Ex. OP3/7, copy of form No.4 Ex. OP3/8, copy of PAN card of deceased Ex. OP3/9, copy of policy schedule Ex. OP3/10, copy of letters by HDFC Bank regarding closure of claim Ex. OP3/11 and OP3/12, copy of reminders regarding supply of documents Ex. OP3/13 to Ex. OP3/15 and closed the evidence.

6.                   The ld. counsel for the complainant has submitted that the main controversy involved in the present complaint is that the opposite parties repudiated the claim, vide letter dated 07.01.2016, without any reasonable cause by stating that insured person has to survive for a period of 30 days from the date of diagnosis of any Critical Illness.  The husband of the complainant was never suffering from the alleged disease and before issuing the policy, opposite parties inquired each and every fact and after being fully satisfied issued the insurance policy. Learned counsel also submitted that the claim of the complainant has been rejected in an arbitrary manner and the complainant had to undergo unnecessary harassment at the hands of the OPs. Learned counsel argued that the OPs have committed gross deficiency in service and the complainant deserves to be compensated for the same. Learned counsel relied upon the case law titled as Iffco Tokio General Insurance Company Ltd. Vs. Permanent Lok Adalat, in 2012(1) R.C.R.(Civil)901.

7.                   On the other hand, learned counsel for OPs No. 1 & 2 submitted that the claim had neither been lodged with OPs No.1 & 2 nor they repudiated the claim, rather OPs No.3 & 4 had repudiated the claim. He pleaded that the matter had been settled with regard to the loan case of the deceased Mange Ram Sharma on 17.08.2016, thus the present complaint qua  OPs No.1 & 2 deserves to be dismissed.

8.                    Learned counsel for OPs No. 3 & 4 stated that the claim of the complainant had rightly been repudiated keeping in view the terms and conditions of the Policy. He further stated that the insured had unfortunately suffered attack on 22.07.2015 and died on the same day. Learned counsel pleaded that as per the policy if the insured had survived for 30 days after the attack, the OP were liable to pay the claim. He further pleaded that the claim was repudiated keeping in view the Specific Exclusion applicable to Section-1: “If the insured person named in the schedule is diagnosed as suffering from a Critical illness which first occurs or manifests itself during the Policy period, and the insured survives for a minimum of 30 days from the date of diagnosis, the company shall pay the Critical Illness Benefit”.

Learned counsel also pleaded that no claim under credit shield was lodged by the complainant nor the complainant has placed any material document to prove his entitlement for the same. He also placed reliance on the case laws, titled as "Vikram Greentech (I) Ltd. and another Vs. New India Assurance Co. Ltd. 2009(4) CLT 313" and further in case titled as "Deokar Exports Pvt. Ltd. Vs. New India Assurance Co. Ltd. 2009(2) CLT 15". It was held in the said case laws that "In a contract of insurance, rights and obligations are strictly governed by the policy of insurance- No exception or relaxation can be made on the ground of equity". The Ld. counsel further relied on the case law titled as LIC of India and others Vs. Mahendra Singh 2011(4) CLT 39 and it was held by the Hon'ble National Commission that " The terms of policy are in the nature of a contract and their interpretation has to be made in accordance with the strict construction of the contract- Thus, the words in an insurance contract must be given paramount importance and interpreted as expressed without any addition, deletion or substitute".

9.         After hearing the Ld. Counsel for the parties and going through the pleadings, evidence produced by the parties and the oral arguments and written submissions, we find force in the submissions made by the ld. counsel for the OPs. In our opinion the claim of the complainant had been repudiated mainly on the ground that as per the terms and conditions of the policy, Ex.OP-3/2, the insured person has to survive for a period of 30 days from the date of diagnosis of any Critical Illness. Complainant has not been able to place on record any material in support of her contentions. With regard to OPs No. 1 & 2, it is established that the loan amount had been settled between the parties and OPs No. 1 & 2 had no concern with regard to repudiation of claim. In our opinion the case law citied by the learned counsel for the complainant are not applicable to the facts of the present case.

10.       Accordingly, in view of aforesaid discussion and the judgments citied by the learned counsel for OPs No. 3 & 4 in Mahendra Singh's & Vikram Greentech (I) Ltd.'s cases(Supra),we find that OPs have not committed any deficiency in service as the claim of the complainant was repudiated keeping in view the terms and conditions of the policy. Thus the present complaint is hereby dismissed being devoid of any merits against the OPs. Parties to bear the costs.  

11.       The arguments on the complaint were heard on 18.08.2017 and the order was reserved. Now the order be communicated to the parties. Copy of the order be sent to the parties free of cost and thereafter the file be consigned to the record room.

Pronounced

Dated: 01.09.2017

(A.P.S.Rajput)

President

 

(Inder Jit)       

      Member