BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 180 of 2019
Date of Institution : 12.04.2019.
Date of Decision : 18.02.2020.
- Sushma Mehta widow of Shri Harish Mehta,
- Sumit, 3. Prince Mehta sons of Shri Harish Mehta, resident of 104A, D.C. Colony, Sirsa, District Sirsa.
……Complainants.
Versus.
- HDFC Bank, Sangwan Chowk, Sirsa, through its Branch Manager.
- HDFC Ergo General Insurance Company, having its corporate office at First Floor, 165-166, Backbay Reclamation, H.T. Parekh Marg, Church Gate Mumbai- 400020.
...…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SH. R.L.AHUJA…………………………PRESIDENT
SMT. SUKHDEEP KAUR………..…… MEMBER.
Present: Sh. Munish Gupta, Advocate for complainants.
Sh. S.L. Sachdeva, Advocate for opposite party no.1.
Sh. R.K. Mehta, Advocate for opposite party no.2.
ORDER
The case of complainants, in brief, is that complainants no.1 to 3 are legal heirs of deceased Harish Mehta who died in an accident occurred on 18.7.2017 near Milk Pant Begu Road, Sirsa. That Shri Harish Mehta had obtained loan of Rs.6,00,000/- for purchase of Nissan Terrrano Car from op no.1 and he was also availing cash credit limit for his business. That at the time of obtaining the loan, the op no.1 had got Harish Mehta insured from HDFC Ergo General Insurance company limited vide policy no.2950200993684500000 w.e.f. 20.2.2015 to 19.2.2020. The premium of the policy namely Sarv Suraksha Plus was being deducted from the account of Harish Mehta and it was a comprehensive insurance policy which covered the accidental death and permanent total disability to the extent of Rs.5,00,000/- and credit shield insurance, if any. It is further averred that on 18.7.2017 at about 5.30/6.00 a.m., Shri Harish Mehta had gone to his godown of glass near Milk Plant, Sirsa where the glass was being stored. A container containing the glasses which was purchased from Delhi had arrived at the godown which was to be unloaded in the godown and when he was standing near the container for getting it unloaded, then accidently big glass sheets all of a sudden slipped from the truck and fell on Harish Mehta, as a result of which he received serious injuries and he was taken to Shah Satnam Hospital but he succumbed to the serious injuries on the way to hospital. That in the meanwhile sons of Harish Mehta also reached on the spot and took the photographs and recording of the spot and lot of blood and broken glass were depicted. It is further averred that complainants were not in the knowledge of the policy and the loan and later on when the bank approached the complainants for recovery of loan, then the complainants came to know regarding factum of insurance policy having been obtained by op no.1 and accordingly the complainant immediately lodged a claim with op no.2 through op no.1. It is further averred that op no.2 also deputed Shri Balram Sharma as Investigator who visited on 30.3.2018 and inspected the spot and made through investigations regarding cause of death as well as legal heirs of Harish Mehta. The investigator also recorded statements of nearby persons and obtained ambulance log books and assured that he would submit the report to the insurance company and would get the claim settled. That to the surprise of complainant, op no.2 again deputed another surveyor Rajesh Kumar who visited on 10.6.2018 and again conducted the investigation and he also assured that claim would be settled. That inspite of lodging of claim since long back, the ops have not responded and have not settled and paid the claim despite the fact that complainants are entitled to accidental death benefit arising out of accidental death of Shri Harish Mehta and also the benefit under credit shield provided under the said policy and on the other hand, op no.1 has started debiting the account of Mehta Glass for recovery of installments of the car loan. That complainants have been approaching the ops and requesting them to pay the death claim as per the policy and also to refund amount of installments which have been illegally deducted but the ops have been putting off the complainants with one pretext or the other and have been lingering on the matter without any rhyme or reason. That a notice was also served to the ops on 22.2.2019 which has been duly received by ops, but the ops have not given any reply of the same nor the bank has lodged the claim of the complainants with the insurance company. Hence, this complaint.
2. On notice, opposite parties appeared. Op no.1 filed reply raising certain preliminary objections. It is submitted that husband of complainant namely Sh. Harish Mehta had approached the branch of the answering op and had sought extension of finance facility for purchase of vehicle model Nissan Terrano XED. He being a businessman offered the finance facility under the auto loan scheme of the answering op. Accordingly, agreement no. 31496858 dated 14.2.2015 was executed at Sirsa between the husband of complainant and answering op and an amount of Rs.5,97,188/- was disbursed for a period of five years which was to be paid by the borrower in 60 monthly equated installments of Rs.13,110/-. There is a default in the aforesaid loan account and at present an amount of Rs.1,46,909/- is due on account of installments accrued and became due as on 27.7.2019. However, in case of default, the Bank has a right to recall the whole loan amount and as on 27.7.2019, an amount of Rs.2,41,402.33 is lying outstanding in lieu of the total liability of the borrower as per the foreclosure statement in the aforesaid loan account and the complainant being the borrower is legally bound to pay the aforesaid amount alongwith interest and other charges as per the terms and conditions of the loan agreement. In addition to this, the complainant is under obligation to pay the aforesaid amount of loan i.e. amount of future installment to the answering op. It is further submitted that in case of default, the complainant is also liable to pay penal charges on the defaulted amount as per terms and conditions of the loan agreement alongwith installment bouncing charges etc. It is further submitted that complainant and other legal heirs of the deceased borrower are also abide by the terms and conditions of the loan agreement. That answering op has got no concern whatsoever with the availing of insurance policy by the husband of complainant. It is being laid straight that the answering op represent a company involved in the business of banking operations and has no insurance business being conducted by it. It is submitted that grievance of complainant is with regard to the deficiency in service on the part of op no.2 and present complaint is bad for mis joinder of parties and answering op is not privy to any contract of insurance. It is further submitted that complainants did not give complete particulars of CC limit. That merely because the payment of the insurance tribunal had been paid from an account maintained by the husband of complainant with answering op is not sufficient to hold that there had been any deficiency whatsoever on their part. It is further submitted that answering op has charged nothing from Harish Mehta on account of insurance policy as alleged and there is no liability of answering op. Remaining contents of complaint are also denied to be wrong and prayer for dismissal of complaint against op no.1 has been prayed for.
3. Op no.2 filed written statement taking certain preliminary objections. It is submitted that no deficiency of service can be attributed to answering op no.2 in declining the present claim and closing of the claim file of the insured as ‘No claim’. The acts of the insurance company in closing the claim file of the complainant are legal, justified and bonafide one and are based upon the insurance contract and terms and conditions and exclusion clauses of the policy cover obtained by the insured. That total fault lies upon the part of insured. The insured failed to comply with the contractual obligations and did not co-operate with the insurance company and did not comply with the formalities and necessities and did not submit the desired requisite documents and information inspite of repeated request, letters. It is further submitted that insurance policy has been obtained by concealment of material facts and insurer has not complied with all the terms and conditions of the insurance policy. That op no.2 sent letters dated 22.8.2017, 1.9.2017, 15.9.2017, 28.9.2017 to the complainant to supply requisite documents viz. duly filled and signed claim form, passport, pan card, aadhar card (KYC documents), bank details, cancelled cheque of nominee, copy of FIR and inquest panchnama, copy of PMR and chemical viscera report, death certificate from government authority, treating doctors certificate giving details of injuries and cause of death, but the complainants failed to supply the aforesaid documents to the op no.2, therefore, the op no.2 closed the claim of complainant. Remaining contents of complaint are denied to be wrong and prayer for dismissal of complaint made.
4. The parties then led their respective evidence.
5. We have heard learned counsel for the parties and have gone through the record carefully.
6. The complainants in order to prove their complaint have furnished affidavit of Smt. Sushma Mehta complainant as Ex.CW1/A in which she has deposed and reiterated all the averments made in the complaint and have also furnished affidavit of Sh. Gobind Singh Ex.CW2/A, affidavit of Sh. Gagandeep Ex.CW3/A. They have also furnished copy of policy schedule Ex.C1, copy of death certificate of Harish Mehta Ex.C2, copy of statement of account Ex.C3, copy of statement of account Ex.C4, copy of entry of log book Ex.C5, copy of courier receipt Ex.C6, copy of receipt Ex.C7, copy of claim form Ex.C8, Ex.C9, copy of legal notice Ex.C10, postal receipts Ex.C11, Ex.C12 and photographs Ex.C13 to Ex.C17. On the other hand, op no.1 has furnished affidavit of Sh. Mohinder Sharma, Senior Manager Law Ex.RW1/A, copy of letter Ex.R1, copy of statement of account Ex.R2 and Ex.R3. Op no.2 has furnished copies of letters ExR4 to Ex.R7.
7. During the course of arguments, Sh. R.K. Mehta, learned counsel for op no.2 has contended that complainants have not supplied the requisite documents despite their repeated letters of request as a result of which they closed claim of complainants due to non supply of documents. On the other hand, learned counsel for complainants has strongly contended that they have already supplied copies of all the requisite documents which were available with them.
8. Keeping in view the facts and circumstances of the present case, it will be in the fitness of things, if present complaint is partly allowed and a direction is given to complainants to supply necessary documents to the op no.2 insurance company and thereafter direction is given to the insurance company i.e. op no.2 to settle and pay the claim of complainants.
9. In view of above discussion, we partly allow this complaint and direct the complainants to supply the documents as detailed in Ex.R4 to Ex.R7 to the insurance company within 15 days from the date of receipt of copy of this order and thereafter op no.2 is directed to settle and pay the claim of complainants as per terms and conditions of the policy within 45 days after receipt of necessary documents. It is however made clear that in case documents like copy of FIR, post mortem report and treating doctors certificate are not available with complainants, then complainants will furnish an affidavit to this effect that they are not having these documents and will give the reason for not having the same in their possession. It is further made clear that in case claim is settled and payment is made by insurance company to the bank who had advanced loan to the deceased Harish Mehta, then bank is directed to settle outstanding amount towards loan amount and will make refund of the amount to the complainants, if any amount is found excess to the loan amount. No order as to costs. A copy of this order be supplied to the parties as per rules. File be consigned to the record room.
Announced in open Forum. Member President,
Dated:18.02.2020 District Consumer Disputes
Redressal Forum, Sirsa.
