For complainant                      Sh. H.S. Sandhu Advocate

For Opposite Party No.1:                 Sh. R.P. Singh Advocate

For Opposite Party No.2:       Sh. A.K. Mehta Advocate

A.K. Mehta, President

1        Complainants Dalbir Kaur and others have filed the present complaint under section  12 sand 13 of the Consumer Protection Act (herein-after called as ‘the Act’) against (i) HDFC Ergo General Insurance Company Limited, HDFC House, Ist Floor, 165-166, Backbay Reclamation, H.T.Parkh Marg, Churchgate, Mumbai-400020 through its MD (herein-after called as ‘Opposite Party No.1-Insurance Company’) and (ii) HDFC Bank Limited, Branch College Road, Khadoor Sahib, Tarn Taran through its Manager (herein-after called as ‘Opposite Party No.2-Bank’) on the allegations of deficiency in service, negligence and unfair trade practice by Opposite Parties with  further prayer to direct Opposite Party No.1-Insurance Company to pay the insurance claim of Rs.3,25,000/- to the complainants and  Rs.50,000/- as compensation on account of  harassment and mental agony, etc and Rs.20,000/- as litigation expenses.

2        The case of the complainants in brief is that the complainants are the legal heirs of deceased Rajbir Singh son of Hardeep Singh who was working with Bureaus Facilities Services Private Limited as security supervisor and died in road accident on 27.12.2015; that Rajbir Singh purchased motor cycle make Hero, model Splendor from Param Motors, Khadoor Sahib vide challan No. 363 dated 16.12.2015 and paid Rs.16,000/- in cash to Param Motors, Khadoor Sahib and Rs.42,000/- by availing loan from Opposite Party No.2-Bank and was going on the said motorcycle when accident took place on 27.12.2015 and Rajbir Singh died; that Opposite Party No.2-Bank as per its policy of securing loan insured Rajbir Singh with accidental life insurance with insurance cover  of Rs.2 lacs for accidental death and Rs.25,000/- as loss of job and householders coverage of Rs.1 lac and as such, total amount of Rs.3,25,000/- as insurance cover was provided by Opposite Party No.2-Bank through policy of Opposite Party No.1-Insurance Company having No.2950 2012 8299 0900 000 for which he paid premium of Rs.791/- which was obtained by Opposite Party No.1-Insurance Company through Opposite Party No.2-Bank vide transfer from the loan account of Rajbir Singh maintained by Opposite Party No.2-Bank; that  the motor cycle was also insured with ICICI Lombard and premium of Rs.1634/- was paid by Rajbir Singh deceased to Param Motors i.e.dealer of the motor cycle on the day of purchase of motor cycle i.e. 16.12.2015; that unfortunately Rajbir Singh died in a road accident on 27.12.2015 and DDR No. 11 dated 28.12.2015 was registered at P.S.Verowal under section 174 Cr.P.C. and other required formalities were also completed by the police; that the complainants approached Opposite Party No.2-Bank to lodge the insurance claim for the policy which was issued by Opposite Party No.1-Insurance Company through Opposite Party No.2-Bank and Opposite Party No.2-Bank sent intimation to Opposite Party No.1-Insurance Company after receiving the death certificate, report under section 174 Cr.P.C, post mortem report and  other relevant documents from the complainants and forwarded these documents to Opposite Party No.1-Insurance Company on 10.1.2016; that the Opposite Party No.2-Bank informed the complainants that the claim has been lodged with Opposite Party No.1-Insurance Company and Opposite Party No.1-Insurance Company had issued reference No. 3538318 to the case of the complainants; that Opposite Party No.2-Bank assured the complainants that the claim will be released to the complainants within a week, but inspite of serving legal notice dated 23.2.2016 through registered post on 24.2.2016, the claim was not released to the complainants nor any reply to the legal notice was given by Opposite Party No.1-Insurance Company inspite of many requests of the complainants.   Hence the complaint was filed.          

3        After formal admission of the complaint, notice was sent to both the Opposite Parties and Opposite Party No.1-Insurance Company  appeared through counsel and filed written reply contesting the complaint on the preliminary objections that the complaint is not legally maintainable  and the claim has not been lodged with the answering Opposite Party by the complainants and as such, the complainants have filed the complaint without any cause of action and the complainants have concealed the material facts from the Forum as the complainants had never lodged any claim with answering Opposite Party till date, nor any claim has been registered nor any intimation of the claim was given to the answering Opposite Party and these facts have been concealed by the complainants and the complaint is liable to be dismissed; that as per the terms and conditions of the policy, the complainants were required to intimate the answering Opposite Party immediately after the occurrence, but till date, the complainants have not intimated the answering Opposite Party regarding the loss, therefore, the complaint is not maintainable against answering Opposite Party; that the complainants have no locus standi to file the present complaint. On merits, it was denied if Opposite Party No.2-Bank sent any information to the answering Opposite Party nor any documents were supplied to answering Opposite Party nor any claim has been lodged by the complainants or by Opposite Party No.2-Bank with answering Opposite Party. It was denied if any legal notice has been received by answering Opposite Party and as no claim has been lodged with answering Opposite Party, therefore, the question of release of the claim does not arise; that as per the terms and conditions of the policy, the complainants were required to intimate the answering Opposite Party immediately after the occurrence, but intimation has not been given to the answering Opposite Party by the complainants.  All other allegations mentioned in the complaint were also denied  by the answering Opposite Party being wrong and  incorrect and also for want of knowledge and a  prayer was made for dismissal of the complaint.

4.       Opposite Party No.2-Bank also appeared through  counsel and filed written version contesting the complaint on the preliminary objections that the complaint is not legally maintainable against answering Opposite Party as the answering Opposite Party is at liberty to recover the outstanding loan amount and has no concern to release any amount of the insurance as answering Opposite Party is doing the business of banking and not of insurance and policy of insurance was also issued by Opposite Party No.1-Insurance Company and not by answering Opposite Party; that the complainants have no locus standi or cause of action to file the complaint against answering Opposite Party and the complainants have not approach the Forum with clean hands and have suppressed the true and material facts. It was asserted that Rajbir Singh deceased was   given loan of Rs.42,000/- for the purchase of motor cycle and loan account was opened in his name and deceased himself voluntarily obtained the life insurance policy from Opposite Party No.1-Insurance Company and as per the directions of deceased to Opposite Party No.2-Bank, Opposite Party No.2-Bank has paid premium to Opposite Party No.1-Insurance Company regarding the said life insurance policy obtained by deceased from Opposite Party No.1-Insurance Company and except this role, Opposite Party No.2-Bank has no concern with the policy obtained by deceased, though on receipt of death claim from the complainants, the answering Opposite Party sent the claim to Opposite Party No.1-Insurance Company and it is for Opposite Party No.1-Insurance Company to verify the claim and documents and to pay or reject the claim and as such, the complaint against answering Opposite Party is liable to be dismissed; that the complainants are not the consumers of Opposite Party No.2-Bank and does not fall under the definition of consumer. On merits, it was admitted that the complainants are legal heirs of Rajbir Singh deceased who died in road accident on 27.12.2015 and was working as security supervisor.  It was submitted that the deceased purchased the motor cycle from Param Motors and paid the down payment of Rs.16,000/- and availed the loan of Rs.42,000/- from replying Opposite Party after completing all the formalities and the said loan amount alongwith all other dues and interest is still outstanding in the loan account of the deceased and the complainants being the legal heirs of deceased Rajbir Singh are liable to pay the outstanding loan amount. It is further submitted that the complainants submitted the documents for claim which were forwarded by the replying Opposite Party to Opposite Party No.1-Insurance Company and it is Opposite Party No.1-Insurance Company who after the verification and survey is to pass or reject the claim. It is denied that answering Opposite Party is guilty of inefficiency, negligence, unfair trade practice by not releasing the claim amount.  All other allegations mentioned in the complaint were also denied  by the answering Opposite Party being wrong and  incorrect and a  prayer was made for dismissal of the complaint.

5        Sufficient opportunities were granted to the parties to lead evidence in order to prove their respective case. The complainants tendered in evidence affidavit of Rajbir Kaur complainant Ex. C-1 alongwith documents Ex. C-2 to Ex. C-12 and closed the evidence. The opposite party No. 1 tendered in to evidence affidavit of Pankaj Kumar Manager Ex. OP1/1 and closed the evidence. The Opposite party No. 2 tendered in to evidence affidavit of Vikas Kalia Branch Manager Ex. OP1/2 and closed the evidence.  

6        We have heard the Ld. counsel for the parties and gone through the evidence and documents produced by the parties on the file.
7        Ld. counsel for complainant contended that complainant are the legal heirs of Rajbir Singh being mother, widow and children of Rajbir Singh. He contended that Rajbir Singh purchased motorcycle from Param Motors Khadur Sahib and paid Rs. 16,000/- as down payment and remaining amount of Rs. 42,000/- by availing loan. He contended that as per policy Opposite Party No.2-Bank got Rajbir Singh insured from Opposite Party No.1-Insurance Company which is sister concern of Opposite Party No.2-Bank and the insurance cover of Rs. 2,00,000/- for accidental death and cover of Rs. 25,000/- for loss of job and cover of Rs. 1,00,000/- for house hold coverage i.e. total cover amount of Rs. 3,25,000/-. He contended that Opposite Party No.2-Bank sent the premium of Rs. 791/- to Opposite Party No.1-Insurance Company vide transfer from loan account of Rajbir Singh. He contended that Rajbir Singh died in road accident on 27.12.2015 when he was going on the motorcycle which he purchased from Param Motors and died at the spot. He contended that complainant contacted the Opposite Party No.2-Bank and requested for lodging report with Opposite Party No.1-Insurance Company. He further contended that police registered D.D.R. No. 11 dated 28.11.2015 regarding the accidental death of Rajbir Singh and also conducted proceedings under Section 174 Cr.P.C and completed the other formalities and sent the dead body for post mortem examination. He contended that the complainant sent the intimation to Opposite Party No.2-Bank alongwith death certificate, report under Section 174 Cr.P.C and other relevant documents which were forwarded by Opposite Party No.2-Bank to Opposite Party No.1-Insurance Company and Opposite Party No.1-Insurance Company gave a reference number which was further given to the complainants by Opposite Party No.2-Bank. He contended that complainants made several requests to Opposite Party No.2-Bank and Opposite Party No.2-Bank assured that claim would be released within a short period but with no effect and then complainant served a legal notice dated 23.2.2016 on the opposite parties but even after expiry of notice period, claim was not released. He contended that conduct of opposite parties caused harassment and mental agony to complainant and it amounts to deficiency in service and unfair trade practice on the part of opposite parties and as such, complaint is required to be allowed and  opposite parties are required to be directed to pay claim amount to the complainant alongwith compensation and litigation expenses.

8        Ld. counsel for Opposite Party No.1-Insurance Company contended that complainant has never given any intimation regarding the death of Rajbir Singh to Opposite Party No.1-Insurance Company nor filed any claim with the Opposite Party No.1-Insurance Company. He contended that even complainants have stated in the complaint that he only requested Opposite Party No.2-Bank but Opposite Party No.2-Bank has not sent any claim documents or other documents to Opposite Party No.1-Insurance Company and in this eventuality no cause of action arose to the complainant to file the complaint against Opposite Party No.1-Insurance Company. He contended that as no claim has been filed with Opposite Party No.1-Insurance Company nor Opposite Party No.1-Insurance Company allotted any claim number or reference number as alleged by complainant, therefore, no deficiency in service is attributed to Opposite Party No.1-Insurance Company and complaint is false and frivolous and has been filed only to pressurize the Opposite Party No.1-Insurance Company and is liable to be dismissed with heavy costs.

9        Ld. counsel for the Opposite Party No.2-Bank contended that Opposite Party No.2-Bank only deals in bank transaction and have no concern with life insurance and as such Opposite Party No.2-Bank has no concern in the case and has been falsely implicated in the complaint. He contended that deceased got the insurance policy voluntarily without any assurance of Opposite Party No.2-Bank and only on the directions of deceased Rajbir Singh, premium amount was sent to Opposite Party No.1-Insurance Company from the loan account of deceased. He contended that bank has right to recover the loan from the L.Rs. of deceased i.e. complainants and has been unnecessarily joined in the complaint and as such, complaint is liable to be dismissed with costs.

10      Admittedly deceased Rajbir Singh purchased motorcycle from Param Motors vide bill Ex. C-10 for Rs. 58,000/-. He paid Rs. 16,000/- in cash as down payment and remaining amount of Rs. 42,000/- was paid to Param Motors by availing loan from Opposite Party No.2-Bank and Opposite Party No.2-Bank opened a loan account in its record. It is also admitted case of the parties that Opposite Party No.2-Bank sent the premium to Opposite Party No.1-Insurance Company from loan account of the deceased. There is no force in the contention of Opposite Party No.2-Bank that it has no concern with the insurance policy issued by Opposite Party No.1-Insurance Company regarding life insurance of Rajbir Singh (deceased) because complainants have proved policy of Opposite Party No.1-Insurance Company which clearly states that H.D.F.C. Bank Ltd. is agent of insurance company and even its agent code and telephone number is given. In this eventuality, Opposite Party No.2-Bank cannot plead that it has no concern with the insurance policy. Death of Rajbir Singh is admitted case of the parties. The contention of the complainant is that immediate intimation was given to the Opposite Party No.1-Insurance Company through Opposite Party No.2-Bank and complainant also submitted the necessary documents i.e. death certificate, policy documents, Post Morten report etc. to Opposite Party No.2-Bank which were also forwarded by Opposite Party No.2-Bank to Opposite Party No.1-Insurance Company but insurance company did not release insurance claim of Rajbir Singh (deceased). However the contention of Opposite Party No.1-Insurance Company is that intimation regarding accidental death of Rajbir Singh was never given to Opposite Party No.1-Insurance Company by the complainant or by Opposite Party No.2-Bank nor any claim papers or relevant documents were submitted to Opposite Party No.1-Insurance Company by complainants or Opposite Party No.2-Bank though opposite party No. 2 Bank stated in the written version that complainants submitted the documents to Opposite Party No.2-Bank which were forwarded to Opposite Party No.1-Insurance Company but no evidence has been produced on the file by complainants or even by Opposite Party No.2-Bank if any intimation was given to Opposite Party No.1-Insurance Company and if any claim papers or relevant documents were sent to Opposite Party No.1-Insurance Company by the complainant or by Opposite Party No.2-Bank. There is categorical denial by Opposite Party No.1-Insurance Company that intimation regarding the death of Rajbir Singh or claim document or other relevant documents were submitted to Opposite Party No.1-Insurance Company by complainant or Opposite Party No.2-Bank. In this eventuality, it was duty of the complainant to produce the evidence on the file to show that intimation was given to Opposite Party No.1-Insurance Company and claim document alongwith other documents were submitted to Opposite Party No.1-Insurance Company nor Opposite Party No.2-Bank has produced any evidence on the file that any intimation or claim document were sent to Opposite Party No.1-Insurance Company. In this eventuality Opposite Party No.1-Insurance Company is not liable to decide the insurance claim of deceased Rajbir Singh. The complainants have produced only affidavit of Rajbir Kaur and 11 documents i.e. Ex. C-2 to C-12. Document Ex. C-2 is death certificate of Rajbir Singh, Ex. C-3 is insurance policy, Ex. C.4 is terms and conditions of the policy, Ex. C-5 is Rapat Roj Namcha, Ex. C-6 is Inquest Report, Ex. C-7 is copy of notice, Ex. C-8 is postal receipt, Ex. C-9 is policy cover note, Ex. C-10 is bill/ challan issued by Param Motors, Ex. C -11 is copy of identity card of Rajbir Singh, Ex. C-12 is copy of Post Mortem Report. As such no document has been produced on the file by the complainant to show that any intimation was sent to the Opposite Party No.1-Insurance Company or claim paper were filed with Opposite Party No.1-Insurance Company nor the complainant has proved any document issued by Opposite Party No.1-Insurance Company acknowledging the report of intimation or receipt of claim documents nor Opposite Party No.2-Bank has produced any evidence that claim form or other relevant documents were forwarded to Opposite Party No.1-Insurance Company by Opposite Party No.2-Bank. In this eventuality deficiency in service and unfair trade practice on the part of Opposite Party No.1-Insurance Company cannot be attributed. Opposite Party No.1-Insurance Company is liable to decide the claim case of the deceased Rajbir Singh only when it would receive the claim case alongwith documents from complainant or Opposite Party No.2-Bank. In the given circumstances, the complaint is disposed off with the directions to complainant to file the claim documents alongwith relevant documents within 15 days from the receipt of copy of order with the Opposite Party No.1-Insurance Company and Opposite Party No.1-Insurance Company is directed to decide the claim case of deceased Rajbir Singh either way within next 1 month from the receipt of documents from the complainant if any. If Opposite Party No.1-Insurance Company fails to decide the claim case of the deceased Rajbir Singh either way within said period then the claim case of the deceased Rajbir Singh shall be deemed to have been allowed as per provisions of insurance policy Ex. C-3. Keeping in view the peculiar circumstances of the case, the parties are left to bear their own costs.  Copy of order be supplied to the parties free of costs as per rules. File be consigned to record room.

Pronounced in Open Forum.

Dated 6.12.2016.