Haryana

Kurukshetra

CC/113/2021

Kusum Devi - Complainant(s)

Versus

HDFC Egro Gen Insurance - Opp.Party(s)

S.K.Saini

21 May 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISISON, KURUKSHETRA

Complaint No. 113 of 2021

Date of institution: 07.04.2021

                                      Date of decision: 21.5.2024

 

1.     Kusum Devi widow of Sh.  Megh  Raj,

2.     Sahil son of Sh. Megh Raj,

3.     Mahinder Singh son of Singh Ram,

4.     Vimla Devi wife of Sh. Mahinder Singh,

All resident of VPO Sanghour, Sub-Tehsil Babain, District Kurukshetra.

                                                                …Complainants.

Versus

 

1.     HDFC Ergo General Insurance Company Ltd., Kuruskhetra through its Branch Manager.

2.     HDFC Ergo General Insurance Company Ltd., Settlar It Park, Tower-I, 5^th Floor, C-25, Sector-62, Noida-201301 through its Managing Director.

3.     HDFC Bank Ltd. Sanghour Branch, District Kurukshetra through its Branch Manager.

.... Opposite parties

 

CORAM:     DR. NEELIMA SHANGLA, PRESIDENT.

NEELAM, MEMBER.

RAMESH KUMAR, MEMBER.

 

Present:    Shri S.K. Saini, Advocate for complainant.

Shri Atul Mittal, Advocate for OPs No.1 & 2.

OP No. 3 ex-parte.

             

Order:

       

        This is a complaint under Section 35 of the Consumer Protection Act, 2019.

2.             It is alleged in the complaint, Shri Megh Raj son of Mahinder Singh, who has died on 15.01.2020 is the husband of the complainant no.1 and the complainant no.2 is the son of Megh Raj and complainant no.3 and 4 are the parents of Megh Raj and the complainants are the legal heirs and dependents of the deceased-Megh Raj. It is further averred that the OPs have widely advertised to provide best services to its customers and to release the claim without any delay and without any harassment to its customers in case of any mis-happening. On being attracted from the above said advertisement and assurances of the OPs, Shri Megh Raj (now deceased) purchased one Health Suraksha Policy bearing no.2828100335235800000 of Ops No.1&2 through the OP no.3 on 24.07.2018, for sum insured Rs.4,00,000/- total premium of Rs.6,960/-, which was deducted from the account of Shri Megh Raj. It is further averred that suddenly on 12.10.2018, Shri Megh Raj suffered heart attack and was admitted in PGI, Chandigarh and three stent were inserted and an amount of Rs.2,00,000/- was spent on the treatment of Megh Raj and he was still under treatment regarding the same. It is further averred that Shri Megh Raj approached for claim of treatment expenses to the OPs and filed his claim before the Ops and all the formalities were fulfilled by Shri Megh Raj as per instructions of the OPs. The OPs demanded all the original documents from Shri Megh Raj which were given to the OPs for releasing the claim, but the OPs have not released the amount of Rs.2,00,000/- to Shri Megh Raj. Hence, this complaint.

3.             On notice, opposite parties No. 1 & 2 appeared and filed their written version raising preliminary objections with regard to maintainability; cause of action; locus standi; jurisdiction and concealment of true and material facts. On merits, complaint was contested and vehemently denied the allegations of the complaint as made out in the complaint and prayed for dismissal of the complaint.

4.             On notice, OP No.3 did not appear despite service and opted to be proceeded against ex-parte, vide order dated 01.03.2023 of the Commission.

5.             Learned counsel for the complainant has tendered into evidence affidavit Ex. CW1/A and documents Ex.C1 to Ex.C26 and closed the same on 19.07.2023 by suffering separate statement.

6.             Learned counsel for the opposite parties No.1 & 2 has tendered into evidence affidavit Ex.OW1/A and documents Ex.O1 to Ex.O4 and closed the same on 13.09.2023 by suffering separate statement.

7.             We have heard the learned counsel for both the parties at length and have gone through the record available on the file carefully.

8.             Sh.S.K.Saini, ld. Counsel for the complainant has argued that Shri Megh Raj son of Mahinder Singh, who has died on 15.01.2020 is the husband of the complainant No.1 and the complainant no.2 is the son of Megh Raj and complainant no.3 and 4 are the parents of Megh Raj and the complainants are the legal heirs and dependents of the deceased-Megh Raj. It is further argued that the OPs have widely advertised to provide best services to its customers and to release the claim without any delay and without any harassment to its customers in case of any mis-happening. On being attracted from the above said advertisement and assurances of the OPs, Shri Megh Raj (now deceased) purchased one Health Suraksha Policy bearing no.2828100335235800000 of Ops No.1&2 through the OP no.3 on 24.07.2018, for sum insured Rs.4,00,000/- total premium of Rs.6,960/-, which was deducted from the account of Shri Megh Raj. It is further argued that suddenly on 12.10.2018, Shri Megh Raj suffered heart attack and was admitted in PGI, Chandigarh and three stent were inserted and an amount of Rs.2,00,000/- was spent on the treatment of Megh Raj and he was still under treatment regarding the same. It is further argued that Shri Megh Raj approached for claim of treatment expenses to the OPs and filed his claim before the Ops and all the formalities were fulfilled by Shri Megh Raj as per instructions of the OPs. The OPs demanded all the original documents from Shri Megh Raj which were given to the OPs for releasing the claim, but the OPs have not released the amount of Rs.2,00,000/- to Shri Megh Raj.  Ld. Counsel for complainant has further argued that the complainants as well as Megh Raj requested the opposite parties to make payment, but opposite parties are further harassing the complainants mentally and physically by not paying the said amount to the complainants inspite of repeated demand and requests. Ld. Counsel for the complainants has further argued that Megh Raj is consumer of the opposite parties and now Megh Raj has died and the complainants being legal heirs and dependents are consumer of the opposite parties and are entitled to receive the medical expenses and compensation from the opposite parties.

9.             Opposite parties have filed the reply.  Complainant was asked to tender the necessary documents in this regard till so far.  No relevant documents have filed by the complainant. 

10.            Ld. Counsel for complainant has argued that the medical bills of deceased Megh Raj is Rs.1,36321/-.  Opposite parties shall have the amount of Rs.1,36,321/- to the complainant if the complainant tender all the relevant documents to the opposite parties within 15 days from today.  Thereafter, opposite parties is directed to pay the amount of Rs.1,36,321/- alongwith 9% penal interest to the complainant within 30 days from today.  Complaint is accepted with cost, which is assessed Rs.11,000/-.  In the eventuality, complainant does not tender the relevant documents mentioned in the reply then automatically the complaint shall be dismissed.

11.            In default of compliance of this order, proceedings shall be initiated under Section 72 of Consumer Protection Act, 2019, as non-compliance of court order shall be punishable with imprisonment for a term which shall not be less than one month, but which may extend to three years, or with fine, which shall not be less than twenty five thousand rupees, but which may extend to one lakh rupees, or with both. A copy of this order be sent to the parties free of cost. File be consigned to the record room after due compliance.     

Announced in open Commission:

Dated:21.5.2024                                             (Dr. Neelima Shangla)            

                                                                    President,

                                                                    DCDRC, Kurukshetra.

(Neelam)                (Ramesh Kumar)

 Member.                Member.