DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BARNALA, CAMP COURT AT AMRITSAR, PUNJAB.
Complaint Case No: RBT/CC/2018/484
Date of Institution: 04.07.2018/29.11.2021
Date of Decision: 15.09.2022
Monica Arora W/o Late Sh. Ashok Kumar aged 48 resident of House No. 10-A, Gali No. 1 Vijay Nagar Batala Road, Amritsar, Punjab. Mobile No. 8360226785.
…Complainant
Versus
- HDFC ERGO General Insurance Company Limited through its Branch Manager/Authorized Signatory Nagpal Tower-1 3rd Floor SCO 128 Ranjit Avenue, Amritsar, Punjab.
- HDFC ERGO General Insurance Company Limited through its Branch Manager/Authorized Signatory Office address: Registered & Corporate Office: 1st Floor HDFC House 165-166 Backbay Reclamation H.T. Parekh Marg Churchgate Mumbai-400020.
…Opposite Parties
Complaint Under Section 11 & 12 of The Consumer Protection Act, 1986 (as amended upto date).
Present: Sh. Sanjeet Singh Adv counsel for complainant.
Sh. R.P. Singh Adv counsel for the opposite parties.
Quorum.-
1. Sh. Ashish Kumar Grover: President
2. Sh. Navdeep Kumar Garg: Member
(ORDER BY ASHISH KUMAR GROVER, PRESIDENT):
1. The present complaint has been received by transfer from District Consumer Commission, Amritsar in compliance of the order dated 26.11.2021 of the Hon'ble State Consumer Disputes Redressal Commission, Punjab, Chandigarh. The complainant has filed the present complaint under Section 11 and 12 of the Consumer Protection Act against HDFC ERGO General Insurance Company Limited and others (in short the opposite parties).
2. The facts leading to the present complaint as stated by the complainant are that the complainant purchased a New Swift Dezire Car vide Registration No. PB02DH7425 of personal use which was duly financed by the HDFC Bank Ltd. On the advice of the agent of opposite parties the complainant got his personal accident cum Credit Shield Insurance through opposite party No. 1 w.e.f. 3.10.2017 to 2.10.2022 vide Master Policy No. 2999201363863001 on 3.10.2017 and paid requisite premium of Rs. 6,761/- for coverage of eight types of risk. It is alleged that on 21.10.2017 when car was backed by Driver Mr. Jaswant Singh in outside of the complainant house, the husband of the complainant unfortunately pressed between the wall and the car from the back side and due to heart press the husband of the complainant was nervous and shocked and the complainant took her husband in the nearby hospital in emergency condition wherein the Doctors of hospital declared him as no response and in this regard the complainant informed the opposite parties and they demanded the relevant documents regarding the said accident and complainant submitted the same documents to them but no acknowledgement was given by the opposite parties. Thereafter, the intimation was given to the police authorities and the same was submitted to the opposite parties. The complainant three times submitted the relevant documents to the opposite parties but due to the non availability of post mortem report the same was pending till date. The complainant number of times requested the opposite parties to pay the insured accident claim amount plus Credit Shield Insurance as per terms and conditions of the cover note policy of Rs. 10,00,000/- but the opposite parties lingered on the matter on the one pretext or the other, but later refused to do so. The above said act of the opposite parties amounts to deficiency in service and unfair trade practice on the part of opposite parties. Hence, the present complaint is filed for seeking the following reliefs.-
1) The opposite parties may be directed to pay the insured claim amount of Rs.10,00,00/- alongwith interest @ 24% per annum from the date of intimation till its realization.
2) To pay Rs. 1,00,000/- on account of compensation for mental agony and harassment and Rs. 25,000/- as litigation expenses.
3) Further to pay Rs. 1,00,000/- with regard to personal visits before the opposite parties.
3. Upon notice of this complaint, the opposite parties filed written statement taking preliminary objections interalia on the grounds of complaint is pre-mature, elaborate evidence and expert evidence is required, concealment of material facts etc. On merits, it is denied that on 21.10.2017 when car was backed by Driver Mr. Jaswant Singh in outside of the complainant house, the husband of the complainant unfortunately pressed between the wall and the car from the back side and due to heart press the husband of the complainant was nervous and shocked and the complainant took her husband in the nearby hospital in emergency condition where the concerned Doctors of hospital declared him as no response. It is further submitted that the alleged DDR bearing No. 10 has been registered on 21.10.2017 at the time of 9.15 a.m., whereas the alleged occurrence took place after 7.30 a.m. Moreover, it is not possible for a person to go to the police station to give the information after two hours of death. However, the Rapat No. 10 dated 21.10.2017 shown as recorded on 26.10.2017 at 9.05 a.m which shows that the complainant has manipulate the documents to get the undue benefit. It is further submitted that post mortem was not conducted intentionally by the complainant to suppress the cause of death of the deceased. All other allegations of the complainant are denied and prayed for the dismissal of complaint.
4. In order to prove the case the complainant at the time of filing the present complaint also tendered the affidavit alongwith documents Ex.C-1 to Ex.C-11.
5. To rebut the case of complainant the opposite parties at the time of filing written version also tendered the affidavit of Pankaj Kumar alongwith documents Ex.O.P1/1 to Ex.O.P1/5.
6. We have heard the learned counsel for the parties and gone through the record on the file. Written arguments have been filed by the parties.
7. Ld. Counsel for complainant argued that the complainant purchased a New Swift Dezire Car vide Registration No. PB02DH7425 of personal use, which was duly financed by the HDFC Bank Ltd., and in this regard the complainant got his personal accident cum Credit Shield Insurance through opposite party No. 1 w.e.f. 3.10.2017 to 2.10.2022 vide Master Policy No. 2999201363863001 on 3.10.2017 i.e. Ex.C-1 and paid requisite premium of Rs. 6,761/- for coverage of eight types of risk. It is further argued that on 21.10.2017 when car was backed by Driver Mr. Jaswant Singh in outside of the complainant house, the husband of the complainant unfortunately pressed between the wall and the car from the back side and due to heart press the husband of the complainant was nervous and shocked, as such the complainant took her husband in the nearby hospital in emergency condition, wherein the Doctors of hospital declared him as no response. It is further argued that the opposite parties were informed accordingly and they demanded the relevant documents regarding the said accident, which were submitted with the opposite parties, but no acknowledgement was given by the opposite parties. It is also argued that the intimation was given to the police authorities and the same was submitted to the opposite parties. Ld. Counsel for complainant argued that she submitted the relevant documents to the opposite parties three times, but due to the non availability of post mortem report the same was pending till date. It is further argued by the Ld. Counsel for complainant that the complainant number of times requested the opposite parties to pay the insured accident claim amount plus Credit Shield Insurance as per terms and conditions of the cover note policy of Rs. 10,00,000/-, but the opposite parties lingered on the matter on the one pretext or the other and later refused to do so.
8. On the other hand, Ld. Counsel for the opposite parties argued that the complainant has tried to manipulate the documents in order to get the claim, which is clear from the facts and documents as submitted by the complainant herself, as prima-facie the letter issued by the hospital dated 21.10.2017 Ex.O.P1/3 does not bear the signatures of any doctor, as the signature marked upon the letter belongs to an attendant which is clearly mentioned in the letter. It is further argued that there is no explanation as how the death of the insured happened nor any cause of death was provided by the hospital. It is also argued that it is wrong that on 21.10.2017 when car was backed by Driver Mr. Jaswant Singh in outside of the complainant house, the husband of the complainant unfortunately pressed between the wall and the car from the back side and due to heart press the husband of the complainant was nervous and shocked and the complainant took her husband in the nearby hospital in emergency condition where the concerned Doctors of hospital declared him as no response. It is further argued that the alleged DDR bearing No. 10 Ex.O.P1/4 has been registered on 21.10.2017 at the time of 9.15 a.m., whereas the alleged occurrence took place after 7.30 a.m. and it is not possible for a person to go to the police station to give the information after two hours of death. It is also argued that the Rapat No. 10 dated 21.10.2017 shown as recorded on 26.10.2017 at 9.05 a.m., which shows that the complainant has manipulate the documents to get the undue benefit. It is further argued that post mortem was not conducted intentionally by the complainant to suppress the cause of death of the deceased. Ld. Counsel for the opposite parties also argued that the complainant has not come with clean hands and did not disclose the material facts whether available or not available to her. Ld. Counsel for opposite parties further argued that the complainant has not produced any cogent evidence to prove that the husband of the complainant was died due to accident as the present insurance policy was taken by the insured for the accidental benefit.
9. We have gone through the evidence produced by the complainant and we did not find any evidence from which it established that Ashok Kumar was died due to accident. The complainant mentioned in the complaint that due to heart press the husband of the complainant was nervous and shocked. The complainant has not produced any expert evidence or postmortem report to prove the accidental death.
10. In view of the above discussion, we find no merits in the present complaint and the same is dismissed. However, there is no order as to costs or compensation. Copy of the order will be supplied to the parties by the District Consumer Commission, Amritsar as per rules. File be sent back to the District Consumer Disputes Redressal Commission, Amritsar.
ANNOUNCED IN THE OPEN COMMISSION:
15th Day of September, 2022
(Ashish Kumar Grover)
President
(Navdeep Kumar Garg)
Member
