DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION

PATIALA.

                                      Consumer Complaint No. 48 of 10.2.2021

                                      Decided on:         28.10.2024

1. Karamjit Kaur aged 52 years wife of Late Sh.Shamsher Singh.
2. Manpreet Singh son of Late Sh.Shamsher Singh
3. Harpreet Kaur daughter of Late Sh.Shamsher Singh

All residents of village Dabali Khurd, Tehsil Rajpura, District Patiala.

                                                                   …………...Complainants

                                      Versus

1. HDFC ERGO General Insurance Company Ltd. Plot No.C-9, 3^rd Floor, Pearl Best Heights- II, Netaji Subhas Palace, North West Delhi through its Branch Manager.
2. HDFC ERGO General Insurance Company Ltd. having its registered office at First Floor, HDFC House, SCO 124-125, Madhya Marg, Sector 8-C, Chandigarh.

                                                                   …………Opposite Parties

Complaint under the Consumer Protection Act

QUORUM

                                      Sh.Pushvinder Singh, President

                                      Sh.G.S.Nagi, Member   

ARGUED BY

                                      Sh.J.S.Saini, counsel for the complainants.

                                      Sh.Amit Gupta, counsel for the OPs.

 ORDER

                                      PUSHVINDER SINGH, PRESIDENT

1. The instant complaint is filed by Karamjit Kaur & Ors. (here-in-after referred to as the complainant) against HDFC ERGO General Insurance Company Ltd. (hereinafter referred to as the OP/s) under the Consumer Protection Act (for short the Act).
2. It is averred in the complaint that late Shamsher Singh s/o Sh.Prem Singh was the owner of Mini Truck No.PB-65-A-6035 and the same was insured with the OPs for the period from 10.6.2019 to 9.6.2020 vide policy No.2315203411687200000. The said policy also included the P.A. cover for owner driver and LL to be paid to driver, conductor , cleaner.
3. It is averred that on 27.9.2020 late Sh.Shamsher Singh was driving the aforesaid vehicle in Delhi and when he reached at light point of Jahangirpuri, Delhi, he suffered heart attack while driving the said vehicle due to exertion  and he became unconscious. Shamsher Singh was taken to Babu Jagjivan Ram hospital in morning from where he was taken to Vinayak Hospital, Derawal Nagar (Model Town) Delhi, for treatment but he died at 8.25 AM on 28.9.2020.
4. It is averred that OP No.1 was informed regarding death of late Sh.Shamsher Singh. Complainants also lodged claim with OP No.1 and submitted requisite documents but the OP No.1 refused to entertain the claim application of the complainants without any reason. That thereafter complainants sent a legal notice dated 18.12.2020 upon the OPs with the request to release the insurance claim on account of death of late Sh.Shamsher Singh but the OPs did not pay any heed to the request of the complainants. It is averred that there is unfair trade practice on the part of the OPs. Hence this complaint with the prayer to accept the same by giving direction to the OPs to pay the insurance claim to the complainants as per policy in question alongwith interest @ 18% per annum; to pay Rs.20,000/- as compensation for causing harassment to the complainants alongwith Rs.20,000/- as litigation expenses.
5. Upon notice, OPs appeared through counsel and filed written statement having contested the complaint by raising preliminary objections that the complainants have no cause of action to file the present complaint as the complainants never lodged/registered any claim against the coverage of owner-driver death and that the complainants are claiming claim under Personal Accident Claim to owner driver. It is pleaded that a false story has been concocted by the complainant as deceased Shamsher Singh was suffering from fever for the last 2/3 days with many other diseases fully described in death summary. It is averred that as per terms and conditions of the policy, death should be caused by violent accidental external and visible means which is independent of any other cause.
6. On merits, it is admitted that Shamsher Singh (Now deceased) had purchased one insurance policy bearing No.2315203411687200000 covering the Mini Truck No.PB-65-A-6035 w.e.f.10.6.2019 to 9.6.2020. Further the OPs reiterated the facts taken in the preliminary objection contents of which are not repeated for the sake of brevity and after denying all other averments have prayed for the dismissal of the complaint.
7. In evidence, ld. counsel for the complainant has tendered Ex.CA affidavit of Karamjit Kaur, complainant, Ex.C1 to Ex.C3 copies of Aadhar cards, Ex.C4 to Ex.C9 copies of documents regarding the vehicle, Ex.C10 copy of DL of Shamsher Singh,Ex.C11 copy of certificate of Gram Panchyat, Ex.C12 copy of death summary, Ex.C13 to Ex.C18 copies of medical reports, Ex.C19 to Ex.C27 medical bills, Ex.C28 copy of emergency registration card,Ex.C29 copy of death certificate,Ex.C30 and Ex.C31 copies of Aadhar card and voter card of Shamsher Singh, Ex.C32 copy of insurance policy, Ex.C33 copy of RC, Ex.C34 copy of Pan card, Ex.C35 and Ex.C36 copies of legal notice, Ex.C37 postal receipts and closed the evidence.
8. The OPs in their evidence have tendered affidavit Ex.OPA of Pokhriyal, Manager Legal claims of OPs, Ex.OP1 copy of policy terms and conditions, Ex.OP2 copy of death summary. Inspite of after availing ample opportunities OPs did not lead any more evidence and evidence of OPs was closed by order.
9. Written arguments on behalf of the complainants have been filed. We have gone through the same  heard the ld. counsel for the parties and have also gone through the record of the case, carefully.
10. Complainants have filed this complaint stating that Shamsher Singh husband of complainant No.1 and father of complainants No.2&3 was driving Mini truck No.PB-65-A-6035 on 27.9.2020 and said truck was insured with the OPs and on 27.9.2020 Shamsher Singh suffered heart attack while driving the above said truck and became unconscious and then he was taken to Babu Jagjivan Ram Hospital from where he was taken to Vinayak Hospital, Derawal Nagar, Model Town, Delhi, where he died on 28.9.2020.The complainants claimed Personal Accidental Claim as the truck was insured with the OPs.
11. The OPs have contested this complaint stating that the complainants are not entitled for the claim as Shamsher Singh   died due to heart attack and not due to any injury sustained in the accident and the ld. counsel for the OPs has relied upon the terms and conditions of the insurance policy.
12. The complainants have produced copy of insurance policy and OPs have also produced the policy as Ex.OP1 and from perusal of Section IV-Personal Accident Cover for Owner-Driver, the Owner/Driver was entitled for claim as under:

Subject otherwise to the terms exceptions conditions and limitations of this policy, the Company undertakes to pay compensation as per the following scale for bodily injury/death sustained by the Owner-Driver of the vehicle in direct connection with the vehicle insured or whilst mounting into/dismounting from or traveling in the insured vehicle as a co-driver, caused by violent accidental external and visible means which independent of any other cause shall within six calendar months of such injury.

From perusal of above said term and condition of the insurance policy, it is clear that only driver who dies due to violent accidental external and visible injury is entitled for the claim.

13. In the present case Shamsher Singh died due to heart attack and did not die due to any injury sustained in any type of accident. So the complainants cannot be held entitled for the claim and we find that the OPs have rightly repudiated the claim.
14. In view of the discussion above, we do not find any merit in the complaint and the same is hereby dismissed. No order as to costs.  
15. The instant complaint could not be disposed of within stipulated period due to heavy rush of work and for want of Quorum from long time.
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85109252238717.  

                                              G.S.Nagi                           PUSHVINDER SINGH

                                              Member                          President