Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 208.
Instituted on : 6.4.2017.
Decided on : 17.02.2022.
- Sumitra Kajal age 50 years wife of Sh. Jagram Kajal,
- Shashi Mohan Kajal son of Sh. Jagram Kajal,
- Priyanka Kajal daughter of Sh. Jagram Kajal,
- Rohit son of Sh. Jagram Kajal,
All residents of H. No.998/10, Tau Nagar, Sonepat Road, Rohtak.
.......................Complainant.
Vs.
- H.D.F.C. Ergo General Insurance Company Ltd. 6th Floor Leela Business Park, Andheri Kurla Road, Andheri (East) Mumbai-4000059, through Manager.
- H.D.F.C. Ergo General Insurance Company Ltd. First Floor, Above Pizza Hut, Ashok Chowk, Delhi Road, Rohtak.
- Housing Development Finance Corporation Limited (HDFC) # 190, First Floor, Civil Lines Near Ashoka Plaza, Delhi Road, Rohtak through its Branch Manager.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
DR. SHYAM LAL, MEMBER
Present: Shri Lalit Kaushik, Advocate for the complainant.
Shri Gulshan Chawla, Advocate for the opposite party no.1.
Shri Vipul Kapoor, Advocate for the opposite party no.3.
Opposite party no.2 already exparte.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that the husband of the complainant no.1 and father of complainant no.2 to 4 namely, Jagram Kajal had taken loan from HDFC Bank vide loan agreement dated 31.10.2014. At the time of sanctioning the said house loan, Sh. Jagram Kajal got insured vide “Home Surakhsha Plus” policy vide policy no.2918200892173400000 and a premium of Rs.65,575/- has been paid to the opposite party no.2. Unfortunately, on 23.4.2016, Sh. Jagram Kajal was died. He has no any previous history of any type of deceases. This was accidental death. In this regard, the complainant had already conveyed intimation to the opposite parties well within time and she has already filed claim vide claim no.291816000187. She also sent a legal notice dated 1.2.2017 through her counsel regarding settlement of the claim to the opposite parties but no reply of the said notice was received from the opposite parties. The complainant visited the office of opposite parties many times but no satisfactory reply has been given by the opposite parties to the complainant. At the time of receiving the amount of premium against the policy, the agent of the opposite parties assured that at the time of untimely death of the insured person the beneficiary would be entitled to get benefit accordingly. The policy was issued in favour of deceased Jagram Kajal. The complainants have not signed any paper of insurance. After the death of Jagram she came to know that the documents of insurance company filled as Mrs. Sumitra Jagram in place of Jagram Kajal. The complainant no.1 is paying the monthly installments (EMI) of the above noted loan amount after the death of his husband regularly. The insurance form was not filled by the complainant or his husband. The personnel of opposite party filed the form themselves. If there is any mistake in filling the form, it is on the part of personnel of insurance company. The complainant cannot be held liable for that. So the opposite parties are liable to indemnify the complainant accordingly. Hence, this complaint and it is prayed that opposite parties may kindly be directed to settle the claim of the complainants by taking over the balanced loan amount i.e. Rs.1197443/- and to repay/refund the amount to the complainant, which they have paid after the death of Sh. Jagram Kajal and all the benefits of the policy be given to the complainants according to terms and conditions of the policy alongwith interest @ 18% p.a. from the date of the death of the insured Jagram Kajal till its realization and also to pay an amount of Rs.5500/- as counsel fees as well as Rs.1,00,000/- on account of mental agony and harassment to the complainants.
2. After registration of complaint, notices were issued to the opposite parties. Opposite party No. 1 in its reply has submitted that a request was received in the office of answering respondent, wherein Sumitra Jagram has opted Home Suraksha Plus. On the basis of application, policy bearing no. 2918200892173400000 was issued in favour of Sumitra Jagram for the period 31.10.2014 to 30.10.2019 covering fire and allied plus earthquake, terrorism burgling, house breaking, theft and other coverage detailed given in the policy schedule. It is denied that Jagram Kajal had opted for home suraksha plus, as alleged rather it was the Sumitra Jagram who had opted for the same and policy was issued as detailed above. It is also submitted that the claim intimation was received in the office of answering respondent, with regard to the death of Jagram Kajal. After going through the documents and policy, it became crystal clear that the policy in question was opted by Sumitra and not by the Jagram Kajal, as alleged. Hence, the answering respondent was having no other option except to repudiate of the claim vide letter dated 20.10.2016 duly served upon the complainant. It is also submitted that the proposal form was duly signed by the complainant and in place of name of proposer the complainant mentioned her name. It is also submitted that the column of Proposer II mentioned in the proposal from was left blank. Only the name of the complainant is mentioned in the policy schedule and no nominee was appointed by the complainant. The policy in question was issued on 31.10.2014, whereas Jagram had allegedly expired on 23.4.2016 and in between period, no such issue of issuing the policy in wrong person has been raised. Hence, the claim of the complainant has been rightly repudiated vide letter dated 20.10.2016 duly served upon the complainant. Hence, there is no deficiency in service on the part of answering respondent. All the other contents of the complaint were stated to be wrong and denied and opposite party no.1 prayed for dismissal of complaint with costs.
3. Opposite party No. 3 in his reply has submitted that the answering respondent has no control or persuasive value insofar as the functioning of the opposite party no.1 and 2 is concerned. The obligation to repay the loan is independent of the understanding/insurance contract executed amongst the complainants and opposite party no.1 and 2. It is also submitted that as regards the finance advanced by the HDFC limited is concerned, the rights of the parties to the present lis are governed by the loan agreement. It is also submitted that as on 16.5.2017 an amount of Rs. 11,20,745/- is payable by the complainants. The answering respondent did not receive any legal notice and the same is addressed to opposite party no.1 and 2. All the other contents of the complaint were stated to be wrong and denied and opposite party no.3 prayed for dismissal of complaint with costs. However, opposite party no. 2 did not appear despite service. As such opposite party no. 2 was proceeded against exparte vide order dated 22.5.2017.
4. Ld. Counsel for the complainants in their evidence has tendered affidavit Ex.CW1/A and documents Ex.C1 to Ex.C10 and has closed his evidence on dated 09.10.2018. Ld. Counsel for the Opposite party no.1 in his evidence has tendered affidavit Ex.RW1/A and document Ex.R1/1 to Ex.R1/4 and has closed his evidence on dated 26.4.2019. Ld. Counsel for the opposite party no.3 in his evidence has tendered affidavit Ex.RW3/A and documents annexure R3/1 to Annexure R3/2, and has closed his evidence on dated 8.3.2019.
5. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
6. In the present case, grievance of the complainant No.1 is that after the death of her husband, she filed a claim with the opposite party but the opposite party has repudiated the claim vide letter dated 20.10.2016 placed on record as Ex.R1/4 on the ground that Mr. Jagram Kajal is not insured in the policy. In this regard we have observed the policy letter Ex.C2 and letter Ex.C4, which are in the name of Sumitra Jagram. Policy Ex.C4 is also in the name of Sumitra Jagram, and in this document the in the column of Gender, it is mentioned as ‘MALE’. In this policy in the clumn of Insured’s name it is mentioned as SUMITRA JAGRAM and in the second column also the insured’s name is SUMITRA JAGRAM. Meaning thereby, the policy is issued in the name of both members i.e. Sumitra and Jagram and the proposer is Male i.e. Jagram. It is nowhere mentioned in the policy that who is non working member or who is not insured. As per ID Card Ex.C8 of Jagram Kajal issued by the Transport Department Haryana, his Mobile number is 93556-23633 and the same number is also mentioned in the policy Ex.C4. Moreover, opposite party has not placed on record any document to prove that any document was submitted by the complainant in the name of Sumitra Jagram. The name of complainant as per Aadhar Card Ex.C10 is Sumitra Kajal. Complaint, affidavit and claim form are also signed by the complainant in the name of Sumitra Kajal. If the complainant No.1 should have been insured under the policy, then the name of proposer should have been written as ‘Sumitra’ or ‘Sumitra Kajal’ or ‘Sumitra w/o Jagram’. But in the policy schedule, proposer name is Sumitra Jagram. Moreover it should have been mentioned specifically by the opposite party in the policy that whether the policy is in joint name or co-borrower. Meaning thereby, both were insured under the policy. Loan is in the name of both Sumitra and Jagram and loan agreement Annexure R3/1 is also signed by both. Repayment of loan is to be made by Jagram. It is not possible that Sumitra who is non working member of the policy, shall repay the loan. Hence the complainants are entitled for the relief as per policy. At the time of arguments, the complainant has placed on record documents ‘Annexure-JN-A’ and ‘Annexure-JN-B’ issued by the HDFC housing Development finance Corporation Limited, as per which it is submitted that Mr. Kajal Jagram and Mrs. Sumitra to whom Housing loan was granted, have repaid the same in full with all dues and that no amount is now due from them towards or in respect of the said loan. As per policy schedule ‘Home Suraksha Plus policy’ placed on record as Ex.R1/2, the personal accident is covered under the policy and under this head sum insured is Rs.865592/-. As per Ex.R1/2, under the head General definitions, it is mentioned in condition no.1 that : “Accident means an unexpected, unforeseen and undesirable event, especially one resulting in an injury or death” Meaning thereby, the death of insured Jagram is covered under the policy and opposite party no.1 & 2 are liable to pay the same to the complainant.
7. In view of the facts and circumstances of the case we hereby allow the complaint and direct the opposite party No.1 & 2 to pay the alleged amount of Rs.865592/-(Rupees eight lac sixty five thousand five hundred and ninety two only) alonwith interest @ 9% p.a. from the date of filing the present complaint i.e. 06.04.2017 till its realization and shall also pay Rs.5000/-(Rupees five thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant. However, opposite party no.3 is also directed to issue NOC to the complainant. Order shall be complied within one month from the date of decision.
8. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
17.02.2022.
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Nagender Singh Kadian, President
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Tripti Pannu, Member.
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Shyam Lal, Member
