District Consumer Disputes Redressal Commission ,Faridabad.
Consumer Complaint No. 279/2021.
Date of Institution:01.06.2021.
Date of Order:24.03.2023.
Smt.. Shahruna wife of late Aarif at present resident of village Aalampur, Tehsil Dhauj, District Faridabad.
…….Complainant……..
Versus
1. HDFC Ergo General Insurance co. Ltd., Local office at Om Shubham Tower, Shop NO. 35 & 36, First floor, Shahid Bhagat Singh Marg, Neelam Bata Chowk, NIT, Faridabad – 121001.
2. HDFC ERGO General Insurance Co. Ltd. Branch office at Sector-62, Noida (U.P).
3. HDFC ERGI General Insurance Co. Ltd. Head office at 6th floor, Leela Business Park, Andheri Kurla, R.D. Andheri nEast, Mumbai (Maharashtra – 400 059.
(through its Branch Manager/Authorized Signatory/representative)
…Opposite parties….
Complaint under section-12 of Consumer Protection Act, 1986
Now amended Section 34 of Consumer protection Act 2019.
BEFORE: Amit Arora……………..President
Mukesh Sharma…………Member.
Indira Bhadana………….Member.
PRESENT: Mohid Sahid , counsel for the complainant.
Sh. D.K.Gosain , counsel for opposite parties.
ORDER:
The facts in brief of the complaint are that the husband of the complainant took policy bearing No. 3317100127349200000 from the opposite party company valid from 06.07.2016 to 07.07.2017. The husband of the complainant met with an accident on 22.06.2017, resulting which the husband of the complainant suffered fatal injuries on his person and died on the spot. After the death of the husband of complainant, the complainant applied for death claim qua the said policy being the nominee of her husband and submitted application form and individual death claim form in the office of opposite parties on 24.01.2018 & 30.01.2019 respectively but the opposite parties did not paid the death claim to the complainant qua the said policy. The complainant requested the opposite parties to give the benefits of the said policy, but the opposite party delayed the matter on one pretext or the other and finally failed to pay the death claim to the complainant qua the said policy. The complainant personally visited the office of the opposite parties several times and requested the opposite parties to release the death claim qua the insurance policy but the opposite parties had failed to pay any heed to legitimate requests of the complainant and contumaciously withholding the said death claim amount qua the above said insurance policy without any sufficient cause and reason. The complainant sent legal notice dated 03.03.2020 to the opposite parties through registered post but all in vain. The aforesaid act of opposite party amounts to deficiency of service and hence the complaint. The complainant has prayed for directions to the opposite parties to:
a) release of the death claim amount qua the above said insurance policy alongwith interest @ 24% p.a. from the date of accident till actual realization.
b) pay Rs. 1,00,000/- as compensation for causing mental agony and harassment .
c) pay Rs. 11,000 /-as litigation expenses.
2. Opposite parties put in appearance through counsel and filed written statement wherein Opposite parties refuted claim of the complainant and submitted that the complainant had neither any cause of action nor locus standi to file the present complaint. The complainant had not come before this Hon’ble Commission with clean hands and had concealed the true, correct and material facts from this Commission. After receipt of documents sent by the complainant and after reviewing the documents the opposite party sent request letter dated 11.01.2018 to the complainant for sending the documents mentioned in the said letter within 7 days including PMR in order to process the claim, however the complainant failed to submit the information and documents as required vide letter dated 11.01.2018 . Opposite parties denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
3. The parties led evidence in support of their respective versions.
4. We have heard learned counsel for the parties and have gone through the record on the file.
5. In this case the complaint was filed by the complainant against opposite parties–HDFC ERGO General Insurance Company Ltd. with the prayer to: a) release of the death claim amount qua the above said insurance policy alongwith interest @ 24% p.a. from the date of accident till actual realization. b) pay Rs. 1,00,000/- as compensation for causing mental agony and harassment .c) pay Rs. 11,000 /-as litigation expenses.
To establish his case the complainant has led in his evidence, Ex.CW1/A – affidavit of Shahruna wife of late Aarif, Ex,C-1 – Personal Accident Insurance, Ex.C2 – FIR, Ex.C4 – death certificate, Ex.C5 – application form,, Ex.C-6 – claim form, Ex.C7 (colly) – legal notice, Ex.C-8 (colly) – reminder in respect of legal notice of demand dated 03.03.2020, Ex.C-9 to 11 – postal receipts, Ex.C-12 to C-14 – postal receipts.
On the other hand counsel for the opposite parties strongly agitated and opposed. As per the evidence of the opposite parties Ex.CW1/A – affidavit of Shweta Pokhriyal, Senior Manager – legal Claims, HDFC Ergo General Insurance Co. ltd., 5th floor, Tower-1, Stellar IT Park, C-25, Sector-62, Noida,, Ex.R-1 –Claim form, Ex.R-2 – Individual Accident policy,, ex.R-3 – Claim reminder letter.
6. In this case, the husband of the complainant took policy bearing No. 3317100127349200000 from the opposite party company valid from 06.07.2016 to 07.07.2017. The husband of the complainant met with an accident on 22.06.2017, resulting which the husband of the complainant suffered fatal injuries on his person and died on the spot. After the death of the husband of complainant, the complainant applied for death claim qua the said policy being the nominee of her husband and submitted application form and individual death claim form in the office of opposite parties on 24.01.2018 & 30.01.2019 respectively but the opposite parties did not paid the death claim to the complainant qua the said policy. As per Claim Reminder letter dated Feb. 01,2019 vide Ex.R3, opposite parties required some documents from the complainant to process the claim.
7. After going through the evidence led by the parties, the Commission is of the opinion that the complaint is allowed. Opposite parties are directed to process the claim of the complainant, subject to submission of documents within 30 days from the date of receipt of the copy of order and pay the due amount to the complainant along with interest @ 6% p.a. from the date of filing of complaint till its realization. The opposite parties are also directed to pay Rs.2200/- as compensation on account of mental tension, agony and harassment alongwith Rs.2200/- as litigation expenses to the complainant. Copy of this order be given to the parties concerned free of costs and file be consigned to record room.
Announced on: 24.03.2023 (Amit Arora)
President
District Consumer Disputes
Redressal Commission, Faridabad.
(Mukesh Sharma)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
(Indira Bhadana)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
