Punjab

Tarn Taran

CC/4/2017

Harbhajan Singh - Complainant(s)

Versus

HDFC Standard life Insu. - Opp.Party(s)

G.S. Walia

06 Aug 2019

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,ROOM NO. 208
DISTRICT ADMINISTRATIVE COMPLEX TARN TARAN
 
Complaint Case No. CC/4/2017
( Date of Filing : 03 Feb 2017 )
 
1. Harbhajan Singh
S.o Bhishan Singh resident of village Malia. Tehsil and District Tarn Taran
Tarn Taran
Punjab
2. Prabjot Kaur
R.o Village Malia.Tehsil and District Tarn Taran.
Tarn Taran
Punjab
...........Complainant(s)
Versus
1. HDFC Standard life Insu.
Company Ltd Lodha Excelus, 13th Floor, Apollo Mills Compound N.M Joshi Marg Mahalaxmi Mumbai through its Managing Director
Mumbai
Mumbai
2. HDFC Standard life Insu.
office Tarn Taran jandiala Road Tarn Taran
Tarn Taran
Punjab
3. Mrs Pinki Kumari
Agent HDFC Standard Life Insurance company LTD Branch office Tarn Taran Jandiala Road Tarn Taran
Tarn Taran
Punjab
............Opp.Party(s)
 
BEFORE: 
  Sh.Charanjit Singh PRESIDENT
  Smt. Jaswinder Kaur MEMBER
 
For the Complainant:G.S. Walia, Advocate
For the Opp. Party:
For the O.P. Nos. 1, 2 Sh. Nishan Singh Advocate
For the O.P. No. 3 None
 
Dated : 06 Aug 2019
Final Order / Judgement

Before the District Consumer Disputes Redressal Forum, Room No. 208 2nd Floor, District Administrative Complex, Tarn Taran

 

Consumer Complaint No  :  04 of 2017

Date of Institution                      :03.02.2017

Date of Decision               : 06.08.2019

  1. Harbhajan Singh son of Bishan Singh,
  2. Prabjot Kaur daughter of Harbhajan Singh both residents of village Malia, Tehsil and District Tarn Taran.

                                                ...Complainants

Versus

  1. H.D.F.C Standard Life Insurance Company Limited, Lodha Excelus, 13th Floor, Apollo Mills Compound, N.M. Joshi Marg, Mahalaxmi, Mumbai through its Managing Director,
  2. H.D.F.C. Standard Life Insurance Company Limited Branch Office Tarn Taran Jandiala road, Tarn Taran through its Branch Manager,
  3. Mrs. Pinki Kumari Agent, H.D.F.C. Standard Life Insurance Company Limited, Branch Office Tarn Taran Jandiala Road Tarn Taran.

…Opposite Parties.

Complaint Under Section 11, 12, 13 and 14 of the Consumer Protection Act.

Quorum:               Sh. Charanjit Singh, President

                             Sh. Jatinder Singh Pannu, Member

For Complainant                     Sh. G.S. Walia Advocate

For Opposite Parties No. 1,2  Sh. Subodh K. Vyas Advocate

For Opposite Party No. 3                 None

ORDERS:

 

Charanjit Singh, President;

1        The complainant Harbhajan Singh etc. have filed the present complaint under Section 11, 12, 13 and 14 of the Consumer Protection Act (herein after called as 'the Act') against H.D.F.C Standard Life Insurance Company Limited, Lodha Excelus, 13th Floor, Apollo Mills Compound, N.M. Joshi Marg, Mahalaxmi, Mumbai through its Managing Director and others (Opposite Parties) on the allegations of deficiency in service and negligence in service on the part of opposite parties with prayer to direct the opposite parties to pay the death claim of Rs. 10,00,000/- of Daljit Kaur (deceased) as mentioned in the insurance policy to the complainants and her sons Rupinder Singh and Satinderpal Singh. The complainants have also prayed Rs. 50,000/- as compensation and Rs. 50,000/- as litigation expenses.

2        The case of the complainants in brief is that Smt. Daljit Kaur wife of Harbhajan Singh complainant No.1 and mother of Prabjot Kaur complainant No.2, took a life insurance policy plan namely HDFC SL Pro growth Super II bearing No.16433142 in the month November, 2013 from the opposite parties No.1 and 2 through agent Pinki Kumari Opposite party No.3 . The deceased Daljit Kaur hired the services of the opposite  parties and as such was consumer of Opposite parties .Smt. Daljit Kaur expired on 27.05.2016 and after her death, the complainants being the legal heirs and successors of deceased are competent to file the present complaint and to invoke the jurisdiction of this Forum against opposite parties. The complainant No.1 Harbhajan Singh was husband of the deceased and retired as Kanungo on 31.05.2013. During his service, salary of Harbhajn Singh complainant No.1 came in account no.14281000051600 at HDFC Bank, Branch Jandiala Road, Tarn Taran. At the  time of retirement, all the retirement benefits including provident fund, gratuity etc. about rupees Twenty One lakhs.(Rs. 21,00,000/-) of Harbhajan Singh came in A/c No.10658747405 at State Bank of India Branch Railway Road, Tarn Taran. The complainant No.1 visited HDFC Bank, Jandiala Road, Tarn Taran to know about FD or investment plans in order to invest money got after retirement, where opposite party No.3 Mrs. Pinki Kumari met him in the Bank. Opposite party No.3 was known to complainant No.1 as he maintains salary account at HDFC Bank, Jandiala Road, Tarn Taran. The Opposite Party No.3 Mrs. Pinki Kumari convinced the complainant to bring all retirement funds in his already running saving account at HDFC Bank but the Opposite party No.3 asked to open new joint account of Harbhajan Singh and his deceased wife and stated that she will invest money in the name of complainant No.1 and deceased Daljit Kaur, then Opposite party No.3 opened a new saving joint account in the name of deceased Daljit Kaur and Harbhajan Singh complainant No.1 bearing account Number 50100013327736 at HDFC Bank, Jandiala Road Tarn Taran and got transferred Rs.20,00,000/-from said account of Harbhajan Singh at SBI to said newly opened joint account of deceased Daljit Kaur and complainant No.1 Harbhajan Singh. Opposite Party No.3 got the signatures of Harbhajan Singh and deceased Daljit Kaur on forms and done three Insurance Polices in HDFC standard Life Insurance company Limited;  one policy in question on the name of deceased Daljit Kaur in the month of Nov 2013 bearing No.16433142 with premium of Rs. 1,50,000/- yearly payable and two policies on the name of complainant No.1 Harbhajan Singh bearing No.16602628 in the month of Nov 2013 with premium of Rs.1,50,000/- yearly payable and bearing No.1645845 in the month of April 2014 with premium  of Rs.1,00,000/- yearly payable. But Sh.Harbhajan Singh and deceased Daljit Kaur were not aware about any of the insurance policy at that time as the premiums of all insurance policies automatically transferred from joint saving account to the account of insurance company in question. The complainant deceased believed that Opposite party No.3 got signatures for fixed deposits and investment plan. The sons of the complainant No.1 and deceased namely Rupinder Singh and Satinderpal Singh have gone to Australia on study visa in the year 2005 and 2009 respectively. The complainant No.1 and deceased Daljit Kaur sent Rs.2,31,000/- to his son Satinder pal Singh in Australia in the month of August, 2014 in order to pay his university fees through HDFC Bank from said joint account. Then complainant No.1 and deceased Daljit Kaur also spent some money on renovation of their house and also spent money on the Marriage of their elder son Rupinder Singh held in April, 2015, as such, balance in joint saving account becomes low. Then in the month of April 2015, the complainant No.1 received call from the HDFC life insurance company that your premium amounting to Rs. 1,00,000/- of insurance policy is due. Then complainant No.1 inquired from the opposite party No.2 and came to know that above said three policies and money was debited from joint saving account automatically and credited to the account of the insurance company. Thereafter, the complainant No.1and deceased Daljit Kaur asked about the same to the Opposite party No.3 and then opposite party No.3 disclosed that she has done the above-said policies. The complainant No.1 also made written complaint against apposite party No.3 with the opposite party No.2 who has also forwarded the same to the head office. The complainant No.1 also asked the opposite party No.3 that he has no money to further continue the insurance policies. Then the opposite party No.3 agreed with complainant No.1 and allowed him to surrender both the insurance policies on his name mentioned above and then the complainant surrendered both his policies in the month of July 2015. The complainant No.1 and deceased Daljit Kaur continued the third policy in question on the name of deceased Daljit Kaur. The opposite party No.2 asked the complainant No.1 to get one small insurance policy on your name having yearly premium of Rs.50,000/- as you have surrendered two big insurance policies which are done without your knowledge and the complainant No.1 agreed with the opposite party No.2 and complainant No.1 took new policy bearing No.17888690 with the premium payable Rs. 50,000/- yearly from opposite party. The deceased Daljit Kaur earlier also got insurance policy in the year 2009 from HDFC Standard life Insurance Company Limited plan namely HDFC SL Youngstar Super II bearing No.14070745 with premium payable Rs. 20,000/- yearly and the same was matured during her lifetime in December, 2015 and maturity amount Rs. 1,37,467.49 Paise was paid to Daljit Kaur. Daljit Kaur also during her lifetime got one insurance policy from SBI life Insurance Company bearing Policy No.56031767501 in the month January, 2013 with premium of Rs. 25,000/- payable yearly, which is to mature in the year 2017. But Daljit Kaur died on 27-05-2016 and the SBI Life Insurance Co. Ltd paid the full death claim of the deceased of Rs. 3,40,000/- on 16-06-2016 without any delay. Deceased Daljit Kaur was housewife and she pays premiums from the saving from her husband’s income. The complainant No.2 also got one insurance policy from opposite party in the year 2014 with premium Rs.20,000/- yearly, which is still continued. The deceased Daljit Kaur was enjoying good health during her life. A cat hit nails on the left foot of the deceased Daljit Kaur due to which her condition deteriorated and remained admitted at Guru Nanak Dev Super specialty Hospital, Tarn Taran and declared dead on dated 27.05.2016. AT that time, deceased diagnosed as suffering from diabetes. Thereafter, her son/nominee Rupinder Singh submitted the original policy and other required documents for death claim of her mother Smt. Daljit Kaur with opposite parties but the opposite parties repudiated the death claim of deceased Daljit Kaur and paid only Rs.4,57,227.97 Paise but refused to death claim i.e. Rs.10,00,000/- without any sufficient cause. The Opposite parties mentioned in the repudiation letter that the deceased while filing application form for purchasing insurance policy in question gave wrong information. The deceased got insurance policy in question through agent opposite party No. 3 and she asked deceased only to sign proposal/application form and remaining columns filed by opposite party No. 3. Moreover, in the month of November, 2013, the deceased was not suffering from diabetes. The opposite party No. 3 agent herself mentioned in the proposal/application form about the occupation and income of the deceased. The deceased and the complainant neither mentioned in the form that they have agriculture land nor gave any document regarding the same to opposite party No. 3. The opposite party No. 3 of her own filled wrong information in the proposal form regarding occupation of the deceased and if any document is attached regarding the same, that also created by her. The sons of deceased Daljit Kaur namely Rupinder Singh and Satinderpal Singh are at present residing in Australia, as such, they could not join the complainants to file the present complainant. Rupinder Singh is also nominee in the said insurance policy in question. The complainants and both the above named sons of deceased are entitled for claim from the opposite parties equally. The complainants requested the opposite parties No. 2 and 3 to admit their claim but they refused and declined their requests. Feeling dissatisfied by the act and conduct of the opposite party, the complainants perforce have filed this complaint against the opposite party.

3        After formal admission of the complaint, notice was issued to Opposite Parties and Opposite Parties No. 1 and 2 appeared through counsel and filed written version contesting the complaint on the preliminary objections that the insured willfully and fraudulently concealed the material facts regarding her health condition at the time of purchase of the insurance policy. The insured gave wrong answers to the questions of the personal statement submitted at the submission of the proposal for purchase of insurance product knowing well that those were incorrect and she stated that she is in good health. However the claim was investigated and as per the investigations, it was established that the life assured was suffering from diabetic Nephropathy and Occupation and Income details disclosed in the application dated 18.9.2013 were found to be false. Therefore, it is evident that the insured was prejudicial to the contents of “Uberrima Fides” which is the basis of all Insurance contracts. Moreover, the fact of ill health and consequent treatment was well within the knowledge of the insured and she was a willful suppression to obtain insurance fraudulently. Had she disclosed history of her pre-existing disease the insurance policy would not have been issued in favour of the insured and hence the insured did not stick to the "Principle of Utmost Good Faith". Therefore, on the strength of above factors and recommendations of the Investigations agency, the competent authority of respondent repudiated the liability under the said policy and conveyed to the complainant vide letter vide letter dated 3.11.2016 as void ab initio. However, the opposite party processed an amount of Rs.4,57,227.97 towards fund value payable under the said policy and the said amount has duly been received by the complainant without any protest at that time. The complainant is debarred to file the instant complaint due to her own act and conduct. The complainant tried to defraud the opposite parties and knowingly concealed the health conditions of the insured at the time of submission of the claim which clearly reveals that mala fide intention of the complainant to grab the public money; hence the complaint is liable to be dismissed. The insured had willfully and wrongly with ill intention concealed the material facts regarding her health at the time of obtaining the insurance policy and as such, the said policy was declared null and void under the provisions of Indian Contract Act, 1872 as well as per the terms and conditions of the insurance contract. The complaint is liable to be dismissed being uncalled for, unwarranted and misuse of the judicial process.  The complainant is estopped to file the instant complaint as there is no deficiency in service on the part of the Opposite Party as defined in Section 2 (I) (g) of the Consumer Protection Act, 1986 under the heading Deficiency. The insurance policy is a 'De Novo' contract i.e. it is a contract of UTMOST GOOD FAITH technically known as "UBERRIMA FIDES". According to this, doctrine proposer who is one of the parties of contract, is presumed to have means knowledge, which are not accessible to the opposite party, who is the other party to the contract. Therefore, the proposer (life assured) is bound to disclose everything affecting the judgment of the insurer, no matter howsoever unimportant it may seem to him/her (proposer.) In all the contracts of life insurance, the proposer is bound to make full disclosure of all the material fact and not merely those, which he thinks material, misrepresentation, non-disclosure or fraud in any document leading to acceptance of the risk automatically discharges the insurer from all liabilities under the contract. At the time of submission of the proposal and statement regarding health for obtaining the insurance policy, the life assured is bound to make full disclosure of all the facts relating to his/her health but the insured deliberately gave false answers to the questions of the proposal form as mentioned in the written version. Had, she mentioned her true state of health while answering questions of the proposal from the contract of insurance would have not been effected. The complaint against the Opposite party does not lie before this Forum under the Consumer Protection Act 1986 with regard to the rejected claim. The matter is also to be decided by a civil court at full scale trial requiring the complete pleadings and evidence according to law the summary trial under the consumer Protection Act, 1986 is not the proper remedy for the complainants. The opposite party had rightly refused the death claim of the Life Insurance policies of the deceased. In view of the provisions contained in the Insurance Act, 1938 which is a specific statue meant for dealing with the disputes under the contract of insurance, the provisions of the Consumer Protection Act 1986 cannot be invoked for dealing with the matter covered by Insurance Act. The insurance policy was obtained by the complainant on the name of his family members on the basis of proposal form duly submitted fill in, in all respects containing all terms and conditions and salient features of the policy and it was only on the basis of the said proposal forms, the insurance policy was issued by the opposite party upon receipt of the premium. The policies were surrendered by the complainant as per his own will and decision and the opposite parties are not responsible for the same.  The Opposite parties No. 1 and 2 have not committed any deficiency of service or unfair trade practice as alleged in the complaint and all the other allegations in the complaint have been denied by the opposite parties No. 1 and 2 and prayer was made for dismissal of the complaint with costs. 

4        The opposite party No. 3 appeared through counsel and has filed separate written version contesting the complaint on the preliminary objections that the present complaint is not legally maintainable as the opposite party No. 3 is an employee of the HDFC Bank and the said bank is dealing with the business of banking and had no concern with any insurance business. Since she is employee of the bank and as such, there is no question arises at all to work as agent of the HDFC Standard Life Insurance Company Ltd. The complainant has no locus standi to file the present complaint against the opposite party No. 3. The complainant is not consumer of the opposite party No. 3 and as such, the present complaint against the opposite party No. 3 does not lie and is liable to be dismissed. The complainant has no cause of action to file the present complaint against the opposite party No.3. This Forum has got no jurisdiction to entertain and try the present complaint. The present complaint is hopelessly time barred. On merits, it was pleaded that the opposite party No. 3 is working in the HDFC Bank having separate entity and opposite Parties No 1 and 2 are doing their business in the separate building. The opposite party No. 3 is not doing any business of any loss or profit and she is mere employee of the bank. Many other customers are maintaining their accounts in the bank and having of any account in the bank does not mean that the complainant is known to the opposite party No. 3. In case the complainant got the transferred his said money, he has so done with his own accord. The opposite party No. 3 has no knowledge regarding any issuance of the policy as she is not doing any business of insurance nor she is employee of the opposite parties No. l and 2. If said policies were purchased those were purchased by the complainant at his own accord from the opposite parties No 1 and 2 and the replying opposite party has no concern with the same. Receiving of any call from the Opposite party No 1 and 2 is not related to the opposite party No. 3 as she is not doing any work with the opposite party No 1 and 2. The money has been debited as per the desire of the complainant for making the payment of premiums. Accepting and repudiating the claim of any policy holder is being done by the opposite parties No. 1 and 2 and the opposite party no 3 has no concern with the same and all the other allegations in the complaint have been denied by the opposite parties No. 3 and prayer was made for dismissal of the complaint with costs. 

5        Sufficient opportunities were granted to the parties to lead evidence in order to prove their respective case. Ld. counsel for the complainants tendered in evidence affidavit of complainant Harbhajan Singh Ex. C-1 alongwith documents Ex. C-2 to Ex. C-9 and closed the evidence. To rebut the evidence of the complainant, Ld. counsel for the opposite parties No. 1, 2 tendered in evidence affidavit of Amit Khanna Manager HDFC Standard Ex. OPs 1, 2/1 alongwith documents Ex. OPs 1,2/2 to Ex. OPs.1,2/12 and closed the evidence. Ld. counsel for the Opposite party No. 3 tendered in evidence affidavit of Ms. Pinki Ex. OP3/1 and closed the evidence.

6        We have heard the Ld. Counsel for the complainant and opposite parties and have gone through the evidence and documents placed on the file by the parties.

7        In the present case insurance is not disputed. Death of Daljit Kaur is also not disputed.

8        The opposite parties No. 1 and 2 in their written version pleaded that the opposite parties No. 1 and 2 processed an amount of Rs. 4,57,227.97 Paise towards fund value payable under the said policy and the said amount has duly been received by the complainant without any protest at that time.  Ld. counsel for the opposite party Nos. 1 and 2 has vehemently contended that the claim of the complainant has rightly been repudiated on the ground that insured was suffering from diabetes. But this fact has been concealed by the insured at the time of obtaining the insurance policy . Had this fact been disclosed by the complainant in the proposal form , the policy would not have been issued to the complainant . So  as per the terms and conditions of the policy the complainant is not entitled to any claim as he was suffering from pre-existing disease at the time of obtaining of the Insurance policy. In view of this, the claim of the complainant was rejected vide letter Ex. OPs 1, 2/2 on record.  Ld. counsel for the opposite parties No. 1 and 2 has vehemently contended that there is no deficiency in service on the part of the opposite parties and a prayer for dismissal of the complaint with cost was made. The opposite parties have placed on record Judgment in civil appeal No.4261 of 2019 titled ‘Reliance Life Insurance Co. Ltd. & Anr Vs Rekhaben Nareshbhai Rathod’ of Supreme Court of India. The complainant has also placed on record Life Insurance Corporation of India Vs Manish Gupta in civil appeal No. 3944 of 2019 of Supreme Court of India.

9       The opposite parties No. 1, 2 have alleged in their written version that claim was repudiated on the recommendation of one investigation agency vide letter dated 3.11.2016 Ex. OPs 1, 2/2. The opposite parties No. 1, 2 have neither disclosed the name of investigator nor placed on record any report of recommendation made by it nor any affidavit of investigator to support version of opposite parties No. 1, 2 has been placed on record by the opposite parties No. 1, 2. So the opposite parties No. 1, 2 have miserably failed to prove that DLA was suffering from diabetic Nephropathy.

10      The opposite parties No. 1, 2 have placed on record death summary Ex. OPs 1,2/7 of Daljit Kaur.  But no affidavit of the doctor who has written the history in death summary has been produced on record. As such, in the absence of the affidavit of the doctor who has written the history in Ex. OPs 1,2/7 , no evidentiary value can be placed upon the discharge summary. Reliance in this connection has been placed upon National Insurance Company Limited Vs. Sardar Kulbir Singh 2010(3) CPC 488 (NC)  wherein it has been held in para 11 as under:-

Affidavit of the Doctor who had prepared the discharge summary has not been filed. It is not disclosed in the discharge summary as to on whose information the doctor had recorded the fact that the respondent was suffering from Chronic Stable Angina for the last 10 years. No reference has been made to any previous medical record in the discharge summary to show that the respondent was suffering from Chronic Stable Angina for the last 10 years. The discharge summary does not disclose as to on what basis it has been stated that the respondent was suffering from Chronic Stable Angina.”

11      From the appreciation of the facts and circumstances of the case, it emerges that the policy in question was in operation on 27.5.2016 when Daljit Kaur died and the opposite parties No. 1 and 2 have not denied this fact in their written version. The opposite parties after admitting the policy, death of Daljit Kaur has paid Rs. 4,57,227.97 Paise towards fund value of the policy which the complainant has already received.  The complainant placed on record death certificate of Daljit Kaur Ex. C-2, repudiation letter Ex. C-3. The only ground on which the claim of the complainant has been repudiated, has been that the complainant was suffering from diabetic disease i.e. prior to the issuance of the insurance policy.  But as per the numerous case law on the point, diabetic is not a disease. In such a situation, it is preposterous to presume that said disease was pre-existing or that non-disclosure thereof at the time of obtaining the insurance policy amount to concealment. Even otherwise,  diabetes is not a material disease, therefore, non disclosure thereof is not a concealment. We draw support from Life Insurance Corporation of India Vs. Sushma Sharma from II (2008) CPJ 213 wherein Hon'ble State Commission has held as under:-

So far as hypertension is concerned, no doubt, it is a disease but it is not a material disease. In these days of fast life, majority of the people suffer from hypertension. It may be only the labour class who work manually and take the food without caring for its calories that they do not suffer from hypertension or diabetes. Out of the literate and educated people particularly who have the white collar jobs, majority of them suffer from hypertension or diabetes or both. If the Life Insurance Companies are so sensitive that they consider hypertension and diabetes as material diseases then they should wind up their business and stop accepting premium. If these diseases had been material Nand Lal insured would not have survived for 10 years after he started suffering from these medical problems. Like hypertension ,diabetes has also infected a majority of the Indian population but the people who suffer from diabetes and continue managing it under the medical advice, they survive for number of years and none of these diseases is fatal and as discussed above, if these diseases had been material deceased Nand Lal insured would not have survived for 10 years.”.

12       We further draw support from Life Insurance Corporation of India Vs. Sudha Jain II (2007) CPJ 452 wherein Hon'ble Delhi State Consumer Disputes Redressal Commission, New Delhi has held that maladies like diabetes, hypertensions being normal wear and tear of life, cannot be termed as concealment of pre-existing disease.

13      The other point taken by the opposite parties No. 1, 2 while repudiating the claim is that the complainant has not disclosed the correct source of income of DLA. The opposite parties No. 1, 2 have not placed on record any document which shows that the complainant has any other source of income except the agriculture income. Moreover, insurance company should not go in to these facts of income because the complainant was paying the premium to opposite parties No. 1, 2 time to time and this aspect can be ascertained by the opposite parties No. 1, 2 at the time of issuing the policy in question.  

14      In such a situation the repudiation made by Opposite Party No. 1, 2 regarding genuine claim of the complainant appears to have been made without application of mind. It is usual with the insurance company to show all types of green pastures to the customer at the time of selling insurance policies, and when it comes to payment of the insurance claim, they invent all sort of excuses to deny the claim. In the facts of this case, ratio of the decision of Hon’ble Apex Court in case of Dharmendra Goel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation.  This ‘take it or leave it’, attitude is clearly unwarranted not only as being bad in law, but ethically indefensible.  It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. In similar set of facts the Hon’ble Punjab & Haryana High Court in case titled as New India Assurance Company Limited Vs. Smt.Usha Yadav & Others 2008(3) RCR (Civil) Page 111 went on to hold as under:-

“It seams that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy.        The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5000/- for luxury litigation, being rich.

15      The complainant has claimed Rs. 10,00,000/- as sum assured from the opposite parties No. 1, 2. In the pleadings, the complainant has admitted that the complainant has received Rs. 4,57,227.97 and now the complainant is entitled to Rs. 5,42,772.03 Paise from the opposite parties No. 1, 2. Moreover, the authorities mentioned placed by the opposite parties No. 1, 2 are not applicable to the present case and are based on different facts and circumstances.

16      From the aforesaid discussion, it transpires that Opposite Parties No. 1, 2  have wrongly  repudiated the claim of the complainant . As such, opposite parties No. 1, 2 are directed to make the death claim of Daljit Kaur to the tune of Rs. 5,42,772.03 Paise( Five Lacs forty two thousand seven hundred seventy two Rupees and three Paise only) as the opposite party Nos.  1, 2 have made the payment of Rs. 4,57,227.97 Paise only out of Rs. 10,00,000/- . The present complaint against the opposite party No. 3 is dismissed. Complainant is also entitled to Rs.10,000/- ( Rs. Ten Thousand only) as compensation on account of harassment and mental agony and Rs 5,000/- (Rupees Five thousand only) as litigation expenses from the opposite parties No. 1, 2. Opposite Parties No. 1 and 2 are directed to comply with the order within one month from the date of receipt of copy of the order, failing which the complainant is entitled to interest @ 9% per annum, on the awarded amount, from the date of complaint till its realisation.  Copy of order be supplied to the parties free of costs as per rules. File be consigned to record room.

Announced in Open Forum

Dated: 06.08.2019

 
 
[ Sh.Charanjit Singh]
PRESIDENT
 
[ Smt. Jaswinder Kaur]
MEMBER

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