Haryana

Bhiwani

CC/46/2019

JETENDER - Complainant(s)

Versus

HDFC - Opp.Party(s)

Hanuman Parsad

06 Mar 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSASL COMMISSION, BHIWANI.

                                                                     Complaint Case No. : 46 of 2019

                                                                     Date of Institution    : 25.02.2019

                                                                     Date of decision:      :  06.03.2024

 

Jitender Kumar son of Sh. Dharambir Singh R/o village Jatai, Tehsil and District Bhiwani.

                                                  ...Complainant. 

 

                                                    Versus.

1. HDFC Bank Limited, Meham Gate, Bhiwani through its Branch Manager.

 

2. HDFC Ergo General Insurance Co. Ltd., having one of its registered office at Hisar,Tehsil and District Hisar, through its Branch Manager.

 

2.  

 

3. Orion Motors Pvt. Ltd., 7^th K.M. Stone, Opp. BBMB, OP Jindal Marg, Hisar Tehsil and District Hisar.

 

...Opposite parties.

 

COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT, 1986.

Before: -       Mrs. Saroj Bala Bohra, Presiding Member.

                    Ms. Shashi Kiran Panwar, Member.

Present:        Sh. Narender Katiwal, Advocate for complainant.

Sh. Satender Kumar Ghanghas, Advocate for OP No.2.

Sh. Jagdish Sheoran, Advocate for OP No.3.

OP No.1 exparte.

  

                                                  ORDER

 

SAROJ BALA BOHRA, PRESIDING MEMBER:

1.                 Brief facts of this case are that in the year 2015, mother of complainant Smt. Rajpati purchased a car make Hyundai Grand i10 Sportz from OP No.3 having registration no. HR-16Q-3294. The car was financed from OP No.1 through OP No.3 and it was insured with OP No.2 under Sarva Suraksha Plus Policy after paying one time extra premium to OP No.2  who assured that the policy covers  Accidental Death, Permanent total disability/Permanent partial disability, Accidental hospitalization, Critical illness, Credit shield insurance, Garage cash and householders coverage, even OP No.2 assured that in the event of expiry of policy holder, amount of loan will not be recoverable from the loanee but their company will clear the loan amount. As such, the car was insured from 20.10.2015 to 19.10.2020.  It is stated that after one year of purchase the policy, Rajpati died due to critical cancer disease.  Complainant has submitted that as per terms of insurance policy, expenses of hospitalization of policy holder covered under insurance policy and amount of loan is also liable to be not coverable from the legal heirs of deceased but the OPs not released such amount of hospitalization rather they sent notices to complainant for recovering the amount of loan and thereafter claimed before Arbitration for recovery of the amount. Hence, the present complaint has been preferred by complainant alleging deficiency in service on the part of OPs and thereby sought directions against them not to recover the amount of vehicle loan and further to pay expenses of hospitalization of deceased Rajpati, further to pay Rs.1.00 lac as compensation for harassment. Further the OP concerned may be directed to clear the loan amount and to issue NOC regarding the vehicle in question. Any other relief to which this Commission deems fit has also been sought.

2.                 Upon notice, OP No.1 did not bother to appear, as such, it was proceeded against as exparte vide order dated 10.04.2019.

3.                 OP No.2 appeared through counsel and tendered reply raising preliminary objections qua maintainability, locus standi and suppression of material facts by complainant & deficiency in service. On merits, it is submitted that the insurance policy was subject to certain terms and conditions. As per policy, the answering OP was liable to pay the outstanding loan amount only in cases of Accidental Death and Permanent Total Disability and a claim under Accidental Hospitalization is payable only in cases where hospitalization is because of any accidental injury.  Since, in the present case, there was no accidental bodily injury, hence, the claim was not payable. Moreover, complainant failed to submit requisite documents to the OP company for processing the claim and as such there is no fault on the part of OP company.  As such, the answering OP denied for any deficiency in service and prayed for dismissal of the complaint with costs.

4.                 OP No.3 filed its written statement taking preliminary objections qua cause of action, locus standi, mis-joinder of necessary party and suppression of material facts. On merits, it is denied that the answering OP got financed the vehicle whereas the vehicle was financed by mother of complainant directly from the OP No.1 and there was no such role of the answering OP in it. The relief of complainant is against OPs No.1 & 2. As such, the answering OP denied for any deficiency in service and thereby any harassment to the complainant. In the end, prayed for dismissal of the complaint with costs.

5.                 Learned counsel for complainant tendered in evidence affidavit of complainant as Ex.CW1/A alongwith documents Annexure C-1 to Annexure C-7 and closed the evidence.

6.                 On the other side, learned counsel for OP No.2 tendered affidavit Ms. Shweta Pokhriyal, Manager (Legal) as Annexure RW2/A and documents Annexure R2/1 to Annexure R2/8 and closed the evidence.

7.                 No evidence was produced on behalf of OP No.3 despite availing sufficient opportunities, as such, its evidence was closed by Court vide order dated 08.08.2023.

8.                 We have heard learned counsel for the contesting parties and perused the record carefully. Written arguments on behalf of OP No.2 filed submitting alongwith it certain case laws.

9.                 Learned counsel for complainant has argued that OP insurance company has wrongly and illegally not released claim amount to the complainant whereas his deceased mother was covered for the insurance benefits under the policy.  The counsel has pointed out that OP was liable to pay the outstanding loan amount in cases of critical illness as is clear from their welcome letter (Annexure C-4) as well as in the insurance policy terms and conditions. But the OP insurance company denied the claim as there was no accidental bodily injury. Further the plea of OP No.2 is that complainant failed to submit requisite documents to the OP company for processing the claim whereas learned counsel for OP insurance company denied for the same.

10.               On the other side, learned counsel for OP No.2 has argued that as per policy, OP insurance company was liable to pay the outstanding loan amount only in cases of Accidental Death and Permanent Total Disability and a claim under accidental hospitalization only in cases where hospitalization is because of any accidental injury.  Since, in the present case, death of insured was due to cancer and not due to any accidental bodily injury, hence, the claim under Accidental Death is not payable. The counsel to strengthen his case has placed  reliance on a case law passed by Hon’ble Supreme Court of India in Civil Appeal No.1375 of 2003 titled M/s Suraj Mal Ram NIwas Oil Mills (P) Ltd. Vs. United India Insurance Co. Ltd. & Anr.  decided on 08.10.2010.  The counsel has further placed reliance on case law delivered by Hon’ble State Consumer Disputes Redressal Commission Punjab, Chandigarh, titled 2020HDFC ERGO Vs. Baljeet Kaur, First Aappeal No.142 of 2019 decided on 10.06.2020 wherein it is held that the insured died due to some ailment and not due to any accident and OP is liable to pay the balance loan amount under this cover in the event of accidental death of the insured or permanent total disablement. We have gone through the case laws referred above.

11.               Perusal of Annexure C-4 reveals that the insurance policy is having coverage of Critical Illness. As per version of complaint and documents of treatment (Annexure C-7) reveal that insured Rajpati died due to cancer and this fact has also not been denied by OP No.2. Section-1 (Critical Illness) of policy terms and conditions (Annexure R2/2) reveals that cancer disease falls under the category of critical illness.  From the record, it is clear that at the time of death, insured was covered under the policy.

12.               In view of above discussion, we are of considered opinion that the claim of complainant has been denied by the OP insurance company arbitrarily and illegally which shows deficiency in service as well as unfair trade practice on their part. This act of OP insurance company must have harassed complainant physically and mentally besides huge monetary loss. Thus the complainant being legal representative of Rajpati (deceased insured) is entitled to get claim from the OP No.2 insurance company. Perusal of copy of R.C. of the vehicle (Annexure C-1) reveals that the vehicle is under HPA/Lease with HDFC Bank Ltd., Hisar (OP No.1).  As such, the amount of claim be given to the OP No.1 bank. OP No.3 has no role in the matter, as such, no liability is attracted towards it. Accordingly the complaint is allowed partly and OP No.2 insurance company is directed to comply with the following directions within forty days from the communication of this order:-

1. To pay the total loan amount on the vehicle referred above, to OP No.1 alongwith interest, if any.
2. To issue No Objection Certificate to the complainant qua the loan on the said vehicle.  
3. Also to pay a sum of Rs.25,000/- (Rs.Twenty five thousand) on account of harassment  caused to the complainant.

(iv)     Also to pay a sum of Rs.5500/- (Rs. Five thousand five hundred) on account of litigation expenses.

                    In case of default, the directions contained in clause (i) to (iv) shall attract simple interest @ 9% per annum for the period of default. 

                    If this order is not complied with, then the complainant shall be entitled to the execution petition under section 71 of Consumer Protection Act, 2019 and in that eventuality, the opposite party may also be liable for prosecution under Section 72 of the said Act which envisages punishment of imprisonment, which may extend to three years or fine upto rupees one lac or with both.  Copies of this order be sent to the parties concerned, free of costs.  File be consigned to the record room after due compliance.  

Announced.

Dated: 06.03.2024