PER:
Charanjit Singh, President
1 The complainant has filed the present complaint by invoking the provisions of Consumer Protection Act under Section 34, 35 and 36 against the opposite parties on the allegations that the complainant Robanjit Singh presently residing at 4A Woodland Road, Tahawai, Bay of Plenty, New Zealand, 3170 and he is unable to file the present complaint in person. So he has appointed his special of attorney vide this power of attorney dated 18.3.2021 to Jaipreet Kaur D/o Late Sukhwinder Singh, village Burj Rai Ke( Raipur Baleem) P.O. Sarhali Kalan, Tehsil Patti, District Tarn Taran, Punjab, India. The above said Jaipreet Kaur has legal right to file the present complaint, to sign the complaint, affidavit, application etc. to make evidence, to make statement, to make compromise, to receive compensation, to receive claim from the opposite party and to do all the acts and deeds related to the present matter involved in the present complaint case. The present power of attorney holder Jaipreet Kaur is fully conversant with the facts of the present case. The opposite party No. 4 is doing the business of insurance through network of branches across, India, including the branch office at Patti, Tarn Taran and Mumbai i.e. opposite parties No. 1 to 3. The complainant was approached by the opposite party and upon the assurance that the insurance services provided by the opposite parties are best in their field, as such, the deceased Sukhwinder Singh son of Kashmir Singh availed one life insurance policy bearing No. 20268134 dated 4.4.2018 having client ID H8607846 from the opposite party No. 1 i.e. HDFC Standard Life Insurance Company Limited, Tarn Taran Road Near Preet Palace, Patti, Tehsil Patti, District Tarn Taran. The date of risk commencement of the above said policy was from 31.3.20185 and the annual premium fixed was for Rs. 95,393/-. The above said policy term was for ten years and the premium paying term was fixed for seven years. The date of maturity is 31.3.2028 and in the event of death of the policy holder, the nominee as appointed by policy holder will get a minimum death benefit of Rs. 9,56,930/-and other bonuses, if any. Moreover, the opposite parties satisfied itself regarding the previous medical history of the deceased and as such the above said policy was issued to the deceased Sukhwinder Singh. The deceased Sukhwinder Singh during his life time had paid two premiums of his life insurance policy vide two receipts i.e. first for sum of Rs. 99,999/- vide receipt dated 3.4.2018 and second for a sum of Rs. 97,847/- vide renewal premium receipt No. F8808584 dated 15.4.2019. Unfortunately, Sukhwinder Singh died on 17.12.2019. The complainant is real son of deceased Sukhwinder Singh. The deceased Sukhwinder Singh appointed his son Robinjit Singh as nominee in the above said life insurance policy. Thereafter, the complainant being the son of deceased Sukhwinder Singh intimated to the opposite party no. 1 about the death of his father, who was having life insurance policy of insurance company and the complainant requested to the opposite party No. 1 to disburse the claim amount of insurance policy of the deceased. Thereafter, the opposite party No. 1 instructed the complainant to submit the requisite documents for getting death claim of his father and as per the instruction of the opposite party No. 1 the complainant submitted all the documents through his sister who personally visited the office of the opposite party No. 1 but in this regard no receipt was given to her. Later on, the opposite party No. 1 further instructed the complainant to again submit all the requisite documents with the opposite party No. 2 as such the complainant through his sister Jaipreet Kaur again deposited all the documents to the opposite party No. 2 by visiting their office, but in this regard no receipt was given to her. Moreover, the complainant through email intimated to the opposite party No. 3 regarding the death of his father Sukhwinder Singh and requested to the opposite party No. 3 to disburse the death claim amount of his father. Upon this, the opposite party No. 3 through email dated 3.3.2020 directed the complainant for submission of requisite documents through e mail as well as through registered post. As per the directions of the opposite party No. 3 the complainant sent all the requisite documents to the opposite parties but the opposite parties have not paid any heed to the genuine request of the complainant. Despite the submission of all the documents by the complainant, till today the opposite parties have not disbursed the death claim of the deceased. The complainant has sent all the documents through registered post as well as e mail. The complainant has submitted his documents and made number of reminders through emails i.e. on 28.2.2020, 3.3.2020, 9.3.2020, 25.5.2020, 25.6.2020, 29.6.2020, 4.7.2020, 10.7.2020, 24.7.2020, 25.7.2020, 14.8.2020, 17.8.2020, 20.8.2020 and 28.8.2020. Sister of the complainant alongwith her mother Kulwinder Kaur had visited the opposite parties No. 1 and 2. The complainant through his counsel has already served a legal notice dated 17.11.2020 to the opposite parties No. 1 to 3 through registered post receipt dated 18.11.2020 and requested to disburse the death claim of his deceased father. But despite of service of legal notice, the opposite parties have miserably failed to response upon the legal notice. The complainant through telephonically as well as through E-mail and through his sister Jaipreet Kaur made number of requests to admit the claim of the complainant and to disburse the death claim of the deceased but the opposite parties have miserably failed to accept the genuine request of the complainant. The complainant has prayed for the following relieves.
- The opposite party may kindly be directed to disburse the death claim amount for a sum of Rs. 9,56,930/- of deceased Sukhwinder Singh alongwith interest up to date and other benefits related to the insurance policy.
- The opposite party may kindly be directed to pay Rs. 50,000/- as compensation as well as Rs. 22,000/- as litigation expenses for causing harassment to the complainant by demanding illegal amount in the interest of justice, equity and fair play.
Alongwith the complaint, the complainant has placed on record affidavit of complainant Ex. C-1, Self attested copy of Special Power of Attorney Ex. C-2, Self attested copy of cover note of insurance policy Ex. C-3, Self attested copy of premium dated 3.4.2018 Ex. C-4, Self attested copy of premium receipt dated 15.4.2019 Ex. C-5, Self attested copy of death certificate of Sukhwinder Singh Ex. C-6, Self attested copy of Aadhaar Card of Robinjit Singh nominee Ex. C-7, Self attested copy of Aadhaar Card of Jaipreet Kaur Ex. C-8, Self attested copy of Postal receipt dated 17.3.2020 Ex. C-9, Self attested copy of e mails sent to opposite parties Ex. C-10, Self attested copy of whatsapp messages sent to the opposite party Ex. C-11, Self attested copy of Legal notice dated 17.11.2020 Ex. C-12, Self attested copy of postal receipt dated 18.11.2020 Ex. C-13.
2 Notice of this complaint was sent to the opposite parties and opposite parties appeared through counsel and filed written version by interalia pleadings that the present complaint is false, frivolous, vexatious and abuse of process of this Commission and therefore, same is liable to be dismissed. There is no deficiency of service or negligence on the part of the opposite party. The complainant has never informed about the death of the insured, no claim form has been submitted till date regarding death claim which is mandatory under the IRDA Rule 2002. As such, the complaint is pre mature and is liable to be dismissed on the simply on the score. The allegations made out in the present complaint are nothing but result of concealment of fact on the part of the complainant. All the terms and conditions are incorporate in the insurance policy and it is obligatory part of the complainant to disclose the death as well as submitting the claim form so the opposite party may proceed further regarding the above said policy. The insurance policy No. 20268134 dated 4.4.2018 was issued in the name of Sukhwinder Singh son of Kashmir Singh. The date of commandment of policy was from 31.3.2018 and the date of maturity was 31.3.2028 but the opposite party is not aware about the death of Sukhwinder Singh. The opposite party has instructed the complainant to lodge a claim alongwith requisite documents for getting death claim of his father. Till date, the complainant has not lodged the claim with the opposite party. Some documents were sent on e-mails but those documents are insufficient to settle the claim of the complainant. The opposite party has denied the other contents of the complaint and prayed for dismissal of the same. Alongwith the written version, the opposite party has placed on record affidavit of Manager Ex. OP-1, Proposal form Ex. OP-2, Illustration issued by the opposite parties Ex. OP-3, Bank declaration Ex. OP-4.
3 The complainant has filed the rejoinder to the written version filed by the opposite parties and denied the stand taken by the complainant in the written version and reiterated the stand as taken in the complaint.
4 We have heard the Ld.counsel for the complainant and opposite parties and have carefully gone through the record placed on the file.
5 Ld. counsel for the complainant contended that the present complaint is being filed by the complainant through his sister Jaipreet Kaur being power of attorney. The deceased Sukhwinder Singh son of Kashmir Singh availed one life insurance policy bearing No. 20268134 dated 4.4.2018 having client ID H8607846 from the opposite party No. 1 i.e. HDFC Standard Life Insurance Company Limited, Tarn Taran Road Near Preet Palace, Patti, Tehsil Patti, District Tarn Taran. The date of risk commencement of the above said policy was from 31.3.20185 and the annual premium fixed was for Rs. 95,393/-. The above said policy term was for ten years and the premium paying term was fixed for seven years. The date of maturity is 31.3.2028 and in the event of death of the policy holder, the nominee as appointed by policy holder will get a minimum death benefit of Rs. 9,56,930/-and other bonuses, if any. The deceased Sukhwinder Singh during his life time had paid two premiums of his life insurance policy vide two receipts i.e. first for sum of Rs. 99,999/- vide receipt dated 3.4.2018 and second for a sum of Rs. 97,847/- vide renewal premium receipt No. F8808584 dated 15.4.2019. He further contended that Sukhwinder Singh died on 17.12.2019. The complainant is real son of deceased Sukhwinder Singh. The deceased Sukhwinder Singh appointed his son Robinjit Singh as nominee in the above said life insurance policy. Thereafter, the complainant being the son of deceased Sukhwinder Singh intimated to the opposite party No. 1 about the death of his father, who was having life insurance policy of insurance company and the complainant requested to the opposite party No. 1 to disburse the claim amount of insurance policy of the deceased. He further contended that the opposite party No. 1 instructed the complainant to submit the requisite documents for getting death claim of his father and as per the instruction of the opposite party No. 1 the complainant submitted all the documents through his sister who personally visited the office of the opposite party No. 1 but in this regard no receipt was given to her. He further contended that later on, the opposite party No. 1 further instructed the complainant to again submit all the requisite documents with the opposite party No. 2 as such the complainant through his sister Jaipreet Kaur again deposited all the documents to the opposite party No. 2 by visiting their office, but in this regard no receipt was given to her. Moreover, the complainant through email intimated to the opposite party No. 3 regarding the death of his father Sukhwinder Singh and requested to the opposite party No. 3 to disburse the death claim amount of his father. Upon this, the opposite party No. 3 through email dated 3.3.2020 directed the complainant for submission of requisite documents through e-mail as well as through registered post. As per the directions of the opposite party No. 3 the complainant sent all the requisite documents to the opposite parties but the opposite parties have not paid any heed to the genuine request of the complainant. Despite the submission of all the documents by the complainant, till today the opposite parties have not disbursed the death claim of the deceased. The complainant has sent all the documents through registered post as well as e mail. The complainant has submitted his documents and made number of reminders through emails i.e. on 28.2.2020, 3.3.2020, 9.3.2020, 25.5.2020, 25.6.2020, 29.6.2020, 4.7.2020, 10.7.2020, 24.7.2020, 25.7.2020, 14.8.2020, 17.8.2020, 20.8.2020 and 28.8.2020. Sister of the complainant alongwith her mother Kulwinder Kaur had visited the opposite parties No. 1 and 2. The complainant through his counsel has already served a legal notice dated 17.11.2020 to the opposite parties No. 1 to 3 through registered post receipt dated 18.11.2020 and requested to disburse the death claim of his deceased father. But despite of service of legal notice, the opposite parties have miserably failed to response upon the legal notice. The complainant through telephonically as well as through E-mail and through his sister Jaipreet Kaur made number of requests to admit the claim of the complainant and to disburse the death claim of the deceased but the opposite parties have miserably failed to accept the genuine request of the complainant and prayed that the present complaint may be allowed.
6 Ld. counsel for the opposite parties contended that the complainant has never informed about the death of the insured, no claim form has been submitted till date regarding death claim which is mandatory under the IRDA Rule 2002. As such, the complaint is pre mature and is liable to be dismissed on the simply on the score. The allegations made out in the present complaint are nothing but result of concealment of fact on the part of the complainant. All the terms and conditions are incorporate in the insurance policy and it is obligatory part of the complainant to disclose the death as well as submitting the claim form so the opposite party may proceed further regarding the above said policy. He further contended that the insurance policy No. 20268134 dated 4.4.2018 was issued in the name of Sukhwinder Singh son of Kashmir Singh. The date of commandment of policy was from 31.3.2018 and the date of maturity was 31.3.2028 but the opposite party is not aware about the death of Sukhwinder Singh. The opposite party has instructed the complainant to lodge a claim alongwith requisite documents for getting death claim of his father. Till date, the complainant has not lodged the claim with the opposite party. Some documents were sent on e-mails but those documents are insufficient to settle the claim of the complainant. The opposite party has denied the other contents of the complaint and prayed for dismissal of the same.
7 We have heard the rival contention of Ld counsel for the parties.
8 In the present case, it is not disputed that Sukhwinder Singh has obtained insurance policy from the opposite parties. It is also not disputed in the present case that Sukhwinder Singh died during the currency period of the policy. The date of risk commencement of the policy is 31st March 2018 and maturity date is 31.3.2018. The minimum death benefit under the policy is Rs. 9,56,930/- . The policy is Ex. C-3. The main objection of the opposite is that the present complaint is pre-mature as the complainant has not submitted the documents but on the other hands the case of the complainant is that he has already submitted all the documents with the opposite parties. According to the complainant he has sent all the documents through registered post as well as e mail. The complainant has submitted his documents and made number of reminders through emails i.e. on 28.2.2020, 3.3.2020, 9.3.2020, 25.5.2020, 25.6.2020, 29.6.2020, 4.7.2020, 10.7.2020, 24.7.2020, 25.7.2020, 14.8.2020, 17.8.2020, 20.8.2020 and 28.8.2020. The e-mails are Ex. C-10 on the file. The complainant has also placed on record one postal receipt Ex. C-9 and weight of register letter is 280 gms and same is amounting to Rs. 87 which shows that the complainant has sent all the requisite documents to the opposite parties. The complainant has also placed on record whatsapp chatting Ex. C-11 which shows that the complainant submitted the documents. On the other hands, the opposite parties in their written version themselves admitted in Para No. 6 that some documents were sent on e-mails but those documents are insufficient to settle the claim of the complainant. The opposite parties have not placed on record any letter with postal receipts which shows that which document are required from the complainant. It shows that the opposite parties are putting off the matter under one pretext or the other. The opposite parties intentionally delayed the payment of claim to complainant and got monitory benefit by retaining the amount of claim. As per guidelines of IRDA, the Insurance Companies have to decide the every claim within a period of three months from the date of its intimation and they cannot take more than six months even in special circumstances and in present case, the O.Ps have not settled the claim of complainant even after passing of about 2 years and complainant is also entitled for interest and compensation alongwith insurance value of the vehicle from the date of intimation till the date of final realization. Ld Counsel for complainant has placed on record copy of citation in CC No.86 of 2015, titled as Phoenix Comtrade Pvt Ltd Vs United India Insurance Co. Ltd wherein Hon’ble National Consumer Disputes Redressal Commission, New Delhi held that Consumer Protection Act, 1986, Section 14-Insurance Claim-Interest-Delay in payment of insurance claim-Held-Since the insurer has utilized the aforesaid amount, the complainant is also entitled to an appropriate interest on that amount-As per the guidelines issued by IRDA, the maximum period of six months from the date of the lodgment of complaint is available to the insurer for payment of the claim. He has further placed reliance on citation in First Appeal No.215 of 2015 with First Appeal No. 230 of 2015 dated 30.09.2015 in case titled as United India Insurance Company Limited Vs Jaswant Rai Verma with Jaswant Rai Verma Vs United India Insurance Company Limited, wherein Hon’ble State Consumer Disputes Redressal Commission, U T, Chandigarh observed that Consumer Protection Act, 1986 Section 2 (1) (g) Insurance Regulatory and Development Authority Regulations, 2002-Insurance Claim-theft of vehicle-Investigator appointed by Insurance Company – Untraced report not filed by Police – State Commission held that as per Insurance Regulatory and Development Authority Regulations, 2002, in special circumstances of the case, the Surveyor could take six months for submission of his report, from the date of his appointment – Even on receipt of untraced report on 11.12.2014 opposite party did not decide the claim – this amounted to deficiency in service and unfair trade practice by OP – The District Forum, erred in awarding interest @ 12% per annum on the IDV of the vehicle from the date of lodging the claim – It should have awarded after six months from the date of lodging the claim by the complainant – thus impugned order needs modification.
9 Furthermore, 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 DharmendraGoel 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.UshaYadav& 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.
By withholding the claim of the complainant for a long time, it amounts to deficiency in service and unfair trade practice on the part of the opposite parties.
10 In light of the above discussion, the complaint succeeds and the same is hereby allowed with costs in favour of the complainant and against the Opposite Parties. The opposite parties are directed to make the payment of Rs. 9,56,930/- i.e. insurance claim to the complainant. The complainant has been harassed by the opposite parties unnecessarily for a long time. The complainant is also entitled to Rs. 35,000/- as compensation on account of harassment and mental agony and Rs. 15,000/- as litigation expenses. Opposite Parties 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. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Commission. Copies of the order be furnished to the parties as per rules. File is ordered to be consigned to the record room.
Announced in Open Commission
15.05.2024
