Present: Sh. V.K. Monga counsel for the complainants with complainant <br /> Sh. B.B. Khurana counsel for the opposite party No. 1 and 2.<br /> Sh. D.S. Sidhu counsel for the opposite party No.3.<br /> <br /> ORDER<br /> DHARAM SINGH PRESIDENT<br /> Baljeet Kaur and others complainants has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 requiring the opposite party No. 1 and 2 to pay claim/compensation of Rs.1,00,000/- alongwith 18% per annum interest from the date of death till final realization alongwith damages to the tune of Rs.20,000/- and litigation expenses in favour of the complainants.<br /> 2. The complainants averred in their complaint that deceased Naranjan Singh was the husband of the complainant No. 1 and father of remaining complainants and he was an agriculturist. On 24.3.2006 the deceased had gone to fields for spraying insecticides to the wheat crop at about 4.00 P.M. but at about 5/5.30 P.M. he returned to home in a very critical condition and he was under the effect of insecticide. The complainants rushed him to Dashmesh Dental Hospital, Faridkot for treatment. He died in the hospital. The police was informed and the police carried out proceedings under Section 174 Cr.PC and the deceased was subjected to post mortem and on the basis of chemical report the death occurred due to the poisonous effect of insecticide. The police also recorded DDR No. 44 dated 25.3.2006 in this respect in P.S. Saddar Faridkot. The deceased accidentally came under the effect of insecticide which he was spraying the crops. The deceased was given treatment in the hospital but due to severity of effect of insecticide, the deceased could not be saved. The deceased during his life time opened a Bank Account in the Faridkot Central Coop. Bank Ltd. Faridkot, B.O. Sugar Mill bearing A/C No. 18/33/1, under the Scheme of Sehkari Beema Yojna. As per above scheme the bank got purchased General Insurance policy from the opposite party No. 1 and 2 covering the risk to the life of deceased caused due to road accident, snake bite, effect of spray, electric shock etc. to the tune of Rs.1,00,000/- and the opposite parties No. 1 and 2 issued policy No. 4005/0003958 in the name of deceased. After the death the complainants without any delay lodged the claim with the opposite party No. 1 and 2 through opposite party No. 3 by completing all the formalities for the payment of claim. The opposite party No. 1 and 2 for a long time kept on pretending the complainants with regard to payment of claim. Opposite party No. 3 also kept on contacting the opposite party No. 1 and 2 but the opposite party No. 1 and 2 vide their letter dated 11.11.2006 informed opposite party No. 3 that the claim is not payable as the deceased died due to the lack of proper treatment and opposite party No. 3 accordingly informed the complainants about the denial of claim by opposite party no. 1 and 2. The complainants tried their best to convince the opposite party No. 1 and 2 that there has been no negligence on the part of complainants but the opposite party No. 1 and 2 have not accepted the request of complainants and has refused to pay the claim on the basis of baseless and flimsy grounds as there had been no lapse on the part of the complainants in getting the deceased treated and in providing proper treatment. So the opposite party no. 1 and 2 are guilty of not providing the service to the complainants. The complainants have suffered a lot of harassment at the hand of opposite party No. 1 and 2 as they have wrongfully refused to pay the claim. Hence this complaint. <br /> 3. The counsel for complainant was heard with regard to admission of the complaint and vide order dated 10.4.2007 complaint was admitted and notice was ordered to be issued to the opposite parties. <br /> 4. On receipt of the notice the opposite party No. 1 and 2 appeared through Sh. B.B. Khurana Advocate and filed written reply taking preliminary objections that the complainants in the present case are not consumers of the opposite party No. 1 and 2 as the complainants have not produced on record as how they have become the consumer of the opposite party No. 1 and 2. The policy has not been issued to them nor they have been declared exclusive legal representative/legal heirs of the alleged deceased insured. The complaint in the present form is not maintainable. The complaint in the present form is bad in law and without merit. The complainants have suppressed true facts from the opposite party No. 1 and 2 and from this Hon'ble Forum. The spraying person to follow strictly precautions and observe maximum safety measures keeping anti-toxicant medicine with him the First Aid kit and above all some one must accompany him to avoid any unexpected accident. But the insured did not follow even a single precaution. No one was with the insured when he went to spray the insecticides in the field. The complainants admitted in the FIR that the deceased was habitual of drinking/alcoholism. A person who consumes alcohol must avoid coming in direct contract with other intoxicating things like insecticides as they double the risk of effect of intoxication on the body. The minimum balance in the account of the account holder should be Rs.1100/- and if in any case the minimum balance drops to less than Rs.1100/- then the insured/account holder would not be entitled to any insurance claim. On the date of alleged occurrence the balance in the account of account holder Niranjan Singh was Rs.1072/- thus not fulfilling the requisite eligibility for insurance claim. As per instruction No. 11 in the passbook it has been mentioned in Punjabi Language that the decision of the bank/insurance company would be final in case any dispute arising. The insured is bound to accept the final decision. In the present case the claim of the complainants has been finally decided/rejected by the Insurance Company, so the complainants are estopped from filing the fresh claim. The alleged death of insured occurred in mysterious and doubtful circumstances. It is still not clear whether the alleged death was accidental, intentional, conspiracy or suicidal. The complainants admitted that the claim has been rejected on the ground that the alleged insured has not been provided timely help care and medical treatment due to which the alleged insured died. So the answering opposite parties are not liable to make any payment. On merits the opposite party No. 1 and 2 submitted that during the last of month of March when the crop of wheat is almost ready to be harvested there is no need to spray any insecticide on it. Further a person who is under severe influence of insecticide and died within a few minutes of the effect of insecticide how he came alone to his house from the fields in such a critical condition and without anybody help. Why there was so much delay in providing or taking to hospital. All these questions create foul play in the death of alleged insured. The death of alleged insured is still a mystery. The alleged insured was not provided proper treatment immediately and there so many flaws and negligence in providing the timely treatment to the alleged insured. The alleged death of insured occurred on 24.3.2006 whereas the information to the bank was given on 2.5.2006 a lapse of 1.5 months whereas as per instruction No. 8 in the passbook it is mandatory to inform the bank within two days from the date of accident/death of claim insurance. The providing of late information to the answering opposite parties clearly shows the malafide intention of the complainants that the complaint has been filed after due delebration after thought and on vaxacious grounds just to extort money from the answering respondents. No act or conduct of the opposite parties ever caused any harassment to the complainants. So the complaint be dismissed with special costs. <br /> 5. On receipt of the notice the opposite party No. 3 appeared through Sh. D.S. Sidhu Advocate and filed written reply in which they admitted the case of the complainants and filed a formal reply.<br /> 6. Both the parties wanted to lead evidence to prove their respective pleadings and proper opportunity was given to them. The complainants tendered in evidence copy of admission record Ex.C-1, affidavit of Baljeet Kaur complainant Ex.C-2, copy of pass book Ex.C-3 of Niranjan Singh, copy of death certificate Ex.C-4, copy of application address to Branch Manager Ex.C-5, copy of letter dated 11.11.2006 received from ICICI Ex.C-6, copy of DDR Ex.C-7, copy of post mortem report Ex.C-8, copy of insurance policy Ex.C-9 and closed their evidence. <br /> 7. In order to rebut the evidence of the complainant the opposite party No. 1 and 2 tendered in their evidence affidavit of Satya Parkash Channel Head ICICI Lombard Ex.R-1, copy of rejection letter Ex.R-2 and closed the evidence of the opposite party No. 1 and 2. The opposite party No. 3 tendered in evidence affidavit of Bhupinder Singh Branch Manager Central Cooperative Bank, Faridkot Sugar Mill, Faridkot Ex.R-3 and closed the evidence of the opposite party No.3. <br /> 8. We have heard the learned counsel for the parties and have very carefully gone through the affidavits and documents on the file. Our observations and findings are as under.<br /> 9. Learned counsel for the complainants has submitted that the complainants are entitled for insurance claim of Rs.1,00,000/- on account of death of Niranjan Singh husband of the complainant No. 1 and father of complainant No. 2 to 5 holder of the insurance policy issued by the opposite parties. <br /> 10. Learned counsel for the opposite party No. 1 and 2 submitted that the Niranjan Singh insured died due to his own negligence. It has not been proved if Niranjan Singh died due to inhaling of insecticides (Spray) at the time of working in his fields. Niranjan Singh have not used anti-toxicants with him. He have not used first aid kit. Even he walked to his house. So it cannot be said that he having effect of the spray. Niranjan Singh might have used alcohol at the time of spraying of the insecticides. So he himself is responsible for his death. <br /> 11. From the perusal of the bed head ticket record of Dashmesh Hospital, Faridkot Ex.C-1 it is made out that Niranjan Singh was admitted in the hospital on 24.3.2006. There is final diagnose of suspected poisoning and he was given treatment in the hospital. He expired in the hospital on 24.3.2006 at about 6.30 P.M. and matter was reported to the police by the hospital. <br /> 12. Baljeet Kaur in her affidavit Ex.C-2 have substantiated averments made in the complaint with regard to the death of her husband Niranjan Singh to have been caused by inhaling insecticides at the time of spraying the wheat crop at about 4.00 P.M. on 24.3.2006. He was taken to Dashmesh Hospital, Faridkot for treatment. He died in the hospital. Niranjan Singh was member of the insurance scheme being employee of the Cooperative Sugar Mill, Faridkot at Faridkot as per his saving account No. 33/1 at Serial No. 18 as per pass book entry Ex.C-3. In the insurance policy admittedly insecticide effected death is covered. Niranjan Singh also have adopted Sehkari Bank Bima Yojna as per application Ex.C-5. The DDR Ex.C-7 reported at Serial No. 44 of 25.3.2006 in police station Saddar Faridkot by Baljeet Kaur also makes out that Niranjan Singh died by inhaling insecticides while working in his fields to spray the wheat crop. Post mortem report Ex.C-8 shows that there was effect of insecticides while spraying the wheat crop which resulted into death of Niranjan Singh. The complainants and deceased have taken precautions and treatment for survival of deceased Niranjan Singh from the effect of insecticides, so it cannot be said that death of Niranjan Singh was caused due to the lack of treatment. <br /> 13. In such like circumstances the opposite party No. 1 and 2 are held to have illegally repudiated the claim of the complainants vide letter Ex.C-6 dated 11.11.2006. <br /> 14. There is deficiency in service on the part of the opposite party No. 1 and 2 to be provided to the complainants for payment of insurance amount. So the complaint filed by the complainants is accepted. Accordingly the opposite party No. 1 and 2 directed to pay amount of Rs.1,00,000/- to the complainants in equal share alongwith interest at the rate of 12% per annum from 11.11.2006 when the claim was rejected by the opposite party No. 1 and 2 till the decision of this case. The share of minors have been given to the complainant No. 1 Baljeet Kaur being their real mother and guardian. The opposite party No. 1 and 2 are also directed to pay the above said amount within the period of one month from the date of the receipt of the copy of this order, failing which the opposite party No. 1 and 2 are directed to pay the above noted amount of insurance and interest thereof alongwith further interest of 18% per annum from the date of the decision of this complaint till the realization of the amount. No order as to costs. Copies of the order be sent to the parties free of costs. File be consigned to the record room. <br /> Announced in open Forum:<br /> Dated: 24.1.2008<br />