Punjab

Sangrur

CC/356/2016

Anjana Rani - Complainant(s)

Versus

Iffco Tokio General Insurance - Opp.Party(s)

Shri Rohit Jain

10 Oct 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.

                                                              

                                                Complaint No.  356

                                                Instituted on:    21.04.2016

                                                Decided on:       10.10.2016

 

1.             Anjana Rani widow of Jagdish Kumar Bansal son of Shri Kundan Lal Bansal.

2.             Anil Bansal son of Jagdish Kumar Bansal son of Shri Kundan Lal Bansal.

3.             Savipnal Bansal Daughter of Jagdish Kumar Bansal son of Shri Kundan Lal Bansal, all residents of Gali NO.4, Mubarak Mehal, Sangrur, District Sangrur-148001.

                                                        …Complainants

                                Versus

1.             Iffco Tokio General Insurance Company Limited, Second Floor above Hotel Hot Chop, Kaula Park Market, Sangrur, District Sangrur.

2.             Iffco Tokio General Insurance Company Limited, Registered Office: Iffco Sadan, C-1, District Center, Saket, New Delhi-110 017.

                                                        ..Opposite parties

 

For the complainant  :       Shri Rohit Jain, Adv.

For OPs                    :       Shri Darshan Gupta, Adv.

 

Quorum:   Sukhpal Singh Gill, President

                K.C.Sharma, Member

                Sarita Garg, Member

 

Order by : Sukhpal Singh Gill, President.

 

1.             Ms.Anjana Rani, Anil Bansal and Savipnal Bansal, complainants (referred to as complainant in short) have preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that Shri Jagdish Rai Bansal husband of complainant number 1 and father of complainants number 2 and 3 was an employee as Assistant Engineer in Tubewell Corporation at Ludhiana and was the owner of two wheeler LML Vespa scooter bearing registration number PB-10-AB-0128, which was got insured from the Ops for 21.5.2015 to 20.5.2016 by paying the requisite premium, which includes insurance of owner driver.

 

2.             The case of the complainant is that Shri Jagdish Kumar Bansal (referred to as DLA in short) met with an accident on 24.5.2015 and as such was got admitted in the Civil Hospital, Sangrur from where he was referred to Amar Hospital, Patiala on 25.5.2015 and remained there admitted upto 28.5.2015, but due to critical condition, he was referred to PGI Chandigarh where he remained admitted upto 26.6.2015.  It is further averred that DLA was operated for femur fracture in the PGI and discharged and further was called for follow up on 6.7.2015, 16.7.2015 and 27.7.2015, where he was attended by Dr. Sampat of Ortho unit, but the DLA succumbed to these injuries on 29.7.2015. It is further averred that no post-mortem on the dead body of the DLA was conducted, but the FIR number 145 dated 1.6.2015 was registered in PS City Sangrur on the statement of DLA.  Further case of the complainant is that the complainants also got registered the claim, but the Ops vide their letter dated 1.12.2015 repudiated the claim on the lame excuse that there is no post-mortem report of the DLA to ascertain the cause of accident.   Thus, alleging deficiency in service on the part of the OPs, the complainant has prayed that the OPs be directed to pay to the complainant an amount of Rs.1,00,000/- along with interest from 24.05.2015 till realisation and further claimed compensation and litigation expenses.

 

3.             In reply filed by the OPs, legal objections are taken up on the grounds that this Forum has got no jurisdiction to try and decide the present complaint, that the complainant has not come to the Forum with clean hands and that the complainant has unnecessarily dragged the Ops into unwanted litigation. On merits, it is admitted that the DLA got insured the vehicle in question and it is also admitted that he was insured for Rs.1,00,000/- regarding accidental death only.  It is further stated that after receipt of the intimation, the Ops appointed Er. Vikas Gulati to investigate the matter in question, who submitted his report dated 5.10.2015 along with the record and it is stated that the complainant number 1 in his statement stated that the DLA died due to blood clot in his lungs and it is also mentioned in the discharge summary of Amar Hospital, Patiala dated 28.5.2015 that the DLA was having chronic liver disease. The family of the DLA did not inform the police after his death and did not got conduct the post-mortem on the dead body of the insured.  It is further stated that the FIR has also been recorded after a period of eight days from the date of accident. It is stated further that the claim has rightly been repudiated.

 

4.             The learned counsel for the complainant has produced Ex.C-1 copy of letter dated 1.12.2015, Ex.C-2 copy of insurance policy, Ex.C-3 copy of RC, Ex.C-4 copy of DL, Ex.C-5 copy of FIR, Ex.C-6 copy of discharge summary of Amar Hospital, Ex.C-7 copy of discharge and follow up card of PGI, Ex.C-8 copy of admission record of PHSC, Ex.C-9 copy of death certificate, Ex.C-10 copy of LR certificate, Ex.C-11 copy of letter, Ex.C-12 copy of postal receipt, Ex.C-13 copy of email, Ex.C-14 copy of order dated 9.3.2016, Ex.C-15 copy of statement of Surinder Singh, Ex.C-16 copy of statement of Shri Gian Inder Kumar, Advocate, Ex.C-17 copy of order dated 18.5.2016, Ex.C-18 affidavit and closed evidence. On the other hand, the learned counsel for the Ops has produced Ex.OP-1 copy of repudiation letter, Ex.OP-2 copy of claim scrutiny report, Ex.Op-3 copy of investigation report, Ex.OP-4 and Ex.OP-5 copies of statements, Ex.OP-6 copy of discharge summary of JK Bansal, Ex.OP-7 copy of claim form, Ex.OP-8 copy of insurance policy, Ex.OP-9 affidavit of investigator and Ex.OP-10 affidavit of Sanket Gutpa and closed evidence.

5.             We have carefully perused the complaint, written version of the opposite parties, evidence of the parties and heard the arguments of the learned counsel for the parties. In our opinion, the complaint merits dismissal, for these reasons.

 

6.             It is an admitted fact that the DLA got insured his scooter in question with the OPs for the period from 21.5.2015 to 20.5.2016 and further the DLA was insured under the accidental insurance for Rs.1,00,000/-. It is further an admitted fact that the DLA met with an accident on 24.5.2015 and as such was admitted in the Civil Hospital, Sangrur, and thereafter referred to Amar Hospital Patiala and from where he was referred to PGI Chandigarh and was discharged from the PGI Hospital on 26.6.2015 and thereafter the DLA died on 29.7.2015.  The grievance of the complainant is that the OP repudiated the rightful claim of the complainant.  On the other hand, the stand of the OPs is that the claim has rightly been repudiated as after receipt of the intimation the claim of the complainant was got invested from Er. Vikas Gulati, who has stated in his report dated 5.10.2015 that the DLA died due to blood clot in his lungs which fact has further been admitted by the complainant in her statement, a copy of which on record is Ex.OP-5. A bare perusal of the statement Ex.OP-5  shows that the complainant Anjana Bansal has admitted that the DLA died due to blood clot. Further this fact is also supported by the affidavit of Er. Vikas Gulati, which on record is Ex.OP-9.  Further the complainant has not produced any cogent, reliable and trustworthy evidence on record to show that the reason for the death of the DLA was accident, which took place on 24.5.2015.  Further the complainant has not produced on record any copy of the post-mortem report to establish the case that the DLA had died due to accident.  Moreover, it is worth mentioning here that the DLA suffered accident on 24.5.2015 , but died on 29.7.2015 after the discharge from the PGI Hospital, Chandigarh.  In the circumstances, we feel that there is no nexus of death of the DLA with the accident in question, as such we feel that the OPs are not at all deficient in repudiating the claim of the complainant.          

 

7.             In view of our above discussion, we find no case made out and as such we dismiss the complaint of the complainants. However, the parties are left to bear their own costs. A copy of this order be issued to the parties free of cost. File be consigned to records.

                Pronounced.

                October 10, 2016.

                                                        (Sukhpal Singh Gill)

                                                           President

 

 

                                                              (K.C.Sharma)

                                                                Member

 

 

 

                                                                (Sarita Garg)

                                                                    Member