Punjab

Faridkot

CC/19/102

Tejinder Singh Romana - Complainant(s)

Versus

Indian Bank - Opp.Party(s)

Amandeep Singh

07 Aug 2019

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FARIDKOT

 

Complaint No. :      102 of 2019

Date of Institution:    11.04.2019

Date of Decision :       7.08.2019

 

Tejinder Singh Romana  aged about 71 years son of Hargopal Singh Romana resident of Near Water Channel, VPO Rajowala, District Faridkot.

                                         

                                                                                                    .........Complainant

Versus   

 

1. Indian Bank, Branch Faridkot, Jubilee Cinema Chowk, 1^st Floor, Jubilee Tower, Faridkot through its Chief Manager/Authorized Signatory.
2. Indian Bank, Bancassurance Service Centre, Corporate Office, 254-260,Avvai Shanmugam Salai, Royapettah, Chennai-600014 through its Chief Manager/Authorized Signatory.

                                          .............OPs

Complaint under Section 12 of the

Consumer Protection Act, 1986.

 

Quorum: Sh. Ajit Aggarwal, President,

               Smt. Param Pal Kaur, Member.

 

Present:  Sh Amandeep Singh Virdi, Ld Counsel for Complainant,

               Ops Exparte.

                                             

ORDER

(Ajit Aggarwal, President)

                             Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against OPs seeking directions to OPs to clear

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the insurance claim under Prime Minister Sureksha Beema Yojna and for further directing OPs to pay Rs.50,000/- as compensation for deficiency in service and harassment alongwith litigation expenses of Rs.11,000/-.

2                                               Briefly stated, the case of the complainant is that complainant has a saving bank account bearing no.6266058057 with OP-1 and on suggestion and being allured by OP-1 regarding benefits of Prime Minister Sureksha Beema Yojna, complainant got himself enrolled under Prime Minister Sureksha Beema Yojna and they started deducting Rs.12/- per anum towards instalment of insurance premium from the account of complainant. It is submitted that on 19.11.2015, complainant fell down from his vehicle and was hospitalized in Guru Gobind Singh Medical College and Hospital, Faridkot and in said accident he suffered 47% hip shortening disability. Thereafter, he lodged claim with OP-1, who recommended his claim to OP-2 through letter dated 9.05.2017. After that complainant approached Ops several times, but to no effect and finally, OP-1 showed him letter showing that Op-2 has repudiated his claim, which amounts to deficiency in service and has caused harassment and mental agony to him. He has prayed for directing OPs to pay compensation alongwith litigation expenses besides the main relief. Hence, the complaint.

3                                              The counsel for complainant was heard with regard to admission of the complaint and vide order dated 22.04.2019, complaint was admitted and notice was ordered to be issued to the OPs.

4                                              Notice containing copy of complaint and relevant documents was sent to OP-1, who was duly served, but despite having sufficient notice of present complaint, OP-1 did not appear in the Forum either in person or

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through counsel on date fixed. It was presumed that OP-1 is not interested in contesting the complaint and therefore, vide order dated 29.05.2019, OP-1 was proceeded against exparte.

5                                                        Registered cover containing notice of complaint alongwith complaint and relevant documents was sent to OP-2, but it did not receive back undelivered and was presumed to be served and acknowledgment might have been lost in transit. No body appeared on behalf of OP-2 on date fixed either in person or through counsel and therefore, vide order dated 12.06.2019, OP-2 was proceeded against exparte.

6                                                        Complainant party was given proper opportunities to prove its case. Ld Counsel for complainant tendered in evidence affidavit of complainant  Ex.C-1 and documents Ex C-2 to C-9 and then, closed the evidence on behalf of complainant.

7                                                        As there is no rebuttal from OPs side, therefore, we have heard the ld counsel for complainant and have carefully gone through evidence and documents placed on record.

8                                                         From the careful perusal of record and evidence and documents placed on record by ld counsel for complainant, it is observed that case of the complainant is that he is having a saving account with OP-1 and on assurance of OP-1 regarding benefits of Prime Minister Sureksha Beema Yojna complainant got insured himself under Prime Minister Sureksha Beema Yojna and they started deducting Rs.12/- per anum as instalment of insurance premium from his account. On 19.11.2015, complainant fell down from his vehicle and was hospitalized in Guru Gobind Singh Medical College and

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Hospital, Faridkot and in said accident he suffered 47% hip shortening disability. He lodged claim with OP-1, who vide letter dt 9.05.2017 recommended his claim to OP-2. Grievance of complainant is that despite repeated visits and several requests by him to OPs, they repudiated his claim without any reason, which amounts to deficiency in service and has caused mental agony to him. He has prayed for accepting the present complaint and stressed on documents ExC-1 to ExC-9.

 9                                                   To prove his pleadings, he has brought our attention towards document Ex C-2 i,e cover note of his bank passbook that proves that complainant was having a saving account with OP-1 bank. Document Ex C-3 is copy of Discharge & Follow Up Card that clears the point that complainant got admitted in Guru Gobind Singh Medical College and Hospital, Faridkot on 19.11.2015 and was discharged therefrom on 25.11.2015. Ex C-5 is copy of certificate for the Physically Handicapped issued by the office of Civil Surgeon, Faridkot. This document is of vital importance and there remains no doubt in respect of pleadings of complainant in the light of this document that fully proves the fact that during said accident complainant was permanently physically disabled upto the extent of 47 %.  It is clearly mentioned in it that complainant is a case of Tubecular arthritis  and Hip Shortening Disability is 47 %.  Through Ex C-6 which is copy of letter written by OP-1 Bank to OP-2 regarding clearing the claim of complainant, it is clear that complainant was insured under Prime Minister Sureksha Beema Yojna and it also proves that OP-1 recommended OP-2 to pass the insurance claim on account of disability attained by complainant. ExC-7 is copy of letter issued by OP-2 to OP-1 which shows repudiation of claim of complainant by OP-2 on false grounds of not entering FIR. Through his affidavit

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Ex C-1 complainant has reiterated his grievance and made prayer for providing him justice. As Ops are exparte in present complaint and there is no rebuttal from OPs side. On the other hand, complainant has produced sufficient and cogent evidence to prove his grievance. Documents placed on record by complainant are fully authentic and are beyond any doubt. It is generally seen that Insurance Companies are interested only in earning the premiums and find ways and means to decline the claims. He further placed reliance on citation 2008(3)R.C.R. (Civil) Page 111 titled as New India Assurance company Ltd Vs Smt Usha Yadav & Others wherein our Hon’ble Punjab & Haryana High Court held that it seems that Insurance Companies are only interested in earning premiums and find ways and means to decline the claims. The 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 the clauses of agreement which a person is generally made to sign on dotted lines at the time of obtaining the policy. He further put reliance upon citation 2012 (1) RCR(Civil) 901 tilted as IFFCO TOKYO General Insurance company Ltd Vs Permanent Lok Adalat (Public Utility Services), Gurgaon and others, wherein our Hon’ble Punjab and Haryana High court held that  Contract Act, 1872 – Insurance Act, 1938 – contract among unequal – Validity – Medicalim Policy – Exclusion clause – Pre existing disease – Exclusion clause is standard form of contracts – When bargaining power of the party is unequal and consumer has no real freedom to contract – Courts can strike down such unfair and unreasonable clause in a contract where parties are not equal in bargaining power.

 10                                                  He argued that complainant is entitled for insurance claim for the disability incurred by him. From the above discussion, we

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are of considered opinion that OPs have wrongly and illegally repudiated the claim of complainant on the basis of wrong terms and condition, which were never explained to him. When the OPs once issued the insurance policy in favour of insured they can not deny the claim on flimsy grounds. As per Prime Minister Sureksha Beema Yojna claim procedure, the claim for the same shall be submitted to the bank alongwith all required documents and the bank shall check the same and to forward the case to the Insurance Company concerned within 30 days of the submission of the claim. The insurer will verify and confirm that premium has been  remitted for insured and the claim shall be processed by the Insurance Company within 30 days from its receipt.

11                                                      But in present case, OPs returned the claim of complainant for want of FIR and other terms and conditions which were never disclosed to him and did not process the claim of complainant. It is clear that the complainant submitted claim form alongwith documents to them but they repudiated the claim without any authority. Moreover, having been exparte, there is nothing on record by Ops side. There is deficiency in service on the part of OPs in processing and clearing the claim of complainant that has caused mental agony and harassment to him. Hence, complaint in hand is hereby allowed. OPs are directed to settle and pay the insurance claim of complainant on account of 47 % hip shortening disability attained by complainant alongwith interest at the rate of 9% per anum from 12.06.2017 when they repudiated the claim of complainant till final realization. They are further directed to pay Rs.5,000/-to complainant for harassment and mental agony suffered by her including litigation expenses within one month of receipt of the copy of the order failing which, complainant shall be entitled to proceed under Section 25 and 27 of the Consumer Protection Act. Copy

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of order be given to parties free of cost under rules. File be Announced in Open Forum

Dated : 07.08.2019                 

 

(Parampal Kaur)                      (Ajit Aggarwal)

                     Member                                   President