Complainant Smt.Sukhwinder Kaur through the present complaint filed U/s 12 of the Consumer Protection Act 1986 (hereinafter, called the Act) has prayed for issuance of necessary directions to the OP to pay double accidental benefit amount as per rules  alongwith interest @ 18% per annum to her and also to pay Rs.50,000/- as compensation for causing mental agony and harassment due to deficiency in service and unfair trade practice by OP. OP be also directed to pay Rs.10,000/- as costs of litigation expenses or pass any other order which this Hon’ble Forum may deem fit, in the interest of justice.

2.        The case of the complainant in brief is that she is a poor widow lady. Her husband late Paramjit Singh son of Satnam was duly insured with OP vide Insurance PolicyNo.471887603 dated 24.1.2007 and sum assured was Rs.55,000/-.The premium of this policy was fixed at Rs.3611/- yearly and her husband was paying the premium regularly. That on 12.03.2012, her husband died due to the electric current. She lodged the report regarding her husband’s death with the police Station Kanwan vide report No.9 dated 27.03.2012. The deceased left behind her as widow and minor 3 children namely1)Tajinder Singh, 2) Gurpinder Singh and 3) Parneet Kaur who all were dependent upon the deceased. She being an illiterate lady was shocked and disturbed due to this untimely death of her husband. She was not aware of the rules of the policy as she is an illiterate lady. OP was informed regarding the death and requested to pay the insurance claim pertaining to abovedsaid policy. The OP was handed over the original policy and other related documents by her as per their demand but the OP paid only Rs.64,000/- to her and failed to pay the full amount as per terms and conditions of the policy for which she was entitled. As per terms and conditions of the policy if a person dies in an accident, double amount benefit is to be given to the legal heirs of the deceased but the opposite party has not followed this rule in her case and intentionally given less amount in violation of terms and conditions of the policy which act on part of OP is highly unjustified, illegal, discriminatory and amounts to unfair trade practice. This act of the OP also amounts to deficiency in service. She sent a registered letter to the OP on 26.05.2017 but they did not pay any heed to this letter. Further a legal notice under registered cover was also served on the OP on 29.07.2017 but the OP did not bother to give any reply. The OP is liable to pay compensation for causing inconvenience, harassment and mental torture to a poor widow lady.  Hence this complaint.

3.           Opposite parties appeared through their counsel and filed their written reply taking the preliminary objections that the present complaint is not maintainable in the present form; the yearly premium under the policy No.471887603 in the name of Paramjit Singh (deceased) was Rs.3564/- but not Rs.3611/- as alleged in the present complaint; the policy in question was lying in lapse condition with unpaid yearly premium of Rs.3564/- of January, 2012. However, taking into consideration the claim concession condition of the policy in question, sum assured and bonus payable amounting to Rs.67,870 has already been paid/credited to the bank account No.84640100477496 on 5.1.2013 being maintained by the valid nominee (wife)- the complainant and as regards to Double Accident Benefit Claim, under the policy in question, the insurer/respondent is not in receipt of the following requirements to admit the DAB claim under the policy in question i.e. FIR, Postmortem Report, Policy Inquest Report. On merits, it was admitted that the policy bearing No.471887603 in the name of Paramjit Singh with yearly premium is 3564 but not Rs.3611/- as alleged in the complaint. It was also admitted that Paramjit Singh (deceased) died on 12.3.2012 but it was not confirmed that death of the deceased was due to electric current or not. It was also denied that the OP paid Rs.64,000/- to the claimant as alleged in the present complaint whereas the OP has paid Rs.67,870/- including bonus of Rs.12870/- after deducting Rs.3564/- as yearly unpaid premium under the policy in question. The said claim amount has already been paid/credited to the complainant’s account  No.84640100477496 of Punjab National Bank, Gurdaspur on 5.1.2013. All other averments made in the complaint has been vehemently denied and lastly prayed that the complaint may be dismissed with costs.

4.       Complainant tendered into evidence her own affidavit Ex.C1 and affidavit of Ramesh Kumar Sarpanch Ex.C-9 alongwith copies of documents Ex.C2 to Ex.C9 and closed the evidence.

5.       Counsel for the OPs tendered into evidence affidavit of Sh.Mohinder Pal Kalotra, Administrative Officer Ex.OP-1 and closed the evidence.

6.       In the present complaint, the case set up by the complainant is that the complainant is a poor widow lady and her husband was duly insured and on 12.3.2012, the husband of complaint died due to electric current regarding which a report was lodged with the Police Station Kanwan vide report No.9 dated 27.3.2012. The complainant being an illiterate lady was not aware.

7.           We have considered the facts and evidence produced before us on the file.

8.         There is no dispute that husband of complainant got insurance policy from the Ops after making payment of the premium and it is not denied by the Ops that an insurance claim was submitted by the complainant. But as per version of Ops  the policy was lying in lapse condition, with unpaid yearly premium of Rs.3564/- of January 2012. However, taking into consideration the claim concession condition of the policy in question, sum assured and Bonus payable amounting to Rs.67,870/- has already been paid/credited to the bank account  No.84640100477496 on 5.1.2013 being maintained by the valid nominee (wife). Further the Ops are not in receipt of the required documents to admit the DAB claim under the policy in question i.e., F.I.R., Post Mortem Report, Police Inquest Report. In the absence of these necessary documents, No claim could be considered under the DAB claim.

9.        The counsel for the complainant referred a judgment of Hon’ble National Consumer Disputes Redressal Commission 2007 (4) C.P.J. 389 United India Insurance Company V. Pallamreddy Aruna (N.C.D.R.C. (New Delhi) in that case it was held that “ Claim was repudiated on the ground that proof of death by snake bite was not established without conducting post-mortem- Contention cannot be accepted – Death was duly proved by certificate of police official, village Administrative officer and the doctor – In a small village, villagers cannot wait for post-mortem in cases of snake bite – A doctor in such cases can certify that person concerned had died because of poison due to snake bite” .

10.     The facts in the above referred case are not similar to the complaint in hand as in that case a Doctor has certified the reason of death in his report and a Doctor is the best person to judge the cause of death and his report can be relied upon authentically. So accordingly Hon’ble National Commission, held that even in the absence of post mortem report the claim can be given.

11.         In the present complaint the plea of OP is that the complainant has not produced on the file any authenticated document or report to prove the cause of death of the husband of the complainant. They have only mentioned that husband of complainant died due to electrocution. But no report of any public authority is placed on the record to prove the cause of death of the husband of the complainant. In the absence of requisite documents i.e. Police Inquest Report, Post Mortem Report, no claim can be granted. Moreover, the OP have already settled the claim as per terms and conditions of the Insurance policy and the same has been disbursed to the complainant vide banking transactions on 5.1.2013 as stated in the affidavit of Mr.Mohinder Pal Kalotra, Administrative Officer L.I.C. of India Branch, Gurdaspur produced as Ex.OP-1 on the file and the complainant has not rebutted this fact. If the complainant has accepted the claim once and that too without any protest, then she has no right to re-agitate the same later on. So, with these observation, we do not find any force in the arguments put forth by ld. Counsel of the complainant, therefore, we find no merits in the complaint of the complainant. Thus, the same is dismissed with no orders as to costs.

12.        Copies of the orders be furnished to the parties free of costs. File is ordered to be consigned to the record room. The complaint could not be decided within prescribed time due to rush of work.

ANNOUNCED:                      (Shri Raj Singh)                        (Rajita Sareen)

November 19, 2019.                         Member                         Presiding Member

 MK