Punjab

Faridkot

CC/20/15

Jasvir Kaur - Complainant(s)

Versus

LIC - Opp.Party(s)

Lakhwinder Singh Chauhan

16 May 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, FARIDKOT

 

Complaint No. :     15 of 2020

Date of Institution:  17.01.2020

Date of Decision :   16.05.2023

 

Jasvir Kaur aged about 47 years,  w/o Gurmel Singh son of Gurdeep Singh r/o  Bazigar Basti, Tehsil and District Faridkot

    ...Complainant

Versus

 

1. Life Insurance Corporation of India, Division Office at Jallandhar, through its Divisional Manager.
2. Life Insurance Corporation of India, Branch Office at Faridkot, through Branch Manager..

                                                                              .......Ops

Complaint under Section 12 of the

Consumer Protection Act, 1986.

(now, u/s 35 of Consumer Protection Act, 2019)

 

Quorum:    Smt Priti Malhotra, President,

Smt Param Pal Kaur, Member,

Present:       Sh Lalwinder Chauhan, Ld Counsel for complainant,

                   Sh Lakhwinder Singh, Ld Counsel for OPs.

ORDER

(Priti Malhotra, President)

                            Complainant has filed the present complaint against OPs seeking directions to OPs to make payment of insurance claim of Rs. 7 lakhs pertaining to insurance policy bearing no.134042465 and

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for further directing OPs to pay Rs.50,000/- as compensation for harassment, inconvenience, mental agony and litigation expenses of Rs.11,000/-.

2                              Briefly stated, the case of the complainant is that Gursewak Singh deceased husband of complainant was insured with OPs under policy in question valid for the period from 07.03.2017 to 07.02.2033 and complainant was nominee for said policy. On 28.01.2019, husband of complainant met with an accident and died during treatment on 11.05.2019. DDR no. 022 dated 11.05.2019 to this effect was also registered in Police Station City, Faridkot and Police also conducted proceedings under Section 174 of Cr. P. C. Thereafter, complainant lodge claim with OPs and submitted all relevant documents alongwith death certificate of her deceased husband to OPs, but they did not make payment of insurance claim to her. even legal notice got served by complainant through her counsel to OPs, also served no purpose. Despite repeated requests, OPs did not do anything needful to clear the insurance claim. All this amounts to deficiency in service and trade mal practice on the part of OPs and has caused harassment and mental agony to him. He has prayed for

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directions to Ops to pay the insurance claim of Rs. 7 lakhs and Rs.50,000/- as compensation besides Rs.11,000/- as cost of litigation. Hence, the present complaint.

3                           The counsel for complainant was heard with regard to admission of the complaint and vide order dated 07.01.2020, complaint was admitted and notice was ordered to be issued to the opposite parties.

4                           On receipt of the notice, OPs filed reply taking preliminary objections that complaint is not maintainable in the present form as complicated questions of law and facts are involved in it and it can not be decided in summary proceedings. Counsel for OPs averred that complaint is liable to be dismissed on account of non joinder of necessary parties as accident occurred due to stray animal and it is the duty of Municipal Council, Faridkot to control and keep stray animals away from road for avoiding accidents, but that has not been made party and therefore, it is liable to be dismissed on this ground. Further averred that deceased husband of complainant purchased policy in question for sum assured of Rs.3,50,000/-by paying monthly premium of Rs.1970/-on 07.03.2017 under plan term

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814-16-16, but it stands “Lapdes-Wout” due to non payment of premium due 06/2016 and moreover, Branch Office did not receive any information regarding death of insured person. On merits, OPs have reiterated the same pleadings and further averred that there is no deficiency in service on their part and made prayer for dismissal of complaint with costs.

5                               Parties were given proper opportunities to prove their respective case. The complainant tendered in evidence his affidavit Ex.C-1/A and documents Ex C-1 to C-10 and then, closed his evidence.

6                              Despite availing sufficient opportunities, OPs did not conclude evidence and therefore, vide order dated 25.05.2022, evidence of OPs was closed by order of this Commission.

7                              We have heard the arguments addressed by ld counsel for complainant as well as Opposite parties and have also carefully perused and gone through the evidence and documents placed on record by respective parties.

 

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8                                    From the careful perusal of record and going through the affidavits, evidence and pleadings of the parties, it is  observed that grievance of complainant is that her husband was insured under the policy in question and during the validity of insurance period, he met with an accident. Due to injuries sustained in accident, he died and after his death, complainant submitted claim alongwith bills and documents to OPs, but they did nothing needful in making payment of her genuine insurance claim. In reply, Ops admitted that complainant was insured with OPs under the policy in question and it also not denied that he died due to said accident. OPs stressed mainly on the point that deceased insured died in an accident on road by striking with a stray animal and duty to control stray animals lies with Municipal Corporation, Faridkot, which is not impleaded in the array of OPs and therefore, they are not liable to make any payment. It is reiterated that there is no deficiency in service on their part.

9                          It is well proved on record that deceased husband of complainant was insured with OPs against policy in question and it is also not denied that insured died during the subsistence of said policy.

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It is evident from the record that OPs have nothing to contradict the allegations of complainant that despite repeated requests by her, they have not made payment of insurance claim on account of death of her husband to her.       

   10                   The only plea taken by OPs that it is the duty of Municipal Corporation, Faridkot to control stray animals and M.C. Faridkot is liable to make payment of insurance claim, has no legs to stand upon in the light of policy produced on record as no such clause or prior terms and conditions were explained by OPs to insured at the time of issuance of said policy that if death is caused due to striking with stray animal, no claim would be payable. It is observed that it is the tendency of Insurance Companies to find ways and means to escape from their liability to pay the insurance claim, but by raising false contentions, they can not be absolved from their duty to pay the genuine insurance claim of complainant. It is further observed that complainant in question is at liberty to take action against appropriate authority as per law for the loss suffered. On the other hand, complainant has placed on record sufficient and cogent evidence to

 

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prove her pleadings and all documents placed on record by her are authentic and are beyond any doubt.

11                            From the above discussion, this Commission is of considered opinion that there is deficiency in service on the part of OPs in not making genuine insurance claim to complainant on account of death of her husband, who was insured with them against policy in question. Therefore, complaint filed by complainant stands hereby allowed with direction to OPs to pay death claim as per terms and conditions of the policy to complainant. Ops are further directed to pay Rs.10,000/-to complainant as consolidated compensation for harassment and mental agony suffered by him and for litigation expenses incurred on present complaint. Compliance of this order be made within one month of receipt of the copy of the order, failing which, OPs shall be liable to pay Rs.50,000/- in addition to the complainant. Copy of order be supplied to complainant as well as OPs free of cost. File be consigned to record room.

Announced in Commission

Dated : 16.05.2023                 

 

                    (Param Pal Kaur)             (Priti Malhotra)

                    Member                   President