Punjab

Patiala

CC/16/80

Kiranjit Kaur - Complainant(s)

Versus

LiC - Opp.Party(s)

Sh Karandip Sharma

28 Feb 2018

ORDER

District Consumer Disputes Redressal Forum,Patiala
Patiala
 
Complaint Case No. CC/16/80
( Date of Filing : 25 Feb 2016 )
 
1. Kiranjit Kaur
aged 42 yrs w/o late sh Jaswinder Singh r/o Quarter No.2 Deputy director Office animal husbandary Ranbir college road Sangrur
Sangrur
Punjab
...........Complainant(s)
Versus
1. LiC
Br.Office Chhoti Baradari Patiala
patiala
Punjab
............Opp.Party(s)
 
BEFORE: 
  Neelam Gupta PRESIDING MEMBER
 
For the Complainant:
For the Opp. Party:
Dated : 28 Feb 2018
Final Order / Judgement

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

PATIALA.

 

                                      Consumer Complaint No. 80 of 25.2.2016

                                      Decided on:                    28.2.2018

 

Kiranjeet Kaur aged 42 years w/o Late Sh.Jaswinder Singh now resident of Quarter No.2, Deputy Director Office, Animal Husbandry, Ranbir College Road, Sangrur.

 

                                                                   …………...Complainant

                                      Versus

  1. LIC of India, Branch Office Chhoti Baradari, Patiala through its Branch Manager.
  2. LIC of India, Jeevan Prakash Building, Sector 17-B, Chandigarh through Sr.Divisional Manager.

                                                                   …………Opposite Parties

                                      Complaint under Section 12 of the

                                      Consumer Protection Act, 1986.

 

QUORUM

                                      Smt. Neena Sandhu, President

                                      Smt. Neelam Gupta, Member                              

                                                                            

ARGUED BY:

                                      Sh. Karandeep Sharma, Advocate, counsel

 for complainant.

Sh. Amit Kumar Bedi, Advocate, counsel

for Opposite party.                                   

 ORDER

                                        SMT.NEENA SANDHU, PRESIDENT

Smt.Kiranjeet Kaur, complainant has filed this complaint under Section 12 of the Consumer Protection Act,1986 ( hereinafter referred to as the Act) against the Opposite Parties (hereinafter referred to as the O.Ps.) praying for givingdirection to the OPs for the following reliefs:-

  1. To pay Rs.5,20,000/-, on account of sum assured & accidental death benefit as per policy alongwith interest @18%  per annum from the date of death of deceased life assured i.e. 20.12.2011 till realization;
  2. To pay Rs.1,00,000/- as compensation for causing mental agony and physical harassment to her;
  3. To pay Rs.22,000/- as litigation expenses and
  4. To grant any other relief,which this Forum may deem fit.            

2.        In brief, the case of the complainant is that the husband of the complainant  late Sh.Jaswinder Singh , (hereinafter to be mentioned as Deceased Life assured i.e.DLA) was duly insured with the OPs vide insurance policy bearing No.164669070 for the period from 10.6.2011 to 10.6.2026. Complainant was appointed as nominee under the said policy. Sum assured under the policy was Rs.2,60,000/-.As per the policy, in case of accident death of the life assured, OPs are bound to pay an additional sum of Rs.2,60,000/- alongwith the sum assured of Rs.2,60,000/- & vested bonus. It is stated that DLA was posted as Poultry Inspector at Govt. Poultry Farm, Jail Road, Patiala. On 19.12.2011 at about 7PM, DLA was having drink at his quarter and was holding glass of liquor in his hand. At the said time Sh.Gurmail Singh (sewadar) came at his quarter and told  the  DLA to fumigate the farm.DLA while holding the glass of liquor in his hand, went to hisoffice situated 10-15 yards from his quarter for bringing medicine/pesticide for fumigation. Then Gurmail Singh came at the quarter and told the complainant that DLA had suddenly fallen ill. Complainant rushed to the office, where her husband told her that  by mistake  he consumed the contents of glass in which medicine/pesticide was poured instead of glass containing liquor, as both the glasses were placed close to each other and colour of contents of both the glasses was similar . DLA was immediately taken to Columbia Asia Hospital, Patiala, but he could not be saved and died on 20.12.2011. Post mortem of the deceased was performed at Rajindra Hospital Patiala on 20.12.2011.DDR No.22 dated 20.12.2011 was also lodged at P.S.Bhawnigarh. After performing the last rites of DLA, complainant submitted the claim form alongwith the relevant documents. However, the OPs did not settle the claim till 2014 and was putting off the matter on one or the other pretext and ultimately repudiated the claim vide letter dated 31.3.2014 stating that as the deceased committed suicide within one year of the policy, hence nothing is payable.The complainant visited  the office of the OPs a number of time and requested for the payment of the claimed amount but to no effect. There is thus deficiency of service on the part of the OPs for which she has been suffering from mental agony and  physical harassment.

3.       On being put to notice, the OPs appeared and filed the written version taking preliminary objections that the complainant is not a consumer; that the complainant has not come to the Forum with clean hands and that the claim of the complainant is not payable as her husband had committed suicide within one year of the policy period. On merits, it is admitted that deceased  Jaswinder Singh obtained policy bearing No.164669070 under T&T 106-15-12 with date of commencement of risk as 11.6.2011 for SA of Rs.2,60,000/-. The premium payment mode amounting to Rs.2800/-was monthly. The maturity date of the policy was 06/2026. Smt.Kiranjeet Kaur was the nominee under the said policy. It is admitted that in case the LA death occurs due to accident then LIC is bound to pay the AB claim with basic sum assured, but only as per terms and conditions of the policy pertaining to clause of AB benefit. It is stated that in the present case the deceased LA Jaswinder Singh had committed suicide within one year from the date of policy, as such policy has become null and void in the light of clause 6 of the policy terms and conditions and nothing was payable to the complainant. The claim being not genuine has rightly been repudiated as per terms and conditions of the policy. There is no deficiency of service on the part of the OPs. After denying all other averments made in the complaint, it was prayed to dismiss the complaint.

4.       On being called to do so, the ld. counsel for the complainant has tendered in evidence Ex.CA affidavit of the complainant, Ex.CB affidavit of Sh.Gurmail Singh alongwith documents Exs.C1 to C5 and closed the evidence.

          The ld. counsel for the OPs has tendered in evidence Ex.OPA affidavit of Sh.V.K.Arora, Manager, L&HPF of OPs alongwith documents Exs.OP1 to OP4 and closed the evidence.

5.       We have heard the ld. counsel for the parties and have also gone through the record of the case, carefully.

6.       At the outset, the ld. counsel for the OPs has vehemently argued that since the DLA had committed suicide within one year of the policy in question, therefore, as per clause No. 6 of the terms and conditions of the policy, the complainant is not entitled  to get any claim. The OPs have rightly repudiated the claim  and  therefore,  the complaint may  be dismissed with costs.

7.       The ld. counsel for the complainant has submitted that on 19.12.2011, at about 7PM, the DLA  was taking liquor at his quarter . At that time  another identical  glass containing pesticide was also lying  nearby. The DLA mistakenly had consumed  pesticides instead of liquor. As a result whereof he died on 20.12.2011. A DDR was lodged on 20.12.2011 with the police station. Postmortem on the dead body of the deceased was also conducted by Govt. Rajindra Hospital, Patiala on the same day. The police authorities after conducting detailed enquiry had furnished a report which is annexed alongwith the letter dated 27.3.2014, Ex.C1. In the said report, it is clearly mentioned that the death of DLA was a natural death. As such the OPs have wrongly repudiated the claim. Therefore, the OPs may be directed to pay the claim as per the insurance policy.

8.       From the perusal of the report dated 7.12.2013 , it is evident that life assured had died  of natural death.  It may be stated here that the said report has not been challenged by the OPs. Since the said report has been given by the Govt. officer after conducting detailed enquiry, therefore, we have no reason to disbelieve the same.  No document whatsoever has been placed on record by the OPs to prove that the DLA had committed suicide. As such the OPs have failed to discharge their onus to prove that the DLA had committed suicide. In this view of the matter, we do not hesitate to conclude that the OPs were not justified in repudiating the claim and they are liable to pay the claim amount to the complainant i.e. nominee,  as per the terms and conditions of the policy.

9.       In view of the aforesaid discussion, we allow the complaint  and direct the OPs in the following manner:

  1. To pay the due claim amount as per the terms and conditions of the policy; alongwith interest @7% per annum from the date of repudiation of the claim i.e. 31.3.2014 till its realization;

 

  1. To pay Rs.10,000/- as compensation for causing mental agony and physical harassment to the complainant;

 

  1. To pay Rs.5000/-as cost of litigation expenses.

The OPs are further directed  to comply the aforesaid order within a period of 45 days from the date of the receipt of the certified copy of this order. Certified copies of this order be sent to the parties free of cost under the Rules.Thereafter, file be indexed and consigned to the Record Room.

ANNOUNCED

DATED:28.2. 2018      

                                                                   NEENA SANDHU

                                                                       PRESIDENT

 

 

                                                                   NEELAM GUPTA

                                                                         MEMBER

 

 

 

 

 
 
[ Neelam Gupta]
PRESIDING MEMBER

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