BEFORE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FATEHABAD.
Complaint Case No.: 12 of 2016.
Date of Institution: 06.01.2016
Date of order: 25.01.2017.
Parveen Kumar son of Sh.Ram Niwas, resident of village & post office Arya Nagar, Hisar.
….. Complainant.
Versus
- Branch Manager, Life Insurance Corporation of India, Ratia Road, Tohana District Fatehabad.
- The Divisional Manager, Life Insurance Corporation of India, 3,4,5 SCO Sector-1, Rohtak.
….Opposite parties.
Complaint U/s 12 of the Consumer Protection Act
BEFORE: Sh. Raghbir Singh, President.
Smt. Ansuya Bishnoi, Member.
Present: Shri Suraj Kiran, Advocate for the complainant.
Shri Naresh Sachdeva, Advocate for the opposite parties.
ORDER:
The complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against the opposite parties (hereinafter to be referred as OPs).
2. Briefly stated the facts of the present complaint are that wife of the complainant namely Smt.Kartar @ Kartar Devi had got herself insured with the OPs vide insurance policy No.176964813 for a sum assured of Rs.2,00,000/- and as per terms and conditions of the policy, if the policy holder died unnatural death then the nominee would be entitled to double of the amount. The complainant has been appointed as nominee in respect of the said insurance policy. Smt.Kartar @ Kartar Devi-life insured had died due to road side accident and regarding this an FIR No.983 dated 29.11.2010 under Sections 302, 304-B and 406 IPC was registered with PS Sadar, Hisar against the complainant. It has been further submitted that the complainant has been acquitted in that case, therefore, being nominee of life assured, he is entitled to get sum of Rs.4,00,000/- (being double of the insured sum as the life assured had died unnatural death) alongwith other benefits as per terms and conditions of the policy. It has been further averred that the OPs have passed the claim of the complainant only for Rs.2 lacs against the above said policy and rest of the amount of Rs.2 lacs has been illegally withheld by them. The complainant has requested the OPs and also got served legal notice upon them to settle the claim but the OPs did not settle the claim. The act and conduct of the OPs clearly amounts to deficiency in service on their part. Hence, this complaint. In evidence, the complainant has tendered his affidavit Annexure C1 and documents Annexure C2 to Annexure C12.
3. Upon notice, OPs appeared through their counsel and resisted the complaint by filing joint reply taking preliminary objections such as cause of action, locus standi, maintainability and suppression of true and material facts. It has been further submitted that the life insured had died due to murder by nominee Parveen Kumar and regarding this FIR was also lodged against him. It has been further submitted that the complainant has now been acquitted but as per terms and conditions of the policy he would be entitled for the claim only after confirmation whether the State has filed any appeal before the higher court against the acquittal of the complainant or not. Other allegations made in the complaint have been controverted and prayer for the dismissal of the complaint has been made. In evidence, the OPs have tendered affidavit of Smt.Gurveen Kaur, as Ex.RW1 and documents Annexure R1 to Annexure R4.
4. We have heard learned counsel for the parties and have perused the case file carefully.
5. We have considered the rival contentions of the parties. It is not disputed that wife of complainant had obtained an insurance policy from OPs for a sum assured of Rs.2 lacs and the complainant had been appointed as her nominee. Perusal of Annexure C3 (death certificate) reveals that the life-insured had died on 13.07.2010. It is also evident on the case file that an FIR No.983 dated 29.11.2010 under Sections 302, 304-B and 406 IPC was registered against the complainant at PS Sadar, Hisar and he was lateron acquitted by the court of Learned Additional Sessions Judge, Hisar vide judgment dated 03.12.2013 (Annexure C8). The post mortem (Annexure R2) on the dead body of the life insured was conducted on 14.07.2010 and in this very document the death of the life assured has been opined due to drowning. The grievance of the complainant is that the insurance company is not making the payment of claim filed on account of unnatural death of life insured Smt.Kartar @ Kartar Devi by him being nominee despite the fact that he had been acquitted in the year 2013. On the other hand, the Ops have come with the plea that the case of the complainant for payment of compensation on account of unnatural death will be examined after confirmation as to whether any appeal against the order of acquittal dated 03.12.2013 has been filed by the State Government of not.
6. Perusal of the case file reveals that insurance of the wife of the complainant namely Smt.Kartar @ Kartar Devi was commenced from 05.11.2009 and the life insured had died on 13.07.2010. The ground taken by the OPs that the nominee of the life assured would be entitled for the claim only on confirmation whether any appeal against the order of acquittal of the complainant has been filed before the Higher Court or not appears to be not plausible. The same is not sustainable in the eyes of law. The matter cannot be kept pending on the ground that the State may file appeal against the order of acquittal. Moreover, mere filing of appeal against the order of acquittal does not disentitle the complainant of the benefit until and unless the order of acquittal is not set aside or stayed in appeal provided that the complainant is otherwise entitled for the claim. Since the complainant has been acquitted vide order dated 03.12.2013 as such decision has to be taken keeping in view the status as on today. No doubt that an FIR was registered against the complainant for murder of his wife (life insured) but when the complainant has been acquitted then how the OPs can withheld the claim of the complainant being nominee of life insured. The act and conduct of the OPs appears that without any valid and tenable reason it has not released the claim amount alongwith its benefits to the complainant forcing him to approach this Forum. It is obligatory on the part of the insurance company that whenever any claim is made, then the same has to be decided as early as possible and the basic purpose of the insurance policy is to indemnify the claimant for which the premium has been paid. A delayed claim settlement affects the very object of the consumer contract and the insurance company cannot keep the claim pending for an infinite period. The money with the Insurance Company is public money invested
for the indemnification as per insurance policies and, therefore, the claim has to be decided as contemplated under the regulations and, if not decided, there is failure to implement mandatory regulations on the part of the Insurance Company. In the present case it appears that the OPs are trying to avoid the claim of the complainant on one pretext or the other.
7. Thus, as a sequel to our above discussion, we accept the present complaint and direct the OPs to pay the amount of Rs.2,00,000/- as accidental benefit to the complainant alongwith interest @ 6 % per annum from the date of filing of present complaint till actual realization. We also direct the OPs to further pay a sum of Rs.5,000/- for harassment including litigation expenses to the complainant. This order should be complied within a period of 30 days from the date of this order, failing which the complainant will be entitled to initiate legal proceedings under Section 25/27 of the Act against the opposite party. A copy of this order be supplied to the parties free of costs. File be consigned to the record room after due compliance.
Announced in open Forum.
Dated: 25.01.2017
(Raghbir Singh)
President
(Ansuya Bishnoi) Distt.Consumer Disputes
Member Redressal Forum, Fatehabad.
