Punjab

Fatehgarh Sahib

CC/97/2016

Baldev Singh - Complainant(s)

Versus

M/s R.K Company MAnpoewr Pvt Ltd. - Opp.Party(s)

SH. Tejinder Singh.

13 Sep 2018

ORDER

 DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FATEHGARH SAHIB.

                      Consumer Complaint No.97 of 2016

                                                            Date of institution:  13.10.2016    

                                                                          Date of decision   :  13.09.2018

 

Baldev Singh S/o Kirpal Singh resident of village Raipur Gujran, Tehsil Bassi Pathana, District Fatehgarh Sahib.

 

……..Complainant

Versus

1. M/s R.K. & Company Manpower Pvt. Ltd., village Kotla Fazil, Sirhind Chandigarh road, Tehsil Bassi Pathana, District Fatehgarh Sahib through its Manager Varinder Singh @ Bunty.
2. Bharti Axa General Insurance. Co. Ltd., branch JMD, Regent Arcade, Shop No.13 to 15, IInd Floor, MG Road, Gurgaon-122001( Haryana) through its Manager.

 …..Opposite Parties

Complaint under Sections 11 to 14  of the Consumer Protection Act 1986.

Quorum

Sh. Ajit Pal Singh Rajput, President                            

 Sh. Inder Jit, Member

                                               

Present :        Sh. T.S.Dhiman, Adv.Cl. for complainant.

                      Opposite party No.1 exparte.

                      Pt. Narinder Kumar, Adv.cl. for OP No.2.

 

ORDER

By Inder Jit, Member

                      Complainant, Baldev Singh S/o Kirpal Singh resident of village Raipur Gujran, Tehsil Bassi Pathana, District Fatehgarh Sahib, has filed this complaint against the Opposite parties (hereinafter referred to as “the OPs”) under Section 11 to 14 of the Consumer Protection Act. The brief facts of the complaint are as under:

2.                   Complainant got insured himself vide policy No.LWC/11193311/13/08/001556 with OP No.2 through OP No.1 under Worker Insurance Scheme. OP No.1 gave assurance to complainant at the time of providing job that  if any damage is suffered due to any accident at the time of performing the duty, the same will be paid by OP No.2 at the instance of OP No.1. Unfortunately on 19.03.2015, the complainant suffered injuries due to accident while performing his duty in the company of OP No.1. The leg of the complainant was fractured. The complainant took treatment and is still under treatment and is unable to do his daily routine work. The complainant spent Rs.2,00,000/- on his treatment but OPs have not paid any single penny to him.  It is further stated that the information regarding the accident was given to OPs along with policy number. The agents of the OPs promised the complainant that they will pay the claim to the complainant. The complainant so many times visited the OPs and requested them to make the payment but they put the matter off on one pretext or the other. The act and conduct of the OPs amounts to deficiency in service on their part. The complainant also served a legal notice on the OPs but all in vain. Hence, this complaint for giving directions to the OPs to pay the said claim amount along with interest and also compensation for harassment and mental agony to the tune of Rs.5,00,000/-.

3.                   Notice of the complaint was issued to the OPs but OP No.1 chose not to appear to contest this complaint. Hence, OP No.1 was proceeded against exparte.

4.                   The complaint is contested by OP No.2. In reply to complaint, OP No.2 raised certain preliminary objections, inter alia, that the complainant is not a consumer as defined under the Consumer Protection Act; the present complaint is not maintainable and the complaint is false and frivolous and is liable to be dismissed. As regards the facts of the complaint, OP No.2 stated that under the said policy 61 employees of OP No.1 were covered for the period from 28.02.2015 to 27.08.2015 and the total risk coverage of all the employees was Rs.35,10,024/- as per policy schedule. The sum assured for the 5 helpers was Rs.2,57,550/- and the complainant was working as a helper. OP No.2 further stated that OP No.1 lodged a claim with it regarding the alleged injuries of complainant. After getting the information, OP No.2 sent emails dated 27.04.2015, 12.06.2015,25.08.2015 and 14.09.2015 to OP No.1 for sending the requisite documents but OP No.1 failed to submit the same and consequently the claim was closed vide e-mail dated 30.09.2015. There is no deficiency in service on the part of the OP No.2. After denying the other averments made in the complaint, OP No.2 prayed for dismissal of the complaint.

5.                   In order to prove his case, the complainant tendered in evidence true copies of documents i.e. policy Ex. C-1, medical bill Ex. C-2, certificate of hospital Ex. C-3, identity card Ex. C-4, attendance register Ex. C-5, salary register Ex. C-6, legal notice Ex. C-7, postal receipt Ex.C-8 and Ex. C-9, policy Ex. C-10, affidavit of complaint Ex. C-11, Xray sheets Ex. C-12 to C-14 and closed the evidence. In rebuttal the Ld. counsel for OP No.2 tendered in evidence affidavit of Kamal Budhiraja Ex. OP2/1, true copies of documents Ex. OP2/2 to OP2/8 and closed the evidence.

6.                   Ld. counsel for complainant argued that the complainant had got insured himself with OP No.2 through OP No.1 under the Worker Insurance Scheme. He got his leg fractured while  performing duty. He lodged his claim of medical expenses with the OPs but OPs till date have not paid any amount to the complainant. He further argued that directions be issued to the OPs to release the claim amount along with interest to the complainant beside ordering adequate compensation and litigation charges.

7.                   Ld. counsel for OP No.2 argued that OP No.1 lodged the claim of the complainant with OP No.2, but on scrutiny, certain documents were required for processing the claim. OP No.2 sent e-mails on various dates to OP No.1 for sending the required documents for processing the claim, but no document was submitted by OP No.1. Consequently, the claim was closed. He further argued for dismissal of complaint.

8.                   We have gone through the written arguments, evidence placed on record and heard oral submissions. We are of the opinion that OP No.2 sent e-mail to OP No.1 for supplying certain documents found to be deficient with the claim. Complainant was never informed either by OP No.1 or OP No.2 about any deficiency regarding any document with his claim lodged with OP No.2. Hence we accept the complaint and direct OP No.2 to collect the required documents found to be deficient with the claim from the complainant and process his claim as per terms and conditions of the policy and make payment to the complainant within 30 days from the date of receipt of this order alongwith interest @ 8% per annum from the date of filing of the claim with OP No.2 by OP No.1 till its payment. Complainant is also held entitled to Rs.10,000/- on account of compensation for harassment, mental agony etc together with litigation costs. Order be complied within 30 days from the date of receipt of certified copy of this order.

9.                  The arguments on the complaint were heard on 07.09.2018 and the order was reserved. Now the order be communicated to the parties. Copy of the order be sent to the parties free of cost and thereafter the file be consigned to the record room.

Pronounced

Dated: 13.09.2018