BEFORE THE DISTR7ICT CONSUMER DISPUTES REDRESSAL FORUM, AMRITSAR.

Consumer Complaint No. 376 of 2015

Date of Institution: 9.6.2015

Date of Decision: 27.01.2016

1. Smt.Ranjit Kaur aged 48 years widow of Late S.Gurbachan Singh
2. Jatinder Kaur aged 30 years, daughter of Late S.Gurbachan Singh
3. Amandeep Kaur aged 27 years daughter of Late  S.Gurbachan Singh
4. Sukhdeep  Singh aged 24 years son of Late S.Gurbachan Singh
5. Vikramjit Singh aged 23 yearsn son of Late  S.Gurbachan Singh

All residents of House No. 1558, Village Kale Ghanupur, Chheharta,Tehsil and District Amritsar

Complainants

Versus

1. National Insurance Company Ltd., Divisional Office-3, situated at Queens Road, Amritsar through its Branch Manager
2. National Insurance  Company Ltd., Gaziabad (Uttar Pradesh) Pin 2011001 through its Branch Manager at 65 Navyug Market
3. Dauphin Touch Network (Private) limited having office at 61-C, Tuli Complex, Moti Nagar, Ludhiana (Punjab) through its branch manager

Opposite Parties

Complaint under section 11 and 12 of the Consumer Protection Act, 1986

Present:    For the Complainant                          :  Sh. A.K.Vermani,Advocate

               For the Opposite Parties No.1 & 2: Sh. P.N.Khanna, Advocate

                For the Opposite Party No.3      : Ex-parte

Quorum:

Sh.Bhupinder Singh, President

Ms.Kulwant Kaur Bajwa, Member

Sh. Anoop Sharma, Member

Order dictated by:

Sh.Bhupinder Singh, President.

1. Present complaint has been filed by complainants under the provisions of the Consumer Protection Act alleging therein that Gurbachan Singh (now deceased), husband of complainant No.1 and father of complainants No.2 to 5, obtained Insurance policy from the opposite parties bearing policy No. 361201/42/12/8200000343 on 13.2.2013 valid from 13.2.2013 to 12.2.2014 with sum assured Rs. 4,00,000/-. According to the complainants on 23.12.2013 Gurbachan  Singh met with an accident  with an Indica car while he was travelling in  Alto car bearing registration No. PB-02-AX-5670 at Nadala. In the aforesaid accident Gurbachan  Singh sustained major injuries. He was immediately taken to Apex Hospita, Subhanpur Road, Nadala . Matter was immediately reported to the police vide DDR No. 13 dated 24.12.2013. Gurbachan Singh could not survive on account of the injuries  sustained by him in the aforesaid accident  and he expired on 26.12.2013. After the death of Gurbachan  Singh complainants being legal heirs of Gurbachan Singh lodged claim with the opposite parties after fulfilling all the requirements, but the opposite parties refused to settle the claim of the complainants. Complainants have also got the claim as per Motor Accident Claim Tribunal vide judgement dated 3.9.2014. Alleging the same to be deficiency in service complaint was filed seeking directions to the opposite parties  to pay the insured amount of Rs. 4,00,000/- alongwith interest @ 18% p.a. Compensation of Rs. 50,000/- alongwith litigation expenses Rs. 25000/- were also demanded.
2. On notice, opposite parties No.1 & 2 appeared and filed written version in which it was submitted that  there is no direct insurance between the complainants and opposite parties No.1 & 2. However M/s. Dauphin Travel Marketing Pvt.Ltd approached opposite parties No.1 & 2  to purchase the policies to be gifted to their respective clients for the purchase of their products. It was submitted that on receipt of the claim from opposite party No.3, letter dated 24.12.2014 was written to the complainants being nominee in the policy, to supply the postmortem report of the deceased. The said request was followed by reminder dated 20.1.2015 and 26.2.2015. But no steps were taken by the complainants to supply the postmortem report of the deceased . As no response was received, therefore finally vide letter dated 19.3.2015  the claim of the complainants was closed as “No Claim”. While denying and controverting other allegations, dismissal of complaint was prayed.
3. Opposite party No.3 in its written version has submitted that as per certain schemes launched by opposite party No.3, an insurance policy was got done by opposite party No.3 from opposite party No.1 & 2 and was gifted to Late  Sh.Gurbachan Singh. The opposite party No.3 has enrolled late Sh. Gurbachan Singh at Delhi and the Insurance policy was issued from Delhi. Hence, this Forum has no jurisdiction to  entertain the present complaint.  It was submitted that complainants are not the consumers of opposite party No.3 as neither the complainants nor deceased Gurbachan Singh has ever paid any consideration to opposite party No.3 for any insurance policy/related services nor opposite party No.3 has sold any insurance policy or provided any insurance related services to the complainants or to deceased Gurbachan Singh. As such the complaint filed by the complainants against opposite party No.3 is not maintainable  and the same is liable to be dismissed.
4. Complainants tendered into evidence affidavit of  Sh. Sukhdeep  Singh son of late Sh.Gurbachan Singh Ex.CW1/A alongwith documents Ex.C-1 to Ex.C-16, affidavit of Smt.Ranjit Kaur widow of Late Sh. Gurbachan Singh Ex.CW2/A, affidavit of Sh.Vikramjit Singh son of Late Sh. Gurbachan Singh Ex.CW3/A, copy of judgement passed by the court of  Sh.Manish Arora which is earlier Ex.C-4 now the certified copy of the same is Ex.C4/A, certified copy of rapat No.13 Ex.C5/B, rapat No. 16 Ex.C6/C, certificate issued by Gurudwara Bouli Sahib, Tarn Taran Ex.C-17.
5. Opposite parties No.1 & 2 tendered affidavit of Sh. Vinod Kumar Mahajan, Divisional Manager Ex.OP1,2/1 alongwith documents Ex.OP1,2/2 to Ex.OP1,2/10.
6. Opposite party No.3 did not appear for leading evidence , as such it was proceeded against ex-parte vide order dated 26.11.2015.
7.  We have carefully gone through the pleadings of the parties, arguments advanced by the ld.counsel for the  parties and have appreciated the evidence produced on record by both the parties with the valuable assistance of the ld.counsel for the parties.
8. From the record i.e. pleadings of the parties and the evidence produced on record by both the parties, it is clear that predecessor in the interest of complainants Gurbachan Singh obtained Insurance policy bearing No.361201/42/12/82000000343 on 13.2.2013 Ex.C-1 from opposite parties No.1 & 2 through opposite party No.3. The said Insurance policy was valid from 13.2.2013 to 12.2.2014 with sum assured Rs. 4,00,000/-  against the life and accidental injuries of Gurbachan Singh. Gurbachan Singh insured met with an accident on 23.12.2013 while travelling in Alto car bearing registration No. PB-02-AX-5670 at Nadala District Kapurthala P.S. Bhulath when the said car was hit by one Indica Car coming from the front side. In the said accident Gurbachan Singh insured sustained serious injuries. He was taken to Apex Hospital Subanpur Road, Nadala and the matter was reported to the police on the basis of which DDR No. 13 dated 24.12.2013 in this regard was recorded at P.S. Bhulath Ex.C-5/B. Information regarding this accident was also given to the opposite party. Gurbachan Singh insured  succumbed to the injuries and expired on 26.12.2013. In this regard DDR No. 16 dated 16.1.2014 Ex,.C-6/C was recorded at P.S. Subanpur. The death certificate of Gurbachan Singh deceased life insured (hereinafter to be called DLA) is Ex.C-8 . Information regarding death of DLA Gurbachan Singh was given to the opposite parties No.1 & 2 on 2.1.2014 vide letter Ex.C-9. The claim was lodged with the opposite parties. But opposite parties No.1 & 2 did not settle the claim of the complainants.  Complainants have also got the claim through Motor Accident Claim Tribunal,Amritsar vide judgement dated 3.9.2014 Ex.C-4. But the opposite parties have failed to pay the insured amount of Rs. 4 lacs to the complainants on account of accidental death of Gurbachan Singh. Ld.counsel for the complainants submitted that all this amounts to deficiency of service on the part of the opposite parties No.1 & 2 qua the complainant.
9. Whereas case of opposite parties No.1 & 2 is that there is no direct insurance between complainant and opposite parties No.1 & 2. However, this policy is through opposite party No.3, who purchased this policy to be gifted to their respective clients. The certificate of insurance in this regard was also issued in the name of Gurbachan Singh which is Ex.C-1. Opposite parties No.1 & 2 submitted that on receipt of the claim regarding death of Gurbachan Singh, DLA , from opposite party No.3 , letter dated 24.12.2014 Ex.OP1,2/7 was written to the complainants being nominee in the policy, to supply postmortem report of the DLA. The said letter was followed by reminders dated 20.1.2015 Ex.OP1,2/8 and 26.2.2015 Ex.OP1,2/9. But the complainants did not supply the postmortem report of DLA , which is one of the basic documents for considering the death claim. Therefore, finally vide letter dated 29.3.2015 Ex.OP1,2/10, complainants were informed that case has been closed as “No Claim”. Ld.counsel for opposite parties NO.1 & 2 submitted that there is no deficiency of service on the part of opposite parties No.1 & 2 qua the complainants.
10. Whereas case of opposite party No.3 is that Gurbachan Singh, DLA had purchased  some products/services from opposite party No.3. Opposite party No.3, has, therefore, enrolled Gurbachan Singh,DLA and Insurance policy was issued in his favour from Delhi from the office of opposite parties No.1 & 2. The certificate of insurance in this regard is Ex.C-1/Ex.OP1,2/2.  The insurance was got done by opposite party No.3 in the name of Gurbachan Singh,DLA , from opposite parties No.1 & 2 and was gifted to Sh.Gurbachan Singh,DLA. So it was opposite parties No.1 & 2 who had to pay the insured amount to the complainants. Opposite party No.3 has nothing to pay to the complainants regarding accidental death of Gurbachan Singh,DLA. Opposite party No.3 submitted that  there is no deficiency of service on the part of opposite party No.3 qua the complainants.
11. From the entire above discussion, it stands fully proved on record that Gurbachan Singh,DLA purchased some products from opposite party No.3 and as such he was enrolled by opposite party No.3 and they got done Insurance policy in question from opposite parties No.1 & 2  and handed over the same to Gurbachan Singh,DLA and opposite parties No.1 & 2 issued certificate of insurance in favour of  Gurbachan Singh Ex.C-1 for the period from 13.2.2013 to 12.2.2014. Said Gurbachan Singh met with an accident on 23.12.2013 when he was travelling in Alto car bearing registration No. PB-02-AX-5670 which was hit by one Indica car in the area of Nadala, P.S. Bhulath, District Kapurthala, as a result of which Gurbachan Singh sustained serious injuries. He was taken to Apex Hospital ,Subanpur Road, Nadala, where he remained admitted from 23.12.2013 to 26.12.2013, where he succumbed to the injuries and expired on 26.12.2013 and the said hospital issued certificate in this regard Ex.C-12. Legal heirs of Gurbachan Singh filed Motor Accident Claim before the Motor Accident Claim Tribunal,Amritsar and the said Tribunal vide award dated 3.9.2014 Ex.C-4 awarded compensation to the complainant regarding death of Gurbachan Singh,DLA holding that Gurbachan Singh died in motor accident. The present complainants filed insurance claim with the opposite parties regarding death of Gurbachan Singh, DLA under the aforesaid insurance, insurance certificate of which is Ex.C-1 with opposite parties No.1 & 2. Opposite parties No.1 & 2 wrote letters to the complainants to provide postmortem report of DLA Gurbachan Singh. The complainants did not got the postmortem of DLA Gurbachan Singh conducted because of religious sentiments , so they could not supply the copy of postmortem report to opposite parties NO.1 & 2  and opposite parties No.1 & 2 vide letter dated 29.3.2015 Ex.OP1/10 closed the case of death claim of Gurbachan Singh treating as “No Claim”.
12. It stands fully proved on record that Gurbachan Singh,DLA was insured with opposite parties No.1 & 2 through opposite party No.3 vide certificate of insurance Ex.C-1. It has been held by the Motor Accident Claim Tribunal vide their award dated 3.9.2014 Ex.C-4 that Gurbachan Singh died as  a result of injuries he has suffered in road side accident  while he was travelling in  Alto car bearing registration No.PB-02-AX-5670. Not only this complainants have also produced on record copy of  DDR regarding this accident Ex.C-5/B i.e. DDR No. 13 dated 24.12.2013 and DDR regarding death of Gurbachan Singh, as a result of injuries he has suffered in the aforesaid motor accident i.e. DDR No. 16 Ex.C-6/C. Not only this complainants have also produced on record certificate from Apex Hospital Ex.C-12 certifying that Gurbachan Singh was admitted in their hospital as a result of road side accident. He remained admitted in that hospital from 23.12.2013 to 26.12.2013 and he expired on 26.12.2013. All this fully proves that Gurbachan Singh died as a result of injuries  he has suffered in road side accident on 23.12.2013, as a result of which he suffered serious injuries and was admitted in Apex Hospital,Subanpur Road, Nadala District Kapurthala, but he succumbed to the injuries and expired on 26.12.2013. Opposite parties No.1 & 2 were not justified in closing the case of the complainants for not producing postmortem report of DLA Gurbachan Singh.
13. Consequently we allow the complaint with costs and opposite parties No.1 & 2 are directed to pay the insured amount i.e. Rs. 4,00,000/-  to the complainants, who are legal heirs of deceased Gurbachan Singh, within one month from the date of receipt of copy of this order ; failing which opposite parties No.1 & 2 shall be liable to pay interest @ 9% p.a. on this amount of Rs. 4,00,000/- from the date of filing of the complaint till payment is made to the complainants. Opposite parties No.1 & 2 are also directed to pay litigation expenses Rs. 2000/- to the complainants. Copies of the orders be furnished to the parties free of costs. File is ordered to be consigned to the record room. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Forum.

27.01.2016                                                           ( Bhupinder Singh )

President

/R/                        ( Kulwant Kaur Bajwa)           (Anoop Sharma)

Member                                   Member