Punjab

Ludhiana

CC/14/473

Rajmukh Singh - Complainant(s)

Versus

National Ins.Co.Ltd - Opp.Party(s)

21 May 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, LUDHIANA.

       C.C. No: 473 of 08.07.2014

                                                                      Date of Decision:21.05.2015

1.Rajmukh Singh aged 36 years son of Bhupinder Singh, resident of 217, Central Town, Pakhowal Road, District Ludhiana.

2.Karan Singh son of Bhupinder Singh, resident of H.No.4/93, Clayton Road, Oakleigh East through Rajmukh Singh.

 

……Complainants

                                                    Versus          

1.National Insurance Company Limited, Registered Office 3, Middleton Street, Post Box No.9229, Kolkatta 700071 through its Manager/Authorized Signatory.

2.National Insurance Company Limited, Feroze Gandhi Market, Ludhiana through its Manager/Authorized Signatory.

                                                                             ……...Opposite Parties

        Complaint under section 12 of the Consumer Protection Act,1986.

         

Quorum:     Sh.R.L.Ahuja, President.                 

                   Sh.Sat Paul Garg, Member.             

                 

Present:       Sh.Gurmail Singh, Adv. for complainants.

Sh.D.R.Rampal, Adv. for Ops.

ORDER

R.L.AHUJA, PRESIDENT

 

1.                Present complaint under Section 12 of the Consumer Protection Act, 1986 (herein-after in short to be described as ‘Act’) has been filed by Sh.Rajmukh Singh and Karan Singh(hereinafter in short to be referred as ‘complainants’) against National Insurance Company Limited and others (herein-after in short to be described as ‘Ops’)- directing them to release the claim amount of Rs.6 lakh and to pay Rs.1 lakh as compensation for the damages and loss suffered by the complainants and other benefits to the complainants.

2.       In brief, the case of the complainants is that Sh.Bhupinder Singh son of Sh.Jagat Singh, father of the complainants insured himself with the Ops on 23.11.2012 at 15:09 Hrs vide insurance Policy Cover Note No.401600/42/12/8100000170 which was valid from 23.11.2012 to 22.11.2013 and as per the said policy, the complainants were mentioned as nominees of Sh.Bhupinder Singh. On 23.11.2012, Sh.Bhupinder Singh suffered a road accident and suffered injuries on his body and due to this reason, he got admitted in Punjab Agriculture University, Hospital, but due to the serious injuries, he was referred to D.M.C.& Hospital. But unfortunately, he was died in the said hospital on 8.7.2013, due to injuries received by him in the said accident. On the date of accident, Sh.Bhupinder Singh even informed the insurance company regarding his accident vide registered letter. After his death, the complainants lodged a claim of above insurance policy with the Ops which was duly received by the Ops. Time and again, the complainants submitted the requisite documents to the Ops as per their demand. Thereafter, despite repeated approaches, requests and letters with the request to sanction the claim, the officials of Ops always postponed the matter on one or the other false pretext. A week back, the Ops flatly refused to give any claim to the complainant on the pretext that death was caused due to negligence on the part of the father of the complainant. Such act and conduct of Ops is claimed to be deficiency in service and unfair trade practice by the complainant. Hence, this complaint.

3.                Upon notice of the complaint, OPs were duly served and appeared through their counsel Sh.D.R.Rampal, Advocate and filed their written reply, in which, they took up certain preliminary objections that complaint is not maintainable in the present form as the same is false and frivolous one; the complaint is bad for non-joinder and mis-joinder of necessary parties; the complainants have not come to this Forum with clean hands and they have suppressed the material facts that the claim of the complainants is not entertainable one as there is no insurance contract at the time of accident i.e. 23.11.2012 and deceased Bhupinder Singh was not covered at the time of alleged accident because the insurance policy issued on that date was cancelled due to dishonouring of the cheque of the deceased and notice dated 30.11.2012 cancelling the said insurance policy was duly issued to the insured and the claim of the complainants was rightly repudiated by the competent authority of the answering Ops and repudiation letter dated 21.3.2014 was duly sent to the complainants informing that there is no claim registered by the answering Ops and said alleged policy No.8100000170 dated 23.11.2012 was cancelled due to dishonouring of the cheque and intimation/notice dated 30.11.2012 was duly sent to Bhupinder Singh. The policy No.401600/42/12/8100000180 attached with the letter dated 24.2.2014 started from 12.12.2012 while accident occurred on 23.11.2012 and accident is not in the policy period and even as per the death report issued by Govt.Medical College and Hospital, Chandigarh, the actual  cause of death is Diabetic foot septicemic/DM Shock Cardiac arrest. The complaint is not verified and complaint is required to be verified in accordance with the provisions of law and due to non verification of complaint, the same is liable to be rejected/dismissed. The complainants are estopped by their act and conduct from filing this complaint and the jurisdiction of this Hon’ble Forum to try and decide the present complaint. On merits, it is submitted that no cause of action has ever accrued to the complainants to file the present complaint. Bhupinder Singh got individual personal accident insurance policy No.401300/42/11/8100000043 valid for the period w.e.f.17.11.2011 to 16.11.2012. After expiry of said policy, Bhupinder Singh filled proposal form dated 23.11.2012 for issuance of fresh individual accidental policy and policy No.401600/42/8100000170 dated 23.11.2012 was issued for the period 23.11.2012 to 22.11.2013. Premium of Rs.1315/- of said policy was paid by Bhupinder Singh through cheque No.478588 dated 23.11.2012 drawn on Axis Bank Ltd. The said cheque was dishonoured by the Axis Bank Ltd, vide memo dated 27.11.2012 and aforesaid insurance policy issued for the period 23.11.2012 to 22.11.2013 was cancelled and information/notice dated 30.11.2012 was duly given to the insured Bhupinder Singh. Thereafter, Bhupinder Singh again filled proposal form and submitted the said proposal form to the answering OP on 12.12.2012 and individual personal accident policy No.401600/42/8100000180 dated 12.12.2012 valid upto 11.12.2013 was issued by the National Insurance Company Limited, Divisional Office No.2, Dholewal, Ludhiana. The said policy started from 12.12.2012. Bhupinder Singh received accidental injuries on 23.11.12. Individual personal accident policy No.401600/42/12/8100000180 dated 12.12.2012 valid upto 11.12.2013 issued by National Insurance Company Limited, Divisional Office No.2, Dholewal, Ludhiana was not subsisting on the date of alleged accident. The claim of the complainants is not entertainable one and was not registered by the answering Ops. Even from the complaint, it is clear that complainants have impleaded wrong offices in the array of parties. The policies aforementioned were issued by National Insurance Company Limited, Divisional Office No.2, Ludhiana and claim of the complainants was rightly declined by the National Insurance Company, DO2, near Dholewal Chowk Ludhiana vide letter dated 21.3.2014 and even postmortem report was not submitted by the complainants. The death report issued by Govt. Medical College and Hospital, Sector 32, Chandigarh is showing the cause of death as Diabetic Septicemic/DM Shock Cardiac Arrest. Bhupinder Singh died due to cardiac arrest and he even did not die due to accidental injuries. As explained above, the policy dated 23.11.2012 was cancelled and thereafter, another policy dated 12.12.12 was obtained by Bhupinder Singh covering risk of accidental injuries. The policy started from 12.12.2012 was not covered the injuries received by him on 23.11.2012, so claim is not entertainable one and was rightly declined/repudiated by the National Insurance Co.Ltd.DO 2, Ludhiana. The due services have been rendered by the answering Ops and there is no deficiency in service on the part of the Ops. At the end, denying all other allegations of the complaint, answering OPs prayed for the dismissal of the complaint.

4.                In order to prove the case of the complainants, learned counsel for the complainants tendered into evidence affidavit of complainant no.1 Rajmukh Singh as Ex.CA. in which, he has reiterated all the contents of the complaint. Further, learned counsel for the complainants has examined Ms.Honey, in which, he has proved the copy of cheque No.478588 dated 23.11.12 as Ex.CE, signatures of Bhupinder Singh Ex.CF and statement of account as Ex.CK. Further, learned counsel for the complainants has proved on record documents Ex.CB to Ex.CJ.

5.                On the other hand, learned counsel for the Ops adduced evidence by placing on record affidavit Ex.RA of Sh.A.S.Grover, its Sr.Divisional Manager, in which, he has reiterated all the contents of the written reply filed by the Ops and rebutted the case of the complainant. Further, learned counsel for the Ops has proved on record documents Ex.R1 to Ex.R11.

6.                We have heard the learned counsel for the parties.

7.                Learned counsel for the complainant has filed the written arguments, in which, he has reiterated all the contents of the complaint and further, it is submitted that the copy of insurance policy and the record regarding the accident of Sh.Bhupinder Singh and injuries suffered by him and his admission in the hospital had already been placed on record and the insurance company was informed about the accident and injuries suffered by Sh.Bhupinder Singh. The Ops are claiming that the said insurance policy was cancelled due to the dishonouring of the cheque. However, there was no fault of the insured in getting said cheque dishonoured as there were sufficient funds in the account of the insured at the time of presentation of the cheque and record in this regard of the bank is already on the file of this case. It is settled law that when there were sufficient funds in the account of the insured but even the cheque was dishonoured by the bank due to any other reason, then the insurance company has no right to cancel the insurance policy. The Ops are claiming that deceased died due to Diabetic and Cardiac arrest. Rather, there are sufficient record with regard to the injuries suffered by the deceased in the accident and regarding his admission in the hospital, as such, the main cause for the death was the injuries suffered in the accident. Thus, the Ops are liable to pay the compensation amount to the complainants as prayed in the complaint.

8.                On the other hand, learned counsel for the Ops has contended that it is proved on record that the complaint is not entertainable as there was no insurance contract on 23.11.2012 between the deceased Sh.Bhupinder Singh and the insurance company and his life was not covered at the time of alleged accident because the insurance policy issued on that date was cancelled due to dishonouring of the cheque of the deceased Bhupinder Singh and due notice dated 30.11.2012 of cancelling the said insurance policy was duly issued to the insured and the claim of the complainants was rightly repudiated by the competent authority of the Ops and repudiation letter dated 21.3.2014 was duly sent to the complainants informing that there is no claim registered by the Ops and said alleged policy No.8100000170 dated 23.11.2012 was cancelled due to dishonouring of the cheque and intimation/notice dated 30.11.2012 was duly sent to Sh.Bhupinder Singh(since deceased). The policy No.401600/42/12/8100000180 attached with the letter dated 24.2.2014 was started from 12.12.2012 while accident occurred on 23.11.2012 and accident is not in the policy period. So, the claim of the complainants is not maintainable. It has also been contended that as per the death report issued by Govt.Medical College and Hospital, Chandigarh, the actual cause of death is Diabetic foot septicemic/DM Shock Cardiac arrest. So, the claim is not entertainable and the same was rightly repudiated by the Ops.

9.                We have gone through the written arguments filed by the learned counsel for the complainants and have also considered the rival contention of learned counsel for the Ops and have also gone through the record on the file very carefully.

10.              Perusal of the record reveals that the complainants have filed this complaint with the specific allegations that their father Sh.Bhupinder Singh(since deceased) son of Sh.Jagat Singh had got himself insured with Ops on 23.11.2012 at 15:09 Hrs vide insurance policy Cover Note No.401600/42/12/8100000170 which was valid from 23.11.2012 to 22.11.2013 and as per the said policy, the complainants were mentioned as nominees of Sh.Bhupinder Singh. Further, as per the allegations of the complainants that  on 23.11.2012, Sh.Bhupinder Singh had suffered a road accident and had suffered injuries on his person and ultimately, he succumbed to his injuries in the DMC & Hospital on 8.7.2013. Thereafter, the claim was lodged with the Ops but the same was repudiated by the Ops illegally and arbitrarily.

11.              On the other hand, there is specific plea of the Ops that the premium was paid by the deceased Bhupinder Singh towards the Policy No.401600/41/11/8100000170 dated 23.11.2012 which was paid by way of cheque No.478588 dated 23.11.2012 drawn on Axis Bank Ltd., which dishonoured, as a result of which, the aforesaid policy was cancelled since inception and due intimation was given to Sh.Bhupinder Singh(since deceased).

12.              There is no dispute qua the issuance of the policy No. No.401600/41/11/8100000170 dated 23.11.2012 for the period w.e.f.23.11.2012 to 22.11.2013 and issuance of the cheque No.478588 dated 23.11.2012 drawn on Axis Bank Ltd. by Sh.Bhupinder Singh(since deceased) and father of the complainants in favour of the Ops which was dishonoured and the aforesaid policy was cancelled by the Ops and due intimation was given to the said Bhupinder Singh regarding cancellation of the policy. Further, it is an undisputed fact between the parties that Ops had issued another insurance policy No.401600/42/12/8100000180 dated 12.12.2012 which was valid upto 11.12.2013 against valid premium. It is also a proved fact on record that during subsistence of the second policy, the deceased Bhupinder Singh did not lodge any claim with the Ops qua his suffering of any injury in any accident during the validity of that policy.

13.              Though, the complainants being legal heirs of Sh.Bhupinder Singh(since deceased) have filed the present complaint with the assertion that Ops continued to delay the payment of claim on one or the other false pretext and ultimately, repudiated the same arbitrarily and illegally. However, perusal of the complaint reveals that there is no reference of cancellation of the first policy and issuance of the second policy w.e.f.12.12.2012 nor there is any reference that said Bhupinder Singh was ever made any representation for revival of the alleged policy which was allegedly issued on 23.11.2012 but the same was cancelled due to non-payment of the premium as the cheque was dishonoured. Perusal of the affidavit of complainant no.1 Sh.Rajmukh Singh Ex.CA which was tendered by the complainants in their evidence also reveals that even after filing the detailed written reply by the Ops, in which, there is specifically mentioned that insurance policy dated 23.11.2012 was cancelled due to non-payment of the premium and a new insurance policy was issued w.e.f. 12.12.2012 and the said Bhupinder Singh did not receive any accidental injury during the subsistence of the second policy. Furthermore, there is a reference of death report which was issued by Govt.Medical College and Hospital, Chandigarh, vide which, the reason for actual cause of death described due to Diabetic foot septicemic/DM Shock Cardiac arrest. However, the complainants did not deny all these facts in their evidence which was produced by way of affidavit Ex.CA of Sh.Rajmukh Singh, one of the complainant.

14.              So, it is proved fact on record that insurance policy, in which, the claim had been lodged by the deceased Bhupinder Singh or the complainants, had been cancelled by the Ops, due to dishonouring of the cheque and no efforts were made by the deceased Bhupinder Singh to get the same revived after making the payment of premium. Rather, Bhupinder Singh(since deceased) had opted to get a new policy by way of filling up new proposal form dated 4.12.2012 and the new policy was issued on 12.12.2012.

15.              So, it appears from the evidence of Ops that Ops had rightly repudiated the claim of the complainants being not maintainable and furthermore, the complainants have not rebutted the evidence of Ops that deceased Bhupinder Singh did not die due to Diabetic foot septicemic/DM Shock Cardiac arrest. Rather, complainants have failed to prove that death of Bhupinder Singh took place due to accidental injuries. So, there does not appear to be any deficiency in service on the part of the Ops.

16.              In view of the above discussion, we hereby dismiss the complaint of the complainants being devoid of any merits. Copy of the order be sent to the parties free of cost and thereafter, file be consigned to the record room.

           

                   (Sat Paul Garg)              (R.L.Ahuja)

                      Member                       President.   

Announced in Open Forum

Dated:21.05.2015

Gurpreet Sharma.