Haryana

Kaithal

227/20

Poonam - Complainant(s)

Versus

National Insurance Co. - Opp.Party(s)

Sh.Manoj Saharan

11 May 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KAITHAL.

                                                     Complaint Case No.227 of 2020.

                                                     Date of institution: 04.08.2020.

                                                     Date of decision:11.05.2023.

Poonam wife of late Sh. Balbir Singh son of Ajmer Singh, resident of Village Kharal, Tehsil Guhla, District Kaithal.

                                                                        …Complainant.

                        Versus

1. National Insurance Company Ltd. Branch Office Dhand Road, Kaithal, through its Branch Manager.
2. National Insurance Company Ltd. Divisional Office X, 803A Konnectus Building, Tower-3, 8^th Floor, Bhavbhuti Marg, New Delhi-110002, through its Divisional Manager.

….Respondents.

        Complaint under Section 35 of the Consumer Protection Act

CORAM:     SMT. NEELAM KASHYAP, PRESIDENT.

                SMT. SUMAN RANA, MEMBER.

                SH. SUNIL MOHAN TRIKHA, MEMBER.

       

Present:     Sh. Manoj Saharan, Advocate, for the complainant.   

                Sh. Amit Kaushik, Advocate for the respondents.

               

ORDER

NEELAM KASHYAP, PRESIDENT

        Poonam-Complainant has filed this complaint under Section 35 of Consumer Protection Act, 2019 (hereinafter referred to as ‘the Act’) against the respondents.

                In nutshell, the facts of present case are that the husband of complainant namely Balbir Singh had purchased a new motor-cycle make Hero Moto Corp HF-Delux bearing registration No.HR-09F-8535 and got insured the same with the respondents vide certificate-cum-policy bearing No.39010231196200484625 valid for the period w.e.f. 22.05.2019 to 21.05.2024 for the sum of Rs.38,380/- and paid cash premium of Rs.4939/-.  It is further alleged that in case of accident, the CPA of Rs.15 lakhs was to be paid by the respondents.  It is further alleged that on 05.01.2020, the husband of complainant was going on his motor-cycle from Village Ram nagar to his village Kharal and the said motor-cycle met with an accident due to which Balbir Singh sustained serious and multiple grievous injuries and he was taken to Govt. Hospital Guhla where the doctors declared him dead.  The post-mortem of dead body of Balbir Singh was duly conducted by the Medical Officer of PHC Khiala Kalan, Distt. Patiala.  An FIR bearing No.3 dt. 06.01.2020 under Section 304-A, 427 IPC was lodged in P.S.Pasyana.  The complainant being nominee of her husband got lodged the claim with the respondents and submitted all the necessary documents but the respondents did not pay the genuine claim of complainant.  So, it is a clear cut case of deficiency in service on the part of respondents and prayed for acceptance of complaint.     

2.            Upon notice, the respondents appeared before this Commission and contested the complaint by filing their written version raising preliminary objections with regard to locus-standi; maintainability; cause of action; that this complaint is pre-mature, hence, liable to be dismissed.  The complainant or any legal heir of said deceased Balbir Singh neither approached the answering respondents for alleged claim nor informed the respondents regarding alleged death of Sh. Balbir Singh.  None has lodged the claim with the answering respondents on account of the alleged incident/accident in terms of the insurance policy.  The complainant has filed this complaint first time without giving any notice to the answering respondents.  The accident in question is of dt. 05.01.2020 and complainant has filed this complaint on 04.08.2020 before this commission.  There is no deficiency in service on the part of respondents.  On merits, the objections raised in the preliminary objections are reiterated and so, prayed for dismissal of complaint.

3.             To prove his case, the complainant tendered into evidence affidavit Ex.CW1/A alongwith documents Anneuxre-C1 to Annexure-C13 and thereafter, closed the evidence.

4.             On the other hand, the respondents tendered into evidence affidavit Ex.RW1/A and thereafter, closed the evidence.

5.             We have heard the learned Counsel for both the parties and perused the record carefully.

6.             Ld. counsel for the complainant has argued that the husband of complainant namely Balbir Singh had purchased a new motor-cycle make Hero Moto Corp HF-Delux bearing registration No.HR-09F-8535 and got insured the same with the respondents vide certificate-cum-policy bearing No.39010231196200484625 valid for the period w.e.f. 22.05.2019 to 21.05.2024 for the sum of Rs.38,380/- and paid cash premium of Rs.4939/- as per Annexure-C4.  It is further argued that in case of accident, the CPA of Rs.15 lakhs was to be paid by the respondents.  It is further alleged that on 05.01.2020, the husband of complainant was going on his motor-cycle from Village Ram nagar to his village Kharal and the said motor-cycle met with an accident due to which Balbir Singh sustained serious and multiple grievous injuries and he was taken to Govt. Hospital Guhla where the doctors declared him dead.  The post-mortem of dead body of Balbir Singh was duly conducted by the Medical Officer of PHC Khiala Kalan, Distt. Patiala.  An FIR bearing No.3 dt. 06.01.2020 under Section 304-A, 427 IPC was lodged in P.S.Pasyana as per Annexure-C3.  The complainant being nominee of her husband got lodged the claim with the respondents and submitted all the necessary documents but the respondents did not pay the genuine claim of complainant.  It is further argued that the complainant also issued legal notice dt. 22.06.2020 to the OPs as per Annexure-C1 but the Ops did not redress the grievances of complainant.  So, it is a clear cut case of deficiency in service on the part of respondents.

7.             On the other hand, ld. counsel for the OPs vehemently contended that this complaint is pre-mature, hence, the same is liable to be dismissed.  It is further argued that the complainant or any legal heir of said deceased Balbir Singh neither approached the respondents for alleged claim nor informed the respondents regarding alleged death of Sh. Balbir Singh.  None has lodged the claim with the respondents on account of the alleged incident/accident in terms of the insurance policy. 

8.             We have considered the rival contentions of both the parties.  The Ops have taken the specific objection in the written statement that the present complaint is pre-mature as the complainant has not lodged the claim with the Ops on account of the alleged accident in terms of the insurance policy.  To rebut the contention of OPs, ld. counsel for the complainant has drawn our attention towards the application dt. 20.04.2021 written by the complainant to the OPs as per Annexure-C13 and vehemently contended that the claim was intimated to the OPs.  On perusal of said application, it is clear that there is no receipt of Ops from which it could be clear that the claim was intimated to the Ops, so, the said contention of complainant has no force.  The another contention of Ops is that the complainant has not mentioned in the complaint whether any claim has been repudiated by the Ops or not, so, the present complaint is pre-mature.  It is clear from the record available on the file that the complainant has not lodged the claim with the Ops and the Ops have not repudiated the claim of complainant.  So, in view of pleadings of both the parties as-well-as facts and circumstances of the case, the ends of justice will be met if we direct the complainant to submit the claim with the Ops and thereafter, the Ops will decide the claim of complainant. 

9.             Thus, in view of above discussion, we disposed of the present complaint accordingly with the direction to the complainant to submit the claim with the Ops within 15 days from today and thereafter, the Ops will decide the claim within 30 days after submission of claim by the complainant.  However, it is made clear that if the complainant is not satisfied with the decision of claim decided by the OPs, then the complainant is at liberty to file the fresh complaint, if so desired as per law.  No order as to costs.  A copy of this order be sent to both the parties free of costs.  File be consigned to the record room after due compliance.     

Announced in open court:

Dt.:11.05.2023.  

                                                                (Neelam Kashyap)

                                                                President.

 

(Sunil Mohan Trikha),           (Suman Rana),          

Member.                            Member.

 

Typed by: Sanjay Kumar, S.G.