Haryana

Karnal

CC/297/2016

Suman Lata - Complainant(s)

Versus

Oriental Insurance Company Ltd - Opp.Party(s)

J.C Jaglan

04 Apr 2018

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

                                                          Complaint No.297 of 2016

                                                         Date of instt. 27.09.2016

                                                         Date of decision:04.04.2018

 

1. Suman Lata (aged about 38 years) wife of late Shri Surender Singh, resident of village & Post Office Kunjpura, now resident of House no.1009, Sector-6, Urban Estate, Karnal.

2. Khyati Chaudhary minor daughter of Shri Surender Singh, resident of V & P.O. Kunjpura, now resident of House no.1009, Sector 6, Urban Estate, Karnal,

Petioner no.2 Khyati Chaudhary minor through her mother Smt. Suman Late being guardian and next friend who have no adverse interest to that of the minor.                                                                                                                                                                                                                   …….Complainant.      

                                        Versus     

 

1. Oriental Insurance Company Ltd. B.O.-3 (code no.272200) 4E/14, Azaad Bhawan, Jhandewalan Extn., New Delhi-55, through its Branch Oriental Insurance Co. Ltd. Karnal through its Divisional Manager.

2. Punjab National Bank, Branch office at Kunjpura, Karnal, Haryana, through its Branch Manager.

                                                                     …..Opposite Parties.

 

           Complaint u/s 12 of the Consumer Protection Act.            

 

Before   Shri Jagmal Singh……President. 

              Shri Anil Sharma……Member

 

 Present  Shri J.C. Jaglan Advocate for complainant.

               Shri Randhir Singh Advocate for OP no.1.

               Shri Somesh Garg Advocate for OP no.2.

               

ORDER:                    

 

                         This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that husband of complainant no.1 and father of complainant no.2 namely Surender Singh (since deceased, herein after referred as DLA) was residing in first storey of his house in village Kunjpura and on 27.6.2015 DLA was found lying in injured condition in the open courtyard of his house as DLA had fallen from his room situated in first storey of the house. Thereafter, Mehak Singh Sarpanch of village and his family members had taken to DLA for treatment to PGI where he died. It is further alleged that Mehak Singh in rapat no.18 dated 27.6.2015 before the police that there were cases pending between DLA and his wife Suman Lata regarding matrimonial dispute in Karnal court and DLA was taking liquor and he remains under tension. Thereafter, complainant no.1 has filed a claim for making payment of Rs.2,00,000/- as compensation on account of Pradhan Mantri Suraksha Bima Yojna with PNB Kunjpura regarding the death of her husband. Then complainant no.1 received a letter from Branch Manager, PNB, Financial inclusion division thereby the complainant was informed that the insurance claim is not permissible under the policy unless and until there was a copy of FIR regarding the death of DLA and thereafter the claim of the complainants was repudiated on 5.8.2016. The complainant no.1 received a photocopy of rapat no.18 dated 27.6.2015 regarding the death of DLA, which was recorded in police station Kunjpura on the statement of Mehak Singh, Sarpanch and earlier to this, the complainant no.1 was not aware of regarding the abovesaid rapat. The Sarpanch of the village has given wrongly facts in the abovesaid rapat that complainant no.1 filed divorce petition against DLA, though complainant no.1 has not filed any divorce petition and she has only filed petition u/s 125 Cr.P.C. and a petition under D.V. Act in Karnal Court and these two cases have already been dismissed as withdrawn on the statement of complainant no.1. It is further alleged that the death of DLA was occurred due to falling from the first storey of his house, it amounts to accidental death. Hence the claim of the complainants was wrongly repudiated by the OPs. In this way there was deficiency in service on the part of the OPs. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OPs, OP no.1 appeared and filed written statement raising preliminary objections with regard to locus standi. On merits, it is submitted that the death of deceased Surender Singh had not occurred due to fall from the first storey of his house. As per the DDR, which was lodged by one Mehak Singh, that DLA had strained relation with his wife Suman Lata. The complainant had also filed a divorce petition against DLA, and due to this DLA was under depression and tension and he used to take liquor in excess and he died due to excessively liquor. No FIR has been got registered either by the complainant herself nor by any family members of the DLA and hence the manner of sustaining the injuries by DLA had not been established and hence the case of the DLA does not cover under the scheme of PMSBY. Since, no FIR was registered, which is mandatory to be registered nor the Punchnama of the body was conducted by the police, which is also necessary for settling the claim under PMSBY Scheme. Hence the claim of the complainant was rightly repudiated by the insurance company, vide letter dated 5.8.2016. Hence there was no deficiency in service on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             OP no.2 filed its separate written statement stating therein that OP no.2 has unnecessarily been arrayed as party, since the OP no.2 has to forward to claim papers to OP no.1 as amount of insurance has to be paid by OP no.1 and not by OP no.2. It is pertinent to mention here that as per policy of the central government, OP no.2 i.e. bank has to deduct the amount of premium of insurance from the account of the account holder to deposit the premium. After the death of account holder, bank has to forward the claim papers to the concerned insurance company. In this case the bank had forward the claim papers for the death of DLA to the insurance company and insurance company has repudiated the claim of the complainant, vide letter dated 5.8.2016 on the ground that since there is no FIR lodged for the death of Surender Singh, so the claim was not admissible. Hence there was no deficiency in service on the part of the OP no.2 and prayed for dismissal of the complaint.

4.             Complainant tendered into evidence affidavit of complainant no.1 Ex.CA and documents Ex.CB to Ex.CH and closed the evidence on 18.8.2017.

5.             On the other hand, OP no.1 tendered into evidence affidavit of Manraj Virk Dy. Manager Ex.O1 and documents Ex.O2 and Ex.O3. OP no.2 tendered into evidence affidavit of N.K. Brar Sr. Manager Ex.OP2/A and documents Ex.OP2/B to Ex.OP2/E and closed the evidence on 19.2.2018 and 18.12.2017 respectively.

6.             We have heard the learned counsel for both the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             According to the version of the complainant that Surender Singh deceased was the husband of the complainant no.1 and father of complainant no.2 who was found lying in injured condition in the open courtyard of his house on 27.6.2015. He was taken to PGI, Chandigarh. After reaching PGI, Chandigarh said Surender Singh expired. Post Mortem was conducted in PGI MER Chandigarh vide PMR no.20218 dated 27.6.2015. Information of the incident was given to the police of Police Station Kunjpura by Shri Mehak Singh, Sarpanch of the village Kunjpura, where GD (General Diary) no.18 dated 27.6.2015 Ex.C-B was recorded by the police in regard to this incident. Complainants made the claim to OP no.1 through OP no.2. The claim of the complainants was repudiated by OP no.1 vide letter dated 5.8.2016 Ex.CD on the ground that no FIR was lodged and as per the PMSBY, FIR is essentially required to settle the claim, hence the claim is not admissible under the policy.

8.             The contention of OP no.1 is that as per the version given in DDR, there were strained relation between complainant Suman Lata and her husband and complainant has filed a divorce petition against Surender Singh deceased, due to the same, said Surender Kumar was under depression and used to take liquor excessively. Further, contention is that no FIR was got registered. Manner of sustaining injuries has not been established. The claim of the complainants has been rightly repudiated.

9.             From the submission of the parties, the main dispute between the parties is that whether any FIR has been got registered or not?

10.           As per the arguments of the learned counsel for the complainant, Shri Mehak Singh, Sarpanch of Kunjpura village gave information to the police of Police Station Kunjpura and the police recorded the DDR on his statement and it for the police whether to record the DDR or FIR. This argument of the complainant has force because a person can only inform the police and it is for the police to record a DDR or FIR. The information of the incident in question was given to concerned police in writing and the police has recorded a DDR only. The fact of DDR has been admitted by the OP no.1 in its reply i.e. para no.5 on merits. Therefore, the contention of OP no.1 regarding FIR is not tenable in the eyes of law because the police has recorded the DDR instead of FIR, so it cannot be said that no report was got recorded in the matter. Moreover, said Surender Kumar died in PGIMER, Chandigarh and Post Mortem was also conducted at PGIMER, Chandigarh. The cause of death as per PMR Ex.CC was cardio Respiratory Arrest due to (or as a consequences of) secondary to severe head injury. Therefore, the death was not natural. In these facts and circumstances of the case, we are of the considered view that the OP no.1 has wrongly repudiated the claim of the complainants. Hence the OP no.1 is deficient.

11.           It is pertinent to mention here that the OP no.1 has contended that there was strained relation between the complainant no.1 and the deceased. No doubt this fact has been admitted by the complainant no.1, but this does not mean that complainant no.1 is not the LR of deceased. OP no.1 has not proved on the file that she had been divorced by the deceased.

12.           Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OP no.1 to pay Rs.2,00,000/- (two lakhs only) to both the complainants in equal share. The share of the minor be deposited in the shape of FDR in Nationalized Bank. We further direct the OP no.1 to pay Rs.5500/- on account of mental pain, agony, harassment and litigation expenses. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:4.4.2018

                                                                       

                                                                  President,

                                                          District Consumer Disputes

                                                           Redressal Forum, Karnal.

 

 

                     (Anil Sharma)

                        Member