Complainant Mrs.Manjit Kaur has filed the present complaint against the opposite parties U/S 12 of the Consumer Protection Act (for short, C.P.Act.) seeking necessary directions to the opposite parties to make payment of insured amount qua his claim on account of accidental death of her husband immediately in terms of the Insurance Policy alongwith interest @ 18% P.A. from the date of death till actual realization. Opposite parties be further directed to pay Rs.30,000/- as compensation on account of mental agony, physical harassment and deficiency in service on the part of opposite parties alongwith Rs.3000/- as litigation expenses, in the interest of justice.

2.       The case of the complainant in brief is that  deceased Surinder Singh her husband availed loan of Rs.2,00,000/- against his land vide receipt No.82 dated 19.10.2005. Another mortgage loan under TLT Account No.23 dated 8.9.2008 for the purpose of harvesting was taken. Both the loans were outstanding during her husband’s life time. Unfortunately, her husband died on 1.11.2010 due to an accident of his own combine No.PB-13-U-6319 which was under loan. Since the deceased Surinder Singh had been insured under PAIS KCC Limit scheme, Manjit Kaur, legal heir of the deceased Surinder Singh approached the respondent No.1 to pay the claim of Insurance amount of Rs. 60,000/- as per the term and conditions of the group Insurance Policy under which the premium used to be deducted at source by the opposite party No.1. She being legal heir of late Surinder Singh approached the opposite party No.1 time and again for the issuance of claim through whom her husband was insured under the scheme launched by opposite party No.2, every time she was assured by opposite party No.1 that insurance claim amount will be paid provided the total outstanding loan is repaid, irrespective of any terms and conditions with the hope of getting insurance claim, Rs. 60,000/- which was great relief for a widow at that juncture. She managed to repay both the mortgage loans on 20.12.2012. Neither any statement of account, nor any policy bond has been given by the opposite party No.1. Even after repayment of the outstanding loan, opposite party No.1 started lingering on the matter on one pretext or the other. Ultimately, a registered legal notice dated 25.11.2013 was sent to the opposite party No.1. Reply of the legal notice was received through letter dated 14.12.2013.  opposite party No.1 admitted that the claim is admissible if cause of death is an accident. Post mortem was not conducted due to most sorrowful and untimely death of Surinder Singh taken place. However, it was reported in Rural dispensary at Kala Baba from where the death certificate has been issued. The opposite parties by not making payment of insured amount to her on baseless observations are trying to back out from their pious obligations of making payment of the sum assured to the policy holder with malafide intention and ulterior motive without any reason or rhyme. This decision of the respondents is liable to be set aside and the complainant is entitled to interest @ 18% P.A. from the death of her husband till the actual realization.  It is a case of clear cut deficiency gross negligence in service and unfair trade practice on the part of the parties who did not pay insured amount to her on false and flimsy grounds and without any reason or rhyme. The first complaint, has been withdrawn vide order dated 16.12.2014 with permission to file fresh complaint on the same cause of action. The total outstanding loan as desired by the respondents No.1 was repaid on 20.12.2012. Hence this complaint.

3.       Upon notice, opposite party no.1 appeared through its counsel and filed its written reply by taking the preliminary objections that the complaint is hopelessly time barred, therefore the same is liable to be dismissed; the complaint is not maintainable against the opposite party and the complaint is bad for non joinder of necessary parties. On merits, it was admitted that both the loan accounts were adjusted. All the borrower who have availed of the Kissan Credit Limit from the Bank are covered under the Policy known as PAIS KCC Limit as a Group. The Insurance amount per year was Rs.15/- out of which Rs.5/- were contributed by the borrower, whereas the amount of Rs.10/- was borne by the Bank. Therefore, no policy bond was issued to the individual borrower. Neither the complainant nor any other legal heir of Surinder Singh demanded the statement of account. The Bank has never refused to give the statement of account to the complainant. It was also admitted that the legal notice dated 25.11.2013 was received by the opposite party and was duly replied by the opposite party.  There is no dispute if the cause of death was accident, the legal heirs are paid a sum of Rs.50,000/- as insurance amount. But the legal heirs must produce the relevant documents. The cause of death was determined from the Post Mortem Report which was never submitted by the complainant to the opposite party. It was wrong that the Post Mortem was not conducted due to the untimely death or grief of Surinder Singh.  The Death Certificate does not anyway prove the cause of death or any treatment given to the deceased. As per Insurance Policy, the complainant must produce the Death Certificate showing cause of death and Death Certificate issued from the Attending Doctor or the Hospital in which the person died due to the accident. In the instant case no such record was ever produced by the complainant.  Thus there is no deficiency in service on the part of the opposite parties. All other averments made in the complaint has been vehemently denied and lastly prayed that the complaint may be dismissed with costs.

4.    Upon notice, opposite party no.2 & 3 appeared through their counsel and filed their written reply taking the preliminary objections that complaint is not maintainable as the complainant has not disclosed whether at the time of withdrawing the previous complaint the Hon’ble Forum has granted any permission to the complainant to file the fresh complaint on same grounds or not; the complaint filed by the complainant is not maintainable against the opposite party as no claim was ever lodged with the opposite parties no.2 and 3 by the complainant in respect to accidental death of deceased Surinder Singh. Moreover no such Master Policy was issued to the opposite party no.1 by the opposite party covering the risk of accidental death of deceased as no premium was paid to the opposite party no.2 by opposite party no.1 and hence, the same was liable to be dismissed as the complainants have miserably failed to disclose deficiency, if any, in the services of the opposite party; the complaint was time barred; the complaint is without any cause of action, hence liable to be dismissed. On merits, all averments made in the complaint has been vehemently denied and lastly prayed that the complaint may be dismissed with costs.

5.      Complainant tendered into evidence her own affidavit Ex.C1 and of Major Singh Ex.C2, alongwith other documents Ex.C3 to Ex.C10 and closed the evidence. 

6.       Sh.Amar Singh Branch Manager opposite party no.1 tendered into evidence his own affidavit Ex.OP-1/1, alongwith other documents Ex.OP1/2 to Ex.OP1/4 and closed the evidence.

7.      Sh.Suraj Mehta, A.O. of opposite party no.2 & 3 tendered into evidence his own affidavit Ex.OP-2, 3/1 and closed the evidence.

8.      We have carefully examined the available evidence on the record file so as to interpret the meaning and purpose of each document determined against the backdrop of the respective arguments of the learned counsels of the litigants. We observe that the prime dispute prompted from the impugned non-settlement of the accidental death claim as filed by the widow complainant. The OP’s plea/objection of ‘delay’ in filing the present complaint does not hold ground as the DLA (Deceased Life Assured) Surinder Singh met his accidental death (Ex.C6) on 01.11.2010 and the OP1 Bank upon approach by the complainant instead of filing the insurance claim with the OP2&3 insurers insisted upon liquidation of Harvest & other Loans first and that could be liquidated only on 20.12.2012. We find that the widowed illiterate complainant could not file the claim with the OP2 insurers in the absence of the Master Policy & other papers/ documents and the OP1 Bank did nothing to assist her in filing the insurance-claim. Finally, she filed consumer complaint # 301 of 2014 and that was allowed to be withdrawn on 16.12.2014 with permission to file the same again on the same cause of action having arisen on 20.12.2012. The present complaint has been filed on 15.01.2015 and thus, shall deem to have been filed within ‘limitation’ under the Act.  We agree that the PMR is the most vital piece of evidence to establish the ‘cause of death’ but in its very absence and for genuine reasons the ‘cause of death’ can be well ascertained through some collateral but cogent evidence. In the present proceedings the affidavits (Ex.C1 & Ex.C2) of Manjit Kaur widow (complainant) & Major Singh eye-witness (land-owner at village Kala Bana) duly depose the accidental death of the DLA, with no reason on records raising disbelief. Further, in its reply (Ex.C4) to the legal notice the OP1 Bank has duly admitted the validity of the applicable insurance policy and the DLA’s eligibility to the insurance master Group Policy as also corroborated by the exhibits Ex.C9 & C10. Further, Ex.OP1/3 & OP1/4 show that the Master Policy was very much alive with the DLA’s name duly incorporated at S. No. 49. The DDR # 12 of 12.11.2010 (Ex.C5) of P.S. Kahnuwan also confirms the factum of death. Moreover, the OPs here have also not been able to establish the cause of death to be some other than the Harvest Combine Accident of 01.11.2010. Under the circumstances, it transpires that the complainant could not file the claim with the OP2&3 insurers sans the assistance and guidance that was not made available by the OP1 Bank. Presently, there should not be any hindrance in an amicable settlement of the impugned insurance death claim under the applicable terms of the related policy.

9.       In the light of the all above, we are of the considered opinion that the present complaint shall be best disposed of  by directing the complainant to approach and submit the requisite documents to OP2&3 insurers  through the proper channel/OP1 Bank (who shall render all active assistance and thread bare guidance etc) and upon receipt of the same the OP insurers are further directed to decide/settle the impugned death-claim (as per the applicable terms of the related Policy) within 30 days of the receipt of the requisitioned documents.

10.     Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to records. 

        (Naveen Puri)

                                                                            President   

Announced:                                                   (Jagdeep Kaur)

October, 28 2015                                                    Member

*MK*