BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 303 of 2018
Date of Institution : 10.12.2018
Date of Decision : 30.05.2019
Paramjit Kaur aged about 40 years widow of Shri Partap Singh son of Shri Rattan Singh resident of village and Post Office Sikanderpur, Tehsil and District Sirsa.
……Complainant.
Versus.
1- Punjab National Bank, Branch at Sikanderpur, Tehsil and Distt. Sirsa through its Branch Manager.
2- Oriental Insurance Company Limited, Divisional Office No. 3, 4E/14, Azad Bhawan, Jhandewala Extension, New Delhi- 55.
..…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SHRI R.L. AHUJA……………… PRESIDENT
SHRI ISSAM SINGH SAGWAL ……MEMBER
MRS. SUKHDEEP KAUR…………..MEMBER
Present: Sh. Parveen Ahmad, Advocate for the complainant.
Opposite party no.1 given up on 28.5.2019.
Sh. A.S. Kalra, Advocate for opposite party no.2.
ORDER
In brief, the case of complainant is that complainant is widow of Shri Partap Singh who had died on account of injuries sustained in the Motor vehicular accident which took place on 22.12.2017. The complainant is having two minor children namely Gurwinder Singh son and Amadeep Kaur minor daughter and both children are fully dependent upon the complainant. That deceased Partap Singh was having account no.6200000100003589 with op no.1 and as per the provisions of the policy namely Prime Minister Suraksha Bima Yojna, the account holder was having the insurance under the said policy which automatically runs under the said account as the premium against the said insurance policy was deducted from the said account of deceased. The Bank authorities have also fully insured the deceased for the payment of sum assured in case of accidental/ incidental death of Partap Singh. It is further averred that on 22.12.2017 Shri Partap Singh husband of complainant met with an accident while he was going to Sardulgarh on his motor cycle and sustained serious head injuries. He was taken to the hospitals but due to serious head injury, he could not be survived and succumbed to the injuries on 26.12.2017. A rapat no.24 dated 23.12.2017 was lodged in police station Sardulgarh regarding the above said accident. It is further averred that deceased Partap Singh was having the insurance of his life under PMSBY with op no.2 through op no.1. The complainant being the widow of the deceased and first class legal heir of deceased applied for the release/ disbursement of the sum assured of Rs.2,00,00/- under the said policy with the ops being their legal liability but they wrongly repudiated the claim of complainant simply asserting that the post mortem of the deceased was not conducted. That ops have caused harassment and mental agony to the complainant. Hence, this complaint.
2. Upon notice, opposite parties appeared. Op no.1 filed written statement taking certain preliminary objections regarding maintainability, estoppal, no consumer dispute, complainant is not a consumer as per the definition given in Section 2 (i) (d) of the Consumer Protection Act, 1986, that answering op only act as per the contract with the Oriental Insurance company and the allegations against op no.1 are false and vague, suppression of material facts and jurisdiction etc. On merits, it is submitted that answering op has sincerely and honestly performed its duties without any delay. As per the RBI and Govt. guidelines namely PMSBY, a minimum and subsidies amount of Rs.12/- as premium was deducted from the account of Partap Singh on 18.10.2016 and 22.5.2017. The risk of Partap Singh covered up to 17.10.2018 under the insurance master policy no.2722004820175701. The answering op deducted and transferred amount with the insurance company as per normal rules and practice. After coming to know about the accidental death of Partap Singh on 22.12.2017, the matter was reported to the Oriental Insurance Company. The documents of the complainant regarding lodging of claim have been duly supplied to the insurance company for releasing the insurance benefits. Thereafter, the bank has no concern with the remaining steps of the insurance company and now the matter is between the complainant and insurance company. Remaining contents of the complaint are also denied and prayer for dismissal of complaint made.
3. Op no.2 in its separate written statement took certain preliminary objections that complaint is not maintainable, that there is no deficiency in service in any manner on the part of answering op or its officials, as order of repudiation/ rejecting the claim for the death of Partap Singh has been passed for want of post mortem report, according to the term and conditions of the norms, policy which has binding effects upon all, compliance of which is mandatory for seeking claim under PMSBY. It is further submitted that process for seeking compensation under PMSBY has been prescribed, which mandates ten requirements to be fulfilled by the banker and family of the deceased. It is further submitted that complainant is estopped by her own act and conduct to file the present complaint before this Forum, as complainant did not fulfill the requirement, which are/ were required to be fulfilled by her. The Nodal Officer of insurance company has desired PMSBY claim form, discharge receipt, FIR/Panchnama, post mortem report, death certificate, supporting documents (copy of PAN card, Aadhar card, bank statement excel sheet etc.). It is further submitted that Master Policy holder is Punjab National Bank and insurance benefits were made available to member/ account holder subject to the conditions specified in the policy document and it was/ has been specifically mentioned that benefits under PMSBY will be payable subject to the fulfillment of conditions specified therein. It is further submitted that PMR was one of the mandatory document to be supplied by the complainant showing/ proving the cause of death of deceased Partap Singh. That it has not been mentioned in the complaint that whether parents of deceased or any other family members are alive, hence complaint is bad for non disclosure of material facts and for non implement of necessary parties. It is further submitted that payment of fix sum insured is only subject to fulfillment of the requirement of company by way of supplying the requisite record, which is mandatory and same is handed over by the banker to the company and without submission of the requisite record, the sum insured is not payable. Death of Partap Singh is not admitted due to the alleged injuries in the accident as alleged as there is no certificate or post mortem report of any doctor in this regard and in absence of PMR, death cannot be said to be occurred because of the injuries. Death certificate is incomplete one. There is no police proceedings under Section 174 Cr.P.C, so cause of death is not certain one. Remaining contents of complaint are also denied and prayer for dismissal of complaint made.
4. The parties then led their respective evidence.
5. It is pertinent to mention here that on 28.5.2019 when the case was fixed for arguments, learned counsel for complainant has suffered a statement that he gives up op no.1 and as such op no.1 was given up.
6. We have heard learned counsel for the complainant as well as learned counsel for op no.2 and have perused the case file carefully.
7. Learned counsel for complainant has contended that it is proved case of complainant that husband of complainant namely Partap Singh was holding account with op no.1 and got himself insured under Prime Minister Suraksha Bima Yojna and premium was deducted from his account maintained with Punjab National Bank and in this way of risk of accident was duly covered upto Rs.2,00,000/-. On 22.12.2017, Partap Singh was going from Sikanderpur to Sardulgarh on his motor cycle for seeing and enjoying the Kabbadi tournament and met with an accident and received multiple injuries on his head and other parts of the body. He was taken to the hospital of Sardulgarh where from he was referred to Bombay hospital, Sirsa and thereafter on account of serious injuries on his head, he was taken to Bharat Multispecialty Hospital, Hisar where he remained under treatment and due to serious head injury he could not survive and died on 26.12.2017. DDR No.24 dated 23.12.2017 was lodged with police station Sardulgarh, but however, no post mortem was conducted on the dead body of deceased. He has further contended that op no.2 repudiated the claim of complainant simply asserting that post mortem was not conducted. The case of the complainant is duly covered under the insurance contract and company is liable to pay insured amount to the complainant. He has relied upon judgment of the Hon’ble State Consumer Disputes Redressal Commission, Punjab in case titled as National Insurance Company Versus Iqbal Kaur, FA No.528 of 2012 decided on 16.5.2014.
8. Opposite party no.1 was given up by learned counsel for complainant on 28.5.2019.
9. On the other hand, learned counsel for op no.2 has strongly contended that op no.2 has rightly repudiated the claim of complainant as complainant has violated the terms and conditions of the policy. As per condition of the policy, complainant was bound to file her claim application alongwith the original FIR/ Panchnama, Post Mortem Report and death certificate whereas complainant had filed only copy of DDR and death certificate but did not file post mortem report which is the mandatory requirement for claim under Pradhan Mantri Suraksha Bima Yojana. He has further contended that there is no opinion of the doctor that death of deceased was due to accidental injuries and judgment relied upon by learned counsel for complainant is not applicable to the facts and circumstances of the present case as facts of the reported judgment are quite different. The op no.2 has rightly repudiated the claim of complainant. He has contended that complaint of complainant is not maintainable on account of non impleding of necessary parties i.e. children of the deceased.
10. We have considered the rival contentions of the parties and have gone through the record as well as judgment relied upon by learned counsel for complainant.
11. The perusal of the record reveals that complainant in order to prove her complaint has furnished her affidavit Ex.C1 in which she has reiterated all the averments of the complaint. She has tendered copy of DDR Ex.C2, copy of medical prescription of Bharat Multispecialty Hospital, Hisar Ex.C2, copy of statement of account Ex.C4, copy of adhar card Ex.C5, copy of adhar card of Gurwinder Singh Ex.C6, copy of adhar card of Amandeep Ex.C7, copy of death certificate Ex.C8 and copy of adhar card of Partap Singh since deceased Ex.C9. On the other hand, op no.2 tendered affidavit of Sh. S.K. Malhotra Ex.R3 who has deposed that there is no certificate or post mortem report of any doctor regarding death of Partap Singh and in absence of PMR, death cannot be said to be occurred because of the injuries suffered by him in the motor vehicular accident and submission of post mortem report is mandatory requirement for the claim.
12. No doubt, husband of complainant namely Partap Singh got injuries on his person while driving the motor cycle on his way to Sardulgarh and thereafter he was taken to hospital at Sardulgarh from where he was referred to Bombay Hospital at Sirsa and then he was shifted to Bharat Multispecialty Hospital at Hisar but perusal of evidence of complainant reveals that none of the doctors at any hospital has given opinion that cause of death of the deceased Partap Singh was due to accidental injuries. No post mortem was got conducted on the dead body of deceased Partap Singh in order to ascertain the cause of death as per requirement of the Pardhan Mantri Suraksha Bima Yojna which is mandatory requirement that claim form should be submitted with original FIR/panchhnama, death certificate and post mortem report etc. Though complainant has placed on record copy of DDR and death certificate, however, did not place on record the post mortem report or any opinion of the doctor who treated the deceased Partap Singh regarding cause of death. The judgment relied upon by learned counsel for complainant is of no help to the complainant as facts of reported judgment are quite different from the facts of the present complaint.
13. In view of the above discussion, the complaint of the complainant is hereby dismissed being devoid of any merit, however, with no order as to costs. A copy of this order be supplied to the parties as per rules. File be consigned to the record room.
Announced in open Forum. President, Dated:30.05.2019.
District Consumer Disputes
Redressal Forum, Sirsa.
Member Member
DCDRF, Sirsa DCDRF, Sirsa
