Chandigarh

DF-II

CC/63/2021

Gurpreet Kaur - Complainant(s)

Versus

Punjab National Bank - Opp.Party(s)

In Person

07 Feb 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-II,

U.T. CHANDIGARH

Consumer Complaint  No	:	63 of 2021
Date  of  Institution	:	01.02.2021
Date   of   Decision	:	07.02.2024

 

 

 

 

Gurpreet Kaur daughter and nomine of late Mrs.Ranjit Kaur, #142, Phase-1, Ram Darbar, Chandigarh.  

….Complainant

Versus

1]  Punjab National Bank, SCO No.1-3,  Sector 28-C, Chandigarh through its Branch Manager/Authorised Signatory.

2]  PNB MetLife India Insurance Company India Ltd., SCO No.68-69, Sector 17-B, Chandigarh through its Branch Manager/Authorised Signatory.

….. Opposite Parties

 

BEFORE:  MR.AMRINDER SINGH SIDHU,       PRESIDENT

        MR.B.M.SHARMA                 MEMBER

 

PRESENT:-    Sh.Savinder Singh Gill, Counsel for the complainant

 

              Sh.Kaveesh, Counsel for OPs No.1 & 2.

 

ORDER BY AMRINDER SINGH SIDHU, M.A (Eng.), LLM, PRESIDENT

         The complainant has filed the present complaint pleading that the mother of the complainant was widow, getting family pension of her late husband and maintaining pension account with OP No.1 (Ann.C-1). It is stated that the mother of the complainant availed a personal loan of Rs.2,10,000/- from OP on 10.12.2019 and in order to secure said loan, the OP No.1 got the life of the loanee/her mother insured from OP No.2 on making due premium payment and accordingly Policy No.23123758 was issued by OP No.2. Unfortunately, the mother of the complainant expired on 27.6.2020 (Ann.C-2), as such, the complainant being nominee lodged claim with OP NO.2 under the policy her mother for closing the loan by adjusting the insurance amount but the same was repudiated by Op No.2 vide letter dated 30.8.2020 on the ground that the mother of the complainant was suffering from hypertension, diabetes and chronic kidney disease and she provided false information regarding her health (Ann.C-4).  It is stated that the complainant was threatened with penal action by OP No.1, so to avoid any penal action, she deposited an amount of Rs.85,000/- in cash on 05.10.2020 with OP Bank and as on 07.11.2020 an amount of Rs.1,09,141/- stands outstanding (Ann.C-5) in said loan.  Alleging the said act & conduct of the OPs as well as repudiation of claim as deficiency in service and unfair trade practice, hence this complaint has been filed with a prayer to direct the OPs to pay claim amount of Rs.2,10,000/- to the complainant after adjusting the current balance outstanding loan amount along with interest from the date of repudiation i.e. 30.8.2020 till the actual payment as well as to pay compensation and litigation expense.

 

2]       After service of notice, the OP NO.1 put in appearance but despite availing opportunities, failed to file written version with the stipulated period, hence the defence of OP No.1 was struck off vide order dated 04.05.2022.

        The OP NO.2 has filed written version and while admitting the issuance of the policy in question in the name of complainant’s mother, stated that she/insured was expired on 27.6.2020 and a claim was raised on 29.7.2020.  It is stated that the claim was rightly rejected by the answering OP on 30.8.2020 qua the mother of the complainant as she had concealed the material information of her health about her suffering from Hypertension, Diabetes and Chronic Kidney Disease and she provided a wrong/false information regarding her health.  It is submitted that the insured/mother of the complainant was regularly visiting for checkups relating to Kidney disease since 15.3.2018 and she was undergoing for the Hemodialysis 2-3 times per week at PGI, Chandigarh as per her OPD Card dated 08.01.2019 (Ann.3).  It is submitted that it was found that the insured (now deceased) was suffering from Chronic Kidney Disease, Hypertension and Diabetes at the time of issuance of the policy as mentioned in her OPD Card of PGI, Chandigarh dated 08.01.2019 which is issued before the issuance of the policy in question.  It is also pleaded that the complainant be put to the proof that why not correct information was provided to the OPs NO.2 regarding the health of the policyholder/now deceased.  Denying all other allegations, lastly it is prayed that the complaint be dismissed with cost.

 

3]      Replication has also been filed by the complainant controverting the assertions of OP No.2 made in its reply.

 

4]       Parties led evidence in support of their contentions.

 

5]       We have heard the ld.Counsel for the contesting parties and have gone through the documents on record including written submissions.

 

6]       In the present case, the mother of the complainant i.e. insured Ranjit Kaur availed the policy in question which commenced from 10.12.2019 as per the contents of the complaint but it is observed that the insured Ranjit Kaur was taking treatment from PGIMER, Chandigarh since 15.3.2018 as she was suffering from Chronic Kidney Disease, Hypertension and Diabetes at the time of availing the insurance policy in question.  The PGI OPD Card of the insured dated 15.3.2018, 17.3.2018 & 08.01.2019 (Annexures A-2 & A-3) not only reveals that she is taking treatment for the above mentioned disease but also did not disclose the same to the OP Insurance Company at the time of taking the insurance policy in question.  As the insured was taking treatment for Kidney dialysis from PGIMER, Chandigarh prior to availing insurance policy so she is duty bound to disclose the same to the OP Insurance Company at the time of availing the policy as she is under legal obligation to disclose the same.  The non disclosure by the insured at the time of availing policy about the fact that she is suffering from serious/chronic disease related to kidney and taking its treatment from PGIMER, Chandigarh amounts to concealment of material from the OP Insurance Company, hence the OP Insurance Company has righty repudiated the claim.  Therefore, the complaint is liable to be dismissed.  Though it is a fit case to be dismissed with cost yet taking a lenient view, the cost is not imposed upon the complainant.

 

7]       In view of the above discussion & findings, the complaint is hereby dismissed. No order as to costs.

8]       The pending application(s) if any, stands disposed of accordingly.

         The Office is directed to send certified copy of this order to the parties, free of cost, as per rules & law under The Consumer Protection Rules & Act accordingly. After compliance file be consigned to record room.     

Announced

07.02.2024                                                           Sd/-

 (AMRINDER SINGH SIDHU)

PRESIDENT

 

Sd/-

(B.M.SHARMA)

MEMBER