Haryana

Karnal

CC/88/2022

Savitri Devi - Complainant(s)

Versus

Reliance General Insurance Company Limited - Opp.Party(s)

Sudhakar Mittal

18 Dec 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMISSION, KARNAL.

 

                                                        Complaint No. 88 of 2022

                                                        Date of instt.21.02.2022

                                                        Date of Decision:18.12.2023

 

Savitri Devi aged about 40 years wife of late Shri Narsi, resident of VPO Jalmana Tehsil Assandh and District Karnal.

 

                                               …….Complainant.

                                              Versus

 

Reliance General Insurance Co. Ltd. having its branch office situated at SCO 147-48, Sector 9-C, Madhya Marg, Chandigarh, through its Branch Manager.

                                                                      …..Opposite Party.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Shri Jaswant Singh……President.

              Shri Vineet Kaushik……Member

                           

Argued by: Shri Sudhakar Mittal, counsel for complainant.

                   Shri A.K. Vohra, counsel for the OP.

 

                    (Jaswant Singh President)

ORDER:   

                

                The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that Mr. Narsi son of Shri Krishan Lal was the registered owner of motorcycle bearing registration no.HR-40H-1371. He had obtained comprehensive insurance policy bearing no.990292023750086732 from the OP. The vehicle was insured from 04.11.2020 to 03.11.2025. Mr. Narsi had made the payment of Rs.5556/- for obtaining the said insurance policy. On 02.02.2021 at about 4.00 p.m. when Narsi son of Shri Krishan Lal was going to his house and reached near bus stand, Jalmana, a car bearing registration no.HR-40F-3173, being driven by its driver rashly and negligently came from Karnal side and hit the motorcycle being driven by the Narsi. The impact of the accident was so heavy that Narsi succumbed to injuries. The police of Police Station Assandh, District karnal have registered the FIR bearing no.0073 dated 03.02.2021, under section 279, 304-A IPC against the driver of the offending vehicle. The complainant being the legal heir of the deceased has filed a claim under personal accident cover of the deceased before the OP. The said claim was duly pursued by the complainant but OP without going through the documents and claim form repudiated the claim of the complainant, vide its letter dated 28.09.2021 on the ground of non-submission of the required documents. Complainant made the request to the OP that she is an illiterate widow belongs to rural area and does not know the technicalities of law. She further requested the OP that after the death of her husband there is no one in the family to take care of her as well as her children. The complainant also submitted the death certificate of her husband, death certificate of Krishan her father in law and her family ID. She also submitted the copy of FIR, PMR, Ration Card, aadhar cards of family and driving licence of Narsi with the OP. But despite submitting the desired documents, the personal accident death claim of Narsi deceased has not been released intentionally by the OP. Under the policy in question, in case of death, the driver of the insured vehicle is entitled for compensation of Rs.15,00,000/- and as such the complainant being the LR of deceased is entitled for the amount of Rs.15,00,000/- as amount of compensation under the policy. Complainant requested the OP for releasing the said amount but OP did not pay any heed to the request of complainant and lastly refused to pay the same.  In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi; concealment of true and material facts and mis-joinder and non-joidner of necessary party. The insured vehicle is hypothecated with the Muthut Capital Service Ltd. who has first charge on the vehicle and therefore is the necessary and proper party to the matter but complainant has failed to implead the financer as a party in the complaint. On merits, it is pleaded that complainant has never intimated the OP and the claim has never been lodged with the OP. Complainant had lodged only OD claim, which was registered vide its claim no.3121080954. The complainant has not submitted all the necessary documents to process his claim and for that OP issued various letter and requested the complainant to submit the necessary documents, which were never provided and lastly the OP issued a final closure letter to the insured which was also not responded, hence the claim was closed due to want of documents. It is further pleaded that the complaint is also bad in the eyes of law since the nominee has the right to claim. In the present complaint, the claim has been filed by the widow of the insured whereas the nominee as per the policy is Mr. Krishan Lal (who is the father of deceased) and as per the complaint, Krishan Lal had already expired. The complainant has not shared legal heir certificate, so the present complaint is liable to be dismissed on this ground. It is further pleaded that without admitting any liability, it is submitted that since the complainant had not lodged any claim for personal accident claim with the OP, the complaint be directed to provide the below documents with the OP, after which the claim will be dealt on its merits.

Documents Required.

1. Original claim form duly filled and signed by Claimant.
2. Attested copy of FIR.
3. Attested copy of the post mortem report.
4. Attested Death Certificate
5. Attested copy of driving license of the insured.
6. Attested vehicle registration copy of insured.
7. Hospital Records if admitted.
8. Police Inquest Report.
9. Family member certificate from Gram Panchyat/Mandal revenue office.
10. Legal heir certificate from magistrate.
11. No objection certificate from other legal heirs duly notarized on stamp paper.
12. Claimant Bank passbook copy attested by concern bank branch manager.
13. NEFT details of the claimant certified by the Claimant’s Bank.
14. Photo ID proof of the insured and Claimant (aadhar card/voter card)
15. PAN card copy of the claimant. If PAN card copy is not available, then form 60 may be submitted.

 

Whereas in the present matter, the complainant has not lodged the claim. It is further pleaded that as the estimate of the repair has not been submitted by the insured, however if the documents submitted, the liability of the OP, if any, will be limited to the amount assessed by the surveyor. The OD claim of the complainant was duly processed and considered the same but it was not found payable, due to the fact that husband of the complainant namely Narsi had expired on 02.02.2021 in a roadside accident. The deceased had obtained comprehensive insurance Bundled policy wherein father of Narsi was the nominee, thus the complainant has no right to claim the personal accident claim of Shri Narsi. The claim of the complainant was repudiated regarding the own damages, vide letter dated 28.09.2021 by assigning the reason that despite several letters dated 12.09.2021, 18.09.2021, 24.09.2021 and telephonic reminders, the complainant has not submitted the desired documents. So, the complaint of the complainant is premature and an abuse on the process of law. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of closure letter dated 28.09.2021 Ex.C1, copy of FIR Ex.C2, copy of RC Ex.C3, copy of insurance policy Ex.C4, copy of death certificate of Narsi Ex.C5, copy of death certificate of Krishan Lal Ex.C6 and closed the evidence on 03.02.2023 by suffering separate statement.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Suryadeep Singh Thakur Ex.OP1/A, copy of death certificate of Narsi Ex.OP1, copy of closure letter dated 28.09.2021 Ex.OP2, copy of FIR Ex.OP3, copy of RC Ex.OP4, copy of insurance policy Ex.OP5 and closed the evidence on 03.10.2023 by suffering separate statement.

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

7.             Learned counsel for the complainant, while reiterating the contents of the complaint, has vehemently argued that Mr. Narsi husband of complainant was the registered owner of motorcycle. He had obtained comprehensive insurance policy from the OP. On 02.02.2021, Narsi met with an accident and succumbed to injuries. An FIR bearing no.0073 dated 03.02.2021, under section 279, 304-A IPC was got lodged in this regard. The complainant being the legal heir of the deceased has filed a claim under personal accident cover of the deceased before the OP. The claim of the complainant has been repudiated by the OP, vide letter dated 28.09.2021 on the ground of non-submission of the required documents whereas complainant has already submitted all the documents with the OP. Complainant requested the OP so many times to settle the claim but refused to settle the same and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for complainant, while reiterating the contents of written version, has vehemently argued that the insured vehicle is hypothecated with the Muthut Capital Service Ltd. who has first charge on the vehicle but complainant has failed to implead the financer as a party in the complaint. He further argued that complainant had lodged only OD claim. The OD claim of the complainant was duly processed and considered but it was not found payable, due to the fact that husband of the complainant namely Narsi had expired on 02.02.2021 in a roadside accident. The deceased had obtained comprehensive insurance Bundled policy wherein father of Narsi was the nominee, thus the complainant has no right to claim the personal accident claim of Shri Narsi. The claim of the complainant was repudiated regarding the own damages, vide letter dated 28.09.2021 by assigning the reason that despite several letters dated 12.09.2021, 18.09.2021, 24.09.2021 and telephonic reminders, the complainant has not submitted the desired documents. So, the complaint of the complainant is premature and an abuse on the process of law. He further argued that the claim has been filed by the widow of the insured whereas the nominee as per the policy is Mr. Krishan Lal (who is the father of deceased) and as per the complaint, Krishan Lal had already expired. The complainant has not shared legal heir certificate, so the present complaint is liable to be dismissed on this ground. Since the complainant had not lodged any claim for personal accident claim with the OP and thus, the present complaint is premature.

9.             Before going to the merits of the case, firstly we decide, whether the present complaint is pre-mature or not?

10.           The onus to prove for submitting the claim with the OP  was relied upon the complainant but complainant has miserably failed to prove her version by leading any cogent and convincing evidence. OP has demanded the following documents, which are reproduced as under:-

1.  Original claim form duly filled and signed by Claimant.
2. Attested copy of FIR.
3. Attested copy of the post mortem report.
4. Attested Death Certificate
5. Attested copy of driving license of the insured.
6. Attested vehicle registration copy of insured.
7. Hospital Records if admitted.
8. Police Inquest Report.
9. Family member certificate from Gram Panchyat/Mandal revenue office.
10. Legal heir certificate from magistrate.
11. No objection certificate from other legal heirs duly notarized on stamp paper.
12. Claimant Bank passbook copy attested by concern bank branch manager.
13. NEFT details of the claimant certified by the Claimant’s Bank.
14. Photo ID proof of the insured and Claimant (aadhar card/voter card)
15. PAN card copy of the claimant. If PAN card copy is not available, then form 60 may be submitted.

 

Complainant has only placed on file closure letter dated 28.09.2021 Ex.C1, copy of FIR Ex.C2, copy of RC Ex.C3, copy of insurance policy Ex.C4, copy of death certificate of Narsi Ex.C5, copy of death certificate of Krishan Lal Ex.C6, except these documents, the complainant has not placed on file any other document. From which, it has been proved that the complainant has not submitted any other documents except the documents, she has placed on file. If the complainant has submitted the claim with the OP and supplied all the required/relevant documents, then she would have placed the copies of the same on the file of the present case. Meaning thereby, the complainant has not submitted the persona accident claim with the OP.

11.           The OP has placed on file letter Ex.R2 dated 28.09.2021 wherein it has been specifically mentioned that OP has written so many letter to complainant to complete the formalities but complainant has failed to complete the formalities. Further, on perusal of the said letter it appears that said claim was OD claim and not personal accident claim. Thus, we are of the considered view that complainant has not submitted the claim with the OP.  Hence, in view of the above, the present complaint is premature and is not maintainable at this stage.

12.           In view of the above observation, the present complaint is disposed of with the liberty to the complainant to submit the claim alongwith required/ relevant documents with the OP and on receipt of the same, OP is hereby directed to settle the claim of the complainant within 60 days, as per the terms and conditions of the policy. No order as to costs. This order shall be complied with accordingly. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 18.12.2023    

                                                       

                                                                President,

                                                    District Consumer Disputes

                                                    Redressal Commission, Karnal.

 

   (Vineet Kaushik)    

  Member