DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, PALWAL
CONSUMER COMPLAINT NO. 104 OF 2014
DATE OF INSTITUTION: 12.08.2014
DATE OF DECISION : 18.02.2015
Rafik son of Sh. Ishab, resident of Village Gailpur, Tehsil Tizara, District Alawar ( Rajasthan).
.. Complainant
Versus
1. Reliance Life Insurance Company Limited, (Regd no. 121) Reliance House 6th floor, No. 6, Haddows Road, Nungambakkm, Chenni 06.
2. Reliance Life Insurance Company Limited, through its Branch Manager, Pushpa Complex 1st floor, Agra Chowk Palwal, present branch situated at 1st floor, of Union Bank of India at Agra Chowk, Palwal, District Palwal.
..Respondents
COMPLAINT UNDER SECTION 12 OF CONSUMER PROTECTION ACT
BEFORE: JAGBIR SINGH: PRESIDENT
KHUSHWINDER KAUR: MEMBER
R.S.DHARIWAL: MEMBER
PRESENT: Sh. K.S.Chauhan, Advocate for complainant.
Opposite party no.1 exparte.
Opposite party no. 2 given up.
ORDER:
Brief facts of the present case are that the complainant
i.e. late Sh. Ramjan was having a life insured policy bearing no. 19862996 w.e.f. 27.2.2012 to 31.3.2027 for a sum of Rs.9,00,000/- and was paying half yearly premium of Rs.15,000/-.
Unfortunately, his brother died in a road accident on10.5.2012 while he was driving his motorcycle and a cow (Neel Gai) struck into his motorcycle. After the accident, his brother was admitted
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to the General Hospital, Palwal for his treatment where he was referred to B.K. Hospital, Faridabad but he died in the way of hospital on the same day sustaining the injuries in that accident.
The cremation of deceased Ramjan was done by his family members without conducting postmortem because there is no Riwaz of postmortem in the religion of their community.
The matter was reported to Police Station Hathin and DDR No. 5 was got registered on 14.5.2012 instead of FIR as the accident was done neither due to the negligence of any other person nor any other vehicle was involved in the accident.
The complainant filed the claim form with opposite party no. 2 and further fulfilled all the formalities regarding the death of the insured Ramjan being his nominee. Opposite parties sent a letter dated 4.6.2012 to the complainant and demanded some documents and also assured the complainant to process the claim within 30 days, so complainant provided all the documents to the opposite parties.
But on 4.10.2012 when the complainant approached the opposite parties to know the status of his claim he came to know that his claim has been rejected. Complainant served the legal notice through his counsel but they did not make the payment of insured amount of life of his brother.
The complainant also filed a pre-litigation application before the court of Permanent Lok Adalat/Utility Court Palwal but the same has been returned to the complainant on 5.12.2013 granting him liberty to approach the opposite parties with demanded documents to get the grievance redressed and Hon’ble Permanent Lok Adalat also directed to opposite parties to redeem his grievances within 60 days after receiving the documents and further ordered that if in case the complainant not satisfied and his grievances not redressed he shall be at liberty to approach the proper court or Forum of Authority.
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But even after getting this order dated 5.12.2013 the opposite parties have not released insured amount of the death claim having malafide and dishonest intentions to grab the insurance claim knowingly and intentionally which caused mental tension, agony and harassment to the complainant. Hence complainant filed this complaint having suffered due to the negligence and deficient services rendered by the opposite parties and prayed to the Forum to direct opposite parties to pay Rs.18,00,000/- as per insurance terms and conditions having accidental death benefit qua the accidental death of his brother and further to direct opposite parties to compensate with Rs.2,00,000/- for mental tension, agony and harassment alongwith litigation expenses.
Upon registering the complaint, notices were ordered to be issued. but even after lapse of one month opposite party no. 1 did not appear before this Forum and as such opposite party no. 1 proceeded exparte vide order dated 29.9.2014.
As far as the opposite party no. 2 is concerned it was given up by the complainant having no correct address as per his statement given on 18.11.2014.
In support of his claim, the complainant placed on record his affidavit Ex.CW1/A wherein he solemnly affirmed the same facts which he enumerated in his complaint and relied upon the documents Ex.C-1 to Ex.C-10.
The Forum heard Sh.K.S.Chauhan Ld. Counsel for the complainant at length and have gone through the case file carefully as well as written arguments.
There is no doubt about the fact that the brother of the complainant late Sh. Ramjan was insured with opposite party bearing policy no. 19862996 w.e.f. 27.2.2012 to 31.3.2027 for a sum insured
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Rs.9,00,000/- by paying a premium of Rs.15,000/- half yearly premium and was died in a road accident caused by a cow (Neel Gai) on 10.5.2012.
The death loss claim was filed by the complainant which was rejected by opposite party on the grounds of non submission of documents. It is evident by Ex.C-4 and even after getting the order dated 5.12.2013 of Hon’ble Court of Permanent Lok Adalat i.e Ex.C-10.
In the interest of justice, the insurer’s decision to reject the claim should be based on sound logic and valid grounds. Rejection of claim on purely technical grounds in a mechanical fashion will result in policy holders loosing confidence in the insurance industry and giving rise to excessive litigation. Therefore, it is advised that all the insurer need to develop a sound mechanism of their own to settle such claims with utmost care and caution.
In the present case in given circumstances, the Forum is of the considered view that the rejection of the claim of the complainant by opposite party is not valid and legal.
There is nothing on record to disbelieve and discredit the aforesaid exparte evidence of complainant against opposite party no.1. Since opposite party no.1 has not come present to contest the claim of the complainant, therefore, the allegations made in the complaint go unrebutted. Therefore, from the exparte evidence it is amply proved that opposite party no. 1 has rendered deficient and short services to the complainant.
Hence the complaint is allowed. As such opposite party no.1 is directed to pay Rs.18,00,000/-(Eighteen Lakh) covering the
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accidental death benefits (inclusive of insured amount) i.e double of the insured sum of (Rs.9,00,000/-) alongwith compensation of Rs.50,000/- towards mental agony, tension and harassment as well as Rs.2200/- as litigation expenses to the complainant within 45 days from the date of receipt of copy of this order failing which the opposite party no.1 will be further burdened to the tune of Rs.15,000/- alongwith the above ordered amount. Copy of this order be given to the parties free of costs and file be consigned to the record room. This order of the Forum is running into 5 pages and each page of this order have been signed by this Forum.
Announced on:18.02.2015 (JAGBIR SINGH)
President
District Consumer Disputes
Redressal Forum, Palwal.
(KHUSHWINDER KAUR)
Member
District Consumer Disputes Redressal Forum, Palwal
(R.S.DHARIWAL)
Member
District Consumer Disputes Redressal Forum, Palwal.