BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 152 of 2019
Date of Institution : 27.03.2019
Date of Decision : 19.02.2020.
Tarsem Singh (aged about 35 years) son of late Sh. Sukhdev Singh, 15A, Ward No.3, Khazakhera, Tehsil and District Sirsa.
……Complainant.
Versus.
1. Religare Health Insurance Company Ltd. Registered Office D-3, District Centre, Saket, New Delhi- 110017 through its Chief Manager/ responsible person/ Incharge.
2. Manager, Religare Health Insurance Co. Ltd. A-3, A-4, A-5, GYS Global, Sector 125, Noida- 201301.
3. Indusind Bank, registered office 2401 GEN Thimmayya Road, Cantonment Pune- 411001 through its Sr. Manager/ Responsible Person/ Incharge.
4. Manager, Indusind Bank, Near HP Gas Agency, Additional Mandi, Sirsa.
5. Bhupinder Singh, authorized agent Indusind Bank, Near HP Gas Agency, Additional Mandi, Sirsa.
...…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SH. R.L. AHUJA……………………PRESIDENT.
SMT. SUKHDEEP KAUR………….MEMBER
Present: Sh. Ravinder Monga, Advocate for the complainant.
Sh. H.S. Raghav, Advocate for opposite parties no.1 and 2.
Sh. M.S. Sethi, Advocate for opposite parties no.3 and 4.
Opposite party no.5 given up.
ORDER
The case of the complainant, in brief, is that father of complainant was agriculturist by profession. He was hale and hearty and was free from any ailment and was managing all the agricultural affairs as the entire family was dependent upon the income of the same. That ops no.4 and 5 came to the premises of complainant being responsible person working on behalf of op no.3 and explored the feature of bank. They had also displayed so many printed broachers, book etc. wherein the detail of agricultural loan and securing health insurance was explained and after detail discussion, the ops no.4 and 5 got father of complainant agreed for advancing loan of Rs.nine lacs on floating interest @12% with half yearly interest frequency. That ops no.4 and 5 further explained that ops no.3 and 1 & 2 are having collaboration with each other and they had launched a new policy in the interest of farmers and complainant was present with his father at that time. The complainant and his father while believing upon the assurances and promises agreed to obtain limit of Rs. nine lacs and opened account on 24.6.2016. It is further averred that ops no.4 and 5 obtained many signatures on the printed proformas and while sanctioning the limit, risk of Sukhdev Singh was also covered under the health insurance policy with the name and style of Ab Health Hameshan- “Secure” and got deducted Rs.4471/- for issuance of a policy against proposal No. 700100106643. The risk covered under insurance under the proposal was to the extent of Rs.nine lacs for tenure of 35 months whereas loan applied and sanctioned was for tenure of 60 months. The sanctioned letter under the reference KCC- 0000004257 dated 14.6.2016 was also issued by putting signatures of authorized signatory and other concerned. It is further averred that agricultural land measuring 45 kanals 18 marlas was also mortgaged with the bank. That while handing over the entire documents i.e. sanctioned letter, policy in presence of complainant, it was made clear that in case of unfortunate accidental death of the farmer Sukhdev Singh, the nominee/ LRs are entitled to receive the amount of Rs. nine lacs. It is further averred that in the second week of May, 2017 father of complainant slipped and fell down in washroom and became unconscious. The complainant immediately took care of his father and immediate treatment was taken from Desi Hakeem. It is further averred that though after few days, condition of father of complainant improved gradually but due to hidden and inside injuries, he died on 23.5.2017. That after performing all ceremonies, the complainant went to the office of op no.4 and informed about the death of his father. The ops no.4 and 5 obtained few signatures on blank papers and other printed forms and advised to come after one month, so that matter should be reported for the purpose of releasing the insurance amount of Rs. nine lacs as well as closing the loan file and releasing mortgage land from all encumbrances. It is further averred that complainant after waiting one month time approached to the ops in the first week of October, 2017 and inquired about the status of his claim file and loan file. The ops advised to deposit few amounts for the early disposal of the pending files. The complainant got reminded the previous assurances given by them at the time of advancing the loan/ limit and insurance policy. The ops told that as per change of policy, the complainant is to pay more than Rs.1.50 lakh for the purpose of receiving all the benefits as assured by them. The complainant upon the assurance and promises made by ops got deposited Rs.69,000/- on 31.10.2017, Rs.72,000/- on 12.3.2018 and Rs.40,000/- on 11.1.2019. The aforementioned amounts were deposited with the bank on cash basis after arranging the funds. That the complainant thereafter visited to the bank for a number of times even the required documents have also been submitted as per the demand of the ops, but no effective steps initiated by them. The complainant while waiting for a long time moved a written application for issuance of No Dues Certificate and releasing of the insurance benefits on account of accidental death of Sh. Sukhdev Singh. It is further averred that ops no.4 and 5 despite receiving the letter did not respond and postponed the matter on one or the other pretext. Even the complainant had also moved an application for providing information under RTI Act for his own account on 16.1.2019. The Manager of the bank duly received both letters but did not care to give reply of the same, which shows the sheer carelessness and negligent conduct on their part. That complainant is taking rounds to the office of ops and making requests for releasing the amount of insurance of Rs. nine lacs and in his favour being lawful nominee and only LR of Sukhdev Singh. The complainant further made a request for stopping the demand of loan amount as per the commitment, assurance and promise made by them at the time of providing the loan facility as well as issuing the insurance in favour of his father but the ops are now taking U turn and twisting from their own commitments which amounts to a foul play with a innocent farmer and prudent consumer and ops no.4 and 5 on behalf of ops no.1 to 3 gave threat for early payment of loan amount. That ops by their act and conduct have been indulged in unfair trade practice and have committed gross deficiency in service towards the complainant. Hence, this complaint.
2. On notice, opposite parties no.1 to 4 appeared. Ops no.1 and 2 filed written statement taking certain preliminary objections. It is submitted that complaint is not maintainable as there is no deficiency in service on part of answering op. The father of complainant was issued a personal accidental policy covering the insured with effect from 25.6.2016 to 24.6.2019 for a sum insured of Rs.9,00,000/- subject to policy terms and conditions. The policy was issued against a loan taken from IndusInd Bank Ltd. on the condition that if there is accidental death or disablement, the proceeds from the insurance cover, if payable as per policy terms and conditions will be settled against the outstanding loan amount. It is further submitted that complainant has not filed any claim reimbursement with the answering ops and necessary claim related documents were never submitted by the complainant to the answering ops for claim assessment. The claim can only be registered, reviewed and processed if all the claim related documents are received by the answering ops. In absence of any claim intimation, the ops no.1 and 2 are not liable under the present complaint. It is further submitted that present complaint is immature and without any cause of action. The complainant has not filed any claim with the answering ops and without following the due procedure as provided in the policy terms and conditions has filed the present complaint and therefore, complaint is liable to be dismissed. Remaining contents of complaint are also denied and prayer for dismissal of complaint made.
3. Ops no.3 and 4 in their separate written statement took certain preliminary objections regarding maintainability, mis joinder of parties and cause of action, no consumer dispute, concealment of true and material facts and that complainant has not impleaded the entire legal heirs of Sukhdev Singh in the present complaint nor has given detail of legal heirs of Sukhdev Singh in the complaint. On merits, it is submitted that Sukhdev Singh father of complainant has availed financial assistance of Rs. nine lacs from the answering ops. He has executed loan documents in favour of answering ops after understanding the contents thereof. It is further submitted that bank officials have never imposed any condition of insurance at the time of providing the loan facility. Borrower/ father of complainant has availed the insurance policy from the officials of ops no.1 and 2 at his own will. The officials of answering ops have not obtained signature on any documents except loan documents. The answering ops have paid the premium of insurance to the officials of ops no.1 and 2 as per instruction of borrower. The matter of insurance and its claim is between Sukhdev Singh father of complainant and ops no.1 and 2. It is further submitted that amount deposited by complainant in the account of Sukhdev Singh has been credited in the account of Sukhdev Singh. Remaining contents of complaint are denied to be wrong and prayer for dismissal of complaint made.
4. Opposite party no.5 was given up by learned counsel for complainant.
5. The parties then led their respective evidence.
6. We have heard learned counsel for the parties and have gone through the record carefully.
7. The complainant in order to prove his complaint has furnished his affidavit Ex.CW1/A in which he has deposed and reiterated all the averments made in the complaint. He has also furnished affidavit of Baldev Singh as Ex.CW2/A, affidavit of Balwinder Singh Ex.CW3/A, affidavit of Shiv Parkash Ex.CW4/A, affidavit of Sandeep Singh Ex.CW5/A and affidavit of Gurvinder Singh Ex.CW6/A. The complainant has also furnished copy of letter dated 5.7.2016 Ex.C1, copy of application Ex.C2, copy of sanction letter Ex.C3, copy of statement of account Ex.C4, copy of death certificate Ex.C5, copy of key benefits Ex.C6, copy of application Ex.C7, copy of proposal form Ex.C8, copy of declarations Ex.C9, copy of policy certificate Ex.C10, copy of premium acknowledgment Ex.C11 and certificate of Gram Panchayat Khajakhera Ex.C12. On the other hand, ops no.3 and 4 have tendered affidavit of Sh. Vinod Kumar, Manager & Principal Officer as Ex.RW1/A, copy of application form Ex.R1, copy of loan cum hypothecation agreement Ex.R2 and copy of statement of account Ex.R3. Ops no.1 and 2 have tendered affidavit of Ms. Shreya Chansoria, Manager Legal Ex.R4, copy of letter dated 30.6.2016 Ex.R5, copy of policy certificate Ex.R6, copy of premium acknowledgment Ex.R7 and copy of terms and conditions Ex.R8.
8. During the course of arguments, learned counsel for ops no.1 and 2 has contended that complainant has not lodged any claim with insurance company nor has submitted any related documents to the insurance company in order to examine his claim and to settle the same despite their letters.
9. Learned counsel for complainant has contended that complainant had submitted all the requisite documents to the ops bank and insurance company in order to get death claim of his father settled and paid, but however, ops were avoiding to settle and pay claim on one or other false pretext and complainant was not having other option except to file present complaint. Complainant never refused to supply the required documents. Complainant is still ready and willing to supply all the requisite documents which are necessary for settlement of claim of complainant.
10. Keeping in view of the facts and circumstances of the present case, it will be in the fitness of things, if present complaint is partly allowed and a direction is given to the complainant to submit all the requisite documents and thereafter a direction is given to the ops to settle and pay the death claim of the father of complainant as per terms and conditions of the insurance policy.
11. In view of above, we partly allow the present complaint and direct the complainant to lodge the claim on the claim form duly approved by insurance company alongwith requisite documents which are required as per terms and conditions of the policy within 15 days to ops no.1 and 2 and ops no.1 and 2 are directed to examine those documents and thereafter settle and pay claim of complainant as per terms and conditions of the policy within 45 days from the receipt of claim form and documents. In case if any amount towards claim is paid directly to ops no.3 and 4 in that eventuality ops no.3 and 4 are directed to overhaul the loan account of deceased Sukhdev Singh in presence of complainant and thereafter settle outstanding amount and if any amount is found excess to the outstanding amount after receiving claim amount from the insurance company, ops no.3 and 4 will make refund of the balance amount to the complainant against proper receipt and verification and will also issue NOC/ No dues certificate to the complainant in this regard. The ops no.3 and 4 will also adjust the amounts so deposited by the complainant. No order as to costs. A copy of this order be supplied to the parties free of costs. File be consigned to the record room.
Announced in open Forum. Member President,
Dated:19.02.2020. District Consumer Disputes
Redressal Forum, Sirsa.
