Ravinder Kaur filed a consumer case on 23 Oct 2015 against Royal Sundaram Alliance in the Nawanshahr Consumer Court. The case no is CC/44/2015 and the judgment uploaded on 21 Dec 2016.
DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
SHAHEED BHAGAT SINGH NAGAR
Consumer Complaint No. : 44 of 24.04.2015
Date of Decision: : 23.10.2015
Ravinder Kaur Wife of Late Sh.Jorawar Singh S/o Sgh.Dalbir Singh Resident of Village Kariha, Tehsil Nawanshahr, District Shaheed Bhagat Singh Nagar.
…Complainant
Versus
1. Royal Sundaram Alliance Insurance Company Limited, Sundaram Towers, 45&46, Whites Road, Chennai – 600014, or Alternate address: 21, Patullos Road, Chennai – 600002, through its authorized signatory/C.E.O./ Head Incharge.
2. Royal Sundaram Alliance Insurance Company Limited, SCO 82, I&II Floor, Sector 40-C, Chandigarh 1600040, through its authorized signatory.Branch Manager.
3. PACL Limited, 7th Floor, Gopaldas Bhawan, 28 Barakhamba Road, New Delhi – 110001; or alternate address: B-1/5, PACL House Paschim Vihar, New Delhi – 110063, through its authorized signatory/CEO/Head Incharge.
4. PACL India Limited, Near Bank of Maharashtra, Chandigarh Road, Nawanshahr and District Shaheed Bhagat Singh Nagar, Punjab, through its authorized signatory/Branch Manager/Office Incharge.
…Opposite Party
Complaint under the Provisions of Consumer Protection Act, 1986
QUORUM:
SH.G.K. DHIR, PRESIDENT
MS.SUDHA SHARMA, MEMBER
COUNSEL FOR THE PARTIES:
For complainant : Sh.Yudhvir Bajaj & Sh.Rohit Basi, Advocates
For Ops No.1&2 : Sh.Jatin Sharma, Advocate
For OPs No.3&4 : Sh.M.P. Nayyar, Advocate
ORDER
PER SH.G.K. DHIR, PRESIDENT
1. Complainant-Ravinder Kaur filed complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred as Act) by alleging that her husband Sh.Jorawar Singh (now deceased), got himself insured under Group Personal Accident Insurance Policy bearing master policy No.PAPACL0001(bearing certificate No.PAPACL00100312 with membership No.3020000846) dated 18.02.2013 from Op No.1 through Op No.4. Op No.2 is branch office of Op No.1, but Op No.3 is using tag mark of “PEARLS” for working in tie-up with Op No.1. Op No.4 is branch office of Op No.3. Complainant was nominated by Sh.Jorawar Singh qua the said policy for assured sum of Rs.5,00,000/-. 100% capital insured sum was payable in case of accidental death. Said Sh.Jorawar Singh died in Road Accident on 05.03.2013. That accident took place on GT Road Village Khatkar Kalan District SBS Nagar. Sh.Jorawar Singh was employed as PC in Punjab Home-guard. Complainant being nominee applied for claim of insurance from OPs by filing the requisite documents as per rules, but the said claim was wrongly rejected vide letter dated 26.04.2013, on the ground that policy inception date was 18.02.2013 and claim lodged within 30 days of waiting period. After receipt of this letter, complainant approached OPs for resolving the matter amicably, but of no use. By pleading deficiency in service, compensation of Rs.2,00,000/- on account of delay in payment, mental and physical humiliation sought. Insured amount of Rs.5,00,000/- with interest @18% P.A. alongwith litigation expenses of Rs.8,000/- even claimed.
2. On appearance OP No.1&2 has filed joint written statement by denying each and every allegation of complaint except that Sh.Jorawar Singh obtained the policy from 18.02.2013 to 17.02.2014 and that intimation regarding death of insured in road accident of 05.03.2015 was received. Said accident occurred within 30 days of issuance of policy. As per terms and conditions of the policy certificate, there was a waiting period of 30 days for lodging the claim from the date of issue of policy. During this waiting period OPs not to incur any liability of payment of insured sum. The claim was repudiated as per terms and conditions of the policy rightly and as such there is no deficiency in service on part of OPs. It is further pleaded that claim of complainant not sustainable legally and factually.
3. In separate joint written statement filed by OPs No.3&4, it is claimed that OP No.4 is company registered under the Indian Companies Act and as such the same enjoys the legal status. Complaint is alleged to be based on false, frivolous and baseless allegations. OPs No.3&4 is one of the pearl group company engaged in real estate business including sale, purchase, development and allotment of land to its customers. This company is also engaged in business of tourism, consumer products and construction of residential as well as commercial complexes. This company has one product of name of “PEARLS Sales Kit”, of worth of Rs.500/-, which contains discount of tour packages, air tickets, hotels and various consumer products. Ops No.3&4 has got a “Group Personal Accident Insurance Policy” from OP No.1 for purpose of providing to its “Pearls Sales Kit” customers absolutely free of costs, the accidental benefits for one year. Applicable premium for this policy is paid by Ops NO.3&4 only without charging anything from its customers. Complainant approached Ops No.3&4 for purchase of “Pearls Sales Kit” against payment of Rs.400/-, due to which benefit of “Group Personal Accident Insurance Policy” was extended to complainant after receipt of Rs.400/-. No premium for this insurance policy was paid by complainant or insured. Accidental Insurance Benefit becomes available to purchaser for one year purely on complimentary basis. No deficiency in service can be complained by complainant, after availing services free of costs. Accidental benefit under the above referred insurance policy payable to customers as per terms and conditions of the policy, which stipulates waiting period of 30 days from the date of commencement of certificate of insurance. Husband of complainant admittedly purchased the insurance certificate on 18.02.2013, but his death took place on 05.03.2013 i.e. within waiting period of 30 days. Repudiation of the claim vide letter dated 26.04.2013 as such alleged to be proper. Complainant has no cause of action and as such prayer made for dismissal of the complaint.
4. Complainant to prove his case tendered his affidavit Ex.CW1/A alongwith photocopies of documents Ex.C-1 to Ex.C8 and then closed the evidence through counsel. Counsel for OPs No.1&2 tendered in evidence affidavit Ex.OP1/A of Sh.Aneesh Bhaskaran, the Sr. Executive, (Legal) alongwith documents Ex.OP-1 to Ex.OP-4 and then closed the evidence. Representative of Ops No.3&4 has tendered his affidavit Ex.OP3/A and then closed the evidence.
5. Written arguments not submitted by any of the parties. Oral arguments addressed were heard and records gone through carefully.
6. Counsel for complainant after taking us through Ex.C-1 alongwith Ex.C-4, but Ex.C-2 alongwith Ex.C-5 vehemently argues that in Ex.C-5 it is specifically mentioned that free accident benefit to commence after 45 days of the date of purchase of sales kit, but both in Ex.C-1 and Ex.C-2 the waiting period of 30 days has been specified and as such there is contradiction of the duration of waiting period clause. Besides in note appended to Ex.C-4, it is mentioned that accidental benefit to start after 45 days from the date of issue of acknowledgement, but that note has overwriting of word 45 in hand above the printed words of 30 days. Therefore, it is contended that such clause of waiting period cannot be treated as a bar for repudiation of the claim. These submissions advanced by counsel for complainant has no force because even if in Ex.C-4, the overwriting of words 45 days may be there, but despite that there is no such overwriting in note No.1 in acknowledge Ex.C-5. Rather, contradiction in contents of Ex.C-1 viz-a-viz Ex.C-4 or Ex.C-2 viz-a-viz Ex.C-5 does not exist at all because if in acknowledgments Ex.C-4 and Ex.C-5 commencement of free accidental benefit stipulated after 45 days of the date of purchase of sales kit, then at the same time in certificates Ex.C-1 and Ex.C-2, waiting period of 30 days stipulated to be continued for 30 days from the date of commencement of these certificates. Date of the purchase of the sale kit in question is 28.01.2013 as disclosed by contents of Ex.C-4. It is on basis of purchase of this Sales Kit that accidental benefit under the insurance scheme to become available to nominee of purchaser Sh.Jorawar Singh, who admittedly is the complainant. So if contents of acknowledgment Ex.C-4 taken into consideration, then the free accidental benefit to accrue w.e.f. 14.03.2013 and not before that. In case contents of Ex.C-1 qua waiting period of 30 days taken into consideration, then by keeping in view the date of commencement of the certificate as 18.02.2013, the said waiting period was to lapse on 19.03.2013. Admittedly, the death of Sh.Jorawar Singh took place on 05.03.2013 as per certified copy of death certificate Ex.C-3 issued by Registrar, Birth and Death, Punjab. So even if contents of Ex.C-1 or Ex.C-4 taken into consideration, despite that free accidental benefit of the insurance policy not to become available to complainant because death of insured took place at least nine days prior to the stipulation of waiting period of 45 days through Ex.C-4, but the same took place at least 13 days prior to the waiting period of 30 days stipulated through Ex.C-1.
7. Contract of insurance is binding on the parties and nothing can be added or subtracted thereto by assigning different meaning to the words. This contention of counsel for OPs supported by ratio of cases Swift Limited vs. New India Assurance Co.Ltd. and others-IV(2012)CPJ-148(N.C.); Usha Sharma vs. New India Assurance Co.Ltd.-I(2012)CPJ-448(N.C.); United India Insurance Co.Ltd. vs. Harchand Rai Chandan Lal-IV(2004)CPJ-15(S.C.) and Deokar Exports Pvt. Ltd. vs. New India Assurance Co.Ltd.-I(2009)CPJ-6(S.C.). So, case of the parties certainly to be governed by terms and conditions of Ex.C-1 = Ex.OP-1 and Ex.C-4. Keeping in view this legal position in mind also, the repudiation of the claim through Ex.Op-4 = Ex.C-7 is legally justified. Documents Ex.C-2 and Ex.C-5 only shows as if earlier too the Pearls sales kit was purchased by Sh.Jorawar Singh with benefit of insurance policy in question for period from 06.01.2012 to 05.01.2013. Those documents has nothing to do with the present claim because in view of the accidental death of Sh.Jorawar Singh on 05.03.2013, the case in hand to be governed by terms of certificate Ex.C-1 or the relevant acknowledgement Ex.C-4 only.
8. It is vehemently contended by counsel for Ops that as the free accidental benefit provided to nominee of Sh.Jorawar Singh without charging any premium and as such Ops No.3&4 not liable because complainant cannot be treated as their consumer. Submissions advanced by counsel for Ops No.3&4 certainly has force in this respect because as per law laid down in case Parveen Sharma Vs Anne Heart and Medical Center and other II (2015) CPJ 50 (NC), if the services of medical examination provided free of charges, then the lab concerned cannot be held liable because complainant availing such services free of charge is not a consumer. In this case before us also OPs No. 3&4 got provided free accidental insurance benefits without charging any premium from complainant, but after accepting the cost of their Pearls Sales Kit only and as such qua the accidental death claim, OPs No.3&4 cannot be held liable.
9. As a sequel of above discussion, the present complaint is dismissed without any orders as to costs.
10. The certified copies of this order be supplied to the parties forthwith, free of costs, as permissible under the rules and the file be indexed and consigned to the Record Room.
Dated: 23.10.2015
(Sudha Sharma) (G.K. Dhir)
Member President
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