DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR
Complaint No. 566
Instituted on: 20.09.2016
Decided on: 16.02.2017
1. Manpreet Singh aged about 24 years son of Shri Bhinder Singh, resident of Village Ballamgarh, Tehsil Dhuri, District Sangrur.
2. Sandeep Kaur aged about 30 years daughter of late Shri Bhinder Singh, resident of Village Ballamgarh, Tehsil Dhuri, District Sangrur now wife of Jagdev Singh, resident of village Changal, Tehsil Dhuri, District Sangrur.
3. Hardeep Kaur aged about 28 years daughter of late Shri Bhinder Singh, resident of Village Ballamgarh, Tehsil Dhuri, District Sangrur now wife of Dharam Singh, resident of Village Katha Ralla,Tehsil Jagraon, District Ludhiana.
…. Complainants
Versus
1. The Sangrur Central Co-operative Bank Ltd. through its Branch Manager, Branch Hathan, Tehsil Malerkotla, District Sangrur.
2. Liberty Videocon General Insurance Company Limited, through its Managing Director, 10th Floor, Tower A, Peninsula Business Park, Ganpatrao Kadam Marg, Lower Parel, Mumbai-400 013
….Opposite parties.
FOR THE COMPLAINANT : Shri Rohit Jain, Advocate
FOR OPP. PARTY No.1 : Shri Japinder Singh Mann, Advocate
FOR OPP. PARTY No.2 : Shri Bhushan Garg, Advocate.
Quorum
Sukhpal Singh Gill, President
Sarita Garg, Member
Vinod Kumar Gulati, Member
ORDER BY:
Sukhpal Singh Gill, President.
1. Shri Manpreet Singh, Sandeep Kaur and Hardeep Kaur, complainants (referred to as complainants in short) have preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that their father, namely, Shri Bhinder Singh was having an account with the OP number 1 and being the account holder was insured with the OP number 2 for Rs.1,00,000/- in case of accidental death. Further case of the complainants is that Shri Bhinder Singh (referred to as DLA in short) on 26.11.2013 when at about 6.30 PM the DLA was going to village Bamal to Village Ballamgarh and when he reached near village Dugani, then a tractor trolley came from village Jatimajra side and struck with the DLA, as a result of which the DLA fell on the road and sustained multiple injuries and died at the spot. It is further averred that the postmortem on the dead body of the DLA was conducted at Civil Hospital, Dhuri and FIR number 286 dated 26.11.2013 was also registered. Further case of the complainant is that the complainant number 1 was getting training at Kolkatta in Merchant Navy from July, 2013 to December, 2013 and came back in January, 2014 and was under deep shock of sudden demise of his father. Further case of the complainant is that he came to know from OP number 1 that the DLA was insured with the OP number 2 for Rs.1,00,000/- in case of accidental death and was asked to submit the relevant documents including death certificate, which were submitted accordingly. It is further averred that mother of the complainants Smt. Nachattar Kaur had already died in 2008. Further case of the complainants is that the claim was lodged late by them due to non availability of the correct death certificate of the DLA and only after that the claim was lodged. But the grievance of the complainants is that the OP number 2 repudiated the claim of the complainants on the ground that they had not intimated about the accident within time and did not submit the required documents. Thus, alleging deficiency in service on the part of OPs, the complainants have prayed that the OPs be directed to pay to the complainants a sum of Rs.1,00,000/- as claim amount under the policy along with interest and further claimed compensation for mental agony, harassment and litigation expenses.
2. In reply filed by OP No.1, legal objections are taken up on the grounds that the complaint is not maintainable, that the complainants have filed the complaint beyond limitation, that the complainants have not come to the Forum with clean hands and that the complainants have unnecessarily dragged the OP into unwanted litigation. That as per the terms and conditions of the policy, the complainants have to give intimation regarding death of the insured person to the insurance company within the period of 15 days after actual date and time of death and the written evidence must be furnished to the insurance company within 30 days, but in the present case, there is delay of about more than two years. On merits, it is admitted that the DLA had an account with the OP number 1. It is stated further that the complainants themselves are admitting that they are started to put pressure upon the OP number 1 to send the incomplete documents and wrong documents to higher authorities. It is further stated that the OP number 2 had intimated the OP number 1 vide letter dated 31.10.2015 that the claim has been repudiated due to the late intimation and submission of the documents and has further stated that as per the terms and conditions number 10 and 11 notification of the claim should be made to the company within 15 days after an actual date and time of accident and further to submit the documents within 30 days after the date of such accident. The other allegations leveled in the complaint have been denied.
3. In reply filed by OP No.2, legal objections are taken up on the grounds that the complaint is clearly time barred, as the complainants have submitted that the DLA died on 26.11.2013 and the present complaint has been filed on 20.09.2017, that as per the condition precedent to the liability, the written notice of claim must be given by the insured nominee to the company within 15 days after an actual date and time of accident, but in this case the intimation of loss was given to the OP on 28.10.2015. On merits, the allegations of the complainants have been denied. It is stated further that in the absence of authentication from the policy holder from OP number 1 and evidence of deduction of premium from the account of the DLA, the OP denies the coverage of DLA under the said policy. It is stated further that the claim has rightly been repudiated.
4. The complainants have tendered documents Ex.C-1 affidavit, Ex.C-2 copy of passbook, Ex.C-3 copy of postmortem report, Ex.C-4 copy of FIR, Ex.C-5 copy of repudiation letter dated 31.10.2015, Ex.C-6 to Ex.C-10 copies of letters, Ex.C-11 copy of email, Ex.C-12 copy of explanation, Ex.C-13 and Ex.C-14 copies of death certificate, Ex.C-15 copy of letter, Ex.C-16 to Ex.C-26 copies of certificates of Manpreet Singh, Ex.C-27 inquest report and closed evidence. On the other hand, the learned counsel for OP number 1 has produced Ex.OP1/1 to Ex.OP1/15 copies of letters, emails and other documents etc. and closed evidence. The learned counsel for OP number 2 has produced Ex.Op2/1 copy of policy schedule, Ex.OP2/2 copy of terms and conditions of policy, Ex.OP2/3 copy of repudiation letter and Ex.OP2/4 affidavit and closed evidence.
5. We have very carefully perused the complaint, written reply, as well as evidence produced on the file and heard the arguments of the learned counsel for the parties. In our opinion, the complaint deserves dismissal, for these reasons.
6. It is an admitted fact that the DLA was insured under the policy in question for Rs.1,00,000/- in case of accidental death with the OP number 2 through the OP number 1. It is further an admitted fact that the DLA died an accidental death on 26.11.2013, as is evident from the copy of the post mortem report, Ex.C-3 and the copy of FIR dated 26.11.2013, Ex.C-4 on record. But, the grievance of the complainants is that the OP number 2 has repudiated the rightful claim of the complainants wrongly on the ground that the claim was not submitted in time. On the other hand, the stand of the Ops number 1 and 2 is that the complainants lodged the claim with the OP number 2 on 28.10.2015, whereas the DLA died an accidental death on 26.11.2013. The learned counsel for the Ops has further contended vehemently that as per the point number 10 of the general terms and conditions of the policy, the claim should have been lodged within a period of 15 days of the actual date of accident and further to complete claim forms and written evidence within the period of thirty days of such accident. But, in the present case, it is not the case of the complainants that they ever intimated the Ops about the claim as per the policy terms and conditions. Moreover, it is the own case of the complainants in the complaint that they lodged the claim with the Ops after the correction in the death certificate on 16.7.2015. But, we are unable to go with such a contention that the claim could not be lodged due to this documentary problem and if there was such a problem then the same could have been explained to the Ops well in time. The complainants have not produced even a single document on record to show that they ever approached the Ops about the accidental death of the DLA. Further we have perused the copy of repudiation letter dated 31.10.2015, wherein it has been clearly mentioned that the DLA expired on 26.11.2013 and the intimation of death was received on 28.10.2015, which itself shows that it is a clear cut violation of the general terms and conditions of the insurance policy, wherein it is clearly mentioned that the company be intimated within 15 days after an actual date and time of accident, but in the present case, no such compliance of the terms and conditions of the policy as mentioned above has been made. The complainants have also produced Ex.C-12 self explanation regarding delay, wherein it has been clearly mentioned that he had no knowledge about the account of his deceased father and as and when it came to his knowledge, he applied for the claim. But, the fact remains that the complainants have violated the terms and conditions in lodging the claim with the Ops. As such, we are unable to find any deficiency in serviced on the part of the Ops in repudiating the claim of the complainants.
7. In view of the above discussion, we dismiss the complaint of the complainants. However, the parties are left to bear their own costs. A copy of the order be supplied to the parties free of charge. File be consigned to records in due course.
Pronounced.
February 16, 2017.
(Sukhpal Singh Gill)
President
(Sarita Garg)
Member
(Vinod Kumar Gulati)
Member
