Chandigarh

DF-I

CC/35/2016

Sharda Devi Garg - Complainant(s)

Versus

SBI General Insurance Co. Ltd. - Opp.Party(s)

Devinder Kumar

27 Mar 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I, U.T. CHANDIGARH

==========

Consumer Complaint  No	:	CC/35/2016
Date  of  Institution	:	14/01/2016
Date   of   Decision	:	27/03/2017

 

 

 

 

 

Sharda Devi Garg wife of Shri Tirath Raj Garg, resident of Amin Chand House Lal Bagh, Upper Kathua, Shimla (H.P).

…………. Complainant.

Vs

 

[1]  SBI General Insurance Co. Limited, 101, 201, 301 Natraj, Junction of Western Express Highway, Andheri Kurala Road, Mumbai 400069, through its Managing Director.

 

[2]  SBI General Insurance Co. Limited, SCO No. 457-458, 1^st Floor, Sector 35-C, Chandigarh – 160036, through its Branch Manager.

……… Opposite Parties

 

BEFORE:   SH.S.S. PANESAR              PRESIDENT

MRS.SURJEET KAUR          MEMBER

                SH. S.K.SARDANA              MEMBER

 

For Complainant	:	Sh. Devinder Kumar, Advocate.
For OPs No.1 & 2	:	Sh. Simrandeep Singh, Advocate.

 

PER SURJEET KAUR, MEMBER

 

 

          Succinctly put, the son of the Complainant namely Sh. Gaurav Garg was having one Personal Accident Insurance Policy, wherein the Complainant was his nominee. The said policy was effective from 13.01.2014 to 12.01.2015. Unfortunately, on 23.08.2014, the aforesaid son died in a car accident at Chandigarh. Copy of FIR No.399 dated 23.08.2014 has been annexed as Annexure C-4. It has been alleged that due intimation was given to the Opposite Parties and thereafter, all the requisite documents, as and when desired, were submitted to the Opposite Parties for processing the claim. Despite receipt of the documents, when the Opposite Parties failed to settle the genuine claim of the Complainant, she got served a legal notice dated 12.11.2015, upon the OPs. In response to the said legal notice, the Opposite Parties vide letter dated 7.12.2015 again demanded the documents, which were already supplied to them, just to linger on the matter. With the cup of woes brimming, the Complainant has filed the instant consumer complaint, alleging that the aforesaid acts amount to deficiency in service and unfair trade practice on the part of the Opposite Parties.

 

2.      Notice of the complaint was sent to Opposite Parties seeking their version of the case.

 

3.      Opposite Parties No.1 & 2 in their joint reply, while admitting the factual aspects of the case, have pleaded that despite requesting time and again, the Complainant failed to provide Viscera report and because of this reason her claim was closed. Denying all other allegations and stating that there is no deficiency in service on their part, Opposite Parties have prayed for dismissal of the complaint.

 

4.      The Complainant also filed replication to the written statement filed by the Opposite Parties No.1 & 2 wherein the averments as contained in the complaint have been reiterated and those as alleged in the written statement by the Opposite Parties No.1 & 2 has been controverted.

 

5.      Parties were permitted to place their respective evidence on record in support of their contentions.

 

6.      We have heard the learned counsel for the parties and have also perused the record.

 

7.      It is evident from Annexure C-1 that Sh. Gaurav Garg, the son of the Complainant, was insured with the Opposite Parties for an amount of Rs.4,00,000/- under Personal Accident Policy, for a period of one year from 13.01.2014 to 12.01.2015. The case of the Complainant is that after the death of her aforesaid son, the Opposite Parties despite having received the required documents closed her genuine claim.

 

8.      The stand taken by the Opposite Parties is that as the Complainant failed to provide the viscera report, therefore, her claim was rightly closed.

 

9.      A careful perusal of the file reveals that the son of the Complainant was duly insured with the Opposite Parties as per Annexure C-1 the Certificate of Insurance. Annexure C-3 is the copy of the driving license of the deceased Gaurav Garg. Annexure C-4 is the copy of the FIR No. 390 dated 23.08.2014 lodged with the Police at PS Sector 34, Chandigarh. Annexure C-6 [colly] are the various documents sent to the Opposite Parties along with the letter by the Complainant. Annexure C-7 and C-8 are the copies of the Postmortem Examination Report and the Death Certificate, respectively, of the deceased son of the Complainant. All the above mentioned documents were admittedly received by the Opposite Parties, except the viscera report. We are of the opinion that it was the duty of the Investigator appointed by the Opposite Parties to arrange the viscera report. Rather the Opposite Parties are shifting the onus of providing the viscera report on the Complainant, which is not a document of her possession. Evidently, during the proceedings of the present case, the Complainant tried her level best to arrange the same by applying for the viscera report, through the RTI.  In these set of circumstances, the act of the Opposite Parties in not settling the genuine claim of the Complainant deliberately, proves deficiency in service on their part, which certainly caused physical and mental harassment to the Complainant.

 

10.      In the light of above observations, we are of the concerted view that the Opposite Parties are found deficient in giving proper service to the complainant and having indulged in unfair trade practice. Hence, the present complaint of the Complainant deserves to succeed against the Opposite Parties, and the same is allowed, qua them. The Opposite Parties are, jointly and severally, directed:-

[a]    To pay Rs.4,00,000/- being the sum insured as personal accident claim to the Complainant;

 

[b]    To pay Rs.25,000/- as compensation for mental agony & harassment suffered by the complainant;

 

[c]    To pay Rs.10,000/- as costs of litigation.

 

11.      The above said order be complied with by the Opposite Parties, within 30 days from the date of receipt of its certified copy, failing which the amount at Sr. No. [a] & [b] above shall carry interest @12% per annum from the date of filing of the present Complaint, till actual payment, besides payment of litigation costs of Rs.10,000/-.

 

12.      Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room.

Announced

27^th March, 2017                                           

Sd/-

(S.S. PANESAR)

PRESIDENT

 

Sd/- 

(SURJEET KAUR)

MEMBER

 

Sd/- 

(S.K.SARDANA)                                                                                                      MEMBER

 “Dutt”