BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FATEHABAD.
Complaint No.:215 of 2017.
Date of Instt.: 01.09.2017.
Date of Decision: 31.05.2018.
Vikram Singh @ Vikram aged 20 years son of Rohtash @ Rohtash Kumar son of Gopal, resident of near Railway Line, Bhattu Kalan, Tehsil & District Fatehabad.
…Complainant.
Versus
1.Star Union Dai Ichi Life Insurance Company Limited, 11th Floor, Vishwaroop IT Park, Plot No. 34, 35 and 38, Sector 30A of IIP, Vashi, Navi Mumbai through its Chairman/Managing Director.
2.Union Bank of India, Branch Fatehabad through its Branch Manager.
…Opposite Parties.
Complaint U/s 12 of the Consumer Protection Act, 1986
Before: Sh.Raghbir Singh, President.
Sh. M.K. Khurana, Member.
Present: Sh.R.K. Rukhaya, counsel for the complainant.
Sh.Vinod Godara, counsel for the OP no. 1.
OP no. 2 exparte.
ORDER:
The present complaint under Section 12 of Consumer Protection Act, 1986 has been filed by the complainant against the Opposite Parties (hereinafter to be referred as OPs) with the averments that Shri Rohtash, father of the complainant got his life insured with the OPs vide policy no. 00997344 for an amount of Rs. 7,78,000/- on 19.8.2016. In the said policy the complainant was nominated as nominee of the life assured. At the time of issuance of the insurance the life assured deposited an amount of Rs. 35,578/- with the OPs by transfer from his saving account. The said policy was for the period of 15 years and the date of commencement of the policy was 31.8.2016 and the last installment of insurance was to be deposited by the life assured on 28.2.2026.
2. It is further submitted that the life assured died on 7.2.2017 in his village Bhattu Kalan and the same is evident from the death certificate attached as Annexure C-2. Since the complainant is nominee in the said policy as such after death of life assured the complainant is consumer of the OPs.
3. It is further submitted that after demise of the life assured the complainant submitted insurance claim with the OPs and all the requisite documents were submitted by the complainant with the OPs. Thereafter, the complainant was assured by the OPs that the insurance claim will be released very soon and the complainant will be intimated regarding the same telephonically. Thereafter, the complainant visited OPs several times regarding release of the insurance claim but all in vain. It is further submitted that on 3.7.2017 the complainant received an email message from the OP no. 1 that vide letter dated 31.5.2017 the insurance claim on account of death of his father has been repudiated on the ground that the death certificate and other documents submitted by the complainant were not found genuine. It is further submitted that the abovesaid act on the part of OPs in repudiating the genuine claim of the complainant amounts to deficiency and unfair trade practice on the part of OPs in rendering service to the complainant. It is further prayed by the complainant that the OPs may be directed for making a payment of Rs. 7,78,000/- i.e. insurance claim along-with compensation on account of mental agony and physical harassment suffered by him. Hence the present complaint.
4. On being served, the OP no. 1 appeared through its counsel and resisted the complaint by filing a reply with the averments that the life assured had expired on 9.7.2016 i.e. before the issuance of the policy in question. The OPs in its reply specifically denied that the life assured had expired on 7.2.2017. It is further submitted that the complainant got the policy issued by giving wrong and false information regarding death of the life assured. As per the government records Annexure R-3 father of the complainant had expired before issuance of the policy. The policy in question was issued on 31.8.2016, whereas father of the complainant had already expired on 9.7.2016. Therefore, the complainant got the policy issued with a malafide intention to cause wrongful loss to OP no. 1. It is further submitted that repudiation of the insurance claim by the OP no. 1 is perfectly in accordance with the terms and conditions of the policy and sustainable in the eyes of law and as such the present complaint is without any merits and the same is liable to be dismissed.
5. Despite proper service OP no. 2 did not appear before this Forum and as such the same was proceeded against exparte vide order dated 6.10.2017.
6. Learned counsel for the complainant tendered affidavit of the complainant in evidence as Annexure C-1 along-with documents as Annexure C-2 to C-16. Sh. Roshal Lal Sarpanch of village Bhattu Kalan also tendered in evidence affidavit as Exhibit C-2 in support of case of the complainant. On the other hand, Sreemaya Athikkat, authorized signatory of OP no. 1 tendered in evidence his affidavit as Exhibit RW1/A on behalf of OP no. 1. The OP no. 1 also tendered in evidence the documents as Annexure R-1 to R-4 and closed its evidence. Thereafter, on 13.4.2018 the learned counsel for OP no. 1 filed an application for giving permission to examine the Anganwari Worker of Bhattu Kalan as witness with death record of Rohtash Kumar, the life assured. The learned counsel for the complainant made a statement that he has no objection in case the abovesaid application is allowed. In the interest of justice, the said application was allowed, on 21.5.2018 and official of Anganwari Centre no. 101, Bhattu Kalan was examined by OP no. 1 and she placed on record the documents as Exhibit R-5 and R-6.
7. The learned counsel for the complainant in his arguments reiterated the averments made in the complaint and further contended that a genuine claim of the complainant has been repudiated by the Ops on false and illegal grounds. It is further contended that the said act on the part of Ops amounts to deficiency and unfair trade practice on the part of Ops in rendering service to the complainant.
8. The learned counsel for the OP no. 1 vehemently rebutted the arguments advanced by learned counsel for the complainant. It is further contended by the learned counsel for OP no. 1 that the complainant got the policy issued by giving wrong and false information regarding the death of his father. It is further contended that as per government record the father of the complainant had died before issuance of the policy in question. As per Annexure R-3, father of the complainant had died on 9.7.2016, whereas the policy in question was issued on 31.8.2016. The said policy was got issued by the complainant with a malafide intention and to cause wrongful loss to the OP no. 1. Therefore, repudiation of the insurance claim of the complainant by OP no. 1 is perfectly in accordance with the terms and conditions of the insurance policy and sustainable in the eyes of law.
9. We have duly considered the arguments advanced by learned counsel for the parties and have also perused the entire material placed on record. In the present case the insurance claim of the complainant has been repudiated by OP no. 1 on the ground that the life assured had already died before the issuance of the insurance policy in question. In support of its case, OP no. 1 has relied upon a document Annexure R-3 alleged to be issued by the Anganwari Worker Centre no. 101, village Bhattu Kalan wherein the date of death of Rohtash life assured has been mentioned as on 9.7.2016. However, the abovesaid contention of OP no. 1 and the document Annexure R-3 has been disapproved by the witness Raj Kumari official of Anganwari Center No. 101 Bhattu Kalan, who was examined by the OP no. 1 itself. She produced the original record regarding death of the life assured maintained by the Anganwari Center No. 101 of Bhattu Kalan. On the basis of the original record she submitted that Rohtash son of Gopal had died on 7.2.2017. Photo-copies of original record are Exhibit R-5 and Exhibit R-6. A perusal of Exhibit R-5 and Exhibit R-6 reveals that the life assured Shri Rohtash had died on 7.2.2017.
10. In view of the aforesaid discussion, the OPs has failed to prove that the ground of repudiation of the claim of the complainant was justified. Therefore, the order dated 31.5.2017 vide which the claim of the complainant was repudiated is hereby set aside. The present complaint is accordingly allowed and the OP no. 1 is directed for making a payment of Rs. 7,78,000/- (Rs.Seven lac seventy eight thousand only) to the complainant alongwith interest @ 7% per annum from the date of filing of the present complaint till realization. The OP no. 1 is further directed for making a payment of Rs. 5,000/- (Rs.Five thousand only) to the complainant as compensation and litigation charges. The Ops are further directed to make compliance of the present order within a period of 45 days, failing which the above said amount will carry an interest @ 8% per annum from the date of order till its realization. Copy of this order be supplied to the parties free of costs. File be consigned to record room after due compliance.
Announced in open Forum. Dated:31.05.2018
President,
DCDRF, Fatehabad.
Member
