BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no.256 of 2011
Date of Institution : 16.11.2011
Date of Decision : 25.5.2015
Kaushlya Bai, aged about 50 years, wife of Shri Karam Chand son of Sh.Gajan Ram, r/o village Mallewala, tehsil and District Sirsa.
……Complainant.
Versus.
1. State of Haryana, through Collector, Sirsa.
2. S.D.O ©, Sirsa having power of Nodal Officer.
3. District Social Welfare Officer, Sirsa.
4.The Branch Manager, The Reliance Insurance Company, IInd Floor, 88 EMT Model Town, Hisar.
...…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SHRI VINOD JAIN…………………PRESIDENT
SMT.GURPREET KAUR GILL……MEMBER.
Present: Sh.Suresh Mehta, Advocate for the complainant.
Ms.Rinkulata, Govt.Pleader, for the opposite parties no.1to 3.
Sh.H.S.Raghav, Advocate for opposite party no.4.
ORDER
Mangat Ram, unmarried son of complainant Kaushlya Bai, on 6.1.2009, met with road side accident, in which he died. Post mortem was conducted on the next day. Complainant Kaushlya Bai filed her claim with opposite parties no.1 to 3, for a sum of Rs.1,00,000/-, under Rajiv Gandhi Parivar Bima Yojna, District Social Welfare Officer i.e. opposite party no.3, being Nodal Officer duly forwarded her claim on 5.6.2009, to Reliance Insurance Company i.e. to opposite party no.4 as there was insurance contract in between Haryana Government and Reliance Insurance Company, for payment of compensation of Rs.1,00,000/-, to one person in the family of the deceased, in case of his accidental death. State of Haryana, on behalf of its citizens, was paying insurance premium to the insurance company. Claim of the complainant, was not settled by the insurance company for considerable long time; hence this complaint, for a direction to the opposite parties, for payment of Rs.1,00,000/- to the complainant with upto date interest, besides damages for her harassment, humiliation, mental tension etc. and for litigation expenses.
2. State of Haryana i.e. opposite parties no.1 to 3, filed their reply, admitting the forwarding of the claim of the complainant, by them to the Insurance Company, vide their official letter no.583 dated 5.6.2009 and pleading that compensation was to be paid by the insurance company, so there is no deficiency of service on their part.
3. Insurance company i.e. opposite party no.4, filed its reply, pleading that the claim is inadmissible, as alleged, claim intimation, was sent to it in the month of July, 2009, whereas the death is dated 6.1.2009 i.e. after about six months, which amounts to violation of condition no.1 of the policy.
4. Various preliminary objections are also taken by the opposite parties, but the same are not pressed before us. We also do not find any merit in any preliminary objection. Even, as per the very pleadings of opposites parties no.1 to 3, settlement of the claim of the complainant, was still pending with the insurance company, on the date of filing of the complaint, so, it cannot be said that filing of the claim on 15.11.2011 is time barred. Since, State of Haryana was paying premium on behalf of its citizens, to the insurance company, so it also cannot be said as pleaded by the insurance company that there is no privity of contract in between the complainant and the insurance company. Since, unmarried son of the complainant had died in road accident, so the complainant is entitled for compensation of Rs.1,00,000/- under the Rajiv Gandhi Parivar Bima Yojna, therefore, she has locus-standi, as well as, cause of action to file this complaint.
5. There is no convincing or cogent evidence to prove the objection of the insurance company, that claim intimation, was received in the month of July, 2009. To prove it, insurance company, at least, could placed on record, copy of its own official record which might have been maintained in regular course of business, regarding receipt of such like claims. But, for the reasons, best known to the insurance company, the same has been withheld from this Forum. Necessary inference is thus against the insurance company. Moreover, very case of the insurance company, in this regard, is quite vague and un-certain. No specific date of July, 2009, is pleaded on the reply to the complaint. On the other hand, Ex.R3 copy of letter of District Social Welfare Officer, Sirsa, written to the Sub Divisional Officer ©, Sirsa, shows that it was written in reference to their earlier letter dated 10.2.2009, which are regarding this insurance claim of the complainant. It is evident by this document that the complainant had duly submitted her claim, even prior to 10.2.2012. Moreover, Ex.R10 is the copy of her claim which is dated 30.1.2012. Therefore, it is very clear that the complainant had duly lodged her insurance claim under the said scheme, well within the period of six months. It was thus upon the opposite parties to process it. Not only this even case of the complainant, in this regard is also admitted by opposite parties no.1 to 3 in their written reply, that claim of the complainant, was duly forwarded by their Nodal Officer i.e. by opposite party no. 3, to the insurance company, vide letter no.583 dated 5.6.2009. It is again well prior to period of six months, as death is dated 6.1.2009.
6. Therefore it cannot be said that there was any undue delay in lodging or receiving the claim. Rajiv Gandhi Parivar Bima Yojna is a public beneficial scheme of the Government. Under the provisions of the scheme, compensation has to be disbursed, within 72 hours, on receipt of the claim, from Nodal Officer. But, here in the case in hand, claim was not even settled for months together, by the insurance company forcing the complainant to file this complaint on 15.11.2011. It was only during the pendency of this complaint, formal repudiation letter Ex.R6l, which is un-dated was prepared, simply mentioning that intimation was received on 2.7.2009, against death of dated 6.1.2009 which even could not be proved by any evidence. Even, as per the fact finding report Ex.R7, of the insurance company, it was a genuine claim. So, in the circumstances, it is very well clear that not-settling the insurance claim of the complainant for considerable long time and then repudiating it, on said flimsy ground, is not only gross deficiency of service, on the part of the insurance company, but is also totally unfair trade practice.
7. Resultantly, this complaint is hereby allowed, with a direction to opposite party no.4, to pay insured amount of Rs.1,00,000/- to the complainant, with interest @ 10% per annum, from the date of death i.e. 6.1.2009, till payment. The complainant is also hereby awarded compensation of Rs.10,000/- (Rupees Ten Thousands), for her harassment, humiliation, mental tension etc. and litigation expenses of Rs.2200/- against opposite party no.4.
Announced in open Forum. President,
Dated:25.5.2015. Member. District Consumer Disputes
Redressal Forum, Sirsa.
Kaushlya Bai vs. State of Haryana
Present: Sh.Suresh Mehta, Advocate for the complainant.
Ms.Rinkulata, Govt.Pleader, for the opposite parties no.1to 3.
Sh.H.S.Raghav, Advocate for opposite party no.4.
Arguments heard. For orders to come up on 25.5.2015
Dated:15.5.2015. Member. President,
DCDRF,Sirsa.
Present: Sh.Suresh Mehta, Advocate for the complainant.
Ms.Rinkulata, Govt.Pleader, for the opposite parties no.1to 3.
Sh.H.S.Raghav, Advocate for opposite party no.4.
Order announced. Vide separate order of even date, complaint has been allowed with costs. File be consigned to record room after due compliance.
Announced in open Forum. President,
Dated:25.5.2015. District Consumer Disputes
Redressal Forum, Sirsa.
Member.
