Haryana

Ambala

CC/68/2020

Sushila Devi - Complainant(s)

Versus

TATA AIG General Insurance Co Ltd - Opp.Party(s)

A.B,Kapoor

05 Jun 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, AMBALA.

 

Complaint case no.	:	68/2020
Date of Institution	:	04.03.2020
Date of decision	:	05.06.2023.

Sushila Devi Wd/o Late Shri Dev Naraiyan Sahu, r/o 103, Pragati Vihar, Ambala Cantt.

 

          ……. Complainant.

 

                                                Versus.

 

1. TATA AIG General Insurance Company Limited, Through Branch Manager, #3^rd Floor, Shanti Complex, Jagadhri Road, Opposite Civil Hospital, Ambala Cantt.
2. Capri Global Capital Limited Company Office at 2^nd Floor Surya Tower, Nicholson Road, Nigar Cinema, Ambala Cantt.

 

                                                                                             ….…. Opposite Parties.

 

Before:        Smt. Neena Sandhu, President.

                             Smt. Ruby Sharma, Member,

          Shri Vinod Kumar Sharma, Member.           

 

Present:      Shri Harshit Kapoor, Advocate, counsel for the complainant.

                   Shri Mohinder Bindal, Advocate, counsel for the OP No.1.

                   Shri G.S. Sandhu, Advocate, counsel for the OP No.2.

 

Order:        Smt. Ruby Sharma, Member.

 

1.                Complainant has filed this complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’) against the Opposite Parties (hereinafter referred to as ‘OPs’) and prayed as under:-  

1. To direct OP No.1 to pay the loan amount of Rs.8,94,092.62 to the OP No.2.
2. To direct OP No.2 to return the documents of the complainant.
3. To direct the OPs No.1 and 2 to pay Rs.50,000/-, as compensation for the mental agony and physical harassment suffered by the complainant and Rs.22,000/-, as litigation expenses.
4. Grant any other relief which this Hon’ble Commission may deems fit.

 

2.             Brief facts of the case are that late husband of the complainant applied for a Home Loan vide Policy No.0235000087 001199 00 00 dated 30.01.2015 and agreement dated 22.01.2018 and valid upto 29.01.2023 (for a period of five years) and the certificate number of the same is 001199. OP No.1 had taken premium for insurance of Late Shri Dev Naraiyan (Husband of the complainant). Late Shri Dev Naraiyan was owner of plot vide sale deed No.1134 dated 22.06.2016 on which he took a loan from the bank i.e. OP No.2 and the said loan was duly insured with OP No.1. Unfortunately Shri DevNaraiyan died on 26.08.2019. Now complainant has received a notice from OP No.2 dated 31.12.2019 demanding a sum of Rs.8,94,092.62. As per insurance policy OP No.1 being the insurer is liable to pay the said amount of loan to the OP No.2. As per notice of the OP No.2, the above said amount is to be paid failing which the complainant shall be dragged in the unwanted litigation. OP No.1 was requested to clear the said loan being the insurer but they did not listen to the request of the complainant. OP No.1 is duty bound to pay the amount as they have taken premium and the policy is within period of five years within which the borrower husband of complainant died on 26.08.2019. Complainant got served a legal notice dated 03.02.2020, upon the OPs, but of no avail. The loan was taken by her husband who was a sole earning member of the family and after his death; she is unable to earn her livelihood and is therefore unable to clear the loan without the claim from OP No.1. OP No.1 is duty bound to make the payment of the due amount of loan to OP No.2 which they have not done till date, hence this complaint.
3.           Upon notice, the OP No.1 appeared and filed written version and raised preliminary objections with regard to maintainability, not come with clean hands and suppressed the material facts etc. Without admitting any liability under the present case, the OP No.1 is ready to entertain the claim of the complainant as per the terms and condition of the insurance policy and its scope provided that the complainant submits the complete required papers like complete treatment record etc. of the insured deceased late Shri Dev Naraiyan and the claim papers as to under which parameter of the said insurance policy her claim falls. It is not out to place to mention here that the Group Credit Secure Insurance Policy is a specific type of insurance policy which only come into existence in case of the critical illness of the insured specifically listed and defined in the policy like cancer end stage of renal failure, multiple scierosis etc., the accidental death of the insured or his accidental permanent total disability. The said policy also covers loss to insured property by earthquake, fire, riot, storm etc. as specifically mentioned in the policy and alongwith attached terms and schedule part of this insurance policy. On merits, rest of the averments of the complainant was denied by the OP No.1and prayed for dismissal of the present complaint with costs.
4.           Upon notice, the OP No.2 appeared and filed written version and raised preliminary objections with regard to maintainability etc. On merits, it has been stated that the loan amount was disbursed to Late Shri Dev Naraiyan Sahu and the complainant herein, being borrowers on 22.01.2018. It is further stated that on the express instructions of the Borrowers herein, the premium amount was paid to OP No.1 by OP No.2 Being arbitration proceedings initiated by OP No.2 to recover the outstanding loan amount from the Borrowers. It is further stated that OP No.2 is a finance company and deals with public funding and is thus answerable to RBI for recovery of loan amount and delinquent accounts. The loan account of the complainant has been classified as NPA due to continuous default, in accordance with the regulations issued by the RBI. Thus, OP No.2 was constrained to initiate proceedings under the Arbitration & Conciliation Act, 1881 to recover the loan amount. No act of the OP No.2 amounts to dragging the complainant into unwarranted litigation. In fact, the complainant has entered appearance before the Ld. Arbitrator. It is further stated that the Borrowers approached OP No.2 and applied for availing loan facilities and based on the documents so submitted that loan was sanctioned and disbursed to the Borrowers. The loan account is being handled as per the regulations issued by RBI and the norms and conditions of the loan agreement as executed between the complainant and OP No.2. Further in view of the default in maintaining financial discipline and since the loan account was declared as an NPA, OP No.2 was constrained to initiate legal action to recover the due loan amount. There is no iota of evidence of any deficiency in services provided by OP No.2. It is further stated that it is OP No.2 who is being harassed at the hands to the complainant as the complainant has failed to maintain financial discipline and has failed to make regular repayments of EMI’s. It is admitted by the complainant that she alongwith her late husband had obtained loan facilities and are thus legally bound to now repay the loan amount. OP No.2 is made to run from pillar to post to recover the loan amount and is incurring litigation charges for the same. In fact, the complainant is liable to pay the OP No.2, litigation charges, for the complainant has failed to repay the loan amount despite several requests and has constrained the OP No.2 to initiate litigation for recovery of loan amount which has now been classified as a Non-performing Asset (NPA). Rest of the averments of the complainant was denied by the OP No.1 and prayed for dismissal of the present complaint with costs.
5.           Learned counsel for the complainant tendered affidavit of complainant as Annexure C-X alongwith documents as Annexure C-1 to C-24 and closed the evidence on behalf of complainant. On the other hand, learned counsel for the OP No.1 tendered affidavit of Sh. Amit Chawla, Authorized Signatory, Tata AIG General Insurance Company Limited, Noida as OPA along with documents Annexure OP1 & OP2 and closed evidence on behalf of OP No.1.  Learned counsel for OP No.2 tendered affidavit of Sh. Nikhil Kharb, Legal Manager, Capri Global Capital Limited, New Delhi as Annexure OP2/A along with documents as Annexure OP2/B & OP2/C and closed evidence on behalf of OP No.2.
6.           We have heard the learned counsel for the parties and have also carefully gone through the case file.
7.           Learned counsel for the complainant submitted that at the time of getting the loan sanctioned/disbursed on 22.1.2018 the OP No.2 got secured the loan of the complainant from OP No.1, fact is admitted by the OPs, while issuing policy No.02350000087 0011990000, dated 30.1.2018 and unfortunately, during the subsistence of the insurance policy the deceased Dev Naraiyan Sahu husband of complainant died on 26.8.2019. The complainant received a letter 31.12.2019 from OP No.2, whereby it had demanded Rs.894092.62ps from the complainant, whereas the amount due on the date of death was/is to be paid by the insurance company to the financier/lender, but the OP No.1 did not listen the complainant.  Not only the insurance was got done by the OP No.2 and the OP No.2 was also duty bound to take up the matter with the insurance company to recover the due loan amount, but the OP No.2 instead of taking up the matter with the OP No.1 putting pressure on the complainant, which amounts to deficiency in service on the of the OPs.
8.           On the other hand, learned counsel for the OP No.1admitted the issuance of insurance policy having sum assured of Rs.800000/- in favour of husband of the complainant to secure his house loan with certain terms and conditions and exclusions clauses enclosed with the insurance policyand submitted that the complainant had never lodged any death claim of her husband late Dev Naraiyan Sahu, allegedly died on 26.8.2019. The OP No.1-insurance company is ready to entertain the claim of the complainant, for which the complainant was required to submit required papers, like complete treatment record as to under which parameter of the said insurance policy her claim falls. It is further submitted that from the perusal of the documents placed on record before this Commission by the complainant, it is amply clear the deceased Dev Nariyan Sahu was diagnosed to be suffering from disease Pancytopenia as mentioned in his treatment record of Rotary Ambala Cancer & General Hospital Annexure C.13 and TB as disclosed in document/treatment record of PGI, Chandigarh Annexure C.9.  Hence, the complainant is not entitled to any relief.
9.           The ld. Counsel for the OP No.2 in the course of his arguments reiterated to the version made into the written statement and prayed for dismissal of complaint as it is the financier/lender and legally entitled to recover the loan amount from the complainant.
10.           Admittedly, the loan was borrowed by deceased Dev Naraiyan Sahu husband of the complainant from OP No.2 in the sum of Rs.838282/- fact is clear from document Annexure C.1, which was secured vide policy No.02350000087 0011990000 for sum assured of Rs.800000/- fact is clear from document Annexure OP.1.  We have perused the document OP.1, which corroborated Policy Coverage & Benefits at page No.2 and out of which one condition at Sr.No.1 is Critical Illness-Sum Assured (Rs.800000/-). 
11.           This Commission has to decide what is the critical illness, the answer is the illness/disease which is dangerous to life or life threatening is critical illness and in the present case in hand as per report of PGI document Annexure C.4 the complainant was suffering from TB and as per definition downloaded from internet the TB is life-threatening disease.  So far Pancytopenia is concerned, to justify the same, this Commission downloaded the literature from internet and it is very much clear the Pancytopenia is serious and should not ignored, without treatment it can lead to life-threatening symptoms that effect the entire body such as oxygen shortage and immune system problems”.  Come what may, the deceased/insured died but the insured had died and it is not a general life insurance policy, it is loan secured policy, wherein the complainant had paid huge premium i.e. Rs.33588/- and it was paid by the husband of the complainant to avoid his family from further inconvenience in repaying the loan in case of any unfortunate event, which unfortunately has been occurred with the deceased.  It is not the case of the insurance company-OP No.1 that the disease of the deceased Dev Naraiyan was pre-existing disease and the husband of the complainant had not died due to the disease explained above. When a person died due to a particular disease, then, it does not matter, whether the disease was critical or not, even the diseases shown by the PGI as well as Rotary Ambala Cancer & General Hospital are life threatening diseases. Since, by whatsoever the loanee has been died and his loan was secured, then, the insurance company should not become hyper technical to deprive the legal heirs from their legal benefits, even the OP No.1 had not placed on record the original insurance policy, which was issued to the complainant and it had placed on record computerized printed terms and conditions, without any attestation, signature or stamp and it cannot be termed as correct with blind eyes.  Another question taken by the insurance company-OP No.1 is, the complainant had not lodged any claim with complete documents, for the sake of arguments, if the version of the OP No.1 is taken to be true, the OP No.1 appeared before this Commission on 1.12.2020 and filed its written version on 28.1.2021, then,it had sufficient time to get the claim of the complainant processed and decide the same, but no step in this regard has been taken by the OP No.1.
12.           No doubt the husband of the complainant had obtained loan of Rs.838282/-, who died on 26.8.2019 and as per statement of account on 10.9.2019 the total balance loan amount was Rs.811555.00ps and the sum assured of the policy is Rs.800000/-.  Since the sum assured was Rs.800000/- and OP No.1 cannot be held liable excess to the amount of Rs.800000/-,but the delay in making the payment of loan amount is due to fault of the OP No.1, hence, the OP No.1 shall be liable to pay the amount of Rs.800000/- as was due on 26.8.2019 along with future interest, if any, accrued on Rs.800000/- to the OP No.2 and rest of the amount, if any, found excess from Rs.800000/- the same is to be paid by the complainant along with up-to-date interest accrued on the said amount.
13.            In view of the aforesaid discussion, we hereby partly allow the present complaint against OPs. OP No.1 is directed to pay the loan amount of Rs.8,00,000/- to the OP No.2 towards loan amount of deceased Dev Naraiyan Sahu, husband of the complainant alongwith interest accrued thereon w.e.f 26.08.2019, i.e the date of death onwards. It is made clear that remaining outstanding amount of Rs.94,092.62 (Rs.8,94,092.62 – Rs.8,00,000/-) shall be paid by the complainant to the OP No.2 towards loan account of her husband alongwith up to date interest accrued on the said amount. OP No.1 is also directed to pay compensation of Rs.3,000/- to the complainant for the mental agony and physical harassment caused to her and pay Rs.2,000/-, to the complainant as litigation expenses. OP No.1 is further directed to comply with the aforesaid directions within the period of 45 days, from the date of receipt of the certified copy of this order. OP No.2 is also directed to return the documents, within the period of 30 days from the date of receipt of amount, after receiving the due loan amount from OP No.1 and complainant. Certified copy of the order be supplied to the parties concerned, forthwith, free of cost as permissible under Rules. File be indexed and consigned to the Record Room.

Announced:- 05.06.2023

 

(Vinod Kumar Sharma)	(Ruby Sharma)	(Neena Sandhu)
Member	Member	President