Haryana

Charkhi Dadri

cc/79/2020

Smt. Narayani - Complainant(s)

Versus

Tata Aig General Insurance Company Ltd. - Opp.Party(s)

Deepak Sheoran

21 Aug 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, CHARKHI DADRI.      

         

                                                                   Complaint No.: 79 of 2020.

                                                                    Date of Institution: 18.11.2020.

                                                                   Date of Decision: 21.08.2024.

Narayani (now deceased) wife of Shri Risal Singh through her LRs 1. Sombir, 2. Bittu, 3. Bijender sons, 4. Sunita, 5. Anita, 6. Kavita, 7. Roshni daughters of Rishal Singh, residents of Charkhi, Tehsil and District Charkhi Dadri.

                                                                             ….Complainant.

                                                                                       

                                      Versus

1.       TATA AIG General Insurance Company Ltd. 15^th Floor, Tower A, Peninsula Business Park, Ganpatrao Kadam Marg. Off Senapati Bapat Marg, Lower Parel, Mumbai - 40013.

2.       TATA AIG General Insurance Company Ltd. Policy Servicing Office, 2^nd Floor, Narayan Complex, Civil Road, Rohtak - 124001 (Haryana).

3.       Axis Bank, Branch Office at village Rawaldhi, Tehsil & District Charkhi Dadri.

                                                                              …...Opposite Parties.

 

                             COMPLAINT UNDER THE

     CONSUMER PROTECTION ACT.

 

Before: -      Hon’ble Mr. Manjit Singh Naryal, President.

                   Hon’ble Dharampal Rauhilla, Member.

 

Present:       Shri Deepak Sheoran, Advocate for the complainant.

Shri R. K. Verma, Advocate for the OP Nos. 1 & 2.

OP No. 3 already exparte.

 

ORDER: -

 

                    Brief facts of the case are that the complainant’s son Sonu had purchased an accident shield policy bearing No. 0285327368 from the OPs No. 1 & 2 through OP No. 3 for a sum of Rs. 25,00,000/- and paid premium of Rs.2631/- to OP No. 1 & 2 through OP No.3.  It is averred that the insured Sonu was unmarried and died on 26.1.2019 accidentally due to electric shock.  It is further averred that the complainant being mother is the only legal heir of the deceased insured Sonu and is entitled to get the amount from OPs No. 1 & 2.  It is further averred that the complainant informed the OPs No. 1 & 2 on 31.1.2019 and deposited the relevant documents, as required by them to release the compensation amount and in response to that a letter from OPs No. 1 & 2 received on 15.3.2019 vide which instruction were given to furnish the relevant documents.  It is further averred that the complainant had again furnished the required documents, but instead of making payments, the OPs No. 1 & 2 have served another letter dated 21.11.2019 demanding again same documents earlier supplied, even then the complainant again complied with the notice.  It is further averred that the complainant being aggrieved from indifferent attitude of the OPs No. 1 & 2, the complainant got served a legal notice dated 19.6.2020 upon the OPs through his counsel, but the OPs have sent false reply of the same.  Thus, it amounts to deficiency in service on the part of OPs, hence, this complaint.

2.                On appearance, the OPs No.1 & 2 filed written statement alleging therein that on receipt of intimation on 2.3.2019 that the insured died on 26.1.2019, the answering OPs had requested the complainant to submit the required documents to process the claim.  It is averred that complainant had submitted few documents, but failed to submit the following documents as per letter dated 15.3.2019: -

“Copy of FIR, Inquest Pachanama, Post Mortem Report, Copy of final police report, Copy of electricity board report towards alleged death due to electrocution, Reason for delayed claim intimation from nominee, copy of other insurance policy, Self attested identity and residence proof of nominee, Copy of bank account statement for last one year of insured Mr. Sonu, certified specimen signature of insured Mr. Sonu from Bank, Copy of medical record for treatment taken for last 2 years, Copy of photographs taken at the time of Panchnama by Police authorities, Copy of income tax return filed for the year 2016-17, 2017-18, mode of transport used to transport insured Mr. Sonu to Hospital. Copy of receipt paid to transport, full body photographs and videos of Mr. Sonu captured during last one year before his death, the details of family members and acquaintances and their mobile numbers, who visited residence after getting information about the accident”.  

          It is further averred that only partial documents were supplied on 8.4.2019 and same set of documents again supplied on 9.12.2019. It is further averred that mandatory documents in the form of police records and post mortem report, which proves beyond doubt that insured died due to accident were not submitted.  It is further averred that these documents were vital for processing the claim as per policy terms, but complainant failed to supply the same despite all reminders and emails to complainant.  It is further averred that due to non- availability of medical record i.e. post mortem report and police records i.e. FIR in order to substantiate the alleged accident of insured, the claim of the complainant is still pending for its assessment.  It is further averred that non-submission of mandatory documents has not only violated the terms of the insurance of contract, but also deprived the rights of the answering OPs to investigate into the veracity of the claim.  Hence, there is no deficiency in service on the part of answering OPs and complaint is liable to be dismissed with costs.

3.                On notice, no one appeared on behalf of the OP No. 3 despite service and OP No. 3 was proceeded against exparte vide its order dated 18.01.2021.

4.                The complainant in his evidence has tendered affidavit Ex. CW1/A and documents Ex. C1 to Ex. C21 and closed her evidence on 5.5.2022.  Ld. counsel for the complainant has further placed on record the marriage card as Mark A.

5.                Ld. Counsel for the OP No.1 has tendered affidavit Ex. RW1/A, documents Ex. R1 & R2 and closed his evidence on dated 12.1.2024.

6.                During the pendency of complaint, the complainant Narayani has died and on the application moved by ld. counsel for the complainant vide order dated 13.10.2023 her LRs were impleaded as party.       

7.                We have heard learned counsels for the parties and have gone through the documents placed on record by both the parties as well as the material aspects of the case very carefully.

8.                Ld. Counsel for the complainant reiterated the contents of the complaint.  Ld. counsel for the complainant submitted that the OPs have wrongly not settled the genuine claim and the complainant is entitled to get the claim amount of Rs. 25,00,000/- from the OPs.  Ld. counsel for the complainant has placed reliance upon RP No. 923 of 2013, titled as Krishi Upaj Mandi Samiti Vs Sarbati Devi, decided on 28.9.2012 by the Hon’ble National Commission, New Delhi, RP No. 569 of 2009, titled as Nihal Devi and other Vs Ravi Hospital and another, decided on 10.1.2012 by the Hon’ble National Commission, New Delhi and CC No. 47 of 2005, titled as Atanu Dutta and ors. Vs Shrii Mool Chand Khairati Ram Hospital and Ayurvedic Research Institute and ors. decided on 18.8.2022 by the Hon’ble National Commission, New Delhi.

9.                Ld. Counsel for the OPs also reiterated the contents of written statement.  Ld. counsel for the OPs has argued that the complainant has failed to supply the required documents due to which she is not entitled to any claim and the complaint of the complainant is liable to be dismissed on this score alone

10.              After hearing learned counsel for both the parties and having gone through the material available on record, we are of the considered view that the complaint of the complainant deserves dismissal, as there is no deficiency in service on the part of the OPs.  It is admitted fact that the insured Sonu was died on 26.1.2019 and intimation was given to the OPs.  The facts of the case law produced by complainant’s counsel and the facts of the case in hand are different, so the same are not applicable to the present case.  The complainant has failed to prove her case beyond shadow of doubts by leading some cogent and convincing evidence.  The complainant has failed in supplying the certain documents demanded by the OPs vide their letters dated 15.3.2019 and 21.11.2019 i.e. copy of Police Report, copy of Post Mortem Report of deceased Sonu, Inquest Panchnama, photographs taken at the time of Panchanama by Police and copy of final police report.  In our view, all the above documents are necessary documents for the settlement of claim of the complainant.  But the complainant has failed in supplying the above mentioned documents.  Thus, it is proved on record beyond any doubt that the complainant has failed in supplying the certain documents required for the settlement of death claim of insured Sonu.  Therefore, there is no deficiency in service on the part of the OPs.

 11.             Therefore, in view of the facts and circumstances mentioned above the OPs have rightly and legally not settled the claim of complainant.  Hence, the complaint of the complainant is hereby dismissed with no order as to costs. Certified copies of the order be sent to the parties free of costs.  File be consigned to the record room, after due compliance.