District Consumer Disputes Redressal Commission ,Faridabad.
Consumer Complaint No.383/2021.
Date of Institution: 03.08.2021.
Date of Order: 21.11.2022.
1. Mrs. Bela Ratra wife of Shri Subhash Chander Ratra, resident of House No. D-8, Nehru Ground, NIT, Faridabad (Haryana).
2. Ms. Ruchi Batra @ Roohi Ratra aged about 38 years (date of birth 6.09.1982), wife of late Shri Ankush Ratra, presently residing at House NO.2-B/42, NIT, Faridabad, holding PAN:AJLPR4284P having Adhar Card No. 466523873993.
3. Master Saksham Ratra (Minor) S/o Shri Ankush Ratra R/o House No.2-B/42, NIT, Faridabad through his mother/guardian/next friend Ruhi Ratra @ Roohi Ratra.
4. Ms. Sanya Ratra (Minor) d/o Lt. Shri Ankush Ratra r/o House No.2-B/42, NIT, Faridabad through her mother/guardian/next friend Ruhi Ratra @ Roohi Ratra.
5. M/s. Metropole, a partnership Firm Plot NO. 30, Street No.5E, Saroorpur Industrial Estate, Faridabad through its partner Shri Parul Ratra son of Shri Subhash Ratra.
…….Complainants……..
Versus
1. TATA AIG General Insurance Company Limited, having its Corporate Office, A-501, Fifth Floor, Building No.4, Infinity Park, General A.K. Vaidya Marg, Dandoshi, Malad (East) Mumbai – 400 097.
(Service be effected through local office at SCO 89, Ist floor, Sector-16, Faridabad).
2. Hinduja Leyland Finance, having its Corporate Office at 27-A, Developed Industrial Estate, Guindy, Chennai – 600 032 and having its Branch office at B1C/14B, Janakpuri, New Delhi – 110 058 through its Branch Manager at Delhi.
…Opposite parties……
Complaint under section-12 of Consumer Protection Act, 1986
Now amended Section 34 of Consumer protection Act 2019.
BEFORE: Amit Arora……………..President
Mukesh Sharma…………Member.
Indira Bhadana………….Member.
PRESENT: Sh. Ankur Gosain, counsel for the complainant.
Sh. O.P.Gaur, counsel for opposite party NO.1.
Opposite party No.2 ex-parte vide order dated 14.12.2021.
ORDER:
The facts in brief of the complaint are that Ankush Ratra son of complainant NO.1 husband of complainant No.2, Father of complainant Nos.3 & 4 and also partner of complainant No.5 died at 1.35 p.m. on 06.02.2020 having met with a railway accident while passing through the level crossing path near New Faridabad Town Railway Station. Shri Ankush Ratra was just 38 years old at the time of his death. Besides wife and mother he left behind wailing two very young children, Master Suksham Ratra, Ms. Sanya Ratrah and father Shri Subhash Chander Ratra. He was a partner alongwith his elder brother Shri Parul Ratra in a Firm known as M/s. metropole Tubes operating from plot NO.30, Street No.5E, Saroorpur Industrial Area, Faridabad, Haryana. Opposite party No.2, a Non-Banking Company (NBFC) known as Hinduja Leyland Finance had lent a sum of Rs.3,10,00,000/- to the said partnership firm M/s. Metropole Tubes. As condition precedent, Shri Ankush Ratra was required to obtain an insurance policy to lower the risk of the lender in the event of injuries or loss of life to the insured. As such, an insurance policy known as “Group Credit secure Plus Certificate of Insurance” bearing policy NO. 023613650500848 effective with effect from 15.11.2009 to 14.11.2024 with base policy coverage and benefits qua insured person (i) Permanent Total/Partial Disability: Rs.2,73,65,800/-, (ii) Accidental Death/Accidental dismemberment. Lien in favour of said lender NBFC was marked on the said policy. As such, said insurance policy was not a matter of choice or lure or temptation. Complainant No.1 to 4 had lodged claim with opposite party No.1, for said insured amount of rs.2,73,65,800/-. Police had held the death of Shri Ankush Ratra was due to rail accident. Complainant had furnished all requisite all necessary documentary as well as oral information in support of the claim. However, with malafide intent of avoiding its liability the opposite party No.1 had repudiated the claim vide its letter dated 13.11.2020. The same had been repudiated citing untenable plea that shri Ankush Ratra had committed suicide. But neither the attending circumstances nor the evidence, including police finding supported such a plea.
The complainant No.1 was the mother, complainant No.2 was the wife and complainant Nos.3 & 4 wee the minor children of late Shri Ankush Ratra who had died on 06.02.2020 in a Rail Accident. The complainant No.5 had obtained financial assistance form opposite party No.2 to the tune of Rs.3,10,00,000/- and late Shri Ankush Ratra was one of the partner of complainant No.5. At the time of obtaining the above said financial assistance, opposite party No.2 insisted that Shri Ankush Ratra being partner of complainant No.5 must obtain an insurance policy to lower the risk of the lender in the even of loss of life in the event of loss of life of Shri Ankush Ratra who was the working partner of complainant No.5. As such “Group Credit Secure Plus Certificate of Insurance” bearing policy No. 023613650500848 effective with effect from 15.11.2019 to 14.11.2024 was obtained by Shri Ankush Ratra. Shri Ankush Ratra was born on 10.08.1982. After completing his studies he had joined the family business. Right since his young age of 23 years i.e. well prior to his marriage with complainant No.2 Shri Ankush Ratra had inculcate the habit of his safeguarding life by way of insurance policies i.e. Medical Insurance Policies from different services providers and Life Insurance Policies from Life Insurance company. Details regarding said two kind of insurance policies were:
i) As on 18.05.2005 i.e. at the age of 23 years, said Shri Ankush Ratra had taken medical policy from United India Insurance Co. Ltd. Wherein he was self insured. The sane was renewed in May,2006. Again it was renewed on 17.05.2007. Further, the same was renewed on 17.05.2008.
ii) As on 18.05.2010 above said medical policy with United India Insurance Limited was renewed whereby said Shri Ankush Ratra. Complainant Nos.2 to 4 and Subhash Chander Ratra were insured. Reliance was placed on cover note dated 19.05.2010 issued by the said insurance company. The same would provide the information that the date of first ever policy issued by United India Insurance Co. Ltd., was issued on 18.05.2005.
iii) As in the year 2011 insurer was changed from United India Insurance Co. ltd., to Apollo Munich Health Insurance: Vide Medical Insurance Cover Note dated 18.5.2011 all the four member of Shri Ankush Ratra i.e. wife, son and daughter were insured for a sum of Rs.1,00,000/-
Till his death Shri Ankush Ratra had never claimed any benefit out of said Annual Medical Policies. Two brothers namely Shri Parul Ratra and Shri Ankush Ratra alongwith their father Shri Subhash Chander Ratra, residing at House NO.D-8, Nehru Ground, NIT, Faridabad, Haryana, were running their business of manufacture, sale and distribution Steel Tubes and Pipes interalia through two partnership firms namely M/s. metropole Tubes and M/s. majestic Tubetech (India) operating at Plot No.30, Street No.5-E, Saroorpur Industrial Area, Sohana Road, Faridabad, Haryana. Said Shri Ankush Ratra was a partner in Firm named M/s. Metropole Tubes where his share was 33.34%. He was deriving remuneration from the said firm out of its profits. Further, he was working as an employee with the other firm named M/s. Majestic Tubetech. Shri Ankush Ratra used to regularly furnish his Income Tax Returns. His net worth in the Current year 2014-15 was Rs.36,66,243.57 which went on increasing in the following years. During the year he paid children’s school fee of Rs.1,48,149/-.
The complainant No.5, was a partnership firm known as M/s. Metropole Tubes, wherein the deceased Shri Ankush Ratra was a partner. It was operating its manufacturing unit at plot No.30, Street No.5E, Saroorpur Industrial Estate, Faridabad. Year on year it had very substantial turnover and business dealings. Reliance in this regard was placed on balance sheet of the firm for the financial year 2017-18 ending at 31.03.2018. As on 16.8.2019 firm M/s. Metropole Tubes, had availed a funding of Rs.3,10,00,000/- from opposite party No.2, Hinduja Leyland Finance, as a loan against property (LAP). Said loan was repayable over a period of 10 years through 120 monthly installments. As such, the insurance policy called “Group Credit Secure Plus Certificate of Insurance” bearing Master policy No.0236136505 000848 for a tenure of 5 years effective from 15.11.2009 to 14.1.2024 for insured sum of Rs.2,73,65,800/- was obtained from the opposite party TATA AIG. A sum of Rs.3,10,000/-, which included GST @18%, stood paid up towards the premium. A bare perusal of the said insurance certificate would show that said insurance cover was linked to the aforesaid loan from Hinduja Leyland Finance Limited. As per the same, base policy coverage, benefits and additional covers were as follows:-
i) Permanent Total Disability: Rs.2,73,65,800/-
ii) Accidental Death: Rs.2,73,65,800/-
iii) Permanent Partial Disability: Rs.2,73,65,800/-
Besides the above said Shri Ankush Ratra had obtained following other insurance policies:
i. HDFC Ergo Health Insurance -
Appolo Munich bearing policy No.111100/21002/2000187095-03.
ii. MAX Newyork Life bearing policy NO. 132087107.
iii. ICICI Lombard.
As usual said Shri Ankush Ratra had started the day on 06.02.2020 by attending to his duties as a partner/employee of the Firm as above. Due to exigencies of the business of manufacture and sale of tubes that the brothers/partners of the said firms had to go at times from Faridabad to Delhi through train and at times he used to visit truck repairer shows and other vendors dealing in truck spare parts as the firm also owns some trucks and such shops were located near the railway track. As on 06.02.2020 Shri Ankush Ratra was crossing the railway line New Town Railway Station, Faridabad. While passing through the level crossing path he died on track III at about 1.35 p.m. being run over by a goods train (STPB) from Agra to Tuglakabad, Delhi. Having found address of the deceased from the search as above, said SPOO Shri Gajinder Singh came to the residence of the complainant No.1 at house No. D-8, Nehru Ground, NIT, Faridabad, Haryana at 3.30p.m. on 06.02.2020 to inform them about the aforesaid Rail accident and death of said Shri Ankush Ratra at New Town, Faridabad Railway station. Hearing the news heel broke upon their head. Shri Subhash Ratra, father of the deceased alongiwth Shri Parul Ratra, brother of the deceased as well as other relatives reached the site of the accident and at the police station, GRP, Old Faridabad. Vide application dated 06.02.2020 Shri Subhash Chander Ratra requested SHO, GRP Old Faridabad for conducting investigation against accidental death of Shri Ankush Ratra. Post mortem of the body of Shri Ankushj Ratra was conducted at B.K.Hospital, Faridabad. As per the same cause of death was: “Shock And Hemorrhage Due to head, Lung Injury And Other Injuries”. As described in the Post Mortem Report said injuries were sufficient to cause death in ordinary course of nature. “The possibility of the injuries mentioned in the post mortem report being caused due to railway accident cannot be ruled out.” “Navbharat Times”, Faridabad dated 07.02.2020 also carried the news. As per the said news report Shri Ankush Ratra while crossing the railway track was run over by the train. In no way the report suggested that Shri Ankush Ratra had jumped before the train or had committed suicide. Independent and fair reporting of the part of a national daily of repute could not be doubted. The police at the said GRP Police Station conducted the Inquest Proceedings. Statements of different persons were recorded. The testimony of the Loco Plot left no manner of doubt that Shri Ankush Ratra was run over by the train while crossing the railway track and that Shri Ankush Ratra died in an accident. On the support of above Ruka, statements police prepared the Inquest report. As per the same cause of death was due to railway accident. None was to be blamed for the death of Shri Ankushj Ratra. The fact of death of Shri Ankush Ratra was duly registered with Muncipal Corporation, NIT, Faridabad vide No. D-2020:6-90213-000726 dated 02.03.2020. The claim on the death of Ankush Ratra was lodged with opposite party No.1 as per the format supplied by the opposite party itself, claiming, thereby a sum of Rs.2,73,65,,800/- on account of accidental death of said Shri Ankush Ratra. As such, through communication dated 11.06.2020 following documents were submitted/furnished to opposite party No.1:
i. Copy of FIR, PMR & Death Certificate.
ii. Copy of photo ID & Address proof of insured and nominee.
iii. Cancelled cheque. Copy of bank account of nominee.
iv. copy of other insurance company policies.
v. News paper cutting.
vi. Completely filed CKYC.
vii. Copy of loan approval letter from Financial Institute.
viii. Certificate from Financial Institute confirming the Principal Loan outstanding amount as on date of loss i.e. 06.02.2020.
As submitted above deceased had obtained different Insurance Policies form Life Insurance Corporation (LIC). Accordingly, claims were lodged with LIC: Vide three separate communications dated 05.06.2020 following detailed three claims were settled:
i. Net Claim of Rs.11,74,450/- was sanctioned under policy No. 126572727.
ii. Net Claim of Rs.20,27,338/- was sanctioned under policy No. 124768257.
iii. Net claim of Rs.1,50,00,000.00 was sanctioned under policy NO. 127407466.
iv. Thereafter, through another communication dated 28.9.2020 LIC had intimated the sanction of another claim of Rs.2,00,00,000.00 was sanctioned under policy No. 128012628.
v. Against policy No. 126572727 claim amount of Rs.5,00,000/- was paid on 20.11.2020.
vi. Against policy No. 121744820 claim amount of Rs.1,00,000/- was paid on 20.11.2020.
vii. Against policy No. 122099706 claim amount of Rs.1,00,000/- was paid on 20.11.2020.
After having remained sitting on the claim file for a period of five months that the opposite party No.1 acting in a malafide manner had repudiated the claim as communicated through its repudiation letter dated 13.11.2020. Claim had been repudiated citing untenable plea that Shri Ankush Ratra had committed suicide. But neither the attending circumstances nor the evidence, including police finding supported such a plea. At the stage vide application dated 30.12.2020 information was sought under RTI Act, from State Public Information Officer sum Deputy Superintendent of Police, Railways, Haryana, Ambala Cantt. In response to the said RTI application said RTI Authority, vide its communication dated 03.02.2021 had supplied the Complete Inquest Report qua the said Rail Accident on 06.02.2020. The aforesaid act of opposite parties amounts to deficiency of service and hence the complaint. The complainant has prayed for directions to the opposite parties to:
a) pay the claim amount of Rs.2,73,65,800/- alongwith interest @ 18% since of the death of insured Shri Ankush ratra i.e.06.02.2020.
b) direct payment of part of compensation amount to opposite party No.2 so as to cover its dues and the remainder to be paid to the complainant sin equal share.
c) pay Rs.25,00,000/- as compensation for causing mental agony and harassment .
d) pay Rs. 5,00,000 /-as litigation expenses.
2. Opposite party No.1 put in appearance through counsel and filed written statement wherein Opposite party No.1 refuted claim of the complainant and submitted that at the very outset, the jurisdiction of this Commission was hereby humbly denied qua pecuniary implications. In terms of prayer clause of the complaint, the monetary relief had been claimed as follows:
Insurance claim amount : Rs.2,73,65,800/-
Compensation towards physical & mental pain : Rs. 25,00,000/-
& agony.
Litigation cost : Rs. 5,00,000/-
Interest claimed @ 18% p.a.
In consideration of such monetary relief pleaded in the complaint by the complainants works out at rs.3,03,65,800/- alongwith cost, in addition to interest component, if any. On the contrary, it was submitted that the pecuniary jurisdiction of the District Commission u/s 34 of Consumer Protection Act, 2019 had been prescribed as under:-
“Section 34(1) “Subject to the other provisions of the Act, the District Commission shall have jurisdiction to entertain complaints where the value of the goods or services paid as consideration does not exceed Rs.1,00,00,000/-.”
The deceased had purchased &obtained “Group Credit Secure Plus Insurance Policy” vide policy No. 0236136505 000848 for the period 15.11.2019 to 14.11.2024 for insuring himself qua “Permanent Total Disability” or “Accidental Death” for the sum insured Rs.2,73,65,800/-. The deceased policyholder had accepted & acknowledge the insurance policy being fully aware of the terms and conditions. Pursuant to execution, signing and furnishing the proposal in this behalf. The Preamble of the policy clearly states, the company will pay insured person, the benefits, as mentioned in the policy schedule. Each benefit was subject to its benefit sum insured and should be part of the bas sum insured. Whereever, the benefit sum insured was over and above the bas sum insured, it should be explicity stated in the policy and additional cover wordings. Repudiation and or denial of claim in accordance with terms and conditions of contract can, by no stretch, be termed as “deficiency in service” as envisaged in Consumer Protection act. It had been laid down that the test of deficiency in service lay in the complainant; providing that there was some fault, imperfection, shortcoming or inadquancy on the part of the insurance company and further such fault etc. must be willful. As per the averments pleaded in the complaint, the policyholder – Ankush Ratra died due to “Railway Accidental” death on 06.02.2020 at about 1.30 p.m. In the given situation and circumstances, the Railway Tribunal under the provisions of the Indian Railways act, 1989 had the jurisdiction to decide such issues & claims. The complainants nowhere specifically pleaded in the complaint that no claim in respect of the cause of occurrence had been filed before the Railway Tribunal or made a declaration that they would not lodge any such claim, at later date, before the Railway Tribunal. The complaint was in the form of disconcert because, in one breath the complainants presents that obtaining the Group Credit Secure Plus Insurance Policy” was the condition precedent by the financer – m/s. Hinduja Leyland Finance Ltd., in order to secure the loan amount in the name of M/s. metroppole, a partnership firm, of which the deceased – Ankush Ratra and his brother Parul Ratra were the partners. In second breath, the insurance policy was obtained in the personal and individual name of Mr. Ankush Ratra to cover personal accident and/or death, meaning thereby, the deceased – Ankush Ratra got insured himself only in personal and individual capacity, instead M/s. Metropole being a partnership firm. As a matter of fact, M/s. Metropole was a joint venture in partnership consisting Mr. Ankush Ratra and Parul Ratra as partners thereof. It was likely that endorsement of lender – M/s. Hinduja Leyland Finance Ltd. In the “Group Credit Secure Plus Insurance Policy” was without disclosure of the material and vital facts & information for the reasons best known to the policyholder and/or the complainants. In terms of “Group Credit Secure Plus Insurance Policy” vide policy No. 0236136505 000848 for the period 15.11.2019 to 14.11.2014, the insurance company had no privity of contract with M/s. Metropole, Plot NO.30, Sweet No.5E, Saroorpur Industrial estate, Faridabad, claiming to be the borrower of loan facility at 2,73,65,800/- with endorsement of lender – M/s. Hinduja Leyland Finance Ltd., except Mr. Ankush Ratra as policyholder in personal and individual capacity. Opposite party No.1 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
3. Registered notice issued to opposite party No.2 on dated 08.12.2021 not received back either served or unserved. Tracking details filed in which it had been mentioned that ”Item Delivery Confirmed”. Hence, opposite party No.2 was hereby proceeded against ex-pate vide order dated 14.12.2021.
4. The parties led evidence in support of their respective versions.
5. We have heard learned counsel for the parties and have gone through the record on the file.
6. In this case the complaint was filed by the complainant against opposite parties– Tata AIA General Insurance Company with the prayer to: a) pay the claim amount of Rs.2,73,65,800/- alongwith interest @ 18% since of the death of insured Shri Ankush Ratra i.e.06.02.2020. b) direct payment of part of compensation amount to opposite party No.2 so as to cover its dues and the remainder to be paid to the complainant sin equal share. c) pay Rs.25,00,000/- as compensation for causing mental agony and harassment. d) pay Rs. 5,00,000 /-as litigation expenses.
To establish his case the complainant has led in his evidence, Ex.CW1/A – affidavit of Ruhi Rata @ Roohi Ratra wife of late Shri Ankush Ratra presently residing at House No.2-B/42, NIT, Faridabad, Ex.C1 – Group Credit Secure Plus Certificate of Insurance,, Ex. C-2 – Mediclaim Insurance, Ex.C-3 - Individual Health insurance Policy, Ex.C-4 – Schedule – easy Health Individual Standard, Ex.C-5 – LIC’s Amulya Jeevan-2, Ex.C-6 – LIC’s Amulya Jeevan-2, Ex.C-7 – Jeevan Anand with Profits (with Accident Benefits), Ex.C-8 to 14 – receipts, Ex.C-15 to 18–Indian Income Tax Return Verification Form, Ex.C-19 – Sanction letter, Ex.C-20 & 21– Optima Restore Policy Schedule – Optima Restore Floater, Ex.C-22 – letter dated 11.04.2014, Ex.C-23 – Optima Restore Policy Schedule – Optima Restore Floater, Ex.C-24 – letter dated 11.05.2014 regarding renewal of Optima Restore Policy, Ex.C-25 to 29– letter regarding Renewal of your Optima Restore Insurance Policy, Ex.C-30 – letter regarding Renewal of your Individual Personal Accident Policy, Ex.C31 to C34 – letter regarding renewal of your Optima Restore Insurance Policy, Ex.C35 to36 – letters, Ex.C-37 – letter to SHO GRP FBD, Ex.C-28 - Fard Jama Takasi,, Ex.C-39 – letter dated 6.2.2020 regarding request for investigation against accidental death of Shri Ankush Ratra, Ex. C-40(colly) – Post Mortem examination report,, Ex.C-41 – News paper cutting, Ex.C-43 – Newspaper cutting, Ex.C-44(colly) – statement of Gajender Singh SRO Thana GRF Faridabad, Ex.C-45(colly) - RTI letter dated 03.02.2021, Ex.C-46 – Death Certificate, Ex.C-47 – email, Ex.C-48 – Claim Form, Ex.C-49 to 51 – letters, Ex.C-52 – Certificate,, E.C-53 – letter dated 28.09.2020, Ex.C-54 - letter dated 31.07.2020, Ex.C-55 – Status report of policy No.1265/2727, Ex.C-56 – Status report of policy No.121744820, Ex.C-57 – Status report of policy No. 122099706, Ex.C-58 – email, Ex.C-59 – Indian Income tax Return Acknowledgement, Ex.C-60(colly) – statement,
On the other hand counsel for the opposite party strongly agitated and
opposed. As per the evidence of the opposite party Ex.RW-1/A – affidavit of Nivrtee R. Magar, Sr. Forensic Expert & Analysis – M/s. ICS Assure Services Pvt. Ltd.,22/23, Goodwill Premises, Swastick Industrial Estate, CST Road, Kalina, Santacruz (East) Mumbai, Annx.O/1 – Group Credit Secure Plus Insurance Policy with T&C, Annx. O/2 – Investigation report dated 30.09.2020 , Annx.O/3 – Death proceedings of police dated 06.02.2020 u/s 174-175 Cr.P.C., Annx.O/3A – Ruqqa dated 06.02.2020 of Railway Station Master to GRP Faridabad, Annx. O/4 – letter dated 05.10.2020 , Annx.O/5 – Forensic Expert Opinion dated 18.12.2020, Annx.O/6 – repudiation letter dated 13.11.2020.
7. In this complaint , the complaint was filed by the complainant with the prayer of death of Ankush Ratra who was insured under the “Group Credit Secure Plus Certificate of Insurance”. It was repudiated by taking flimsy plea that the insured committed the suicide. As per the repudiation letter, insurance company i.e. opposite party No.1 had the 3 legal points to repudiate the claim of the above noted the above persons.
i. Pecuniary jurisdiction of the present District Commission is barred as the claimed amount is Rs.3,03,65,800/-.
ii. Insured Ankush Ratra has committed suicide and thus complainant are not entitled for the benefits of insurance.
iii. Insured has obtained the policy without disclosing of him having several other policies and thus the insured amount is not payable.
i. Objection regarding Pecuniary Jurisdiction: Pecuniary jurisdiction of district Commission is defined in Section 34(1) of Consumer Protection Act, 2019 which reads as under:
“Section 34(1) – Subject to the other provision of this Act, the District Commission shall have jurisdiction to entertain complaints where the value of the goods or services paid as consideration does not exceed One Crore Rupees.”
Whereas the previous Consumer Protection Ac 1986 the pecuniary jurisdiction of District Forum was defined in Section 11(1) of the said Act, which reads as under:
“Section 11(1) – Subject to other provisions of this Act, the District Forum shall have jurisdiction to entertain complaints where the value of the goods or services and the compensation, if any, claimed does not exceed Rupees Twenty Lakhs.”
Therefore, from the plan reading of the above it is loud and clear that as per the old Act it was “the value of the goods or services and the compensation claimed” was to be taken into consideration while determining the pecuniary jurisdiction but as per the new 2019 Act only the “value of the consideration paid” into be taken into consideration while determining the pecuniary jurisdiction and not the claimed amount.
In the present matter the value of the consideration paid is the premium paid for purchasing insurance policy which is merely Rs.3,10,000/-. Hence, this Hon’ble District Commission has pecuniary jurisdiction to adjudicate the complaint. Further even the Hon’ble National Commission has clearly held in various judgment that as per the Consumer Protection act. 2019, only the value of goods and services paid as consideration is to be considered while determing the pecuniary jurisdiction. In case titled as “M/s. Pyaridevi Chabiraj Steels (P) Ltd. Versus M/s. national Insurance Co.” law finder id 1739515 and “Ligare Aviation Limited Vs. Oriental Insurance “ 2021(3) C.P.R. 188, Law finder id 1874029, it has been held that for determining the pecuniary jurisdiction, in insurance matters, it is the amount of premium paid, which is to be considered while determining the pecuniary jurisdiction and not the amount claimed.
Hence, this Hon’ble Commission has jurisdiction to adjudicate the present complaint.
ii) Second Objection is repudiation of claim on the ground that Insured committed suicide:-
The Locomotive Pilot got recorded his statement u/s 175 Cr.P.C. wherein he has stated “Bheed main Ek Aadmi Bhag Kar railway Line paar karne haga jo meri gaadi ke chapat main aa gya”. Then in the Inquest report the opinion given is “In my opinion the cause of death in this case due to Railway accident”. Further, in the final report by police the cause of death is Railway Accident. Similarly, in tasdeek byThana Prabhandak it has been held as a case of Railway Accident. Not only thus but the insured was also having LIC policies with Double benefit in case of accidental death, the LIC after thorough investigation passed the Death Claim of Shri Ankush Ratra and paid Double sum insured holding the death of Ankush Ratra in an accident.
iii. Third Objeciton is insured was having multiple policies which fact was not disclosed while obtaining insurance policy.
The objection is baseless, the insured had paid the premium for purchasing policy form respondent insurance, even otherwise this ground was not taken by the insurance Co. while repudiating the claim and the Insurance Co. cannot travel beyond the grounds mention in the letter of repudiation – In other words, insurance company cannot resist a claim on grounds beyond those cited by them while repudiating a claim. The Hon’ble Apex Court while deciding Civil Appeal No. 7630 of 2022 titled as “JSK Industries Vs. Oriental Insurance Company” has held that Insurance Co. cannot resist a claim on the ground beyond those cited by them while repudiating a claim. In the present case no such ground was taken by the Insurance Company while repudiating the claim. Further it is submitted that at the time of filing of present complaint thee were dues payable to respondent No.2 as such in the prayer clause it was mentioned that the opposite party No.1 be directed to make part payment of compensation amount to the opposite party No.2 so as to cover its dues and the remainder be paid the complainants but during the pendency of the present complaint, the complainants had cleared the dues of the opposite party No.2 and now the complainants are entitled for entire compensation.
8. In view of the above submissions, the counsel for the complainant argued about the opposite party No.2 who was proceeded against ex-party who was the financier of the loan taken by the deceased complainant and he has also given the NOC certificate from Hinduja Leyland Finance letter dated 30.04.2022. The loan amount was settled by opposite party NO.2 who was proceeded against ex-parte on 14.12.2021. As per letter the amount had taken by the complainant/deceased had already been paid and it has been settled by opposite party No.2 by contract No. DHDLDEA000012 and also stated at Bar that the opposite party cannot take additional plea of repudiation which they have issued the repudiation letter . As per settled law by the Hon’ble Supreme Court of India in case titled Saurashtra Chemicals Ltd. Vs. National Insurance Co. Ltd. 1(2019) 19 SCC 70) wherein it has been held:
“23. Hence, we are of the considered opinion that the law, as laid down in Galada (Galada Power & Telecommunication Ltd. V. United India Co. ltd.,, (2016) 14 SCC 161: (2017) 2 SCC (Civ) 765) on issue (2), still holds the filed. It is a settled position that an insurance company cannot travel beyond the grounds mentioned in the letter of repudiation, if the insurer has not taken delay in intimation as a specific ground in letter of repudiation, they cannot do so at the stage of hearing of the consumer complaint before NCDRC.”
9. In this complaint, the complainant deceased has obtained the Life Insurance Policy also from the LIC Carriers. They have paid the double of the claim amount to the complainant. As per the evidence led by the complainant and also paid the benefit of the double amount in case of accident. As per evidence Ex.C-44(colly) page 139 & 140 regarding the statement of Shri Sandeep Kumar stating that “Bheed main Ek Aadmi Bhag Kar railway Line paar karne bhaga jo meri gaadi ke chapat main aa gya”. Statement given by the officials of GRP Railway Department that it was a case of railway accident and the complainant also led in his evidence Ex.C-45 i.e. DSP Head Quarter of GRP has given his report and information in RTI to the complainant. As per the information of the DSP Head Quarter dated 16.03.2020 , it was a case of railway accident . After going through the post mortum report and page No. 144 RajPal SI given the post mortum report in which the cause of death is railway accident and the final report of SHO GRP, Faridabad on page No. 166 is proving the same and also filed the final report of the death on page 167. Cause of death is railway accident and as per Annexure A25, the documents of LIC and Ex.C-55 on page 181 it shows the double benefit amount was given to the complainant by the LIC.
10. After going through the report of DSP, SHO, SI and documents of the LIC, the Commission is of the opinion that no doubt this was a case of railway accident and the complainant has the insurance policy. Hence, the complaint is allowed. Opposite party No.1 is directed to process the claim of the complainant and issue the claim of the complainant in due course of law within 30 days of receipt of the copy of order and pay the due amount to the complainant along with interest @ 9% p.a. from the date of filing of claim of the complainant till its realization. The opposite party No.1 is also directed to pay Rs.11,000/- as compensation on account of mental tension, agony and harassment alongwith Rs.11,000/- as litigation expenses to the complainant. Copy of this order be given to the parties concerned free of costs and file be consigned to record room.
Announced on: 21.11.2022 (Amit Arora)
President
District Consumer Disputes
Redressal Commission, Faridabad.
(Mukesh Sharma)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
(Indira Bhadana)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
