DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BHIWANI.
CONSUMER COMPLAINT NO.403 of 2013
DATE OF INSTITUTION: - 21.08.2013
DATE OF ORDER: - 10.04.2017
Diksha aged about 5 years minor daughter of Shri Ajay Attri son of Shri Ram Avtar Attri, resident of village Dhanana, Tehsil and District Bhiwani through her mother Smt. Usha and self.
……………Complainant.
VERSUS
- TATA AIA LIFE INSURANCE COMPANY LIMITED, Peninsula Towers, 6th Floor, Peninsula Corporate Park, Canpatrao Kadam Magar, Lower Parel Mumbai-400013 through its General Manager.
- Manager TATA AIA LIFE INSURANCE COMPANY LIMITED, Plot No. 23-25 Ist & IInd Red Square Market Hissar.
- TATA AIA LIFE INSURANCE COMPANY LIMITED, IInd Floor, above Rich Look Show Room, Opposite City Mal Hansi Gate Circular Ropad, Bhiwani.
………….. Opposite Parties.
COMPLAINT U/S 12 & 13 OF CONSUMER PROECTION ACT
BEFORE :- Shri Rajesh Jindal, President
Mrs. Sudesh, Member
Mr. Parmod Kumar, Member
Present:- Shri Ranvijay Singh, Advocate for complainant.
Shri Sanjay Sharma, Advocate for Ops.
ORDER:-
Rajesh Jindal, President:
The case of the complainant in brief, is that the father of the complainant had taken a child policy from the Ops with rider, according to which the benefit under the policy was available to the complainant in case of death of the policy holder. It is alleged that the father of the complainant died on 28.05.2009, therefore, the Ops are liable to deposit the premiums of the said policy of the complainant till the maturity. Smt. Usha mother of the complainant completed the necessary formalities to take the benefit under the said policy. The Ops have refused to deposit the premiums for the policy and asked to furnish the chemical analysis report and final investigation report of police. It is alleged that as no FIR has lodged regarding the death of the father of the complainant, hence the said report is not available. The complainant further alleged that due to the act and conduct of the opposite parties, she had to suffer mental agony, physical harassment and financial losses. Hence, it amounts to deficiency in service on the part of OPs and as such she had to file the present complaint.
2. Opposite parties on appearance filed written statement alleging therein that the instant complaint is premature one as till date the respondent company had not repudiated the claim of the complainant on account of death of deceased Ajay Kumar as the chemical viscera analysis report from FSL and final investigation report from the police is still awaited one to ascertain the real cause of death of Ajay Attri. It is submitted that over here that upon the application of the complainant, the respondent company after in receipt of duly filled proposal form from the deceased Ajay Attri, had issued a policy bearing no. U087929803 on an annual premium of Rs. 12468/- with sum assured of Rs. 120000/-. It is submitted that the respondent company were in receipt of death claim form from Usha Devi on dated 10.08.2009 whereby the widow of the Ajay Attri speaks that her husband Sh. Ajay Attri on account of sudden death of his uncle was became very upset and on account of the same, her husband on 28.05.2009 had consumed 2-3 sleeping pills and resultant which her husband became unconscious and later on died. It is submitted that unless and until the exact cause of death can only be certain only after in receipt of chemical examination report and if chemical report decleared it a suicide case on account of consumption of sleeping pills. Hence, in view of the facts and circumstances mentioned above, there is no deficiency in service on the part of respondents and complaint of the complainant is liable to be dismissed with costs.
3. In order to make out his case, the complainant has placed on record Annexure C-1 to Annexure C-7 along with supporting affidavit.
4. In reply thereto, the opposite parties have placed on record affidavit Exhibit RW1/A and documents Annexure R-1 to Annexure R-9.
5. We have gone through the record of the case carefully and have heard the learned counsel for the parties.
6. Learned counsel for the complainant reiterated the contents of the complaint. The father of the complainant had taken a child policy from the Ops with rider, according to which the benefit under the policy was available to the complainant in case of death of the policy holder. The father of the complainant died on 28.05.2009, therefore, the Ops are liable to deposit the premiums of the said policy of the complainant till the maturity. Smt. Usha mother of the complainant completed the necessary formalities to take the benefit under the said policy. The Ops have refused to deposit the premiums for the policy and asked to furnish the chemical analysis report and final investigation report of police. The counsel for the complainant submitted that as no FIR has lodged regarding the death of the father of the complainant, hence the said report is not available.
7. Learned counsel for the Ops reiterated the contents of reply. He submitted that the claim of the complainant has not been repudiated by the Ops because chemical viscera analysis report from FSL and final investigation report from the police is required to ascertain the real cause of death of Ajay Attri, the father of the complainant. He submitted that the mother of the complainant told the Ops that his husband Ajay Attri had consumed 2-3 sleeping pills and later on died. The DDR was entered with the concerned police station and post mortem of the dead body of the deceased was conducted. To ascertain the cause of death, the viscera of the dead body of the deceased was sent to FSL for chemical examination and still the report is awaited. He submitted that as per the exclusion clause under the policy in case of suicide, the sum assured be not admissible to the nominee.
8. We have perused the record carefully. The Post Mortem Report Annexure C-2 has been placed on the file. According to the remarks given by the medical officer, the cause of death will be given after the report of chemical examination. This Post Mortem Report is dated 29.05.2009. About a period of 8 years has to pass but still the report of chemical examination has not been received from the FSL. It is the duty of the FSL and police department to provide the report of chemical examination to settle the cause of death of the deceased. The complainant cannot be held responsible for not providing report of chemical to the OP. Considering the facts and circumstances of the case, we direct the Ops to provide all admissible benefits under the policy treating the death of the father of the complainant to be natural. Provided, if the report of chemical examination held that the death of the deceased was not natural and it was suicide then the OP shall be at liberty to withdraw the benefits given under the policy. With this observation, the complaint of the complainant is disposed of. Certified copies of the order be sent to the parties free of costs. File be consigned to the record room, after due compliance.
Announced in open Forum.
Dated: 10.04.2017. (Rajesh Jindal)
President,
District Consumer Disputes
Redressal Forum, Bhiwani.
(Sudesh) (Parmod Kumar)
Member. Member.
