Punjab

Rupnagar

CC/18/34

Iqbal Kaur - Complainant(s)

Versus

The Branch Manager LIC of India - Opp.Party(s)

Sh. Chetan Kumar Gupta, Adv

06 Aug 2018

ORDER

BEFORE THE DISTT. CONSUMER DISPUTES REDRESSAL FORUM, ROPAR

                                 Consumer Complaint No. :  34 of 02.06.2018

                                 Date of decision                    :     06.08.2018

 

Iqbal Kaur, aged about 48 years, widow of Sarabjit Singh, resident of Village Purkhali, Tehsil & District Rupnagar.  

                                                                 ......Complainant

                                             Versus

    The Branch Manager, LIC of India, Branch Plot No.81-82, City     Centre, Morinda, District Rupnagar. 

                                                                          ....Opposite Party

                                   Complaint under Section 12 of the                                                      Consumer Protection Act, 1986

QUORUM

 

                        SH. KARNAIL SINGH AHHI, PRESIDENT

                        SMT. SHAVINDER KAUR, MEMBER

 

ARGUED BY

 

Sh. Chetan Kumar Gupta, Adv. counsel for complainant  

Sh. H.C.Verma, Adv. counsel for O.P. 

 

                                           ORDER

 

              SH. KARNAIL SINGH AHHI, PRESIDENT

 

1.         Complainant has filed the present complaint seeking directions to the opposite party to pay a sum of Rs.1,00,000/- on account of accidental policy cover along with interest @ 12% per annum on amount of Rs.2,27,600/- from the date of accident till its realization; to pay Rs.10,000/- for mental pain and suffering harassment by the OP; to pay Rs.25,000/- as cost of litigation. 

2.    Brief facts made out from the complaint are that husband of the has purchased one money back accidental policy of Rs.1 Lac on 31.12.2001 bearing policy No.162126097 from OP which was to mature on 28.9.2021 and husband of complainant had paid regular premiums. On 08.07.2007, husband of the complainant met with an accident near police station Aut District Mandi and the dead body of Sarabjit Singh got washed away in the river and could not be traced as such the complainant filed a civil suit for declaration in the court of CJJD, Rupngar for declaring Sarabjit Singh presumed to be dead on account of non tracing of dead body and the same was decreed by the Hon'ble Court vide its judgment dated 25.5.2016. Thereafter, complainant approached office of the OP and submitted an application along with documents for releasing the claim. The original documents were attached with the application as directed by the O.P. The total claim came out to Rs.2,27,600/- (Rs.1,00,000/- Simple Insurance + Rs.1,00,000/- for accidental cover + Rs.27,600/- on account of premium paid) but OP had passed an amount of Rs.1,27,600/- only with simple amount of insurance policy, however this policy pertains to accidental policy and OP had to pay the amount of Rs.2,00,000/- along with TRs.27600/- along with interest from the date of accident. As such, OP has not paid the interest incurred on accident policy from the date of accident i.e. 12% per annum neither OP had paid Rs.1,00,000/- on account of accidental policy cover. Hence, this complaint.    

  3.  On notice, O.P. appears through counsel and filed written reply taking preliminary objections; that the complainant has no locus standi to file the present complaint; that the complaint is not maintainable; that this Hon'ble Court has no jurisdiction to entertain and try the complaint; that the complainant has no cause of action against the answering OP. On merits, it is stated that policy was issued for a sum assured of Rs.1,00,000/- under PTT 75/20/20 and basic sum of Rs.1,27,600/- was paid through NEFT on 8.11.2016 to the complainant. Accidental benefit was not paid as dead body of the policy holder washed away which was not traced. As per double accident benefit claim rules are that " FIR, PIR and Post mortem report is must to prove the accidental death. In this case post mortem report and PIR is not available in the papers submitted by the complainant.  The post mortem was not done as the body of the deceased was not traced. The accident benefit is pending for want of PIR, hence the accident benefit has not been paid due to the reasons mentioned above to the complainant. Rest of the allegations made in the complaint have been denied and prayer has been made dismissal thereof. 

4.    On being called upon to do so, the learned counsel for the complainant has tendered documents Ex.C1 to Ex.C7 and closed the evidence.  The learned counsel for the O.P. has tendered sworn affidavit of Sh. Rajeev Malohtra, Manager Legal, Ex.OP1 along with documents Ex.OP2 to Ex.OP5 and closed the evidence.  

5.    We have heard the learned counsel for the parties and have gone through the record of the file, carefully.

6.    Complainant counsel Sh. Chetan Kumar Gupta, argued that husband of Iqbal Kaur namely Sarabjit Singh @ Kaka died in accident dated 8.7.2007. He along with some other persons gone to Himachal Pradesh and on the fateful day i.e. 8.7.2007 when their vehicle was near Nagesavi Police Station, District Mandi and care fell down in the beas river. The dead body washed in the river (Water) qua that occurrence FIR No.97 dated 8.7.2007 was registered at Police Station Aut. Then complainant filed civil suit with the prayer to declare Sarabjit Singh @ Kaka dead. Civil Court, in its judgment/decree dated 25.5.2016 declared Sarabjit Singh @ Kaka dead. Then the claim was lodged against the policy with the OP who made the payment of Rs.1,27,600/- but not paid the accidental benefits/claim of Rs.1,00,000/-. Non payment of Rs.1,00,000/- amounts to deficiency in service, when sufficient evidence has come on file that Sarabjit Singh @ Kaka died in an accident. Lastly prayed to allow the complaint.

7.    OP counsel Sh. HC Verma, argued that so far the issuance of the policy is concern i.e. admitted. Complainant has come to the forum that Sarabjit Singh @ Kaka died in an accident but while lodging the claim the application/request was not supported by report of post mortem and PIR i.e. the basic requirement and guidelines of the higher authority/rules. In support of the argument, learned counsel referred chapter 5 para No.1.3.1. of the rules and prayed that in the absence of these documents it cannot be held that Sarabjit Singh @ Kaka died in the accident. Lastly prayed that claim has rightly been repudiated qua Rs.1,00,000/-. The complaint be disposed of as dismissed.

8.    Sarabjit Singh @ Kaka husband of the complainant purchased policy from the OP and OP has the office in District Rupnagar, whereas, Iqbal Kaur/Sarabjit Singh @ Kaka are resident of Village Purkhali, District Rupnagar. OP made part payment towards claim considering the claim of death Sarabjit Singh. Now the remaining part of accidental relief has been declined. So, it is a consumer dispute and complaint is maintainable. This forum has the territorial jurisdiction.

9.    Coming to the real controversy, whether complainant is entitled to the relief or not. The burden to prove the deficiency lies upon the complainant, whereas OP has taken the specific stand that Sarabjit Singh @ Kaka not died in an accident. For that purpose OP demanded from the complainant, copy of the post mortem report and PIR. Both documents are the material documents for deciding the claim qua the accidental death. Complainant pleaded that on 8.7.2007 vehicle fell down in the beas river, the body of Sarabjit Singh @ Kaka along with 3/4 other persons washed in the water. FIR was registered, copy of which is Ex.C5. The information was given to the OP qua the said occurrence and OP written one letter to the complainant firstly towards condonance and secondly demanded the documents. The dead body was not recovered i.e. why the complainant has to rely upon filing civil suit to get declare Sarabjit Singh @ Kaka dead. The civil suit was filed on 1.4.2015 and decided on 25.5.2016 titled as Iqbal Kaur Vs GP in which prayer was made that declaration be given that Sarabjit Singh @ Kaka son of Harcharan Singh, who is missing since 8.7.2007 be declared dead/presumed to be dead. The civil court vide its judgment Ex.C2 pass the order, that Sarabjit Singh @ Kaka is presumed to be dead. Relying upon the said report, OP extended the benefits of the policy in favour of complainant by making payment Rs.1,27,600/-. But with held the accidental relief of Rs.1,00,000/-. OP in reply as well as in affidavit then in letter Ex.C6 made request to the complainant for supply of FIR, PIR and post mortem. This forum appreciated the arguments and the written reply of OP then has come to the conclusion that when dead body was not recovered then how the PIR and post mortem because FIR is on the file and it was supply to the OP then decision of civil court it all speaks that dead body of Sarabjit Singh @ Kaka was not recovered. In case the body recovered then the police is to prepare FIR and doctor is to conduct post mortem. So these both documents are beyond the reach of the complainant. Rather its reply is in the judgment of civil court Ex.C2. So the demand of these documents is not the legal demand rather the demand of these documents should be waived according to the prevailing circumstances. Non payment of the accidental benefit to the complainant qua Sarabjit Singh @ Kaka amounts to deficiency in service. So the complaint deserves to be allowed.

10.  In the light of discussion made above, the complaint stand allowed with the direction to the OP to pay Rs.1,00,000/- as accidental benefit to the complainant along with interest @ 7.5% per annum from the date of accident i.e. 8.7.2007 with cost of Rs.5000/-. 

               11.   The OP. is further directed to comply with the said order within the period of 30 days from the date of receipt of certified copy of this order.

12.   The certified copies of this order be supplied to the parties forthwith, free of costs, as permissible under the rules and the file be indexed and consigned to Record Room.

 

                     ANNOUNCED                                                    (KARNAIL SINGH AHHI)

                     Dated.06.08.2018                                     PRESIDENT
 

 

 

                                                          (SHAVINDER KAUR)

                                                                             MEMBER