Complainant Smt.Sulekha Rani through the present complaint U/S 12 of the Consumer Protection Act 1986 (hereinafter for short the Act) has prayed for the issuance of the necessary directions to the opposite parties to pay Group Personal Accident Insurance Policy amount of deceased Constable Baldev Raj in her favour alongwith Rs.5,000/- as litigation expenses, in the interest of justice.

2.       The case of the complainant in brief is that Sh.Baldev Raj deceased had retired from service on 25.12.2013 on attaining age of 58 years. He was insured through opposite party no.1 to 2 under “Group Personal Accident Insurance Policy” by the opposite parties no.2 to 4 through their agent at Gurdaspur for the period of 19.12.2013 to 18.12.2014 and paid Rs.3100/- as premium/installment of the said policy which was deducted from the salary of deceased Baldev Raj Constable.  Her husband died in an accident on 22.3.2014, after retirement during the validity of insurance policy. She has further pleaded that after the death of her husband she and other legal heirs namely Deepak (son) and Deepika (daughter) are legally entitled to receive insured amount of Rs.6,00,000/- covered under “Group Personal Accident Insurance Policy”. She also moved many applications to the opposite parties for payment and has also served legal notice dated 4.11.2015 through her counsel but the opposite parties have refused to pay her claim. Thus, there is deficiency in service on the part of the opposite parties. Hence this complaint.

3.        Upon notice, the opposite party no.1 appeared and filed its reply through its counsel taking the preliminary objections that the complaint is not maintainable in the present form; the complaint is under valued for the purpose of Court fee and jurisdiction; no cause of action has arisen to the complainant to file the present suit against the opposite parties and the receipt of notice under 80 CPC is admitted but its legality and validity is challenged. On merits, it was submitted that husband of the complainant was enrolled as a Volunteer as PHG organization on 23.3.2012 and he was performing duty at P.S.Dera Baba Nanak on completion of 58 years of age 24.12.2013. He was called off from duty. If deceased was insured at the time of his alleged death, it would be through opposite parties no.2 to 4. It was further submitted that Rs.2000/- and Rs.1100/- were deducted from wages on 3.11.2013 and 4.12.2013 respectively while the deceased was on duty but he called off from duty on 24.12.2015. The decision of the claim of the policy is to be taken by opposite party no.2 to 4 and not by opposite party no.1. The deductions were made, when the volunteer was on duty and were made on behalf of opposite parties no.2 to 4. A legal notice served by the complainant was received, which was replied by the State Head Quarter. All other pleadings made in the complaint have been denied and lastly the complaint has been prayed to be dismissed.

4.       Upon notice, the opposite parties no.2 to 4 appeared and filed their joint reply through their counsel taking the preliminary objections that the complainant has no cause of action and locus standi to file the present complaint; the complaint of the complainant is premature. The complainant never approached the opposite parties. No claim no. or any document has been produced on the file to show that any claim has been filed by the complainant. So the complaint is liable to be dismissed being premature; the complainant himself attached one letter issued by Punjab Home Guards and Civil Security Department and the contents of the letter clearly show that the deceased had already retired from his services and not entitled for benefit covered under the Group Insurance Policy and the liability under the policy is of Rs.3,00,000/- only. On merits, it was submitted that the fact regarding period of insurance and amount of premium are subject to verification and as per record. Even the complainant herself stated that the death took place after retirement. The letter dated 24.11.2015 of Punjab Home Guard and Civil Security Department, clearly shows that the retired employee is not entitled for “Group Insurance”. There is no liability of the insurance company. It was further submitted that the complainant may put strict proof that they are legal heirs of the deceased and till then it was denied that the complainant alongwith others are legal heir of the deceased. The complainant may be directed to get the succession certificate in this regard. All other pleadings made in the complaint have been denied and lastly the complaint has been prayed to be dismissed.

5.      Complainant tendered into evidence her own affidavit Ex.CW1/A, alongwith other documents Ex.C1 to Ex.C4 and closed the evidence.

6.       Sh.G.P.S.Dhillon Battalion Commander No.2 tendered into evidence his own affidavit Ex.OP1/1 and closed the evidence.

7.       Counsel for the opposite parties no.2 to 4 tendered into evidence affidavit of Sh.Karan Nagla, authorized signatory Ex.OP2 to Ex.OP4/1 and closed the evidence.

8.         We have examined all the pleadings ,documents/evidence produced on record and have also duly considered and perused the arguments duly put forth by the learned counsels for both the sides, while adjudicating the present complaint. At the outset without going into the merits of this complaint we find From the pleadings and evidence on record that the opposite party no. 2 to 4 have yet not finally decided the insurance claim of the claimant and the present complaint is premature. It is the case of the OP no. 2 to 4 that the complainant never approached them. No claim has been lodged with them nor any document has been produced on the file to show if any claim has been lodged by the complainant.

9.          In the light of all above we find that the present complaint is premature since the opposite parties no.2 to 4 has not yet finally decided the insurance claim. Thus we dispose of the complaint and direct the complainant to approach the opposite parties and submit the requisite relevant documents/information desired by them for settling the insurance claim within 15 days of the receipt of these orders and further direct the opposite party insurance providers to decide the claim as per the terms and conditions of the policy within 15 days of the receipt of documents from the complainant. The opposite party is further directed to decide insurance claim duly filed by the complainants duly verified as per the settled procedure laid down by their regulating Agency IRDA.

10.        Copy of the order be communicated to the parties free of charges. After compliance, file be consigned.

     (Naveen Puri)

                                                                       President     

ANNOUNCED:                                     (Jagdeep Kaur)

August 17, 2016.                                              Member.

*MK*