Haryana

Karnal

128/2014

M/s Bala Ji Corporate Services - Complainant(s)

Versus

The New India Assurance Co - Opp.Party(s)

Yashbir Singh

15 Feb 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.     

                                                                Complaint No.128 of 2014                                                                                         

                                                                Date of instt.: 7.5.2014

                                                                Date of decision: 15.02.2016

 

M/s Balaji Corporate Services through its partner-cum-authorized signatory Shri Suresh Sharma son of Sh.Avtar Krishan Sharma, aged 46 years, resident of house no.2308, Sector -13, Urban Estate, Karnal.

.                                                                   ……..Complainant.

                                      Vs.

The New India Assurance Company Limited  near old GT Road, near Old Tehsil Karnal through its Branch Manager.

                                                                           ……… Opposite Party.

                     Complaint u/s 12  of the Consumer

                     Protection Act.

Before          Sh.K.C.Sharma……….President.             

                   Sh.Anil Sharma…….Member.

Present:-        Sh.Yashbir Singh Advocate for the complainant.

                     Sh.Gurmit Singh Advocate for the  Opposite Party

 

ORDER:       

                        This  complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986, on the averments that he got insured his eighty employees with the Opposite Party, vide insurance policy No.35360142120100000018, which was  valid from 23.4.2012 to 22.4.2013 and  insurable interest of each employee was Rs.4.00 lac. Sanjay Kumar son of Kala Singh, who was one of his workers, was deployed at the  site of M/s Uttam Sugar Mills Shermau  District Saharanpur and he died on 11.8.2012 due to accident. After the death of Sanjay, he  complainant lodged claim with the Opposite Party  on 27.8.2012 and completed all the formalities. Thereafter, he wrote many letters and reminders to the Opposite Party.  However, with great difficulty, the Opposite Party paid an amount of Rs. three lac only in February, 2014 and deducted  an amount of Rs.one lac illegally. Therefore, he again wrote letter dated 15.4.2014 to the Opposite Party  for release of the remaining amount of Rs.one lac, but the Opposite Party did not pay  any heed to his requests. Thus, the  delay in making payment of the  amount of Rs.3 lac and deduction of Rs.one lac  by the Opposite Party amounted to deficiency in service and unfair trade practice,  which caused him mental pain and harassment apart from financial loss.

2.                Notice of the complaint was given to the Opposite Party, who appeared and filed written statement disputing the claim of the complainant. Objections have been raised that the complaint is not maintainable in the present form; that the complainant is estopped from filing the present complaint by  his own acts and conduct  and that complicated questions of law and facts are involved, therefore, this Forum has no jurisdiction to entertain and decide the present complaint.

                   On merits, it has been submitted that the  complainant had agreed to accept the amount of Rs. three lac as per letter dated 12.4.2014, because only the said amount was payable as per  policy conditions. The other allegations made in the complaint have been denied.

3.                In evidence of the complainant, his affidavit Ex.C1 and documents Ex.C2 to Ex.C8 have been tendered.

4.                On the other hand, in evidence of the Opposite Party, affidavit of  K.L.Sarin, Divisional Manager Ex.OW/A  and documents Ex.O2 and Ex.O2 have been tendered.

5.                We have appraised the evidence on record,  the material circumstances of the case and the arguments advanced by the learned Counsel for the parties.

 

6.                The parties are not at dispute that the complainant had obtained group insurance policy of 80 employees from the Opposite Party  and one of the  worker’s namely Sanjay had died in an accident. Claim was  lodged by the complainant and  instead of insured amount of Rs .four lac, an amount of Rs. three lac was paid by the Opposite Party. The complainant has claimed balance amount of Rs.one lac. The Opposite Party has raised  the plea that the complainant had agreed to accept the amount of Rs. three lac as per letter dated 12.4.2014, because  only the said amount was payable as per the policy conditions.

7.                The learned counsel for the Opposite Party has put a great thrust upon the contention that the complainant had accepted the amount of Rs. three lac as full and final settlement of the claim and gave consent letter dated 12.4.2014, the copy of which is Ex.O1, therefore, the complainant is now estopped from claiming the amount of Rs.one lac.

8.                Thus, the main plank of the Opposite Party is the consent letter Ex.O7, according to which, the complainant was ready to accept the claim amount of Rs .three lac as discussed with the officer of the Opposite Party. It is settled proposition of law that obtaining consent letter from the complainant by the insurance company before making payment of the  insured amount, amounts to coercive bargaining as the insurance company cannot be expected to take away legal rights of the insured regarding seeking redressal of his grievance.  In fact, obtaining consent letter is nothing, but taking  undue benefit of unequal weakness status of the contracting party i.e. insured.  In this regard sustenance may be sought from the decision of Hon’ble National Commission in case   Abhay Neelawarne Versus New India Assurance Co.Ltd.and another 2008 CPJ 261 (NC).    .

9.       It is worth pointing out that  the Opposite Party has not been able to point out any term or condition of the insurance policy, according to which the complainant could get the claim for an amount of Rs. three lac, despite the fact that insured  sum was Rs. four lac. Therefore, plea of the Opposite Party in the written statement that only the amount of Rs. three lac was payable as per the policy condition cannot be accepted. The language of the letter Ex.O1 clearly indicates that the officer of the Opposite Party had pressurized the complainant to sign the consent letter so that he could get claim of Rs. three lac instead of insured amount of Rs. four lac.  It is pertinent to note that in the said letter, it was not clarified that the amount of Rs. three lac was accepted by the complainant as full and final settlement of the claim and he would not remain entitled to get the balance amount of Rs.one lac. The Opposite Party could not  take away legal right of the complainant regarding redressal of his grievance for recovery of the balance amount merely on account of the said consent letter, which was obtained from the complainant by coercive bargaining, taking undue advantage of unequal  weakness of status of the complainant. Thus, the act of the Opposite Party regarding non payment of the balance amount of Rs.one lac to the complainant amounted to deficiency in services on its part.

10.               As a sequel to the foregoing discussion, we accept the present complaint and direct the Opposite Party to make the payment of Rs.one lac to the complainant alongwith interest at the rate of nine per cent per annum from the date of filing of the present complaint i.e. 7.5.2014 till its actual realization. The complainant shall also be entitled for a sum of Rs.5500/- for the mental pain and agony caused to him and for the litigation expenses. The Opposite Party shall make the compliance of this order within a period of thirty days from the date of receipt of the copy of this order.  The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced
dated: 15.02.2016.

                                                                    (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

(Anil Sharma )      

   Member.