Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 309.
Instituted on : 21.08.2020.
Decided on : 28.07.2021.
- Nirmala w/o Late Sh. Ajit R/o VPO Paposa Tehsil Bawani Khera, District Bhiwani.
- Parveen Kumar s/o late Sh. Ajit R/o VPO Paposa, Tehsil Bawani Khera, District Bhiwani.
- Sachin s/o Late Sh. Ajit R/o VPO Paposa, Tehsil Bawani Khera, District Bhiwani.
Vs.
The Oriental Insurance Company Ltd. having office at IInd floor, Jawahar Market, Opposite D-Park, Model Town,Rohtak-124001, through its Divisional Manager.
……….Opposite party.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
MS. TRIPTI PANNU, MEMBER.
Present: Sh.Ankit Joon, Advocate for complainant.
Sh.R.K. Bhardwaj, Advocate for opposite party.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that Govt. of India floated a Scheme(Pradhan Mantri Suraksha Bima Yojana(PMSBY) and as per scheme, people in the age group 18 to 70 years with a bank account who give their consent to join/enable auto-debit on or before 31st May on annual renewal basis. The risk coverage under the scheme is Rs.2 lakh for death. The premium of Rs.12 per annum is to be deducted from the account holder’s bank account through ‘auto debit’ facility in one installment. Accordingly Sh. Ajit s/o Sh. Jaswant opted for Pradhan Mantri Suraksha Bima Yojana(PMSBY), as Life assured was maintaining bank account with Sarva Haryana Gramin bank bearing Account No.80178800013585 having branch at VPO Jamalpur, Tehsil Bawani Khera, District Bhiwani, Haryana. Unfortunately on 10.02.2020 life assured met with an accident while driving the motor-cycle and thus suffered a fatal injury. The life assured had died due to the injuries sustained in the accident due to rash and negligent driving of the vehicle no.HR-61B-7117. In this context FIR bearing no.0078 dated 10.02.2020 was registered at P.S. Tosham, District Bhiwani. After the death of the life assured, the claim was lodged with the concerned Bank alongwith all the documents and they forwarded the same to the respondent Insurance company. But inspite of several visits and reminders, the insurance company failed to disburse the claim and vide their letter dated 12.06.2020 had repudiated the claim of the complainant on the false and frivolous ground. The insurance company demanded the driving licence of the life assured but the complainant could not trace the same as the same was the personal belonging of the life assured. The life assured was driving the motor cycle for last many years and was having the valid and effective D.L. to drive the vehicle. The act of opposite party of repudiating the genuine claim of the complainant is illegal and amounts to deficiency in service. Hence this complaint and it is prayed that opposite party may kindly be directed to make the payment of Rs.200000/- alongwith interest, compensation and litigation expenses to the complainant as explained in relief clause..
2. After registration of complaint, notice was issued to the opposite party. Opposite party in its reply has submitted that the deceased was driving the motorcycle without helmet and without D.L. He was driving the motorcycle in a rash and negligent manner. Wrong FIR was lodged against the driver of vehicle no.HR-61-B-7117 only to grab the false compensation from the answering opposite party. The insurance company is not liable to pay any compensation to the complainant. All the other contents of the complaint were stated to be wrong and denied and opposite party prayed for dismissal of complaint with costs.
3. Learned counsel for the complainant in his evidence tendered affidavit Ex.CW1/A, documents Ex.C1 to Ex.C10 and has closed his evidence on dated 01.02.2021. Ld. counsel for the opposite party in his evidence has tendered affidavit Ex.RW1/A, documents Ex.R1 to Ex.R4 and closed his evidence on dated 19.07.2021.
4. We have heard learned counsel for the parties and have gone through the material aspects of the case very carefully.
5. In the present complaint, it is not disputed that Sh. Ajit s/o Sh.Jaswant was insured with the opposite party under Pradhan Mantri Suraksha Bima Yojana and as per statement of Account Ex.C1, an amount of Rs.12/- has been deducted from his account as premium. It is also not disputed that the life assured died in a road-side accident. After the death of life assured, complainants being legal heir of Ajit has filed the insurance claim with the opposite party but the same has been repudiated by the opposite party. As per the written statement filed by the opposite party the deceased life assured was driving the vehicle in a rash and negligent manner and he was not having driving licence to drive the motorcycle in question. But to prove the same opposite party has not placed on record any document that deceased was driving the vehicle in rash and negligent manner. On the other hand, as per copy of FIR Ex.C2 placed on record by the complainant, the alleged accident had taken place due to rash and negligent driving of the vehicle no.HR-61B-7117. Regarding other plea that the life assured was not having any driving licence, respondent insurance company failed to prove that driving licence is a necessary document for settlement of claim of the complainants. Moreover this type of policy has been issued by the Central Government of India for the benefits of the account holders. In fact a letter has been issued by Sarv Haryana Gramin Bank to the complainant on dated 18.09.2020. In this letter it has been mentioned that the Oriental Insurance Company sent master policy, relevant terms and conditions of Pradhan Mantri Suraksha Bima Yojana and other documents to the bank vide mail dated 04.09.2020. After receiving these documents i.e. Sarv Haryana Gramin Bank forwarded the same to the complainant vide letter dated 18.09.2020 i.e. Ex.C6. Meaning thereby the complainant received first time the master policy terms and conditions through letter dated 18.09.2020. We have perused the rules of Pradhan Mantri Suraksha Bima Yojana annexed with Ex.C6 from page no.1 to 10. As per eligibility conditions given on page no.3, it is submitted that : “The saving bank account holders of the participating banks aged between 18 years (completed) and 70 years(age nearer birthday) who give their consent to join/enable auto-debit, as per the above modality, will be enrolled into the scheme”. At page no.8, under the head Claim Process: the documents required for claim process are as under:-
Documents-FIR/Panchnama , PMR/Death Certificate by a Govt. Doctor clearly giving cause of death”.
Meaning thereby driving licence is not needed for the settlement of the claim of the complainant. Moreover the DL is required when a person is insured under the Motor Vehicle Act but in this case the deceased was insured under life insurance. So the driving licence is not a necessary document for the purpose of settlement of claim of the complainant. Hence the claim of the complainant has been wrongly repudiated by the opposite party and opposite party is liable to pay the claim amount to the complainant as per policy.
6. In view of the facts and circumstances of the case, we hereby allow the complaint and direct the opposite party to pay the insurance claim of Rs.200000/-(Rupees two lacs only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 21.08.2020 till its realization and shall also to pay a sum of Rs.5000/-(Rupees five thousand only) as compensation and Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant within one month from the date of decision. However, opposite party is further directed to pay the 50% of the awarded amount in favour of complainant no.1 Nirmala i.e. wife of life assured and remaining 50% amount shall be disbursed to the complainant no.2 Sh. Parveen s/o Sh.Ajit and Sachin s/o Ajit in equal share.
7. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
28.07.2021.
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Nagender Singh Kadian, President
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Tripti Pannu, Member.
