Haryana

Yamunanagar

CC/376/2011

Balwinder Singh S/o Yad Ram - Complainant(s)

Versus

The Oriental Insurance Company Ltd. - Opp.Party(s)

Dharamvir Singh

10 Mar 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

 

                                                                                          Complaint No. 376 of 2011.

                                                                                          Date of institution: 21.04.2011   

                                                                                          Date of decision: 10.03.2017

 

Balwinder Singh, aged about 35 years, son of late Shri Yad Ram resident of village Manakpur-II, Post Office Udhamgarh, Tehsil Jagadhri, District Yamuna Nagar.

…Complainant.

                                      Versus

1. The Oriental Insurance Company Limited near Hindu Girls Sr. Secondary School, Old Court Road, Jagadhri, District Yamuna Nagar through its Branch Manager.
2. The Oriental Insurance Company Limited, 80 First Floor, FIE Patpar Ganj, Industrial Area, Delhi-110092 through its Manager.
3. The Oriental Insurance Company Limited, Registered & Head office A-25-27, Asaf Ali Road, New Delhi 110002 through its Managing Director.
4. DTN Pvt. Ltd. A12C/304, Tirupati Plaza, Street No.01, Shakarpur, Delhi through its Managing Director/Authorized Signatory.

                                  

                                                                                                          ...Respondents

 

BEFORE:       SH. ASHOK KUMAR GARG…………….. PRESIDENT.

                        SH. S.C.SHARMA………………………….MEMBER.

 

Present:          Sh. Dharamvir Singh, Advocate for complainant.

                        Sh. Sanjay Sharma , Advocate for OP No.1 to 3.

                        OP No.4 already ex parte.

 

ORDER (Ashok Kumar Garg, President)

 

1                       The present complaint has been filed under section 12 of the Consumer Protection Act 1986 amended upto date.

2.                     Brief facts of the present complaint, as alleged in the complaint, are that father of the complainant Shri Yad Ram purchased an insurance policy bearing Cover Note No.270000493344 forming part of Nagrik Suraksha Policy No.271700/48/2011/1735 of the respondent No.2 (hereinafter referred as OP No.2) through OP No.4 for a sum of Rs.4,00,000/- (3,20,000/- for personal accident and Rs.80,000/- for hospitalization) which was valid from 19.11.2010 to 18.11.2011. On 22.02.2011,  the father of the complainant was constructing a house and during the construction period, the father of the complainant Shri Yad Ram fell from new constructed stairs and suffered grievous injuries on his head. On this, the complainant immediately brought his father to Mittal Hospital, Jagadhri, were he succumbed to injuries on the same day. After the death of his father, the complainant immediately intimated the OPs and lodged his claim and sent all requisite documents to the OP No.2 through OP No.4 and further requested vide letter dated 07.03.2011 to accept the claim and to disburse the same to him, but neither any action was taken by the OPs nor any correspondence was done by the OPs Insurance Company, then the complainant personally visited the OPs and also requested telephonically but all in vain. Hence, there is deficiency in service or unfair trade practice on the part of the OPs and lastly prayed for directing the OPs to release the claim amount of Rs.4,00,000/- on account of death of Shri Yad Ram father of the complainant and also to pay compensation as well as litigation expenses. Hence, this complaint.

3.                     Upon notice, OP No.1 to 3 appeared and filed its written statement by taking some preliminary objection such as complaint is not maintainable; present complaint is without cause of action against the OPs; complainant has not followed the procedural law by placing the requisite record and documents as desired by the OPs such as there is no deficiency in service on the part of the OPs and on merit all the contents of the complaint were denied for want of knowledge, however, it has been specifically mentioned that no intimation was given to the OPs as per procedure regarding death of Shri Yad Ram nor any documents were made available and lastly  prayed for dismissal of the complaint.

4.                     Upon notice OP No.4 appeared through authorized representative on 26.05.2011 and filed its written statement. However, after that none appeared on behalf of OP No.4. Hence, OP No.4 was proceeded ex parte vide order dated 18.07.2011.

5.                     In support of his case, learned counsel for the complainant tendered into evidence affidavit of the complainant as Annexure C-X, photocopy of certificate of insurance as Annexure C-1, photocopy of certificate issued by Mittal Hospital dated 28.02.2011 as Annexure C-2, photocopy of death certificate as Annexure C-3, photocopy of intimation letter dated 07.03.2011 Annexure C-4, photocopy of postal receipt as Annexure C-5 and C-6, photocopy of ration card as Annexure C-7, photocopy of literature of OP Insurance as Annexure C-8 and closed the evidence on behalf of complainant.

6.                     On the other hand, learned counsel for the OPs No.1 to 3 tendered into evidence affidavit of Shri Gurmej Singh, Manager, OIC as RW1, photocopy of discharge voucher dated 13.09.2011 Annexure R-1, photocopy of internal letter of OPs insurance company as Annexure R-2, photocopy of letter dated 27.10.2011 as Annexure R-3, photocopy of repudiation letter dated 30.11.2011 as Annexure R-4, photocopy of another letter as Annexure R-5 and closed the evidence on behalf of OP No.1 to 3.  

7.                     We have heard the learned counsels of both the parties and have gone through the pleadings as well as documents placed on the file very carefully and minutely.

8.                     It is not disputed that deceased Shri Yad Ram father of the complainant had obtained a Nagrik Suraksha Policy No.271700/48/2011/1735 valid from 19.11.2010 to 18.11.2011 for a sum of Rs.4,00,000/- (Rs.3,20,000/- personal accident and Rs.80,000/-  for hospitalization ) from the OPs Insurance Company, which is duly evident from the photocopy of certificate of Insurance (Annexure C-1). It is also not disputed that name of the complainant Balwinder Singh has been shown in this policy as Assignee name. It is also not disputed that father of the complainant expired on 22.2.2011 is also evident from the death certificate (Annexure C-3).

9.                     The only plea of the complainant is that he lodged the claim with with the OPs No.1 to 3 Insurance company through OP No.4 on account of death of his father who died on 22.02.2011 when he was doing the construction work of house and fell from newly constructed stairs and received grievous injury. Learned counsel for the complainant draws our attention towards the certificate issued by Mittal Hospital dated 28.02.2011 (Annexure C-2) and death certificate (Annexure C-3) and argued that from these documents, it is duly evident that deceased Shri Yad Ram died on 22.02.2011 due to head injury. Learned counsel for the complainant further draw our attention towards literature of the OPs Insurance Company (Annexure C-8) and prayed for acceptance of the complaint.

10.                   On the other hand, learned counsel for the OPs Insurance Company argued at length that complainant has totally failed to prove his case as no copy of postmortem report or FIR/DDR has been placed on file to prove that the deceased Shri Yad Ram had died due to any accidental injuries. Learned counsel for the OPs further draw our attention towards the certificate issued by Mittal Hospital (Annexure C-2)  and argued that complainant is relying upon only this document which has been procured one as this certificate shown to has been issued on 28.02.2011, whereas as per version of the complainant father of the complainant Shri Yad Ram died on 22.02.2011 has been procured after 6 days. Learned counsel for the OP No.1 to 3 further argued that as per this certificate, father of the complainant received grievous injury including head injury but no treatment record or admission in the hospital has been placed on file to prove that the deceased Yad Ram received such type of any injuries. Learned counsel for the OPs Insurance Company further argued that even this certificate (Annexure C-2) has also not been duly proved by the complainant as neither any affidavit of issuing doctor has been placed on file in support of this certificate nor any doctor has been examined to prove the same. Further, even the complainant has also not placed on file any hospital charges bill/ receipt or any medical bills to prove that deceased Shri Yad Ram died due to the alleged injury as mentioned in the complaint as well as this certificate. Learned counsel for the OPs No.1 to 3 further argued that complainant has also totally failed to submit any documents to the OPs Insurance Company despite so many letters dated 12.09.2011 and draw our attention towards letters dated 27.10.2011 and 30.11.2011 (Annexure R-3 and R-5) and lastly argued that claim of the complainant has been rightly repudiated by the OPs Insurance Company vide repudiation letter dated 30.11.2011 (Annexure R-4) and prayed for dismissal of the complaint.

11.                   After hearing both the parties at length, we are of the considered view that there is no deficiency in service or unfair trade practice on the part of the OPs No.1 to 3 Insurance Company as the complainant has totally failed to prove that deceased Shri Yad Ram died due to the injuries as alleged in the complaint as neither any postmortem report or any MLC or FIR/DDR and treatment record or OPD slips has been placed on file nor any doctor has been examined to prove the same. Even, no affidavit of any treating doctor has been placed on file to prove that deceased Shri Yad Ram had suffered grievous injuries, as alleged in the complaint. We have perused the certificate issued by Mittal Hospital on 28.02.2011 (Annexure C-2) but this certificate has not been duly proved by the complainant as neither any affidavit in support of this certificate has been placed on file by the complainant nor the said doctor has been examined. As per this certificate Shri Yad Ram died on 22.02.2011 whereas this certificate has been issued on 28.02.2011. In support of this certificate, no OPD slip bearing Number or indoor treatment record of the hospital or any prescription of medicines given to the deceased has been placed on file. Further, the complainant has also failed to file any affidavit of any Sarpanch/Member/Lambardar or any neighbour of the deceased Shri Yad Ram to prove that Shri Yad Ram received the injuries due to fall from the stairs and died due to the same. Further, from the perusal of photocopy of Ration Card (Annexure C-7) that it is duly prove that deceased Shri Yad Ram was more than 62 years old at the time of death, so possibility of natural death cannot be ruled out in the absence of cogent evidence by way of postmortem report or otherwise.

12.                   In the circumstances noted above, we are of the considered view that complainant has totally failed to prove that deceased Shri Yad Ram had died due to any accidental injuries and further complainant has not submitted the required documents to the OPs Insurance Company. Hence, we have no option except to dismiss the present complaint as no deficiency in service or unfair trade practice has been proved against the OPs Insurance Company.

13.                   Resultantly, we find no merit in the present complaint and the same is hereby dismissed with ho order as to costs. Copies of this order be supplied to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Pronounced in open court: 10.03.2017.

                                                                                          (ASHOK KUMAR GARG)

                                                                                           PRESIDENT

                                                                                          DCDRF Yamuna Nagar

 

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER