Punjab

Sangrur

CC/201/2015

Kulwinder Kaur - Complainant(s)

Versus

The Sangrur Central Co-Op. Bank - Opp.Party(s)

Shri Rajinder Goyal

02 Sep 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.

 

                                                               

                                                Complaint No.    201

                                                Instituted on:      10.04.2015

                                                Decided on:       02.09.2015

 

1. Kulwinder Kaur @ Chhinder Kaur widow of Mohinder Singh.

2.Charanjeet Singh son of Mohinder Singh, both residents of village Bir Kalan, District Sangrur.

                                                        …Complainants

                                Versus

1.             The Sangrur Central Cooperative Bank Limited, Head Office, Patiala Gate, Sangrur through its Manager.

2.             The Sangrur Central Cooperative Bank Limited, Branch Office Cheema, through its Branch Manager.

3.             The Bharti AXA General Insurance Co. Limited, Pearl Plaza, K-24, Plot No.ABCD & E, 2^nd Floor, Sector 18, Noida.

4.             Bharti AXA General Insurance Company Limited, 1^st Floor, Ferns Icon, Survey No.28, Next to Akme Ballet, Doddanekundi, Off Outer Ring Road, Banglore.

                                                        ..Opposite parties

 

For the complainant    :       Shri Amit Aggarwal, Adv.

For OPs No.1&2        :       Shri Amit Goyal, Adv.

For OP No.3&4         :       Shri G.S.Shergill, Adv.

 

Quorum:    Sukhpal Singh Gill, President

                K.C.Sharma, Member

                Sarita Garg, Member

 

 

Order by : Sukhpal Singh Gill, President

 

1.             Smt. Kulwinder Kaur and Charanjeet Singh, complainants (referred to as complainant in short) have preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that the husband of the complainant number 1 Shri Mohinder Singh  availed the services of the OP number 1 and 2 by opening a saving bank account number 952 and under the said account, the husband of the complainant was insured for an amount of Rs.1,00,000/- under the policy issued by OPs number 3 and 4 for the members who will kept the balance amount of Rs.1300/- in the account.  Further case of the complainant is that on 12.9.2012, the said Mohinder Singh (referred to as DLA in short) died in a road accident near Bihar Village and the accident took place due to the rash and negligent driving of the driver of tanker, who hit the tractor of said Mohinder Singh. The DLA died on the way to hospital.  Thereafter post-mortem on the dead body of the DLA was also conducted and FIR number 167/12 under section 279/304A IPC was recorded at PS Dera Pur, Kanpur Dehat was also got lodged by one Gurpreet Singh son of Jaswant Singh against the unknown driver of the tanker.  It is further averred that after completing the last rites of Mohinder Singh, the complainants lodged the claim with OP number 2 vide application dated 4.10.2012 and also submitted all the required documents and the Ops further assured that the claim will be paid within 2/3 months, but the same was not paid.  It is further averred that in the month of April, 2013, the complainants received a letter dated 15.4.2013 from OP number 2 stating that the death claim of Mohinder Singh was repudiated as there were shortcomings of driving license and incomplete post-mortem report, whereas the allegation of the complainant is that he has already submitted the complete post mortem report.  Moreover, it is stated that there is no need of driving license of the DLA, as the tanker struck with the tractor of the DLA. It is further averred that the complainant also got served a legal notice upon the OPs on 11.11.2014, but all in vain.  Thus, alleging deficiency in service on the part of the OPs, the complainants have prayed that the Ops be directed to pay to the complainants the claim amount of Rs.1,00,000/- along with interest @ 18% per annum from the date of death of the insured till realisation and further claimed compensation and litigation expenses.

 

2.             In reply filed by Ops number 1 and 2, preliminary objections are taken up on the grounds that the complaint is not maintainable, that the complainants have no cause of action and locus standi to file the present complaint and that the complainant has not come to the Forum with clean hands.  On merits, it has been admitted that the DLA Mohinder Singh had opened an account bearing number 952 with the OP number 2 and the DLA was insured for a sum of Rs.1,00,000/- in case of accidental death and further it has been admitted that the DLA died in an accident on 12.9.2012 as per the FIR submitted by the complainants. It has been further admitted that the complainant moved an application dated 4.10.2012 with the OP number 2 and also submitted the copy of FIR and PMR, which was duly forwarded to OP number 3 on 12.11.2012 after completing the formalities.  It is admitted that the OP number 2 intimated the complainant about the repudiation of claim vide letter dated 15.4.2013.  It is further averred that the complainant had concealed material information regarding another claim being lodged by the complainants with OP number 3 through OPs number 1 and 2 for the sum of Rs.50,000/- payable in respect of accidental death of Kissan Credit Card Holder and claim of the complainant had also been repudiated by OP number 3. 

 

3.             In reply filed by OP number 3&4, legal objections are taken up on the grounds that the complaint is not maintainable as there is a violation of terms and conditions of the policy. It is further averred that the DLA died on 13.9.2012 and intimation regarding the accident was given on 22.4.2013 with a delay of 221 days and copy of death certificate as well as copy of valid driving license was provided. It is further stated that the contract of insurance is between the complainants and OPs. On merits, it is admitted that the DLA was insured under Sehkari Bank Bima Yojna and the claim is payable as per the terms and conditions of the policy.  It is further stated that as per the record of the Ops, intimation regarding the accident was given on 22.4.2013 with a delay of 221 days and after getting the information the complainant through Ops number 1 and 2 vide letter dated 23.4.2013 asked to give reasons for delay, but despite that the complainant did not give any reason for delay in intimation.  The investigator appointed by the OPs also sent letter dated 7.6.2013 to the complainants for providing the documents, but the same were not provided, ultimately the claim of the complainant was repudiated vide letter dated 25.9.2013. However, any deficiency in service on the part of the Ops has been denied.

 

4.             The learned counsel for the complainants have produced Ex.C-1 affidavit, Ex.C-2 copy of pass book, Ex.C-3 copy of PMR, Ex.C-4 copy of FIR, Ex.C-5 copy of legal notice, Ex.C-6 to Ex.C-9 postal receipts, Ex.C-10 copy of letter dated 15.4.2013, Ex.C-11 copy of letter dated 13.11.2014, Ex.C-12 copy of letter dated 23.4.2013, Ex.C-13 copy of letter dated 25.9.2013, Ex.C-14 copy of letter dated 29.10.2013, Ex.C-15 copy of disposal, Ex.C-16 copy of body disposal slip, Ex.C-17 copy of will dated 10.9.2007, Ex.C-18 copy of application dated 4.10.2012, Ex.C-19 copy of certificate of Gram Panchayat and closed evidence. On the other hand, the learned counsel for OP number 1 and 2 has produced Ex.OP1&2/1 affidavit, Ex.OP1&2/2 to Ex.Op1&2/6 copies of letters, Ex.OP1&2/7 copy of claim forwarding letter, ExOP1&2/8 to Ex.OP1&2/10 copies of letters and closed evidence.  The learned counsel for OPs number 3 and 4 has produced Ex.OP3&4/1 affidavit, Ex.OP3&4/2 copy of policy, Ex.OP3&4/3 copy of terms and conditions and closed evidence.

 

5.             We have carefully perused the complaint, version of the opposite parties, evidence produced on the file and written submissions and also heard the arguments of the learned counsel for the parties. In our opinion, the complaint merits acceptance, for these reasons.

 

6.             In the present case, the DLA had purchased the personal accident policy for Rs.1,00,000/- from the OPs number 3 and 4 through OPs number 1 and 2 and after the accidental death of the DLA, the complainant became the consumer of the OPs being the beneficiary under the policy.

 

7.             OPs number 1 and 2 have admitted having issued the said policy and with regard to the other contents, the learned counsel has submitted that the same is the matter of record.  OPs number 1 and 2 have further submitted that the complainant moved an application dated 4.10.2012 in the office of OP number 2 and submitted copy of FIR and PMR and the said application was sent to OP number 1. However, the OP number 1 sent back the application to OP number 2 with a direction to submit claim form duly filled in by the complainants along with other documents. Thereafter the Op number 2 informed the complainant to submit the claim form duly filled in, in the office of OP number 1 vide letter dated 5.11.2012 for further necessary action. Thereafter the OP number 1 sent the claim case of the complainant to OP number 3 vide letter dated 12.11.2012. It is ample clear from the version of the OP number 1 and 2 that the claim of the complainant was forwarded to OP number 3. Whereas the learned counsel for OPs number 3 and 4 has contended that the claim of the complainant has rightly been rejected as the intimation of the death of the DLA was sent after 221 days, but we are unable to accept such a contention of the learned counsel for the OPs number 2 and 3 that the claim was lodged after 221 days, whereas it is ample clear from the reply of OP number 1 and 2 that the claim was submitted to OP number 3 vide letter dated 12.11.2012 (whereas the death of the DLA took place on 12.09.2012) i.e. within two months from the date of death of the DLA. Further the complainant has produced on record the copy of post-mortem report Ex.C-3 and a copy of FIR Ex.C-4, which clearly proves that the DLA died an accidental death on 12.09.2012. We have also perused the copy of letter dated 12.11.2012, Ex.OP1&2/3 sent by OP number 1 to the insured company office at Ludhiana through registered post, which clearly reveals that the intimation of death of the DLA was given to the insured within a period of sixty days of the death of the DLA.  Moreover, the Hon’ble National Commission in CEO, Cholamandalam and another versus Abhijat Saini and another 2014(4) CPR 178 (NC) has held that the provisions of delay in informing the insurance company or lodging report with police are of little significance as these are of directory nature and not of mandatory nature.  In that case, vehicle damaged in the accident. To expert a person to immediately first rush to insurance company to inform about accident when his vehicle meets a very serious accident or causing death is too much and is beyond prudence of common man. Insurance company should take a decision in respect of any event or in respect of any eventuality keeping in view response by a reasonable and prudent man. Every decision taken by the service provider has to be tested on the anvil of terms of contract unless occurrence or information given by insurer is found to be afflicted with a malafide or falsehood, claim should be accepted. Provisions of delay in informing insurance company or lodging report with police are of little significance as these are of directory nature and not of mandatory nature.

 

8.             Further a bare perusal of the file clearly reveals that the accident took place due to the gross negligence of the driver of the tanker, who struck the tanker in the tractor of the DLA, as such, we feel that there is no requirement of the driving license of the DLA, as there was no fault of the DLA in driving the vehicle. On this point, reliance can be placed on the judgment  titled as United India Insurance Co. Ltd. versus Gaj Pal Singh Rawat III(2009) CPJ 254 (NC). In that case, the claim was repudiated that the driver was not holding a valid and effective license at the time of accident. Complaint was allowed. In the appeal, it was held by the State Commission that in the absence of nexus between the license of the driver and accident, the insurer would be liable to pay the claim.  No fault on the part of driver proved and revision petition dismissed by the Hon’ble National Commission. In the present case also, the OP had not been able to assign the nexus between the driving license of the DLA and the accident because the accident was caused due to rash and negligent driving of another vehicle i.e. tanker, which struck with the tractor of the complainant.  As such, we feel that by not settling the claim of the complainants, the Op number 3 and 4 are deficient in service.

  

9.             In the light of above discussion, we allow the complaint and direct the OP number 3 and 4 to pay to the complainants an amount of Rs.1,00,000/- along with interest @ 9% per annum from the date of filing of the present complaint i.e. 10.4.2015 till realisation.  OP number 3 and 4 are further directed to pay to the complainants an amount of Rs.5,000/- in lieu of consolidated amount of compensation and litigation expenses.

 

10.            This order of ours be complied with within a period of thirty days of its communication. A  copy of this order be issued to the parties free of cost. File be consigned to records.

                Pronounced.

                September 2, 2015.

                                                        (Sukhpal Singh Gill)

                                                           President

 

 

                                                              (K.C.Sharma)

                                                                Member

 

 

                                                                (Sarita Garg)

                                                                    Member