Punjab

Sangrur

CC/1069/2015

Harkirat Kaur - Complainant(s)

Versus

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

Shri Rohit jain

17 Jun 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR

                            

                                                                       Complaint No. 1069

Instituted on:  15.09.2015

                                                                        Decided on:    17.06.2016

 

1.     Harkirat Kaur aged about 45 years wife of late Shri Jaswant Singh son of Jarnail Singh.

2.Vipneet Kaur aged about 14 years (DOB 19.07.2001) minor daughter of late Shri Jaswant Singh son of Jarnail Singh.

3.     Mehroob Kaur aged about 12 years (DOB 12.5.2003) minor daughter of late Shri Jaswant Singh son of Jarnail Singh.

4.     Gurnoor Kaur aged about 7 years (DOB 14.10.2008) minor daughter of late Shri Jaswant Singh son of Jarnail Singh, minors through their next friend and natural guardian their mother Harkirat Kaur wife of late Shri Jaswant Singh son of Jarnail Singh, all residents of village Mubarakpur, Tehsil Malerkotla, District Sangrur.  

                                                                                                                                        …. Complainants  

                                         Versus

1.     The Sangrur Central Co-operative Bank Limited, through its Branch Manager, Branch Hathan, Tehsil Malerkotla, District Sangrur.

2.     Liberty Videocon General Insurance Company Limited through its Managing Director, 10^th Floor, Tower A, Peninsula Business Park, Ganpatrao Kadam Garg, Lower Parel, Mumbai 400 013.                                                                             

 

                                                                                                                                         ….Opposite parties.

 

FOR THE COMPLAINANTS:         Shri Rohit Jain, Advocate                           

FOR OPP. PARTY No.1         :         Shri R.S.Toor,  Advocate                    

FOR OPP. PARTY No.2         :         Shri Bhushan Garg, Advocate                    

 

Quorum

         

                   Sukhpal Singh Gill, President

                   K.C.Sharma, Member

                   Sarita Garg, Member

                 

ORDER BY:     

 

Sukhpal Singh Gill, President.

 

1.             Smt. Harkirat Kaur and her children Vipneet Kaur, Mehroob Kaur and Gurnoor Kaur, 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 namely, Shri Jaswant Singh (referred to as DLA in short) was the husband of the complainant number 1 and father of the complainants number 2 to 4. The DLA was an agriculturist and  employed as a driver with Punjab Roadways Ludhiana. It is further averred that the DLA was having an account with the OP number 1, as such was insured for Rs.1,00,000/- with the OP number 3 in case of accidental death, but the Ops neither issued any separate policy nor supplied the terms and conditions. 

 

2.             Further case of the complainant is that the DLA left his house on 24.2.2014 at about 5.00 AM on his scooter to Bus Stand, Malerkotla and on the way some unknown vehicle hit from the back side of the scooter of the DLA, due to which the DLA fell down on the road and sustained head injury, as such was taken to Civil Hospital, Malerkotla, from where he was referred to Dayanand Medical College and Hospital, Ludhiana, where he remained admitted upto 9.3.2014 and lastly died on 9.3.2014 due to the head injury sustained in the said accident. It is further averred that DDR number 21 dated 28.2.2014 was registered in PS Sandour and postmortem on the dead body of the DLA was also conducted in Civil Hospital Malerkotla.  It is further averred that thereafter the complainants approached the Ops and lodged the claim with the Ops and also submitted the required documents for settlement of the claim.  The Ops lingered on the matter and lastly on 1.6.2015 repudiated the rightful claim of the complainant on flimsy grounds. Thus, alleging deficiency in service on the part of OPs, the complainant has prayed that the OPs be directed to pay to the complainant a sum of Rs.1,00,000/- as claim amount under the policy along with interest  from 24.2.2014 till realization and further claimed compensation for mental agony, harassment and litigation expenses.

 

3.             In reply filed by the OP No.1, legal objections are taken up on the grounds that the complaint is not maintainable, that the complainant has concealed the true and material facts from the Forum and that the complainant has no cause of action to file the present complaint. On merits, it is admitted that the DLA had opened a saving bank account number 756 dated 30.10.2006 under Sehkari Bank Beema Yojna. It is denied that the DLA met with an accident on 24.2.2014 and died on 9.3.2014 due to that accident.  It is admitted that the claim of the complainant was repudiated by the Ops.  However, any deficiency in service on the part of the OP number 1 has been denied.

 

4.             In reply filed by OP No.2,  legal objections are taken up on the grounds that there is no deficiency in service on the part of the OP, that the complainant did not submit the driving license of the DLA, as such the claim has been rightly repudiated, that the DLA died due to alleged accidental injuries on 9.3.2014 whereas information of the same was given to the OP on 27.5.2015 after an inordinate delay of fourteen months.  On merits, it is denied by the Op number 2 that the complainant submitted the documents in time to the OP. It is stated further that since the complainant did not submit the documents, as such the claim of the complainant has rightly been repudiated. It is further stated that in the absence of the driving license of the DLA, the claim of the complainant could not be settled, as the same was repudiated. However, any deficiency in service on the part of the OP has been denied.

 

5.             The complainant has also filed rejoinder to the reply of the complaint filed by Ops number 1 and 2, wherein the complainant has reiterated the contents of the complaint, whereas the allegations of the Ops have been denied in toto. It has been further stated that the OP never demanded the driving license of the DLA.

 

6.             The complainant has tendered documents Ex.C-1 copy of bank passbook, Ex.C-2 copy of ration card, Ex.C-3 copy of death certificate, Ex.C-4 copy of Aadhar card, Ex.C-5 copy of voter card, Ex.C-6 copy of Aadhar card of Harkirat Kaur, Ex.C-7 copy of  voter card of Harkirat Kaur, Ex.C-8 to Ex.C-10 copies of Aadhar cards of Vipneet Kaur, Mehroob Kaur and Gurnoor Kaur, Ex.C-14 copy of driving license, Ex.C-15 copy of identity card, Ex.C-16 copy of PMR, Ex.C-17 copy of DDR, Ex.C-18 copy of repudiation letter, Ex.C-19 affidavit and closed evidence. The learned counsel for OP number 1 has produced Ex.OP1/1 copy of account opening form, Ex.OP1/2 copy of account detail, Ex.OP1/3 copy of letter dated 15.5.2015, Ex.Op1/4 copy of letter dated 1.6.2015, Ex.OP1/5 affidavit and closed evidence. The learned counsel for the OP number 2 has produced Ex.OP2/1 affidavit, Ex.OP2/2 copy of letter dated 15.5.2015, Ex.Op2/3 copy of letter dated 1.6.2015, Ex.OP2/4 copy of postal receipt, Ex.OP2/5 copy of insurance policy, Ex.OP2/6 copy of terms and conditions and closed evidence.

 

7.             After hearing the arguments of learned counsel for the parties and on perusal of the documents placed on record, we find that the DLA was insured for Rs.1,00,000/- under Sehkari Bank Beema Yojna, as he was having a saving account number 756 dated 30.10.2006 with the OP number 1. The DLA died on 09.03.2014 due to an accident which took place on 24.02.2014 as a vehicle hit from the back side of the scooter of the DLA.  The complainant lodged the claim with OPs No.1 and 2 and after processing the formalities and verifying the contents thereof  the OP No.2 had repudiated the claim of the complainant vide letter dated 01.06.2015 on the ground that the complainant lodged the claim on 27.5.2015 after a long period of incident and that the complainant did not complete claim form and written evidence thereof. The learned counsel for the OP No.2 has vehemently argued that as per the terms and conditions of the policy the claimant should have submitted the claim within 15 days of the actual date of the accident.

 

8.             The OP No.1 has admitted that the complainant has approached it and had lodged the claim and the same was forwarded to OP number 2 immediately.  On carefully examining the terms and conditions of the policy contained in document Ex.OP2/6 under the head “Notification of claim”  we find  that though the intimation was to be given in 15 days but then it has also been mentioned in this document that “ however, the company may condone the delay on merits of the claim subject to getting satisfied  that the delay in notification was due to reasons beyond the control of the insured/ insured person/ nominee”. In the present complaint, the insured died suddenly due to a road accident and the complainant had submitted the claim and in such circumstances, it cannot be said that the complainant has submitted the claim with deliberate delay. Moreover, this condition does not even say that if the notice is not given within 15 days then the claim shall stand repudiated.  In support of his version learned counsel for the complainant has submitted the judgment of Hon’ble Tamilnadu  State Commission, Chennai delivered in case A.P. No.850/99 titled as  The Branch Manager, New India Assurance Company Limited Vs. Soosai, 2004(1) CLT 672, wherein it has been held that “ this condition does not say that if notice is not given within a month, the claim shall stand repudiated. On the other hand, it would only require that a notice to be given within a month after the event. It does not bar or state that failure to issue any notice within the prescribed period of one month would estop or eschew or prohibit anyone from making a claim. Even if there is such a condition, it cannot be upheld since it is unconscionable. The contract of insurance being one based upon honesty and good faith, such trivial technicalities cannot be allowed to sway the ultimate aim and goal of insurance. Therefore, we are unable to accept the contentions of the learned counsel for the  appellant and that the repudiation is justified on account of the proviso and the conditions”.

 

9.             In the present complaint, the learned counsel for the Ops has contended vehemently that the OP number 1 has demanded driving license of the DLA from the complainant, but on the perusal of the repudiation letter dated 1.6.2015 Ex.C-18 placed on record, we find that the claim has been repudiated by OP number 2 is on the ground of delay in submission of the claim intimation and time for filing claim documents. There is no mention of requirement of driving license in the document Ex.C-18. However, it is worth mentioning here that the complainant was working as a driver in the Punjab Roadways, Ludhiana and copy of his driving license on record is Ex.C-14. As such, we find that the Ops cannot repudiate the rightful claim of the complainant on the ground of driving license of the DLA.  Moreover, it is on the record that the scooter of the DLA was hit from the back side by some unknown vehicle. 

 

10.           No doubt, Ex.OP2/2 is the copy of letter dated 15.5.2015 sent by OP number 1 to the complainant regarding registration of the claim of the complainant regarding death of the DLA. But, we have perused the copy of the post mortem examination report Ex.C-16 in respect of DLA and further Ex.C-17 it he copy of DDR to show that the DLA died an accidental death. So, in the light of above, we find that if there is any delay in intimating the claim to the Ops, but on that ground the claim of the complainant cannot be thrown out, as it is evident from the document Ex.C-16 and Ex.C-17 that the DLA died an accidental death. To support such a contention reliance can be placed on the citation of the Hon’ble National Commission pronounced in National Insurance Company Limited versus Kulwant Singh IV(2014) CPJ 62 (NC), wherein it has been clearly stated that the insurance company should not have repudiated the claim merely on account of delay, particularly when there was absolutely no delay in lodging FIR with the police.          

 

11.           So, in view of the above discussion, we find that the OP No.2 is not only deficient in service but also indulged in unfair trade practice and has enforced the complainants to seek legal remedy in order to receive their rightful claim which has been supported by cogent evidence. The Hon’ble Punjab & Haryana High Court  in case tilted as New India Assurance Company Limited Vs. Smt. Usha Yadav and others 2008 (3) R.C.R. 9 ( civil) 111 has held that the insurance companies  are in the habit to take these type of projections to save themselves from paying the insurance claim. The Insurance companies are only interested in earning the premiums and find ways and means to decline claims.

 

12.           Further, the Hon’ble Supreme Court of India in Madras Port Trust Vs. Hymanshu International, (1979) 4 SCC 176 whereby, it deprecated the practice  often adopted by governmental and public authorities, of denying  just claims of citizens  on technical pleas, even though the claim lodged with them was otherwise well founded”. The relevant observations are extracted here in below:-

“ ……2. We do not think that this is a fit case where we should  proceed to determine whether the claim of the respondent was  barred by Section 110 of the Madras Port Trust Act (II of 1905) . The plea  of limitation based on this Section is one which the court always looks upon with disfavour and it is unfortunate that a public authority like the Port Trust should, in all morality and justice, take up such  a plea to defeat  a just claim of the citizen.  It is high time that governments and public authorities adopt the practice of not relying upon technical  pleas for the purpose of defeating legitimate claims of citizens and do what  is fair and just to the citizens”. Here, it is obvious that the claim of the complainant was a just claim supported by the cogent and reliable evidence  of the complainant. Moreover, IRDA’s circular dated 20.09.2011, 14.4 clearly  says that genuine claims cannot be rejected on account of delay in intimation,  and that, the insurer’s decision to reject a claim must be based on “ sound logic” and “ valid grounds”. 

 

13.           In the light above facts, we allow the complaint of the complainants and direct OP No.2 to pay them a sum of Rs.1,00,000/- being insured amount along with interest 9% per annum from the date of filing of complaint i.e. 15.09.2016 till realization. We further order the OP No.2 to pay to the complainant a sum of Rs.10,000/- on account of mental agony, harassment and also to pay a sum of Rs.5,000/- as litigation expenses.

 

14.           This order of ours shall be complied with within 30 days from the receipt of copy of the order.  Copy of the order be supplied to the parties free of charge. File be consigned to records in due course.     

Pronounced.

 

                June 17, 2016.

 

                                                (Sukhpal Singh Gill)                                                                                                                                      

                                                                President

 

                                                             (K.C.Sharma)

                                                                 Member

 

                                                             (Sarita Garg)

                                                                  Member