DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.
Complaint No. 672
Instituted on: 22.11.2016
Decided on: 19.04.2017
Tara Singh aged about 60 years son of Gujjar Singh, resident of Village Hathan, Tehsil Malerkotla, District Sangrur.
…Complainant
Versus
1. The Sangrur Central Cooperative Bank Limited, Branch Office: Patiala Gate, Sangrur through its District Manager.
2. The Sangrur Central Cooperative Bank Limited, Branch Office: Hathan, District Sangrur through its Branch Manager.
3. IFFCO TOKIO General Insurance Company Limited, Branch Office: Kaula Park, Sangrur through its Managing Director.
4. The Hathan Cooperative Agricultures Service Society Limited, Hathan, Tehsil Malerkotla, District Sangrur through its Branch Manager.
…Opposite parties
For the complainant : Shri Azadwinder Ashta, Advocate.
For OP Number 1&2 : Shri Pawan Gupta, Advocate.
For OP Number 3 : Shri Darshan Gupta, Advocate.
For OP Number 4 : Shri Sonam Mohinder, Advocate.
Quorum: Sukhpal Singh Gill, President
Sarita Garg, Member
Vinod Kumar Gulati, Member
Order by : Sukhpal Singh Gill, President.
1. Shri Tara Singh complainant (referred to as complainant in short) has preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that he was the member of the society i.e. OP number 4 under card number 225 and as such was insured for Rs.50,000/- with the OP number 3 under Cooperative Bank Personal Accident Group Insurance Scheme.
2. The grievance of the complainant is that on 19.12.2014 he suffered injuries on his person when the complainant was in his field on hired tractor and suffered disability of 90% as per the certificate issued by Civil Surgeon Sangrur. Further it is stated that the OP number 4 has regularly deducted an amount of Rs.5/- from the account of the complainant under the policy. Thereafter the complainant lodged the claim with the Ops number 1 to 3, but the Ops passed the insurance claim to the tune of Rs.25,000/- only against the claimed amount of Rs.50,000/-, which is said to be deficiency in service on the part of the Ops. Further case of the complainant is that though he approached the Ops for payment of the remaining amount, but nothing happened despite serving of legal notice dated 6.9.2016 upon OP number 3. Thus, alleging deficiency in service on the part of the Ops, the complainant has prayed that the OPs be directed to pay to the complainant an amount of Rs.25,000/- along with interest @ 18% per annum from the date of accident till realisation and further claimed compensation and litigation expenses.
3. In reply filed by OP number 1 and 2, legal objections are taken up on the grounds that the complaint is not maintainable, that the complainant has no locus standi to file the present complaint and jurisdiction of this Forum has also been disputed. On merits, it is admitted that the complainant is insured under the policy for Rs.50,000/- from OP number 3. It is also admitted that the OP number 3 released the claim amount of Rs.25,000/- to the complainant and the same has been credited in his account in September, 2016. The other allegations levelled in the complaint have been denied.
4. In reply filed by OP number 3, preliminary objections have been taken up on the grounds that the complainant has no cause of action to file the complaint, that the present complaint has complicated questions of law and facts and that this Forum has no jurisdiction. On merits, it is admitted that on the request of the OP number 1, the OP number 3 issued a Janta Personal Accident Policy in favour of the OP number 1 for the period from 29.9.2014 to 28.09.2015 as per the list supplied and the sum insured under the policy was Rs.50000/- only in case of permanent total disablement. It is stated further that the OP number 3 has legally and rightly assessed its liability to the extent of 50% and paid the sum of Rs.25,000/- to the complainant. However, it has been denied that the complainant is entitled to get the amount of Rs.50,000/-. Lastly, any deficiency in service on the part of the OP has been denied.
5. In reply filed by OP number 4, it has been admitted that the complainant is a member of the society. It is admitted that the OP number 3 has paid an amount of Rs.25,000/- to the complainant on the basis of 50% disability.
6. The learned counsel for the complainant has produced Ex.C-1 to Ex.C-10 copies of the documents and affidavits and closed evidence. On the other hand, the learned counsel for OP number 1 and 2 has produced Ex.OP1&2/1 affidavit and closed evidence. The learned counsel for OP number 3 has produced Ex.OP3/1 to Ex.OP3/5 copies of the documents and closed evidence. The learned counsel for OP number 4 has produced Ex.Op4/1 to Ex.OP4/4 documents and affidavits and closed evidence.
7. We have carefully perused the complaint, version of the opposite parties and heard the arguments of the learned counsel for the parties. In our opinion, the complaint merits acceptance, for these reasons.
8. It is an admitted case of the parties that the complainant was having a card number 225 issued by OP number 4 and was further insured with the OP number 3 for Rs.50,000/- as per the policy as admitted by the OP number 3. It is also not in dispute that the complainant suffered injuries on 19.12.2014 and the claim was lodged with the Ops and the Ops settled the claim at Rs.25,000/- only , whreas the policy was for Rs.50,000/-. Now, the complainant has claimed an amount of Rs25,000/- from the OP number 3 on the ground that the same has been wrongly deducted without assigning any proper reason, whereas the complainant suffered 90% disablement, as is evident from the copy of the disability certificate issued by the Civil Surgeon Sangrur on 9.4.2016, wherein it has been further written that the complainant suffered 90% disability which is not likely to improve. The OP number 3 has paid only an amount of Rs.25,000/- being 50% of the insured amount. Since the complainant has suffered 90% disablement, there is nothing on record to support the contention that why the OP number 3 settled the claim at 50%, whereas the complainant has suffered permanent disablement to the tune of 90%. There is nothing on record to show that how the OP number 3 came to the conclusion that the complainant is entitled to get only 50% of the insured amount, more so when he suffered disablement to the tune of 90%. Under the circumstances, we feel that ends of justice would be met if the OP number 3 is directed to pay to the complainant the remaining amount of Rs.25,000/- as he has suffered 90% disablement.
9. 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. The above said view was taken by the Hon’ble Justice Ranjit Singh of Punjab and Haryana High Court in case titled as New India Assurance Company Limited versus Smt. Usha Yadav and others 2008(3) R.C.R. 9 Civil) 111.
10. In view of our above discussion, we allow the complaint and direct OP number 3 to pay to the complainant an amount of Rs.25,000/- along with interest @ 9% per annum from the date of filing of the present complaint i.e. 22.11.2016 till realisation. Op number 3 shall also pay to the complainant an amount of Rs.5000/- in lieu of compensation and litigation expenses.
11. 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.
April 19, 2017.
(Sukhpal Singh Gill)
President
(Sarita Garg)
Member
(Vinod Kumar Gulati)
Member
