BEFORE THE PRESIDENT DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BHIWANI.
Complaint No. 339 of 2015
Date of Instt.: 23.12.2015
Date of Decision: 9.4.2021
- Sunita Devi wife of Vijay Kumar resident of village Hansawas Kalan, Tehsil Badhra, District Charkhi Dadri.
- Ankita minor daughter of Vijay Kumar resident of village Hansawas Kalan, Tehsil Badhra, District Charkhi Dadri through her mother and natural guardian Sunita Devi wife of Vijay Kumar resident of village Hansawas Kalan, Tehsil Badhra, Charkhi Dadri.
……..Complainants
Versus
- United India Insurance Company, SCO No. 72, Phase-9, 2nd Floor, SAS Nagar, Mohali having its branch office at Circumlar Road, Bhiwani, through its Branch Manager.
- The Bhiwani Central Cooperative Bank Ltd, Bhiwani through its Branch Manager.
- Dhansari Cooperative Society Limited, Dhanasari, P.O. Chandawas, Tehsil Badhra, District Charkhi Dadri.
-
Complaint under the Consumer Protection
Act.
Before: Mr. Nagender Singh, President.
Mr. Shriniwas Khundia, Member.
Present: Sh. Amit Viijayrania, Adv. for complainant.
Sh. R.K. Sharma, Adv. for the OP No.1.
OP Nos. 2 & 3 already exparte.
ORDER:-
NAGENDER SINGH, PRESIDENT
Brief facts of the present complaint are that the husband of complainant No.1 namely Vijay Kumar was issued a Kisan Credit Card bearing No. HNK/496 for a sum of Rs. 19,346/- by the respondent No. 3. At the time of issuance of said Kishan Credit Card to the husband of complainant, the respondent No. 1 also sanctioned a plan for accidental claim insurance policy for a sum of Rs. 50,000/-and deducted Rs. 2/-from the account of agriculturist for the said insurance purpose. It is averred that on 15.11.2012, the husband of complainant No. 1 (Vijay Kumar) died in a road side accident and a case FIR No. 222 dated 16.11.2012 u/s 279/304 A IPC was got registered in P.S. Badhra and the postmortem was also got conducted in G.H. Hisar vide PMR No. VKD/13/12 dated 16.11.2012. After the death of Vijay Kumar, the complainant submitted all the documents with the respondent No. 3 within a period of 10 days regarding death claim. The respondent No. 3 forwarded the same to the respondent No. 2 and the respondent No. 2 forwarded the same to the respondent No.1. But it is averred that despite submission of claim form, requests and visits, the respondents did not pay any heed and when the complainant served a legal notice, the respondent No. 2 vide letter/reply dated 25.8.2015 replied that the claim of complainant has been repudiated as the claim was received in their office after 116 days of occurrence. It is further pleaded that the said repudiation letter of respondent No. 1 is wrong, illegal, null and void and not binding on the rights of complainant. It is averred by the complainant that there is deficiency in service on the part of the respondents. Accordingly, the complainant seeks directions against the respondents to pay policy amount of Rs. 50,000/-along with compensation and the litigation expenses besides any other relief which this Forum (now Commission) finds to be just and proper.
2. Upon notice, the respondent No. 1 appeared and filed its written statement. The respondent Nos. 2 & 3 appeared before the Forum (now Commission) on dated 29.2.2016 and filed their written version. Thereafter, the respondent Nos. 2 & 3 were proceeded against exparte vide order dated 8.2.2019 due to their non-appearance.
The respondent No. 1 in its written statement averred that the claim intimation in respect of death of Vijay Singh i.e. Kishan Credit Card Holder was received by the respondent company office after 116 days of the occurrence of the accident, whereas as per MOU page “13” at point 11.1, the nominee of the insured person/injured card holder is required to give notice in writing to the branch office of the insured bank within 45 days of the occurrence of accident and thus the respondent No. 2 bank was responsible to intimate to the answering respondent within 90 days of such occurrence. Hence, the respondent Nos. 2 & 3 have violated the MOU signed by the respondent No. 2 bank with the answering respondent. Therefore, the claim lodged under policy No. 112100/47/12/43/00000107 of Vijay son of Inder Singh KCC-80 was repudiated by the insurance respondent company after passing speaking order and the intimation of repudiation of claim was duly given to the respondent No. 2 vide memo No. DOM/claim 2014/3156 dated 7.2.2014. Hence, it is averred that there is no deficiency in service on the part of the respondent company and accordingly, the respondent No. 1 prays for dismissal of complaint with costs being not maintainable in the present form.
3. The complainant has tendered into evidence affidavit and documents annexure CW-1/A and documents Annexure C-1 to annexure C-10.
On the other hand, the respondent No.1 tendered into evidence documents Annexure R-1 to Annexure R-25.
4. We have heard the arguments of learned counsel of complainant and the learned counsel of respondent No. 1 and gone through the entire evidence so placed on record by the parties very carefully and minutely and also perused the written version/reply filed by the respondent Nos. 2 & 3 on dated 29.2.2016.
During the course of arguments, the complainant reiterated the contents of his complaint and the learned counsel of respondent No.1 reiterated the contents of reply filed by the respondent No.1 and drawn the attention of this Forum/Commission towards the documents so placed on record by both the parties.
5. We have perused the documents placed on file very carefully and minutely. After hearing arguments and going through the entire case file and perusing the documents so placed on record very carefully and minutely, we have observed that in the present complaint, the claim of the complainant has been repudiated by the opposite party No.1 vide its letter Annexure C-7 on the ground that claim intimation has been received in the office after 116 days of occurrence of the accident which is a violation of MOU. As per MOU page “13” at point no.11.1 the nominee of the insured person/injured card holder is required to give notice in writing to the branch office of the insured bank within 45 days of the occurrence of accident and it is the responsibility of the bank to ensure that all incidents likely to give rise to claim are intimated to the insurer within 90 days of such occurrence, failing which insurer shall be under no liability for such incident.
6. Documents perused. As per Ex.C5, a letter has been written by the Manager, The Dhanasari CCSS Ltd. Bhiwani to the Regional Manager, UIIC, Mohali submitting therein that the claim papers have been sent by the bank on dated 11.02.2013 to their office. As per letter Annexure R6 dated 01.02.2013, written by Prabhandhak, The Dhanasari CCSS Ltd. Dhanasari(Bhiwani) to the Chief Executive Officer, The Bhiwani Central Cooperative Bank Ltd., Bhiwani, the required and requisite documents have been sent to the Bank for processing the claim of the complainant and all the required documents have been annexed with the application. In fact, the insured had died on 15.11.2012 and as per letter Annexure C5 and Annexure R6, all the required and relevant documents have been deposited with the insurance company as well as in the Central Cooperative Bank Ltd., Bhiwani on dated 01.02.2013 and they also informed vide Endst.No.P&D/BWN/2012-13/24267 dated 11.02.2013. Meaning thereby, all the required documents have been submitted with the Regional Manager, United India Insurance Company, SCO 72, Phase-9(2nd floor), SAS Nagar, Mohali within the prescribed period of 90 days of occurrence. Hence the repudiation of claim by the opposite party No.1 is illegal and amounts to deficiency in service. At the time of arguments, the other objection taken by the opposite party is that there is one another L.R of the deceased i.e. mother of the deceased namely Savitri who is alive. This fact has been admitted by Smt. Sunita Devi in her statement Annexure R-20 that her mother in law Smt. Savitri, aged 60 years is still alive.
7. In view of the facts and circumstances of the case, we hereby allow the complaint and direct the opposite party No.1 to pay the claim amount of Rs.50000/-(Rupees fifty thousand only) alongwith interest @ 9% p.a. from the date of filing the present complaint till its realization and also to pay Rs.10000/-(Rupees ten thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses in the loan account of the deceased Vijay Kumar lying with the opposite party No.3 for settlement of loan amount. The respondent Nos. 2 & 3 are further directed that after settlement of the loan amount, the remaining amount be paid to the three legal heirs of deceased, namely Sunita Devi wife of deceased Vijay Kumar, Ankita minor daughter of Vijay Kumar and Savitri mother of Vijay Kumar in equal shares. However, share of Ankita minor be deposited in any nationalized bank till the date of majority and will be disbursed to her on attaining the date of majority. Order shall be complied within one month from the date of decision.
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 Commission
Dated: - 9.4.2021
(Shriniwas Khundia) (Nagender Singh)
Member President,
District Consumer Disputes
Redressal Commission, Bhiwani.
