DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MANSA.
Complaint No.81/23.2.2012
Decided on : 19.09.2012
Smt.Karnail Kaur widow of Sh.Bhagwant Singh S/o Sh.Bachan Singh.
Sh.Fouja Singh )
Sh.Gurjit Singh ) Sons of Sh.Bhagwant Singh S/o Sh.Bachan Singh.
all residents of Village Khokhar Kalan, Tehsil and District Mansa.
..... Complainant.
VERSUS
United India Insurance Co. Ltd., Gaushala Road, Mansa through its Branch Manager.
The Central Cooperative Bank Limited, Branch Kotli Kalan, Tehsil and District Mansa, through its Manager.
..... Opposite Parties.
Complaint under Section 12 of the Consumer Protection Act, 1986.
Present: Sh.S.K.Singla, Advocate counsel for complainant.
Sh.P.K.Singla, Advocate counsel for Opposite Party No.1.
Sh.H.S.Sadhuwala, Advocate counsel for Opposite Party No.2.
Before: Sh.Surinder Mohan, President.
Smt.Neena Rani Gupta, Member.
ORDER:-
Surinder Mohan, President
Brief facts are that Bhagwant Singh deceased husband of Complainant No.1 opened a Saving Bank Account No. 610 with OP No.2 and deposited Rs.1200/-. OP No.1 provided insurance of Rs.1,00,000/- for the death of Account Holders accidentally/incidentally. Complainants are Contd..........2
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beneficiary of the above said policy, being Bhagwant Singh had deposited the amount with OP No.2. Bhagwant Singh was a poor, illiterate and rustic farmer. When he was working in his fields, he was suddenly bitten by a snake. He was got treated by various Vaids of the area. This facts is known to all villagers. Gram Panchayat of Village Khokher Kalan also passed a Resolution and confirmed the snake bite and death of Bhagwant Singh due to snake bite and he died incidentally and suddenly.
2. Complainants applied for taking benefit of insurance claim with OPs and submitted required documents along with an application being Bhagwant Singh died accidentally. Thereafter, OP No.2 sent the case to the Manager of OP No.1 vide letter No.910 dated 28.5.2011, but OPs instead of releasing the payment of insurance, sent letter No.2658 dated 20.9.2011 and declined the claim on the ground, that complainants have not complied with the policy conditions i.e. non availability of Postmortem report, DDR/FIR etc and late submission of claim, which is totally illegal, against law and same is not applicable to the present case. In this way, claim has been wrongly and illegally declined by OPs. Complainants are entitled to insurance amount of Rs.1,00,000/- along with interest @ 18% since the date of death i.e. 5.5.2011. When the complainants applied for claim, then OP No.1 appointed an investigator to investigate the matter and settle the claim, but investigator gave his report arbitrarily, against law and facts. Investigator did not join common villagers, Panchayat etc in his investigation and also failed to join eye witness of the case and did not try to collect the Resolution from the Panchayat. Investigator investigated the matter in a biased manner just to give 'no claim' to the complainants. OP No.1 denied the genuine claim vide letter dated 20.9.2011 under the garb of vague, baseless and false allegations and in this way there is 'deficiency in Contd..........3
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service' on the part of the OPs towards complainants. So complainants are entitled to compensation to the tune of Rs.50,000/- and Rs.10,000/- as litigation expenses .
3. In reply, OP No.1 has taken several legal objections. That complainants do not fall within the definition of Consumer Protection Act. Complainants have no cause of action and locus standi to file the present complaint. The complaint is false and vexatious to the knowledge of complainants. The complainants have violated the terms and conditions of the insurance policy. Complaint is bad for non joinder of necessary parties and mis joinder of parties. Intimation about the happening was given very late and complainants were duty bound to inform about the incident promptly and intimation is to be filed within one month from the date of happening. Complainants have not complied with policy conditions i.e. non availability of Postmortem report, DDR/FIR and late submission of claim. Under these circumstances, OP No.1 was unable to arrive at a conclusion, that death occurred due to snake bite and claim was correctly declined. The report of investigator is correct. The complaint deserves dismissal on the basis of statement of Fouja Singh. Moreover, elaborate evidence is required in this case and it cannot be decided by following summary procedure. Complainants have not taken the help of any educated and professional expert with valid license. Complainants are producing different documents as compared to original ones. Complainant No.3 is not a legal complainant as per record of the replying OP. Complainants failed to prove, that Bhagwant Singh died due to snake bite without obtaining Postmortem report, DDR/FIR, in violation of policy conditions. He died due to illness only. Earlier complainants have disclosed the material actual facts, but they are now trying to get easy claim by concealing the same. Contd..........4
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Other paras of the complaint have been denied and OP No.1 prayed for dismissal of the complaint.
4. In separate reply, OP No.2 has also taken several legal objections as have been taken by OP No.1. It is admitted that Bhagwant Singh got opened a Saving Bank Account with OP No.2. No intimation was given to answering OP by the complainants in time and there is no documentary proof regarding the snake bite. When the answering OP was informed about the alleged death of Bhagwant Singh, then answering OP sent information to the Insurance Company within time. Complainants are not entitled for any relief, as there is no deficiency in service on the part of the answering OP. Other paras of the complaint have been denied and OP No.2 also prayed for dismissal of the complaint.
5. In order to prove their case, complainants placed on file Ext. C-1 Repudiation letter dated 20.9.2011 and short affidavit of Fouja Singh Ext.C-2.
6. In order to rebut this evidence OP No.1 tendered Letter dated 20.9.2011 Ext.OP-1, reply dated 15.9.2011 to letter 29.7.2011 Ext.OP-2; repudiation letter Ext.OP-3, letter dated 29.7.2011 Ext.OP-4, Investigation report Ext.OP-5; declaration of Sh.Fouja Singh dated 11.7.2011 Ext.OP-6; declaration of residents of village Ext.OP-7; letter dated 5.7.2011 by OP No.2 to OP No.1 Ext.OP-8; claim form dated 16.6.2011 Ext.OP-9, Account statement Ext.OP-10; Ration card Ext.OP-11; Death Certificate Ext.OP-12, Account opening form Ext.OP-13; Pass Book Ext.OP-14; List of members Ext.OP-15; copy of policy Ext.OP-16 and Ext.OP-17 affidavit of Sh.P.L.Dhingra, Branch Manager.
7. OP No.2 tendered Current account ledger Ext.OP-18; voucher No.2143 Ext.OP-19; letter dated 31.05.2010 Ext.OP-20; list of members Contd..........5
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Ext.OP-21; insurance policy Ext.OP-22 and letter No.2658 dated 20.9.2011 Ext.OP-23.
8. We have heard the counsel for the parties and have gone through the file.
9. Undisputed facts are, that Bhagwant Singh opened a Saving Bank Account No. 610 with OP No.2 and he was insured under 'Sehkari Bank Bima Yojna Scheme' to the extent of Rs.1,00,000/- by OP No.1. There is no dispute, that Bhagwant Singh has died on 5.5.2011. The case of the complainants is, that Bhagwant Singh was bitten by a snake, but there is no pleadings in the complaint when Bhagwant Singh was bitten by a snake. It is also pleaded in the complaint, that the investigator failed to join the eye witnesses of this case. Complainants have not disclosed who are the eye witnesses of the incident. Now there are two alleged incidents, one incident is regarding snake bite and other is that of death. Death of a person is a fact. Complainants have not disclosed which eye witnesses they are talking. There is no affidavit of any such eye witness on the file. It is admitted, that investigator was appointed by OP No.1, who recorded statements of the witnesses. Intimation was also given to OP No.1, though late as on 31.5.2011, whereas this intimation was given to OP No.2 also very late. The claim was repudiated on the basis of letter dated 20.9.2011, which is Ext.C-1 on the file. According to Ext.OP-3 repudiation order, it was observed, that claimant has not lodged FIR, nor got postmortem of the dead person. Claimant has violated condition No.2 of the policy, hence claim filed was recommended for 'no claim'. On the basis of this order repudiation letter was issued accordingly.
10. During arguments, learned counsel for complainants has laid much stress, that Bhagwant Singh was treated by Vaids and there is no Contd..........6
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condition, that particular treatment is to be followed. It may be Ayurvedic, Allopathic, Homeopathic, Unani etc. It has also been argued that Postmortem and FIR are not mandatory and he has relied upon I(2000) CPJ 113 with the title Branch Manager, Life Insurance Corporation of India vs Raj Kumar Mishra, wherein Hon'ble UP State Commission, Lucknow was pleased to observe, that “deceased died due to sari being caught in wheel of motorcycle. head injury sustained. Death merely by accident. Non-furnishing of FIR and postmortem report would not mean that no accident took place. Event covered by the word 'accident'. Repudiation baseless. OP liable to make payment along with interest.”
11. He has also also relied upon I (2000) CPJ 548 with the title Divisional Manager, L.I.C of India versus Y.Ratnamma, wherein Hon'ble AP State Commission was pleased to observe, that “complainant's husband fell from palm tree and succumbed to injuries. Accident benefit denied as no FIR was lodged nor postmortem was conducted. It was observed that FIR or postmortem report was not mandatory.”
12. The proposition of law laid down in the above said authority is not disputed. It was for the complainants to prove and satisfy the conscious of this Forum, that Bhagwant Singh died due to snake bite. As per pleadings, Bhagwant Singh was working in the field and the investigator did not join eye witnesses, but there is absolutely no evidence, that Bhagwant Singh was working in the field or there was any eye witness to the event of snake bite. In case there was any such eye witness, the complainants should have attached affidavit of those eye witnesses and to give opportunity to OPs to cross examine those witnesses to elicit truth.
13. Similarly, in case Bhagwant Singh was treated by some Vaids, Contd..........7
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but there is no such affidavit on the file of any Vaid. Whether such Vaid was a qualified person or a quack. Again complainants did not give any opportunity to OPs to cross examine such alleged Vaid. Not only this, complainants even did not file their own detailed affidavits. Ext.C-2 is a short affidavit of Fauja Singh and it is “no evidence” in the eyes of law.
14. Sh.Satish Kumar, Investigator visited the village and recorded some statements. Fouja Singh suffered a statement on 11.7.2011 at the time of investigation, wherein Fauja Singh deposed, that his father was suffering from back pain and after that he was suffering from TB and he was given Ayurvedic and Allopathic treatment. Afterwards his father was confined to bed for a month and his leg got gangrene. He was subjected to Ayurvedic treatment, but no Allopathic treatment. That his father died on 5.5.2011 after being confined to bed for one month. That they did not got conduct postmortem or lodged FIR. He has a suspicion, that his father died due to some poisonous substance. He has no concrete proof for that nor for any treatment.
15. Some villagers, namely, Jaad Singh, Shambhu Singh, Sikander Singh and Gurdev Kaur of the village also suffered statement before the investigator, that Bhagwant Singh died on 5.5.2011 and he was confined to bed for the last one month. That his LRs did not got conduct postmortem nor lodged any police report. That his LRs have no knowledge regarding any postmortem or police report.
16. This entire evidence shows, that even the villagers were not aware, that Bhagwant Singh died due to any snake bite nor Fauja Singh. However, at the time of lodging claim on 16.6.2011, which is Ext.OP-9 on the file, it is mentioned, that the incident happened on 5.5.2011. The information was received on 24.6.2011 from Fouja Singh. This claim form Contd..........8
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was signed by Fouja Singh on 16.6.2011, but it is strange how date 24.6.2011 in Column No.5 has been mentioned on the first page of the claim form. This evidence on the file has created a lot of confusion regarding date of alleged snake bite, treatment by Vaids and non mentioning of snake bite by Fouja Singh in his statement dated 11.7.2011, as well as that of other residents of village.
17 Therefore, this complaint cannot be decided in summary manner, as it requires elaborate evidence and cross examination of witnesses regarding death of Bhagwant Singh. Therefore, the complainants may knock the doors of competent court for their redressal. The complaint stands disposed of. Parties are left to bear their own costs.
18. Let certified copies of order be communicated to the parties free of cost by registered post and file be consigned to the record room.
Announced:
19.09.2012
Neena Rani Gupta, Surinder Mohan,
Member. President.
