DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,<br /> BATHINDA (PUNJAB)<br /> <br /> CC. No. 194 of 18-07-2008<br /> Decided on : 10-03-2009 <br /> <br /> Davinder Kaur alias Jagwinder Kaur aged about 50 years widow of Late Sh. Iqbal Singh, resident of Village Balam Garg, District Mukatsar.<br /> ... Complainant<br /> Versus<br /> <br /> 1.United India Insurance Company Limited through its Chairman-cum-Managing Director, 24 Whites Road, Chennai.<br /> 2.Divisional Manager, United India Insurance Company Limited, 2090-B, The Mall, Bathinda.<br /> 3.Ashok Kumar, Development Officer, United India Insurance Co. Ltd., 2090-B,The Mall, Bathinda.<br /> <br /> ... Opposite parties<br /> <br /> Complaint under Section 12 of the Consumer Protection<br /> Act, 1986.<br /> <br /> QUORUM <br /> <br /> Sh. Pritam Singh Dhanoa, President<br /> Dr.Phulinder Preet, Member<br /> Sh. Amarjeet Paul, Member<br /> <br /> Present : Sh. Navneet Kumar, Advocate, counsel for the complainant<br /> Sh. M.L Bansal, Advocate, counsel for the opposite parties<br /> <br /> O R D E R<br /> <br /> SH. PRITAM SINGH DHANOA, PRESIDENT<br /> 1. This complaint has been filed Smt. Davinder Kaur alias Jagwinder Kaur, widow of late Sh. Iqbal Singh, a resident of Village Balam Garg, District Mukatsar, under Section 12 of the Consumer Protection Act, 1986 (in short called the 'Act') against United India Insurance Company Limited through its Chairman-cum-Managing Director and Divisional Manager, Bathinda, for payment of Rs. 1,50,000/- under the policy secured by the insured and a sum of Rs. 40,000/- on account of compensation and Rs. 5500/- on account of costs incurred by him and any other additional or alternative relief, as deemed fit. Briefly stated the case of the complainant may be descirbed as under :<br /> 2. The deceased husband of the complainant Sh. Iqbal Singh, secured Insurance policy No. 200400/42/07/01/00000188 for the period from 24-07-07 to 23-07-2008 from opposite party No. 1 and paid premium in the sum of Rs. 404/-. The said policy was issued by opposite party No. 3, who is the agent of opposite party No. 1 and is working in the office of opposite party No. 2 under his control. At the time of purchase of policy, the husband of the complainant was accompanied by Manpreet Singh son of Sh. Gurjant Singh, a resident of village Mehma Sarja, Tehsil and District Bathinda. The insured was informed by opposite party No. 3, that he would get payment of lump sum amount in case of partial and total disablement and in case of death. He further informed him that amount may be paid under the policy in case of natural death or accidental death. On 05-08-2007, husband of the complainant suddenly felt sick and fall on the wooden leg of his cot and due to sustaining of injury on his forehead, he expired. On 06-09-2007, the complainant accompanied by Sh. Manpreet Singh, conveyed intimation about the death of insured to opposite party No. 2 vide letter dated 06-09-2007. She was informed by opposite party No. 2 that policy covers only accidental death and insured has died due to natural death. He also asked her to submit claim with copies of postmortem report and her statement about place of death where it took place, vide letter dated 06-09-2007. The complainant served legal notice through her counsel on the opposite parties on 25-10-2007, demanding copy of Insurance policy containing terms and conditions. In response to the same, the opposite parties sent carbon copy of the policy alongwith duplicate schedule. On 11-09-2007, the complainant alongwith Sh. Manpreet Singh, delivered claim letter and a letter issued by Sarpanch of Gram Panchayat regarding cause of death of her husband, but no reply has been given by the opposite parties. Thereafter, complainant served another notice dated 07-11-2007, through her counsel but it is also not responded. As such, there is deficiency in service on the part of the opposite parties because of which, complainant has been subjected to mental and physical agony and she is entitled to claim amount payable under the Insurance policy and for payment of compensation and costs incurred by her in filing the complaint.<br /> 3. The opposite parties filed written version resisting the complaint by taking preliminary objections that complainant has no locus standi to file the complaint; that the opposite parties have no obligation to pay any amount under the policy in case of natural death because it covers only death in case of accident; this Forum has no jurisdiction to entertain and try the complaint because the claim of the complainant has been repudiated on technical grounds; that complainant has not approached this Forum with clean hands as she has concealed material facts from this Forum and has filed the complaint to pressurize the opposite parties, as such, complaint is liable to be dismissed. On merits, it is admitted that Insurance policy under reference has been issued in the name of husband of the complainant viz Iqbal Singh for the period from 24-07-2007 to 23-07-2008 and he deposited a sum of Rs. 404/- on account of premium. It is further admitted that policy was issued by opposite party No. 3, but it is asserted that he is the agent of opposite party No. 1. However, it is reiterated that insured secured Personal Accident Insurance Policy which does not cover accidental death and it is submitted that complainant has neither produced postmortem report nor any other documentary evidence like police report lodged with the police showing the cause of accident to enable the opposite parties to finalise her claim. It is submitted that complainant has fabricated false version about the death of her husband and placed the same before this Forum, as such, the opposite parties are not liable to make the payment of amount claimed and to pay compensation and costs incurred by her. Rest of the averments made in the complaint have been denied and prayer has been made for dismissal of the same.<br /> 4. On being called upon, by this Forum, to do so, the learned counsel for the complainant submitted affidavit of the complainant Ex. C-1 and the affidavit of Sh. Manpreet Singh Ex. C-15 and closed her evidence after tendering documents from Ex. C-2 to Ex. C-14 and Ex. C-16. On the other hand, learned counsel for the opposite parties have tendered in evidence affidavit of Sh. Balwinder Singh, Divisional Manager, Ex. R-1 and copy of letter dated 30.10.07 Ex. R-2, before he closed their evidence.<br /> 5. We have heard, the learned counsel for the parties and perused the oral and documentary evidence, adduced on record, by the parties, carefully, with their kind assistance.<br /> 6. Admittedly Insurance policy in question has been issued by opposite party No. 3 on behalf of opposite party No. 2, in the name of the husband of the complainant who has expired on 05-08-2007. It is also admitted that insured has deposited a sum of Rs. 404/- on account of premium and Cover Note No. A 82505 was issued by opposite party No. 3 on 24-07-2007, in the capacity of authorised agent of remaining opposite parties. <br /> 7. Learned counsel for the complainant Sh. Navneet Kumar, Advocate, has submitted that it is established by the affidavit of the complainant and of an independent person tendered by her in evidence that opposite party No. 3 had explained the insured at the time of issuance of policy that it would cover 'accidental' as well as 'natural' deaths and also factum of death of the insured by fall on the wooden leg of his cot but opposite parties have not led any evidence to the contrary, as such, their action of repudiation of claim is not justified merely because the complainant has failed to produce on record copy of postmortem report, F.I.R. or any other document to establish cause of death of her husband. Learned counsel argued that complainant is entitled to seek compensation under the policy secured by her deceased husband and payment of adequate amount on account of compensation for physical and mental harassment and amount spent by her on account of costs for filing the complaint. In support of his contentions,learned counsel has placed reliance on 2005(1) CPC 533 Life Insurance Corporation of India & Others Bs. Smt. Nidhi Sahi, wherein death of insured occurred in scooter accident but claim lodged by his widow was repudiated by the Insurance company on the ground that no F.I.R has been lodged nor postmortem examination was performed on the body of the insured. It was held by our own Hon'ble State Commission that factum of death is well proved and supported by statement of witness who was pillion rider of the scooter of deceased insured at the time of accident and order passed by the District Consumer Forum was upheld and appeal filed by the insurer was dismissed. Learned counsel has also relied upon 2004(1)CPC 440 United India Insurance Company Limited Vs. Mehar Chand, wherein death of insured took place by falling from Chajja, but insurance claim was contested by the insured on the ground that his death has taken place because of illness although claim was supported by affidavit and certificate issued by Gram Panchayat regarding cause of death. It was held that it is not necessary that injury should be visible in every accident and order passed by the Consumer Forum was upheld in appeal.<br /> 8. On the other hand, Sh. M L Bansal, Advocate, learned counsel for the opposite parties has submitted that opposite party No. 3 has no personal liability because he has issued the policy under reference on behalf of remaining opposite parties as their agent. Learned counsel has further attracted our attention to the copies of letters Ex. C-8 & Ex. C-9, written by the complainant to the Branch Manager of the opposite parties wherein cause of death has not been mentioned and has argued that version projected by the complainant, has been subsequently concocted on the legal advice. Learned counsel has further argued that there is no evidence on record except self serving documents of the complainant and the witness examined by her who is close associate of her deceased husband, as such, on the basis of the same, it cannot be accepted that death has taken place in the manner projected in the complaint especially when cause of death is not found mentioned in the notice served by the complainant on the opposite parties.. Learned counsel has argued that as the complainant has failed to prove the death of her husband has taken place due to accident, as such, her claim has been rightly repudiated by the Insurance company and she is not entitled to payment of any amount on account of compensation or costs.<br /> 9. The arguments advanced by the learned counsel for the opposite parties has failed to sound well with us because the contents of affidavit of the complainant tendered in evidence Ex. C-1, are corroborated by the affidavit of Sh. Manpreet Singh, Ex. C-15. Both have claimed personal knowledge about the accident whereas the witness examined by the opposite parties has not claimed any personal knowledge about the death of the insured. The widow of the complainant is the best witness if the death has taken place at home. The mere fact that there is omission to mention the cause of accident in the notice served upon the opposite parties by the complainant after death of her husband, does not mean that she has concocted a false version solely for the purpose of getting claim on the basis of legal advice. The factum of death of the husband of the complainant by fall on the leg of his wooden cot is also corroborated by a certificate dated 10-09-2007, issued by Sarpanch of the village of the complainant and the deceased insured. The opposite parties have not alleged any connivance between the complainant and the Sarpanch of her village. There is no reason for the Sarpanch of the Gram Panchayat to issue false certificate and to invite criminal liability if death of the insured had taken place in some other manner and at some other place. The complainant is a illiterate women, as such, she might not be aware about the necessity of registration of FI.R. and importance of post mortem examination. Moreover, it is not a case of either of the party to the complaint that death of the insured has taken place due to old age or some chronic disease. In the absence of any evidence to the contrary, the complainant cannot be denied the reliefs prayed for on the basis of conjuncture and surmises alone.<br /> 10. In the light of our above discussion, we are of the opinion that the opposite parties were not justified in repudiating the claim lodged by the widow of the insured. As such, there is deficiency in service on the part of the opposite parties and they cannot escape liability incurred under the policy to make payment of compensation and costs demanded by the complainant. However, we are inclined to award interest, therefore, complainant is not entitled to payment of compensation for mental and physical pain suffered by her due to repudiation of claim by the opposite parties because simultaneously interest and compensation cannot be awarded by Consumer Forum.<br /> 11. For the aforesaid reasons, we dismiss the complaint against opposite party No. 3 and accept the same against the remaining opposite parties and direct them to pay a sum of Rs. 1,50,000/- to the complainant against the Insurance policy secured by her deceased husband, alongwith interest at the rate of 9 percent per annum from the date of repudiation of claim i.e. 06-09-2007, till the date of payment with further direction to pay her a sum of Rs. 1,000/- on account of costs, within a period of two months from the date of receipt of copy of this order. The copies of this order be sent to the parties, free of costs as per rules, on the subject.<br /> File be indexed and consigned. <br /> Pronounced :<br /> 10-03-2009 (Pritam Singh Dhanoa)<br /> President<br /> <br /> <br /> (Dr. Phulinder Preet)<br /> Member <br /> <br /> <br /> (Amarjeet Paul ) <br /> Member <br /> <br /> <br />