Punjab

Faridkot

RBT/CC/24/8

Bharawa Bai - Complainant(s)

Versus

United India Insurance co Ltd - Opp.Party(s)

M.S Chahal

18 Sep 2024

ORDER

  DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, FARIDKOT

 

Complaint No. :       305 of 2021

R.B.T. No. :              08 of 2024

Date of Institution:    23.07.2021

Date of Decision :     18.09.2024

 

Bharawa Bai, aged about 56 years, wife of Mukhtiar Singh, resident of Village Bhamba Wattu Hithar, Tehsil Jalalabad, District Fazilka.

 

                                                                           .........Complainant

Versus

1. Branch Manager, United India Insurance Company Limited Branch, Mall Road, Ferozepur.
2. The Divisional Manager, United India Insurance Company Limited, SCO No. 72, Second Floor, Phase – 9, Mohali.
3. The Manager, Reliance General Insurance Company Ltd. SCO-57-58-59, 4^th Floor, Sector 17-A, Chandigarh-160017.

                                                                          .............OPs

Complaint under Section 12 of the

Consumer Protection Act, 1986.

(Now, under Section 35 of the Consumer Protection Act, 2019)

 

 

Quorum: Sh Rakesh Kumar Singla, President,

               Smt Param Pal Kaur, Member.

 

Present:  Sh Manjinder Singh Chahal, Ld Counsel for Complainant,

               Sh Ashwani Sharma, Ld Counsel for OPs.

 

* * * * * * * *

(Rakesh Kumar Singla, President)

ORDER

 

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                                             Complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against  OPs seeking directions to OPs to make payment of insurance claim of Rs.5 lacs on account of death of her husband and for further directing OPs to pay Rs.50,000/-as compensation for harassment and mental agony suffered by her besides litigation expenses of Rs.11,000/-.

2                                     Briefly stated, the case of the complainant is that Mukhtiar Singh husband of complainant was insured with OPs under Bhagat Puran Singh Health Insurance Scheme. He was issued card no.0364 8000 0540 3500, 5 and as per insurance policy in the event of death of head of family, family is entitled for sum of Rs. 5 lacs. It is further submitted that during the subsistence of policy in question, husband of complainant died in an incident on 07.04.2016 in respect of which, FIR No.51 dated 07.04.2016 was got registered in Police Station , Sadar Fazilka and his post mortem was conducted at Civil Hospital, Fazilka on 07.04.2016. Thereafter, complainant contacted OPs and also furnished all documents required for processing the death claim to the OPs, but they did not pay even a single penny on account of insurance claim for the death of her husband. Complainant made several requests to OPs to make payment of genuine insurance claim, but all in vain, which amounts to deficiency in service. They have caused unnecessary harassment to her by not paying the genuine  claim on account of death of her husband and this act of OPs amounts to trade mal practice and

 

 

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deficiency in service and it has caused harassment and mental agony to complainant for which she has prayed for directions to OP to pay Rs.50,000/-as compensation alongwith Rs.10,000/-as cost of litigation besides the main relief. Hence, the present complaint.

3                                       The counsel for complainant was heard with regard to admission of the complaint and vide order dated 03.08.2021, complaint was admitted and notice was ordered to be issued to the opposite parties.

4                                            On receipt of the notice, OP-1 and 2 filed written statement taking preliminary objections that complaint filed by complainant is false and frivolous and complainant has not come to the Commission with clean hands and has concealed the material facts from this Commission. It is further averred that complicated questions of law and facts are involved in present matter and this matter is required to be relegated to the Civil Court. On merits, also OP-1 and 2 have denied all the allegations of the complainant being wrong and incorrect and asserted that when Bhagat Puran Singh Sehat Bima Yojna was formulated by Punjab Government for the period from 01.01.2016 to 31.10.2016, at that time Reliance General Insurance Company was the insurer for personal accident coverage of blue card holders. Answering OPs cover the blue card holders from the period 01.11.2016 onwards and as death of husband of complainant occurred on 07.04.2016 due to accident, therefore, deceased does not come under the purview of policy of United India Insurance Company/OP-1 and 2. Moreover, death of

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husband of complainant occurred on 07.04.2016, but complainant has filed the present complaint on 03.08.2021 that is after about three years and 4 months which is much beyond the period of limitation. Thus, complaint is time barred and is liable to be dismissed on this ground also. It is further averred that no application for condonation of delay is filed by complainant. All the other allegations levelled by complainant are denied being wrong and incurred and prayer for dismissal of complaint with costs is made.

5                                       OP-3 also filed written statement through counsel wherein denied all the allegations of the complainant being wrong and incorrect and asserted that complainant has filed a wrong complaint against answering OP. Complainant has concealed the material facts from this Commission. No cause of action arises against answering OP. Moreover, death of husband of complainant occurred on 07.04.2016, but complainant has filed the present complaint on 03.08.2021 that is after about three years and 4 months of period of limitation. Thus, complaint time barred and is liable to be dismissed on this ground also. It is further averred that there is breach of trust on the part of complainant as at the time of accident, deceased insured Mukhtiar Singh was not having effect and valid driving license. As deceased violated the terms and conditions of the policy in question, therefore, his claim was rightly repudiated on the ground that at the time of said accident, he was not having valid and effective driving license. Further averred that complainant has no locus standi to file the present

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complaint. Complicated questions of law and facts are involved in present complaint that require voluminous evidence, which is not possible in the summary procedure of Consumer Protection Act. All the other allegations and the allegation with regard to relief sought too are denied being wrong and incorrect and it is reiterated that there is no deficiency in service on their part and made prayer for dismissal of complaint with costs.

6                                             Parties were given proper opportunities to prove their respective case. Ld Counsel for complainant tendered in evidence affidavit of complainant as Ex.C-1 and documents Ex C-2 to Ex C-8 and then, closed the evidence.

7                                     In order to rebut the evidence of the complainant, Ld Counsel for OP-2 tendered in evidence affidavit of Bhushan Kumar Goyal Ex OP-1,2/1 and then, closed the same on behalf of OP-1 and 2. Ld Counsel for OP-3 tendered in evidence affidavit of Suryadeep Singh Thakur Ex OP-3/1/A, documents Ex OP-3/1 to 7 and then, closed the same on behalf of OP-3.

8                                                        We have heard the learned counsel for the parties and have very carefully gone through the affidavits and documents on the file.

9                                              From the careful perusal of evidence on record, documents and pleadings put forward by complainant as well as OP-1 to OP-3, it is observed that case of the complainant is that

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Mukhtiar Singh husband of complainant was insured with OPs against policy in question. Said Mukhtiar Singh died in a vehicular accident on 07.04.2016 and after his death, complainant lodged claim with OPs, but despite repeated requests, OPs did not make a single penny on account of death of insured Mukhtiar Singh. On the other hand, plea taken by OP-1 and 2 is that United India Insurance Company was not insurer at the time of death of insured husband of complainant, rather Reliance General Insurance Company was the insurer at that time. Second plea taken by OP-1 and 2 is that complainant has filed the present complaint after long delay of more than three and half years and prayed for dismissal of complaint with costs. Now, Reliance General Insurance Company/OP-3 has sternly denied all the allegations of the complainant being wrong and incorrect and asserted that death of insured Mukhtiar Singh occurred on 07.04.2016, whereas complainant has filed the present complaint after a long span of more than five years and it is time barred. Another plea taken by OP-3 is that at the time of said accident, deceased Mukhtiar Singh was not having valid and effective driving license which was necessary as per terms and conditions of the policy. Deceased himself violated the terms and conditions of policy and breached the trust of Insurance Company. OP-3 has also prayed for dismissal of complaint with costs.

 10                                         From the careful perusal of complaint filed by complainant, it is also transpired that complainant has not specified the period of insurance and ld counsel for complainant has also not

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produced any documentary evidence to prove the fact that death of husband of complainant occurred during the subsistence period of insurance policy in question. Nowhere in the entire complaint and during the proceedings of whole case, neither complainant nor his counsel uttered a single word about subsistence period or the period during which husband of complainant was insured with them.  Thorough scrutiny of entire evidence and documents placed on record, also does not help in bringing on record the validity of insurance period. Counsel for complainant has nothing to contradict this point.

11                                From the above discussion and keeping in view the documents placed on record, it is noticed that there is no doubt regarding the fact that deceased Mukhtiar Singh was insured with OP-3, but it is also brought on record that death of Mukhtiar Singh husband of complainant occurred on 07.04.2016, but his wife has filed the present complaint on 23.07.2021 after about 5 years of his death and it is time barred as it is filed much beyond the limitation period of two years. Moreover, ld counsel for complainant has nothing to place on record to contradict the allegations of OP-3 that at the time of death of husband of complainant on 07.04.2016, he was not having valid and effective driving license, which is a violation of terms and conditions of the policy in question. As complainant has failed to prove her case, therefore, complaint in hand is hereby dismissed.          

12                               However, in peculiar circumstances of the case, there are no orders as to costs.

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13                                  Complaint could not be decided within stipulated period due to heavy pendency of work and incomplete quorum.

 

14                                    Copy of the order be supplied to parties free of cost as per law. File be consigned to the record room.

Announced in Commission

Dated: 18.09.2024      

                                       (Param Pal Kaur)         (Rakesh Kumar Singla)             

                                      Member                          President