Complaint No: 66 of 2023.
Date of Institution: 27.03.2023.
Date of order: 06.10.2023.
1. Kamaljit Kaur aged 30 years widow of Satnam Singh son of Dharam Singh.
2. Veer Singh, minor son of Satnam Singh.
3. Surinder Singh, minor son of Satnam Singh through their mother Kamaljit Kaur as next friend and natural guardian.
4. Ranjit Kaur wife of Dharam Singh all residents of Village Nabi Nagar, Tehsil Dera Baba Nanak District Gurdaspur.
….......Complainants.
VERSUS
1. United India Insurance Co. Ltd. Divisional Office SCO No.72, Phase 9, S.A.S Nagar-Mohali, through its Divisional Manager / Authorized Signatory. Pin Code - 140055
2. United India Insurance Co. Ltd. Hanuman Chowk, Improvement Trust Shopping Complex, Police Lines, Gurdaspur, Punjab - 143521.
3. Health and Family Welfare Department, Punjab, Parivar Kalyan Bhawan, Himalaya Marg, Sector- 34-A, Sector 34, Chandigarh-160022, through its Director / Authorized Signatory.
….Respondents/Opposite parties.
Complaint U/s 35 of the Consumer Protection Act, 2019.
Present: For the Complainants: Sh.Uttam Raj Sharma, Advocate.
For the Opposite Parties No.1 & 2: Sh.A.K.Joshi, Advocate.
For the Opposite Party No.3: Sh.Rahul Vashisht, Advocate.
Quorum: Sh.Lalit Mohan Dogra, President, Sh.Bhagwan Singh Matharu, Member.
ORDER
Lalit Mohan Dogra, President.
Kamaljit Kaur etc., Complainants (here-in-after referred to as complainants) has filed this complaint under section 35 of the Consumer Protection Act, (here-in-after referred to as 'Act') against United India Insurance Co. Ltd. etc. (here-in-after referred to as 'opposite parties).
2. Briefly stated, the case of the complainant is that the complainant No.2 and 3 are minor and they cannot pursue and file the present complaint personally, hence the present complaint is being filed through their mother i.e. complainant No.1 being natural guardian who has no adverse interest against the minors. It is submitted that the Govt. of Punjab launched "Bhagat Puran Singh Beema Yojana" scheme throughout the Punjab for poor/weaker section of the society which is being controlled and managed under the Health and Family Welfare Department, Punjab. It is further submitted that the deceased Satnam Singh was doing labour work and he was also covered under the aforesaid scheme and Card bearing No. 9303 5000 0270 2890 was duly issued to Satnam Singh and as per the aforesaid Scheme Satnam Singh was insured with the OP No. 1 and 2 for a Personal Accidental Risk of Rs.5 Lakh. It is further submitted that on 12.04.2017 Satnam Singh died due to electrocution / electric while he was switching on the electric Tubewell and he was taken to PHC Kalanaur where the doctor declared him dead. It is further submitted that intimation regarding the death of the deceased Satnam Singh was duly given to the Police of PS Kotli Surat Malhi and the police of PS Kotli Surat Malhi moved written application to the Medical Officer PHC Kalanaur to ascertain the cause of death of deceased Satnam Singh and on the report of concerned medical officer, the cause of death of the Satnam Singh is given due to electric shock and subsequently DDR No. 018 Dated 18.05.2017 was lodged at Police Station Kotli Surat Malhi. It is alleged that the intimation regarding the death of deceased Satnam Singh was also given to the OP No. 1 and 2 i.e. United India Insurance Co. Ltd. and the claim has been duly lodged before the OP’s by the complainants and all the requisite formalities have been duly completed by the complainants, but the OP No. 1 and 2 always procrastinated the matter on the pretext that personal accident claim of the complainant is under process and the same been referred to the head office and as soon as the same is passed, the claim will be disbursed to the complainants accordingly. It is further alleged that afterwards the complainant No. 1 many times approached to the office of the OP No. 2 and asked about the status of the insurance claim and further requested to make the payment of insurance claim of deceased Satnam Singh but the OP’s put the matter with one pretext or the other and have not paid the same to the complainants so for. It is further alleged that act of the OP’s not making the payment of insurance claim of the deceased Satnam Singh to the complainants is illegal, null and void, against the law and instructions, against the principal of natural justice and according to law the OP’s is bound to make the payment of insurance claim of the deceased Satnam Singh to the complainants alongwith interest. It is further pleaded that due to this illegal act and conduct of the opposite parties the complainant has suffered great loss and also suffered mental agony, Physical harassment and inconvenience. It is further pleaded that there is a clear cut deficiency in services on the part of the opposite parties.
On this backdrop of facts, the complainant has alleged deficiency and negligence in services and unfair trade practice on the part of the opposite parties and prayed that necessary directions may kindly be issued to the opposite parties to make the payment of Rs.5 Lakh as insurance claim of the deceased Satnam Singh alongwith interest @ 24% per annum from the date of its due till its realization and the opposite parties may also be burdened with compensatory costs to the tune of Rs.50,000/- alongwith litigation expenses of
Rs.20,000/- to the complainants, in the interest of justice.
3. Upon notice, the opposite parties No.1 and 2 appeared through counsel and contested the complaint and filing their written reply by taking the preliminary objections that the complaint filed by the complainants against the replying opposite parties is hopelessly PRE-MATURE. It is further pleaded that complainants till the date neither lodged their claim with the OP’s insurance company, nor gave any information to the replying OP’s company regarding the alleged claim; hence, the question of rejection of the alleged claim or payment of the claim does not arise. It is further pleaded that the present claim of the complainants is liable to be dismissed on this score only. It is further pleaded that the present complaint of the complainants is time barred and liable to be dismissed on this ground only. It is further pleaded that no alleged accident ever took place, nor the deceased Satnam Singh died in the alleged accident. It is further pleaded that Neither any FIR or DDR ever registered in any concerned Police Station regarding the alleged accident, nor any Post Mortem ever conducted on the dead body of the deceased Satnam Singh and that no cause of action has arisen against the OP’s insurance company and in favour of complainants, hence the present complaint is not maintainable and is liable to be dismissed. It is pleaded that it is wrong that the intimation regarding the death of deceased Satnam Singh was given to the OP’s insurance company. It is further pleaded that it is also wrong that the claim has been lodged with the OP’s insurance company by the complainants and all the requisite formalities have been completed by the complainants. It is further pleaded that till the date, the complainants have not lodged their claim. It is further submitted that when the complainants have not lodged their claim with the OP’s No.1 and 2, then the question of payment of the claim amount does not arise.
On merits, the opposite parties No.1 and 2 have reiterated their stand as taken in legal objections and denied all the averments of the complaint and there is no deficiency in services on the part of the opposite parties. In the end, the opposite parties prayed for dismissal of complaint with costs.
4. Upon notice, the opposite party No.3 appeared through counsel and contested the complaint and filing their written reply by taking the preliminary objections that the complaint under reply is not maintainable against the opposite party No. 3 as the complainant had to take sanction first from the Corporation before initiating any legal proceeding against the opposite party No. 3 as per Section 15 of Punjab Health System Corporation Act, 1996 and the same is clear from the perusal of section 15 Punjab Health System Corporation Act, 1996 as follows:-
Section 15
- No suit or prosecution shall be entertained in any court against the corporation or against any officer or servant of the Corporation or person acting under the order or direction of the corporation for anything which is in good faith done or intended to be done under this Act or any regulation made there under.
- No suit, prosecution or other legal proceedings shall lie against any officer or servant of the corporation for any act done of purporting to be done under this Act or any regulation made there under without the previous sanction of the corporation.
That, the complainants never approached to the district grievance committee before filling the present complaint.
On merits, the opposite party No.3 have reiterated their stand as taken in legal objections and denied all the averments of the complaint and there is no deficiency in services on the part of the opposite party. In the end, the opposite party prayed for dismissal of complaint with costs.
5. Learned counsel for the complainants has filed SELF DECLARATION of Complainant Kamaljit Kaur as Ex.CW-1/A alongwith other documents as Ex.C-1 to Ex.C-9.
6. Learned counsel for the opposite parties No. 1 and 2 has tendered into evidence affidavit of Sh. Ashok Kumar Gill, (Deputy Manager, United India Insurance Company Ltd, Amritsar) as Ex.OP-1,2/A alongwith reply.
7. Learned counsel for the opposite party No. 3 has tendered into evidence affidavit of Dr. Romi Raja, (Deputy Medical Commissioner, Gurdaspur) as Ex.OP-3/A alongwith reply.
8. Rejoinder filed by the complainant.
9. Written arguments not filed by both the parties.
10. Counsel for the complainants has argued that Satnam Singh husband of complainant No.1 and father of complainants No.2 to 4 was member of "Bhagat Puran Singh Beema Yojana" Scheme and was accordingly card holder under the said scheme and insured for a personal accidental risk of Rs.5 Lakh. It is further argued that on 12.04.2017 Satnam Singh died due to electric shock and matter was reported to the police. However, on claim being lodged the opposite parties have not paid the compensation to the complainants.
11. On the other hand counsel for the opposite parties No.1 and 2 has argued that complaint is pre-mature as claim has not been lodged with the opposite parties No.1 and 2.
12. Counsel for the opposite party No.3 has argued that as per Section 15 of Pb Health system Corporation Act 1996 the present complaint is not maintainable and is liable to be dismissed.
13. We have herd the Ld. counsels for the parties and gone through the record. Perusal of file shows that complainants have not placed on record any intimation letter to prove this fact that claim was ever lodged by the complainants. Accordingly, present complaint is dispose off with the following directions:-
(i) Complainants are directed to lodge claim within 7 days
of receipt of copy of this order with the opposite parties No.1 and 2 alongwith all the documents.
(ii) Opposite parties No.1 and 2 are directed to settle the claim within 30 days after receipt of intimation of the claim from
the complainants. No order as to costs.
14. The complaint could not be decided within the stipulated period due to heavy pendency of Court Cases.
15. Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record room.
(Lalit Mohan Dogra)
President
Announced: (B.S.Matharu)
Oct. 06, 2023 Member
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