Punjab

Sangrur

CC/57/2019

Bhinder Kaur - Complainant(s)

Versus

United India Insurance Company Limited - Opp.Party(s)

Sh.Udit Goyal

19 Nov 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SANGRUR .

                                                                         Complaint No. 57

 Instituted on:   11.02.2019

                                                                         Decided on:     19.11.2024

   

Bhinder Kaur aged about 38 years wife of Late Sh. Manjinder Singh, resident of Village Bhalwan, Tehsil Dhuri, District Sangrur.

                                                         …. Complainant 

                                                 Versus

1.             United India Insurance Company Limited, Railway Station Road, Sangrur through its Divisional Manager.

2.             Punjab Health System Corporation, Civil Hospital Complex, Sangrur through its Senior Medical Officer.

3.             State of Punjab through Deputy Commissioner, Sangrur.

                                                        ..Opposite parties.

 

For the complainants :       Shri Udit Goyal, Adv.

For OP No.1             :       Shri Ashish Kumar Garg, Adv.

For OP No.2&3         :       Shri Vinay Kumar Jindal, Adv.

Quorum                                          

Jot Naranjan Singh Gill,                 :President

Sarita Garg,                                     :Member

Kanwaljeet Singh,                           :Member

 

ORDER

JOT NARANJAN SINGH GILL, PRESIDENT.

 

1.             Complainant  has preferred the present complaint against the opposite parties on the ground that late husband of complainant, namely, Shri Manjinder Singh was the member of Bhagat Puran Singh Sehat Bima Yojna, against which the OPs issued card bearing number 9305-3000-0420-3967-2 under which a benefit of Rs.5,00,000/- was available in case of accidental death of card holder as per the scheme of the Punjab Govt. The husband of the complainant namely Shri Manjinder Singh was the head of the family and was the only bread earner of the family and complainant was the nominee under the said insurance scheme.  Further case of complainant is that on 18.02.2018 unfortunately, Shri Manjinder Singh was returning after completing his duties at KRBL Bhadaur on his motorcycle bearing number PB-70-8049 and at about 6.30 PM when he reached near Flour Mill, Village Bhojowali, then in the meantime a stray animal suddenly came in front of the motorcycle of the deceased and he/deceased lost control over the motorcycle and struck with the electric pole, as a result of which Shri Manjinder Singh fell down on the road and sustained multiple grievous injuries on his person and he was immediately taken to Civil Hospital, Dhuri, where he was declared brought dead by the doctor.  Post mortem on the dead body of the deceased was conducted at Civil Hospital, Dhuri and DDR number 13 dated 19.02.2018 was also got recorded at P.S. Sadar Dhuri.  Further case of complainant is that the complainant being the legal heir as well as nominee of Shri Manjinder Singh lodged the claim on the toll free number 104 of the OPs and the OPs promised that they will depute the surveyor to collect the documents and for verification of the claim. Thereafter the surveyor of the OPs came at the house of the complainant and took number of documents from the complainant and got signed on blank printed performa and assured that the OPs will release the claim amount within a short span, but no claim amount was released to the complainant.  Thus, alleging deficiency in service on the part of the Ops, the complainant has prayed that the Ops be directed to pay to the complainant the claim amount of Rs.5,00,000/- along with interest and further claimed compensation of Rs.1,00,000/- on account of mental tension, agony, pain  and further an amount of Rs.22,000/- was claimed as litigation expenses.

2.             In reply filed by OP number 1,  issuance of the insurance policy is admitted. However, it is averred that neither the complainant nor the insured informed OP number 1 regarding the death of Shri Manjinder Singh in the alleged accident dated 18.02.2018. It is denied that the complainant informed the OPs on toll free number 104. It is averred further that the complainant never approached the OP and directly approached this Forum/Commission regarding claim of her husband. Therefore, the OP has prayed that the complainant be directed to produce the documents such as lodging of claim/intimation, original death certificate of deceased Manjinder Singh with Govt. logo, postmortem report of the deceased, FIR/DDR and 3 ID proofs of the deceased. It is denied further that Shri Manjinder Singh died in a road accident. Lastly, OP has prayed for dismissal of the complaint with costs.

3.             Record shows that vide orders dated 24.08.2021, defence of OPs number 2 and 3 was struck off.

4.             The learned counsel for the complainant has produced Ex.C-1 to Ex.C-5 copies of documents and affidavit and closed evidence. On the other hand, the learned counsel for OP number 1 has produced Ex.OP1/1 to Ex.OP1/2 copy of document and affidavit and closed evidence.

5.             We have gone through the pleadings put in by the parties along with their supporting documents with their valuable assistance. 

6.             At the outset, it is an admitted fact between the complainant and OP number 1 that Shri Manjinder Singh was insured with the OP number 1  for Rs.5,00,000/- in case of accidental death. It is also not in dispute that Shri Manjinder Singh died on 18.03.2018 due to an accident, as is evident from the copy of GDR number 013 dated 19.02.2018 and copy of post-mortem report Ex.C-4, wherein it has been clearly mentioned at page number 7 in the column of opinion that the cause of death in this case is due to head injury. On the other hand, the stand of the OP number 1 is that the complainant neither lodged the claim nor submitted the required documents for the settlement of the claim.   In the present case, the disputed fact is only that the complainant did not submit the requisite documents to the OP number 1 for settlement of the claim and the OP number 1 has also contended that the complaint is premature as such the same should be dismissed. It is worth mentioning here that the objection raised by the OP number 1 that the complainant did not supply the requisite documents  seems to be vague and without any basis, as a bare perusal of the file reveals that the complainant has already produced on record the copy of police report i.e. GDR dated 19.02.2018 Ex.C-3 as well as copy of post-mortem report Ex.C-4, which clearly proves/shows the accidental death of Shri Manjinder Singh. All the relevant documents have been placed on the file by the complainant and this complaint was filed on 11.02.2019. It is worth mentioning here that the OP number 1 could have easily taken the documents and settled the claim or to repudiate the same, but the OP number 1 did nothing.  Further it is worth mentioning here that as per the document Ex.Op1/1,  clause 5.3 provides that in case of accidental death, the payment towards the claim shall be made to the spouse of the deceased HoF beneficiary. Accordingly, we are of the considered opinion that the insurance amount of Rs.5,00,000/- is payable  to the complainant being the spouse of Shri Manjinder Singh insured. As such, we find that in the present case, the complainant has sufficiently proved her case by producing cogent, reliable and trustworthy evidence on record and withholding of the amount of Rs.5,00,000/- by the OP number 1 is a case of clear cut deficiency in service on the part of OP number 1.

7.             In view of our above discussion, we allow the complaint and direct OP number 1 to pay to the complainant an amount of Rs.5,00,000/- along with interest @ 7% per annum from the date of filing of the complaint i.e. 11.02.2019 till realisation in full. We further direct OP number 1 to pay to the complainant an amount of Rs.10,000/- in lieu of compensation for mental tension, agony and harassment as well as litigation expenses.

8.             This order shall be complied with by OP number 1 within a period of sixty days of receipt of copy of this order.

9.             The complaint could not be decided within the statutory time period due to heavy pendency of cases.

10.           Copy of this order be supplied to the parties free of cost. File be consigned to the records after its due compliance.      

                        Pronounced.

 

                        November 19, 2024.