Punjab

Sangrur

CC/317/2019

Biro Devi - Complainant(s)

Versus

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

Sh.Sandip Kumar Goyal

09 Oct 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SANGRUR .

 

                                                                        Complaint No. 317

 Instituted on:   11.07.2019

                                                                         Decided on:     09.10.2024

 

1.      Jaswinder Singh son of Ambu Ram @ Amar Ram @ Amar Chand.

2.      Veena Daughter of Ambu Ram @ Amar Ram @ Amar Chand, both residents of Ram Nagar Basti, Opposite Railway Station, Sangrur.

                                                         …. Complainants 

                                                 Versus

1.             United India Insurance Company Limited, Railway Chownk, Sangrur through its Branch Manager.

2.             State of Punjab through Deputy Commissioner, Sangrur.

3.             Punjab Health Systems Corporation, SIHFW Complex, Phase-6, Mohali through its Managing Director.

 

                                                        ..Opposite parties.

 

For the complainants   :       Shri S.K.Goyal, Adv.

For OP No.1                 :       Shri G.S.Sibia, 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.             Earlier this complaint was filed by Smt. Biro Devi wife of Late Ambu Ram @ Amar Ram @ Amar Chand. Later on during the Pendency of the present proceedings, Smt. Biro Devi died on 13.07.2022 and after that Shri Jaswinder Singh son of Ambu Ram and Smt. Veena Daughter of Ambu Ram were impleaded as complainants being the only legal heirs of Ambu Ram @ Amar Ram @ Amar Chand S/o Lalu Ram @ Lal Chand (here in after referred as Ambu Ram).

2.             Further case of complainant is that Late Ambu Ram was the member of Bhagat Puran Singh Sehat Bima Yojna, against which the OPs issued smart card bearing number 930530002084800273 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.  Further case of complainant is that Ambu Ram unfortunately met with an accident on 09.11.2018 and died on 14.11.2018 due to accident at police station Goraya, District Jalandhar  when he was going to village Jamalpur. Further case of complainant is that the complainant being the legal heir as well as nominee lodged the claim on the toll free number 104 of the OPs. Further case of complainant is that the employee of the OP i.e. United India Insurance Company visited the house of the complainant and supplied the claim form to the complainant and after claim form was filled and supplied the copies of various documents such as police report, copy of aadhar card, copy of death certificate and copy of post-mortem report copy of Smart Card etc. Though the complainant got served the legal notice dated 28.05.2019 upon the OPs for release of the claim amount of Rs.5,00,000/- but nothing was paid till filing of the complaint.  Thus, alleging deficiency in service on the part of the OPs, the complainants have prayed that the Ops be directed to pay to the complainants the claim amount of Rs.5,00,000/- along with interest and further claimed compensation of Rs.10,000/- on account of mental tension, agony, pain  and further an amount of Rs.10,000/- was claimed as litigation expenses.

3.             In reply filed by OP number 1,  preliminary objections are taken up on the grounds that the complaint is not maintainable, that the complainant has filed the present complaint by concealing the true and material facts from this Commission, that the complainant has unnecessarily dragged the Opposite Party into uncalled litigation, that the complainant has no locus standi and cause of action to file the present complaint and that the complainant has not come to this Court with clean hands. On merits, it is admitted that the complainant lodged the claim with the OP No.1 and the OP No.1 demanded several documents from the complainant and in this regard OP sent letters to the complainant, but despite the receipt of said letters, the complainant failed to submit the death certificate in original with Government Logo and legal heir certificate from Tehsildar as per the notification of Govt. of Punjab. It is further averred that due to non supply of the same, the OP is unable to settle the claim of the complainant. As such, the present complaint is premature and is not maintainable. Lastly, prayed for dismissal of the complaint with costs.

4.             Record shows that vide order dated 07.12.2021, defence of OPs number 2 and 3 was struck off.

5.             The learned counsel for the complainant has produced Ex.C-1 to Ex.C-14 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.OP1/3 copies of documents and affidavit and closed evidence.

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

7.             At the outset, it is an admitted fact between the complainants and OP number 1 that Late Ambu Ram @ Amar Ram @ Amar Chand was insured with the OP number 1  for Rs.5,00,000/- in case of accidental death. It is also not in dispute that Late Ambu Ram @ Amar Ram @ Amar Chand died on 14.11.2018 due to an accident, as is evident from the copy of General Diary No.023 dated 14.11.2018 Police Station Goraya, District Jalandhar Rural Ex.C-6 and Ex.C-4 is the copy of post-mortem report, wherein it has been clearly mentioned at page number 4 in the column of opinion that the cause of death in this case is shock and haemorrhage, resulted due to head injury happened due to road accident. All the injuries are antemortem in nature. Ex.C-2 is the copy of legal notice and Ex.C-3 is the copy of postal receipts. Ex.C-5 is the copy of card of Bhagat Puran Singh Sehat Bima Yojna of Ambu Ram S/o Lalu Ram. Ex.C-7 is the death certificate of Amar Chand son of Lal Chand. Ex.C-8 is the affidavit of Sajjan Ram son of Sahu Ram Municipal Councillor of Ramnagar Basti, Sangrur, wherein he has clearly mentioned that deceased Ambu Ram @ Amar Ram @ Amar Chand son of Lalu Ram @ Lal Chand was the one and same person who died on 14.11.2018 in accident at Police Station Goraya, District Jalandhar Rural. Similarly, Ex.C-9 is the affidavit of Lachaman Dass son of Sher Singh R/o Ram Nagar Basti, Sangrur mentioning same facts that Deceased Ambu Ram @ Amar Ram @ Amar Chand son of Lalu Ram @ Lal Chand was the one and same person who died on 14.11.2018 in accident at police station Goraya, Distt. Jalandhar rural. Ex.C-12 is the copy of death certificate of Biro Devi showing the date of death 13.7.2022. Ex.C-13 and Ex.C-14 are the identity proof of Jaswinder Singh son of Ambu Ram and of Veena Daughter of Ambu Ram, resident of Ram Nagar Basti, Sangrur. On the other hand, the stand of the OP number 1 is that the complainant did not submit the death certificate in original with Government logo and legal heir certificate from Tehsildar. We may mention that the complainant has produced on record the death certificate of insured Amar Chand son of Lal Chand Ex.C-7 and of Biro Devi wife of Ambu Ram, Ex.C-12. As such, after considering the above said evidence, we find that deceased Ambu Ram @ Amar Ram @ Amar Chand son of Lalu Ram @ Lal Chand was the one and same person who died on 14.11.2018. Further to support the contention that Jaswinder Singh and Veena Rani are the only legal heirs of that Late Ambu Ram @ Amar Ram @ Amar Chand son of Lalu Ram @ Lal Chand have filed their duly sworn attested affidavits alongwith the application to implead the legal heirs on record, wherein it has clearly been mentioned that there is no any other legal heir except them i.e. Jaswinder Singh and Veena Rani. Moreover, All the relevant documents has been placed on file by the complainant and this complaint was filed on 11.7.2019. The OP no. 1 could have easily taken the documents and settled the claim or repudiated the same. In the circumstances of the case, we find that the complainants are entitled to get the insurance claim amount of Rs.5,00,000/- from the OP number 1 and by not settling the claim of the complainants, the OP number 1 is deficient in rendering service towards them.

8.             In view of our above discussion, we allow the complaint and direct OP number 1 to pay to the complainants an amount of Rs.5,00,000/- in equal Share (i.e. Rs.2,50,000/- each to Jaswinder Singh and Veena Rani) along with interest @ 7% per annum from the date of filing of the complaint i.e. 11.07.2019 till realisation in full. We further direct OP number 1 to pay to the complainants an amount of Rs.10,000/- in lieu of compensation for mental tension, agony and harassment as well as litigation expenses to the complainants in equal share. (i.e. Rs. 5,000/- each)

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

10.            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.

                        October 9, 2024.

                                                                      (Kanwaljeet Singh)  (Sarita Garg) (Jot Naranjan Singh Gill)

                                                                               Member               Member                   President