Chandigarh

DF-I

CC/967/2022

KAJAL - Complainant(s)

Versus

UNITED INDIA INSURANCE COMPANY LIMITED - Opp.Party(s)

ANKIT CHAHAL

04 Oct 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-I,

U.T. CHANDIGARH

                                     

Consumer Complaint No.	:	CC/967/2022
Date of Institution	:	9/12.2022
Date of Decision	:	4/10/2024

 

Kajal wife of Late Sh. Amarjeet, resident of village Jhanj Khurd, Tehsil & District Jind, Haryana. At present residing at Daughter of Kuldeep, Village Bahadurgarh, Tehsil Safidon, District Jind, Haryana.

...Complainant

 

Versus

1. United India Insurance Company Limited, having its registered office at 2/27 Okhla Road, Opp. Hotel Softel Surya, Sarai Jullena, New Delhi-110025 through its Managing Director.

2. Vipul Insurance Brokers Private Limited (Agent Code No.BRC0000224), having its registered office at 217, Ansal Chambers-2, Bhikaji Cama Place, New Delhi-110066 through its Director.

 

... Opposite Parties

 

CORAM :	SHRI PAWANJIT SINGH	PRESIDENT
	MRS. SURJEET KAUR	MEMBER
	SHRI SURESH KUMAR SARDANA	MEMBER

 

                                                                               

ARGUED BY	:	Sh. Ankit Chahal, Advocate for complainant
	:	Ms. Shalini Bagdi, Advocate for OP  No.1.
	:	None for OP No.2

Per Pawanjit Singh, President

1. The present consumer complaint has been filed by the complainant under Section 35 of the Consumer Protection Act 2019 against the opposite parties  (hereinafter referred to as the OPs). The brief facts of the case are as under :-
   1. It transpires from the averments as projected in the consumer complaint that the husband of complainant, namely, Amarjeet was working as Security Guard in G4S Secure Solutions India Pvt. Ltd, (hereinafter referred to be as employer of deceased insured) and OP No.2 the Vipul Insurance Brokers Private Limited is an authorized Agent of United India Insurance Company Limited. On 08.02.2021, the representative/employee of OP no.2 visited the office of husband of the complainant at Chandigarh and collected the premium of Rs.785/- in cash from him for Individual Personal Accident Insurance Policy and on the same day i.e. 08.02.2021, the authorized representative/employee of OP no. 2 has also taken the signatures of husband of complainant on the proposal form for individual personal accident insurance and other allied documents and assured him that the insurance policy will be received by him very soon. On 18.02.2021, the husband of complainant was going to Yamuna Nagar (Haryana) from Dappar (Punjab) alongwith three others while travelling a car bearing no. PB-65AV-3451 (hereinafter referred to be as subject car) being driven by the insured husband of the complainant and when they reached near Kakkar Majra Mor, Shahzadpur on National Highway-344 (Panchkula-Yamuna Nagar Road), the car met with an accident due to coming of a stray cow all of a sudden in front of the aforesaid car and while trying to save the stray cow, the husband of complainant suddenly applied the brakes of car and thus, the above said car firstly struck with divider as a result of which all occupants sustained injuries. on the road and then to the pole erected on the divider. Thereafter, husband of complainant and other three occupants of car were immediately shifted to CHC Shahzadpur and the concerned Doctor declared the husband of the complainant Amarjeet dead (hereinafter referred to be as deceased insured) and Post-mortem was conducted by Medical Officer, CHC Shahzadpur, District Ambala on 19.02.2021. A DDR with regard to the above said accident vide DDR No.35 dated 18.02.2021 was also recorded by the police of P.S. Shahzadpur. District Ambala. The copies of the DDR, Post-Mortem Report and Death Certificate of the husband of complainant are annexed as Annexure C-1 to C-3. After the death of deceased insured the complainant, contacted the OPs and also visited to their office to get the death claim benefit under the  Individual  Personal Accident Insurance Policy, being nominee of her husband. But the OPs did not give any positive response. Thus the, complainant moved an application under Right to Information Act on 13.08.2022 to the OPs and vide letter no. RTI/82/2022 dated 02.09.2022, the OP No. 1 provided receipt of cash, proposal form, insurance policy and other allied documents to the complainant and the complainant was shocked to see the subject documents   as it was found that the cash receipt of cash Rs.785/- was generated on 25.03.2021 instead of 08.02.2021 and the Insurance Policy No. 0423014220P115098113 (hereinafter referred to be subject policy) was issued valid from 24.03.2021 to 23.03.2022 instead of 08.02.2021 to 07.02.2022 as  the premium amount was received on 8.2.2021  by OP No.2 and it was also found in proposal form that the signature of the deceased insured was dated 01.03.2021. The true copies of the receipt of cash, proposal form and Insurance Policy are attached herewith as Annexure C-4 to C-6. In this manner as the deceased insured had already paid premium amount  to OP No.2 on 8.2.2021 but the OPs had issued the subject policy  valid w.e.f. 24.03.2021 to 23.03.2022 instead of 08.02.2021 to 07.02.2022  with sum insured to the tune of Rs.7. lakh, the aforesaid act amounts to deficiency in service and unfair trade practice on the part of OPs. OPs were requested several times to admit the claim, but, with no result.  Hence, the present consumer complaint.
   2. The OPs resisted the complaint and filed their separate written version. In its written version OP No.1 resisted the claim of complainant, inter alia, taking preliminary objections of maintainability, cause of action, concealment of facts and also that  the complainant has not approached this Commission with clean hands.  However, it is alleged that the premium amount was received by the answering OP after the demise of the deceased insured who died on 18.2.2021 and the said premium amount was received from OP No.2.. It is denied that any amount of premium was received directly from the deceased insured or obtained signature on the proposal form. However, it is alleged that the documents were sent to the complainant on receiving request under RTI  Act. It is alleged that the complainant did not approach  the employer G4S of the deceased insured to inquire about dates of proposal or payment of premium. In fact the answering OP has received the premium amount from OP No.2 on 25.3.2021 and accordingly the subject policy was issued without knowing the fact that the deceased insured  has already expired.  It is further alleged that the answering OP has no knowledge of the death of the deceased insured till the receipt of legal notice dated 29.9.2022. On merits, the facts as stated in the preliminary objections have been re-iterated. The cause of action set up by the complainant is denied.  The consumer complaint is sought to be contested.
   3. OP No.2  in filed written version, inter alia, taking preliminary objections of maintainability, cause of action, concealment of facts and non-joinder of necessary parties and the complainant has not approached this Commission with clean hands. However, it is alleged that on receiving the legal notice dated 29.9.2022 from the complainant, the answering OP  has replied to the said notice intimating that the premium amount was received on 19.2.2021 after the demise of the deceased insured as the name of the deceased insured was not earlier covered in the list sent by the employer of the deceased insured i.e. G4S and later on his name was included in revised list sent to the answering OP  on 19.2.2021, by the said employer of the deceased insured. The  answering OP had received premium amount from the said employer only on 19.2.2021 i.e. after the death of deceased insured who died on 18.2.2021. It is further alleged that the proposal forms of all the employees were  received by OP No.2  only in the second week of March 2021 and thereafter the premium amount and the aforesaid forms alongwith revised list of employees were shared  by answering OP with OP No.1 and accordingly the subject policy was issued. It is denied if any amount was collected in cash by the representative of the answering OP from the deceased insured  directly on 18.2.2021.  However, it is alleged that the premium amount was deposited by the employer of the deceased insured  on 19.2.2021 alongwith the revised list of employees and copy of receipt 19.2.2021 is annexed as Annexure “E”. It is further alleged that the answering OP is a facilitator between the employer G4S  and deceased insured  and OP No.1  for generating group accidental policy for the employees. The cause of action set up by the complainant is denied.  The consumer complaint is sought to be contested.
   4. Complainant chose not file rejoinder.   
2. In order to prove their respective claims the parties have tendered/proved their evidence by way of respective affidavits and supporting documents.
3. We have heard the learned counsel for the complainant and OP No.1 and also gone through the file carefully, including the written arguments on record.
   1. At the very outset, it may be observed that when it is an admitted case of the parties that the deceased husband of the complainant Amarjeet was working with the M/s G4S  and he died on the noon of 18.2.2021 when the subject car met with an accident, having been driven by the deceased husband of the complainant near Kakkar Majra Mor, Shahzadpur, which resulted in severe  injuries to the  deceased husband of the complainant  and he succumbed to  injuries on the same day as is also evident from copy of postmortem report Annexure C-3 and the copy of death certificate Annexure C-2 with copy of DDR Annexure C-1, the case is reduced to a narrow compass as it is to be determined if  the  insured deceased   had paid premium amount of Rs.785/- for  the subject policy  on 8.2.2021  to the representative of OP No.2 and the OPs have falsely prepared the  documents with respect to the insurance policy  and thereby issued the subject policy valid w.e.f. 24.03.2021 to 23.03.2022 and the complainant is entitled  for relief as prayed for, as is the case of the complainant or if the deceased insured has not paid any premium amount to OP No.2 for obtaining the subject policy  and the complaint of the complainant being false and frivolous is liable to be dismissed.
   2. As per case of the complainant, the representative of OP No.2 collected the premium amount from the deceased insured Amarjeet on 8.2.2021 from his office in cash. However, there is no iota of evidence on record in order to prove that if any representative of the OP No.2 had collected the premium amount from the deceased insured in cash as the complainant has failed to produce any receipt or any other document or disclose the name of the representative who collected the premium amount from the deceased insured. Thus, one thing is clear that the complainant has failed to prove on record that premium of Rs.785/-  was collected by the representative of OP No.2 for the personal accidental insurance policy to be issued in favour of deceased insured. On the other hand the defence of the OP No.1  is that in fact the employer of the deceased i.e. G4S  had deposited the premium amount of 21 employees including the deceased insured with OP No.2 on 19.2.2021 i.e. after demise of the deceased insured  on 18.2.2021  which fact has also been proved from the email Annexure D  sent by the employer of the deceased insured to the OP No.2 alongwith employees list with the email. Not only this, the group insurance premium of the employees  to the tune of Rs.37,170/-  was also received by the OP No.2 on 19.2.2021 from the employer of the deceased insured as is evident from
      Annexure E. Thus, one thing is clear on record that in fact the premium amount of 21 employees of  M/s G4S i.e. the employer of the deceased insured  was  received on 19.2.2021  by OP No.2 i.e. after death of deceased insured on 18.2.2021 and as such there is no question of  issuance of the subject policy in favour of the deceased insured prior to that especially when no premium amount was paid to the OP No.1 .
   3. The complainant has tendered copies of the receipt Annexure C-4  dated 25.3.2021 and the proposal form  which bears the signature of deceased insured Amarjeet  on 1.3.2021  which are contradictory as it shows that the said  proposal form was signed after the demise of the deceased on 18.2.2021 and there was no question of signing the proposal form by the insured deceased on 1.3.2021. Further it has come on record that the OP No.1 has received the premium amount on 25.3.2021  on account of Personal Accidental Polices for 21 employees from OP No2, who received the said premium amount from G4S the employer of  deceased insured on 19.2.2021  and accordingly the OP No.1 having no knowledge of the death of the deceased insured Amarjeet had issued the subject policy w.e.f. 24.3.2021 to 23.3.2022.
   4. From the foregoing discussed, it is established on record that  in fact the deceased insured was not covered under the subject insurance policy  as the premium amount was not received  on 8.2.2021 prior to his death as claimed by the complainant rather the same had been received by OP No.2 on 19.2.2021 i.e. after the death of the deceased insured from his employer i.e. G4S , hence, it is unsafe to hold that that there is any deficiency of service on the part of the OPs.
4. In the light of the aforesaid discussion, the present consumer complaint, being devoid of any merit, is hereby dismissed leaving the parties to bear their own costs.
5. Pending miscellaneous application(s), if any, also stands disposed off.
6. Certified copies of this order be sent to the parties free of charge. The file be consigned.

Announced 4/10/2024			[Pawanjit Singh] President
mp
			[Surjeet Kaur] Member
			[Suresh Kumar Sardana] Member