United India Insurance Company Limited V/S Murti Devi W/o Ramesh - Consumer Court Case

Haryana

Karnal

337/2013

Murti Devi W/o Ramesh - Complainant(s)

Versus

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

J.B. Rohilla

19 Jan 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

Complaint No.337 of 2013

Date of instt.: 31.07.2013

Date of decision: 19.01.2016

1.Smt.Murti Devi wife of late Sh.Ramesh alias Rameshwar son of Shri Daya Nand , son of Shri Ram Sarup.

2.Rekha Devi(daughter)aged 20 years.

3.Amarjeet(minor son)aged 17 years

4.Manju (minor daughter) aged 14 years

5.Som Dutt (minor son) aged 12 years

6.Santosh (minor daughter) aged 10 years (nominee)

7.Sorabh (minor daughter) aged 8 years

8.Manish (minor son)aged 6 years, of late Shri Ramesh Kumar son of Dayanand through their mother Smt.Murti Devi being natural guardian and next friend, all residents of village Sitamai tehsil Nilokheri district Karnal.

. ……..Complainants

Vs.

1.United India Insurance Company Limited through its Divisional Manager, Karnal.

2.The Nigdhu Primary Agriculture Cooperative Society Ltd. Nigdhu Karnal through its Manager.

……… Opposite Parties

Complaint u/s 12 of the Consumer

Protection Act.

Before Sh.K.C.Sharma……….President.

Sh.Anil Sharma…….Member.

Present:- Sh.J.B.Rohilla Advocate for the complainants.

Sh.Parveen Daryal Advocate for Opposite Party No.1.

Sh.Jaswant Singh Advocate for Opposite Party No.2.

ORDER:

The Present complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986, on the averments that Shri Rameshwar Dass @ Ramesh (deceased life assured) was member of Opposite Party No.2 and had dealings with the same being an agriculturist. Under a scheme launched by the Opposite Party no.1 office of Opposite Party no.2 obtained a group insurance scheme policy according to which all the members/customers of Opposite Party no.2 were insured for a sum of Rs.50, 000/- each vide policy No.47124300000095. Thus, the deceased life assured was insured under the group insurance scheme of Opposite Party no.1. Deceased life assured expired on 1.12.20012 in a road side accident. First Information no.97 dated 1.11.2012 was also registered regarding the said accident. Post mortem on the dead body of the deceased was conducted in the General Hospital, Kaithal. After the death of deceased life assured, his legal heirs became entitled to get benefits under the scheme/policy, therefore, the complainant no.1 approached the Opposite Party no.2 and submitted claim form duly filled in and then the Opposite Party no.2 sent duly filled in claim form to the Opposite Party no.1, but the Opposite Party no.1 repudiated the claim on flimsy ground that in the post mortem report and death certificate , name of deceased was mentioned as Ramesh whereas in the policy his name was recorded as Rameshwar Dass. In fact, the deceased life assured was known with two names i.e. Rameshwar Dass and Ramesh and there is no other person with the said name and parentage in the village. In this way, there was deficiency in services on the part of the Opposite Parties, which caused the complainants mental harassment apart from financial loss.

2. Notice of the complaint was given to the Opposite Parties. The Opposite Party no.1 filed written statement disputing the claiam of the complainant. Objections have been raised that the complainants have got no locus standi and cause of action to file the present complaint; that the complaint is not maintainable in the present form; that the complainants are estopped from their own acts and conduct from filing the present complaint; that the complainants have not approached this Forum with clean hands and that the complaint is an abuse of the process of law.

On merits, it has been submitted that the policy was in the name of Rameshwar, whereas in the post mortem report and death certificate submitted by the complainants, the name of deceased was mentioned as Ramesh. As the deceased was not covered under the policy, the claim was closed as “No Claim.” There was no deficiency in services on the part of Opposite Party no.1. All other averments made in the complaint have not been admitted.

3. The Opposite Party No.2 filed separate written statement. Objections have been raised that the complaint is not legally maintainable and that the complaint is bad for want of notice u/s 124 of the Haryana Cooperative Societies Act 1984.

On merits, it has been submitted that Rameshwar son of Dayanand resident of Sitamai was enrolled as member of Opposite Party no.2 on 21.2.1985. He was known by two names i.e. Ramesh and Rameshwar but in the record of the society, his name was recorded only as Rameshwar alias Rameshwar Dass.

4. In evidence of the complainants, affidavit of complainant no.1 Ex.C1 and documents Ex.C2 to Ex.C6 have been tendered.

5. On the other hand, in evidence of the Opposite Parties, affidavit of Shri S.S.Vasudeva Divisional Manager Ex.O1 and documents Ex.D1 to Ex.D3 have been tendered.

.6. We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned Counsel for the parties.

7. The parties are not at dispute that Rameshwar son of Dayanand resident of Sitamai was member of Opposite Party no.2 and under the group insurance scheme, obtained by Opposite Party no.1, he was also insured for Rs.50,000/- alongwith other members with the Opposite Party no.1. As per the case of the complainants, the deceased life assured was known with two names i.e. Rameshwar and Ramesh and he died on 1.12.2011 in a road side accident. The Opposite Party No.1 has repudiated the claim of the complainants on the ground that in the post mortem report and death certificate, name of the deceased, who died in a road side accident, was mentioned as Ramesh, whereas as per record Rameshwar son of Dayanand resident of Sitamai was insured under the group insurance scheme.

8. The complainant Smt.Murti Devi in her affidavit Ex.C1 reiterated that her husband was known with two names i.e. Rameshwar and Ramesh. He was member of Opposite Party No.2 and was insured with the Opposite Party No.1 under group insurance scheme.

9. The main plank of the complainants is the copy of Haryana Domicile Certificate Ex.C4, wherein it was mentioned that Rameshwar Dass alias Ramesh son of Dayanand was resident of village Sitamai Distrit Karnal. The said certificate was issued on 6.8.1998 by Sub Divisional Officer (Civil) Karnal. The complainant No.1 in her affidavit also specifically mentioned that there was no other person with the name of Rameshwar Dass alias Ramesh son of Dayanand in village Sitamai. This evidence of the complainants has gone completely unrebutted and unchallenged and there is no reason to disbelieve the same. Even Opposite Party no.2 has admitted in the written statement that Rameshwar was also known with the name of Ramesh. Therefore, it is established that Rameshwar Das son of Dayanand resident of village Sitamai district Karnal, who was member of Opposite Party No.2, was also known with the name of Ramesh. Therefore, the complainants being h is legal heirs are entitled to get the benefit of group insurance scheme under which he was insured.

10. As a sequel to the foregoing discussion, we accept the present complaint and direct the Opposite Party No.1 to pay the sum insured to the complainants together with other admissible benefits under the policy. The Opposite Party No.1 shall make the compliance of this order within a period of thirty days from the date of receipt of the copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced
dated:19.01.2016

(K.C.Sharma)

President,

District Consumer Disputes

Redressal Forum, Karnal.

(Anil Sharma )

Member.