Punjab

Sangrur

CC/227/2018

Surjit Kaur - Complainant(s)

Versus

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

Sh.Lovepreet Singh Walia

25 Mar 2019

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.

 

                                               

               

                                                Complaint No.  227

                                                Instituted on:    08.05.2018

                                                Decided on:       25.03.2019

 

 

Surjit Kaur wife of Late Sh. Labh Singh, resident of Village Dharamgarh, Tehsil Sunam, District Sangrur.

                                                        …Complainant

                                Versus

1.             United India Insurance Company Limited, Registered Divisional Office: SCO 72, Phase IX, Mohali through its Regional Manager.

2.             Punjab Health Systems Corporation, Civil Secretariat Chandigarh, through its Managing Director.

3.             State of Punjab through Deputy Commissioner, Sangrur.

                                                        …Opposite parties

 

 

For the complainant  :               Shri Lovepreet Walia, Adv.

For OP No.1             :               Shri G.S.Sibia, Adv.

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

 

 

Quorum:   Vinod Kumar Gulati, Presiding Member

                Manisha, Member

 

Order by : Vinod Kumar Gulati, Presiding Member.

 

1.             Smt. Surjit Kaur, complainant (referred to as complainant in short) has preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that the husband of the complainant, Shri Labh Singh was the member of Bhagat Puran Singh Sehat Bima Yojna and under that scheme, Shri Labh Singh was insured for an amount of Rs.50,000/- for medical treatment and further was insured for Rs.5,00,000/- on account of accidental death of the card holder and the said Labh Singh was issued card bearing number 9305-3000-2890-3986-9 and except that no terms and conditions of the policy were issued by the OP number 1.

 

2.             Further case of the complainant is that on 07.12.2017, the husband of the complainant, namely, Labh Singh died due to accident while he was doing labour work within the jurisdiction of PS Cheema. Thereafter on the statement of Gurpreet Singh son of Labh Singh, DDR number 3 dated 7.12.2017 was lodged at PS Cheema.  Post mortem on the dead body of the deceased was also conducted at Civil Hospital, Sunam.  That thereafter the complainant being the nominee and beneficiary lodged online claim with the Ops on their customer care number 104 on 23.12.2017 on account of death and the claim was registered at serial number 830. Further case of the complainant is that in the month of January 2018, the surveyor of OP number 1, namely, Nirmal Singh visited the house of the complainant and took all the relevant documents for settlement of the claim, but the claim amount was not released.  It is stated further that despite submission of all the documents to the OPs, the claim was not settled. 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 and litigation expenses.

 

3.             In reply filed by OP number 1, preliminary objections are taken up on the grounds that the complaint of the complainant is false, frivolous and vexatious in nature, that the complainant has not come to the court with clean hands, that the complainant has unnecessarily dragged the OP into unwanted litigation and that this Forum has got no jurisdiction to hear and decide the present complaint. On merits, it is admitted that the husband of the complainant died on 6.12.2017. It is admitted that the complainant lodged the claim with the OPs and thereafter the OPs appointed surveyor, who demanded several documents from the complainant for settlement of the claim, but the complainant failed to submit the relevant documents with the surveyor, due to which the claim could not be settled. It is specifically stated that the complainant failed to submit the original death certificate to the Ops for settlement of the claim. However, any deficiency in service on the part of the OPs has been denied.

 

4.             In reply filed by OPs number 2 and 3, legal objections are taken up on the grounds that the complaint is not maintainable, that the complainant has no cause of action, that the complainant has not come to the Forum with clean hands and that this Forum has no jurisdiction to hear and entertain the present complaint. On merits, it is admitted to the extent that husband of the complainant was the member of Bhagat Puran Singh Sehat Bima Yojna  and was insured under the policy issued by United India Insurance Co. Ltd. for the period from 1.11.2016 to 31.10.2017. The other allegations levelled in the complaint have been denied.

 

5.             The learned counsel for the complainant has produced Ex.C-1 to Ex.C-11 copies of documents and affidavit and closed evidence. On the other hand, the learned counsel for OP number 1 has produced OP1/1  to Ex.OP1/2 copies of documents and affidavit and closed evidence.  The learned counsel for OP number 2 and 3 has produced Ex.P2&3/1 to Ex.OP2&3/4 copies of documents and affidavit and closed evidence. 

 

 

6.             We have carefully perused the complaint, version of the opposite parties and heard the arguments of the learned counsel for the parties.  No written arguments have been filed by either of the parties.

 

 

7.             It is an admitted fact between the parties that the husband of the complainant was a member of Bhagat Puran Singh Sehat Bima Yojna which is being run by PHSC and PHSC issued card number 9305-3000-2890-3986-9 to the husband of the complainant.  As per the death certificate Ex.C-8, the deceased Labh Singh died on 6.12.2017 and the  FIR was lodged in PS Cheema on 7.12.2017 and the post-mortem Ex.C-10 was also conducted on 7.12.2017 and the complainant lodged claim with the OPs and the Ops appointed surveyor, who demanded several documents from the complainant for settlement of the claim, but the complainant failed to submit the relevant documents i.e. original death certificate with the surveyor and due to non supply of the relevant document i.e. original death certificate with Govt. logo, the OPs could not settle the claim as the same is mandatory for settlement of the claim.   The complainant in his complaint has contended that the above mentioned document was sent to the OP number 1 through Trackon courier on 21.2.2018. In the circumstances of the case, we feel that the ends of justice would be met, if the complainant is directed to supply the original death certificate of Labh Singh with Govt. logo to the OPs within ten days from the date of receipt of copy of the order and the OPs shall decide the claim of the complainant within 30 days of receipt of the said document and intimate the complainant accordingly by registered post.  With these observations, the complaint stands disposed of. If the complainant still feels unsatisfied  with the decision of the OPs, then it will be open for her to approach this Forum again, if she so desired.  A copy of this orders be issued to the parties free of cost. File be consigned to records.

                                Pronounced.

                                March 25, 2019.

 

                                       

 

                                             (Vinod Kumar Gulati)

                                                       Member

 

 

 

                                                   (Manisha)

                                                     Member