PER:
Ms. Nidhi Verma, Member
1 The complainant has filed the present complaint by invoking the provisions of Consumer Protection Act under Section 34, 35 and 36 against the opposite parties on the allegations that the complainant is widow of deceased Kuldeep Singh who was serving in Punjab Police Department and both the complainant and her deceased husband availed Housing Loan from the opposite party No. 2 and to secure its loan the opposite party No. 2 at the time of sanctioning the loan insured the deceased husband of the complainant with life insurance policy of the opposite party No. 1 with insurance policy having name and style HDFC Life Group Credit Protection Plus having policy Number PP000291 by obtaining premium from deceased Kuldeep Singh. Unfortunately Kuldeep Singh husband of the complainant died of natural causes on 22.4.2020 after brief illness at Guru Nanak Dev Super-specialty Hospital, Tarn Taran. The complainant having knowledge of the above said life insurance policy of the above said deceased Kuldeep Singh and also being a co borrower of the above said loan from the opposite party No. 2 immediately informed the opposite party No. 1 regarding the death of Kuldeep Singh and also lodged the claim case with this party and at the time of lodging of the claim case all the necessary documents which includes death certificate of the deceased, post mortem report of the deceased, police proceedings U/s 174 Cr.P.C. and the medical treatment record of deceased Kuldeep Singh etc. were supplied to this party by the complainant. For the easy perusal of the documents, translations of the above said documents alongwith the copies of the documents were also supplied to the opposite party No. 1 as per its requirements. After lodging of the complaint with the opposite party No. 1, this party assured the complainant that the housing loan outstanding at the time of death of deceased Kuldeep Singh will be adjusted with the insurance claim of the deceased Kuldeep Singh as per the terms and conditions of the policy mentioned above being issued for these purposes and as such, the complainant was satisfied that after lodging of the claim the outstanding loan amount will be automatically be written off against the claim amount and she will not have to pay a penny from her pocket in lieu of the loan outstanding. Inspite of the fact that all the documents mentioned above were supplied to the opposite party No. 1 by the complainant but still the opposite party No. 1 instead of paying the claim amount to the opposite party No. 2 and writing of the outstanding loan, issued a letter dated 17.6.2021 to the complainant whereby again demanding the same documents as already had been supplied to this party, so the complainant again had to supply those documents to this opposite party and she awaited for NOC from the opposite party No. 2 regarding the housing loan mentioned above. Inspite of awaiting for more than 6 months no NOC was issued by the opposite party No. 2 to the complainant, the complainant got issued a legal notice dated 12.1.2022 through her counsel to the opposite party No. 1 whereby directing the opposite party No. 1 to immediately pay the claim amount of the above said insurance policy to the opposite party No. 2 but insptie of issuing the legal notice to this party nothing has been done by the opposite party No. 1 regarding the insurance claim rather the opposite party No. 2 had been harassing the complainant to repay the above said housing loan amount and is also threatening to get the residential house of the complainant vacated from her. Both the parties are sister concerns and as such are not acting as per terms and conditions of life insurance policy and are unnecessarily harassing the complainant by not releasing the life insurance claim and by not writing off the housing loan amount against this insurance claim amount and further by demanding the repayment of housing loan from her and also by threatening her to vacate her residential house of which they are not legally entitled and as such any such harassment of the complainant is a result of unfair trade practice of opposite parties being hand in gloves with each other. The complainant has prayed the following relieves:-
- The opposite party No. 1 may kindly be directed to release the life insurance claim in favour of the opposite party No. 2 equivalent to the outstanding housing loan amount of Rs. 2,00,000/-
- The opposite party N. 1 kindly be directed to pay compensation of Rs. 1 Lakh for causing harassment of the complainant.
- The opposite parties may kindly be directed to pay litigation expenses of Rs. 50,000/- to the complainant.
Alongwith the complaint, the complainant has placed on record affidavit of complainant Ex. C-1, Self attested copy of death certificate of deceased Kuldeep Singh Ex. C-2, Self attested copy of acceptance copy Ex. C-3, Self attested copy of letter dated 17.6.2021 Ex. C-4, Self attested copy of police proceedings U/s 174 Cr.P.C Ex. C-5, Self attested copy of treatment record Ex. C-6, Self attested copy of legal notice Ex. C-7, Self attested copy of Adhar Card of the complainant Ex. C-8.
2 The opposite party No. 1 appeared through counsel and filed written version by interalia pleadings that the complaint filed by the complainant is pre mature and not maintainable. The complainant was requested by the opposite party no. 1 vide letter dated 17.6.2021 to supply the following documents.
(i) Full copy of Post Mortem Report.
(ii) FIR attested by the Master Policy holder i.e. HDFC Ltd.
(iii) Sick leave records of the life assured for the past three years from the employer.
iv) Treatment, consultation records including admission, discharge and death summary alongwith indoor case papers from Kalra Hospital and Guru Nanak Dev Super Speciality Hospital.
v) Mediclaim records on benefits availed by the life assured in the past three years.
vi) Bank statement of the life assured and nominee for the last two years.
It was clearly mentioned in the aforesaid letter that the claim can only be processed upon receipt of the aforesaid documents which have to be scrutinized and after investigation based upon the supplied documents, the opposite party will be able to accept/repudiate its liability and claim will be processed and paid if found payable as per terms and conditions of the insurance policy which is a document of contract between the parties. But in spite of the said letter, the complainant has failed to supply the documents and filed the present complaint without any basis therefore the opposite party is unable to process the claim of the complainant for want of the aforesaid documents. The complaint filed by the complainant has otherwise become time barred. As stated above, vide letter dated 17.6.2021, complainant was requested to supply the documents mentioned above but till date, she has not supplied the same although statutory period of limitation of two years has already expired. As such the complaint otherwise cannot proceed and liable to be dismissed. The complainant is estopped to file the instant complaint as there is no deficiency in service on the part of the Opposite Party as defined in Section 2(1)(g) of the Consumer Protection Act under the heading Deficiency. In view of the provisions contained in the Insurance Act, 1938 which is a specific statue meant for dealing with the disputes under the contract of insurance the provisions of the Consumer Protection Act 1986 cannot be invoked for dealing with the matter covered by Insurance Act. It was clearly mentioned in the aforesaid documents which have to be scrutinized and after investigation based upon the supplied documents, the opposite party will be able to accept/ repudiate its liability and claim will be processed and paid if found payable as per terms and conditions of the insurance policy which is a document of contract between the parties. But inspite of the said letter, the complainant has filed to supply the documents and filed the present complaint without any basis therefore the opposite party is unable to process the claim of the complainant for want of the aforesaid documents. The opposite party No. 1 has denied the other contents of the complaint and prayed for dismissal of the same. Alongwith the written version, the opposite party No. 1 has placed on record affidavit is Ex. OP1/A.
3 The opposite party No. 3 appeared through counsel and filed written version by interalia pleadings that the present complaint is not maintainable before this Commission as this Commission has got no territorial jurisdiction to entertain the present complaint. Thus, the present complaint is liable to be dismissed on this sole ground only. The grievance of the complainant is mainly against the insurance company for settlement of death claim of her deceased husband and not against the opposite party No. 2. No cause of action has arisen against the Opposite Party No. 2 as the complainant being co-borrower along with her husband has availed two loans from the Opposite Party No. 2 one Home Equity loan and another insurance premium funding. The said insurance was only financed by the Opposite Party No. 2 on the request of the borrower's. Therefore, no deficiency can be attributed on the part of the Opposite Party No. 2. Therefore, the present complaint is liable to be dismissed on this sole ground only qua the Opposite Party No. 2. The complainant has not approached this Commission with clean hands, hiding the fact that the insurance was availed from HDFC Life Group Credit Protect Plus. The opposite party No. 2 has no role in settlement of claim. The complainant has concealed the material facts from this Commission as the borrower's availed the Home loan of Rs. 13,00,000/- as Home Equity Loan and Rs.1,17,851/- as Insurance Premium Funding from the Opposite Party NO. 2. The opposite party No. 2 had sanctioned the loan with pre- condition that the borrowers are required to avail the policy in order to mitigate the risk in lending. However the borrowers were free to avail from any insurance company of their choice, however they opted for HDFC Life Insurance Company Limited. The copy of the Home Loan Agreements is OP- 2/1. The complainant has tried to misrepresent the true facts with this Hon'ble Court by projecting wrong facts. Now after the death of the co-borrower, the complainant is trying to avoid her legal liability and the answering opposite party being a secured creditor has every right to recover the dues. As on 26.07.2022, a sum of Rs. 16,10,631/- in Loan account No. 645981628 and Rs.1,45,847/- in Loan account No.646918737 is outstanding in the loan accounts. Now the complainant has not approached this Commission with clean hands and thus, the present complaint is liable to be dismissed on this sole ground only. The copy of the Loan account statements are annexed as AnnexureOP-2/2. The present complaint is based on self-contradiction as on the one hand, the complaint is alleging non supply of documents and the other hand, the complainant is placing on record each and every document. Thus, the whole claim of the complainant is based on self contradictions and wrong facts and thus is liable to be dismissed on this ground only. The complainant never contacted the opposite party for issuing the NOC. The complainant herself admitted that the complainant contacted the opposite party No. 1 only. The opposite party No. 2 has denied the other contents of the complaint and prayed for dismissal of the same. The opposite party No. 1 has placed on record Photostat copy of agreement Ex. OP2/1, Copy of account statement Ex. OP2/2, Affidavit of Sh. Aditya Kochar Ex. OP2/3.
4 We have heard the Ld. counsel for the parties and have carefully gone through the record.
5 The case of the complainant is that Kuldeep Singh husband of complainant was serving in Punjab Police Department and both the complainant and her deceased husband availed Housing Loan from the opposite party No. 2 and to secure its loan the opposite party No. 2 at the time of sanctioning the loan insured the deceased husband of the complainant with life insurance policy of the opposite party No. 1 with insurance policy having name and style HDFC Life Group Credit Protection Plus having policy Number PP000291 by obtaining premium from deceased Kuldeep Singh. Unfortunately Kuldeep Singh husband of the complainant died of natural causes on 22.4.2020 after brief illness at Guru Nanak Dev Super-specialty Hospital, Tarn Taran. The complainant having knowledge of the above said life insurance policy of the above said deceased Kuldeep Singh and also being a co borrower of the above said loan from the opposite party No. 2 immediately informed the opposite party No. 1 regarding the death of Kuldeep Singh and also lodged the claim case with this party and at the time of lodging of the claim case all the necessary documents which includes death certificate of the deceased, post mortem report of the deceased, police proceedings U/s 174 Cr.P.C. and the medical treatment record of deceased Kuldeep Singh etc. were supplied to this party by the complainant. For the easy perusal of the documents, translations of the above said documents alongwith the copies of the documents were also supplied to the opposite party No. 1 as per its requirements. After lodging of the complaint with the opposite party No. 1, this party assured the complainant that the housing loan outstanding at the time of death of deceased Kuldeep Singh will be adjusted with the insurance claim of the deceased Kuldeep Singh as per the terms and conditions of the policy mentioned above being issued for these purposes. The complainant was satisfied that after lodging of the claim the outstanding loan amount will be automatically be written off against the claim amount and she will not have to pay a penny from her pocket in lieu of the loan outstanding. Inspite of the fact that all the documents mentioned above were supplied to the opposite party No. 1 by the complainant but still the opposite party No. 1 instead of paying the claim amount to the opposite party No. 2 and writing off the outstanding loan, issued a letter dated 17.6.2021 to the complainant whereby again demanding the same documents as already had been supplied to this party, so the complainant again had to supply those documents to this opposite party and she awaited for NOC from the opposite party No. 2 regarding the housing loan mentioned above. Inspite of awaiting for more than 6 months no NOC was issued by the opposite party No. 2 to the complainant, the complainant got issued a legal notice dated 12.1.2022 through her counsel to the opposite party No. 1 whereby directing the opposite party No. 1 to immediately pay the claim amount of the above said insurance policy to the opposite party No. 2 but inspite of issuing the legal notice to this party nothing has been done by the opposite party No. 1 regarding the insurance claim rather the opposite party No. 2 had been harassing the complainant to repay the above said housing loan amount and is also threatening to get the residential house of the complainant vacated from her.
6 On the other hands, the case of the opposite party No. 1 is that the complaint filed by the complainant is pre mature and not maintainable. The complainant was requested by the opposite party no. 1 vide letter dated 17.6.2021 to supply the following documents.
(i) Full copy of Post Mortem Report.
(ii) FIR attested by the Master Policy holder i.e. HDFC Ltd.
(iii) Sick leave records of the life assured for the past three years from the employer.
iv) Treatment, consultation records including admission, discharge and death summary alongwith indoor case papers from Kalra Hospital and Guru Nanak Dev Super Speciality Hospital.
v) Mediclaim records on benefits availed by the life assured in the past three years.
vi) Bank statement of the life assured and nominee for the last two years.
It was clearly mentioned in the aforesaid letter that the claim can only be processed upon receipt of the aforesaid documents which have to be scrutinized and after investigation based upon the supplied documents, the opposite party will be able to accept/repudiate its liability and claim will be processed and paid if found payable as per terms and conditions of the insurance policy which is a document of contract between the parties. But in spite of the said letter, the complainant has failed to supply the documents and filed the present complaint without any basis therefore the opposite party is unable to process the claim of the complainant for want of the aforesaid documents.
7 From the perusal of the file, neither the complainant nor the opposite party has placed on record any document i.e. repudiation letter which reveals that the claim of the complainant has been decided. Infact the claim has not been decided so far and the same is still pending. Moreover, the opposite party No. 1 has specifically pleaded in Para No. 1 of Preliminary objection of written version that ‘the complaint of the complainant is premature’. In case Balu Waman Kadam vs. ICICI Lombard General Insurance Co. IV (2013) CPJ 16A (CN) (Mah.), the matter was similar, wherein the Insurance Company was asking the complainant to submit the documents again and again and the complainant was alleging that he had already submitted the requisite documents to the Insurance Company. In such circumstances, the Hon’ble State Consumer Disputes Redressal Commission Maharashtra disposed of the matter, by directing the Insurance Company to reconsider the claim of the complainant within one month on receipt of the required documents from the complainant.
8 While relying upon the above said authority, the Hon’ble State Commission, Punjab, Chandigarh passed the similar orders in case M/s Trends, through its Proprietor vs The Oriental Insurance Company Limited & Anr. Consumer Complaint No.245 of 2015 decided on 04.08.2017; and M/s Gurbir Rice Mills v. United India Insurance Company Ltd. & Ors. Consumer Complaint No.404 of 2016, decided on 09.10.2017, directing the Insurance Company to reconsider the claim of the complainant after submission of requisite documents by the complainant to it.
9 In view of our above discussion as well as keeping in view the ratio of above said judgments, we are of the opinion that the ends of justice would be met, if the Insurance Company be directed to decide the claim of the complainant, after the complainant submit all the requisite documents.
9 In view of the above discussion, the present complaint is disposed of with the following directions
(a) The opposite party No. 1 will submit the list of requisite documents to the complainant within 15 days from the date of receipt of copy of this order.
(b) The complainant will submit the claim with requisite documents to the opposite party No. 1 -Insurance Company for deciding the claim within a period of further one month and on approaching the complaint for supplying the requisite documents, the opposite party No. 1 will issue proper receipt acknowledging the same.
(c) The opposite party No. 1 shall decide the claim of the complainant within a further period of two months therefrom
In case of failure on the part of the opposite party No. 1 the claim case of the complainant deemed to have been accepted. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this commission. Copies of the order be furnished to the parties as per rules. File is ordered to be consigned to the record room.
Announced in Open Commission
05.07.2024
