Punjab

Faridkot

CC/18/18

Kuldeep Kaur - Complainant(s)

Versus

Kotak Mahindra Bank - Opp.Party(s)

Dildeep Singh

08 Apr 2019

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FARIDKOT

 

C. C. No. :              18 of 2018

Date of Institution:   12.02.2018

Date of Decision :      8.04.2019

 

Kuldeep Kaur widow of Nachattar Singh r/o Village Sukhan Wala, District Faridkot.                                        

      ........Complainant

Versus

1. Kotak Mahindra Bank, near HDFC Bank and Amar Theatre, Faridkot Road, Kotkapura District Faridkot-151204.
2. Kotak Mahindra Old Mutual Life Insurance Ltd, 2032 A, 2^nd Floor, Gees Mall, Mall Road Bathinda, Punjab, 155001.
3. Kotak Mahindra Old Mutual Life Insurance Ltd, Kotak Towers, 7^th Floor, Zone-4, Building No. 21, Infinity Park, Off Western Express Highway, Goregaon Mulund Link road, Malad East,  Mumbai-400097.

........OPs

Complaint under Section 12 of the

Consumer Protection Act, 1986.

 

Quorum: Sh. Ajit Aggarwal, President,

               Smt Param Pal Kaur, Member.

 

Present: Sh Dildeep Singh, Ld Counsel for complainant,

              Sh Neeraj Maheshwari, Ld Counsel for OP-1,

               Sh Jatinder Bansal, Ld Counsel for OP-2 and 3.

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ORDER

(Ajit Aggarwal, President)

                                                          Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against OPs seeking directions to OPs to make payment of  insurance claim on account of death of her husband and for further directing OPs to pay Rs.4,00,000/- as compensation for harassment and mental agony besides litigation expenses.

 2                                                       Briefly stated, the case of the complainant is that Nachattar Singh deceased husband of complainant was having an account with OPs and on advice of OP-1 who is agent of OP-2 and OP-3 Insurance Company, he purchased the Insurance Policy “Kotak Assured Saving Plan” bearing no.0961856 and guaranteed maturity benefit of Rs.2,88,014.70. Date of commencement of policy was 31.03.2017 with annual premium of Rs.20,999/-. Term of policy was for 15 years. At the time of purchasing the said policy, Nachattar Singh deceased husband of complainant completed all requisite formalities and submitted all the documents demanded by OPs. Policy in question was purchased on 27.03.2017 and complainant was nominee in said policy. Husband of complainant paid premium of Rs.21,000/- on 27.03.2017 and next premium was to be paid on 27.03.2018.  It is further submitted that husband of complainant died on 6.05.2017 and after his death, complainant gave due intimation regarding his death to OPs and also submitted death certificate and other

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relevant documents for processing the insurance claim on account of death of her husband. At that time, OPs assured to pass the claim, but thereafter, despite repeated requests, they did not pay a single penny on account of insurance claim, rather kept putting her off on one pretext or the other and then, finally she was  handed over a letter vide which Ops repudiated the claim of complainant.  Complainant also issued legal notice to OPs, but OPs did not pay any heed to genuine requests of complainant, which caused her great harassment and mental agony. This action of OPs in not making payment of insurance claim amount amounts to deficiency in service and trade mal practice on their part. The complainant has prayed for directions to Ops to make payment of insurance claim alongwith other benefits under the policy and for further directing OPs to pay Rs.4,00,000/- as compensation for harassment and mental agony besides litigation expenses . Hence, the complaint.

3                                               The counsel for complainant was heard with regard to admission of the complaint and vide order dated 20.02.2018, complaint was admitted and notice was ordered to be issued to the opposite parties.

4                                              On receipt of the notice, the OP-1 filed written statement taking preliminary objections that complainant is not the consumer of answering OPs. It is further averred that there is no deficiency in service on their part. Complaint filed by complainant is false, frivolous and vexatious and is liable to be dismissed. Complaint

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involves complicated questions of law and facts requiring detailed evidence, which is not permissible in the Consumer Protection Act.  Complainant has concealed the material facts from this Forum and no cause of action arises against them. Answering OP is a bank and they only assisted the complainant in availing the said policy. Amount deposited by complainant under policy in question is neither received by them nor they have any role in making payment of insurance claim as claim sought by complainant is payable only by OP-2 and OP-3 Insurance company. Complainant has no locus standi to file the present complaint and it is bad for non joinder of necessary parties as complainant has not impleaded other legal heirs of deceased Nachattar Singh party in the present complaint. However, on merits, OP-1 had denied all the allegations of complainant being wrong and incorrect and asserted that they never advised deceased Nachatter Singh to purchase the policy in question, rather he himself purchased the same with his own free will after fully understanding all the terms and conditions of the policy. He was an educated person and he signed the proposal form and paid the premium to OP-2 and OP-3 and not to OP-1. It is denied that complainant ever informed them regarding death of her husband and asserted that when complainant approached them for processing the claim on account of death of her husband, they told her that insurance claim sought by her is payable only by OP-2 and OP-3 and they have nothing to do in processing of the same. All the other allegations have been denied being wrong, incorrect and false and it is reiterated that

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there is no harassment, deficiency in service or unfair trade practice on the part of OP-1. The allegations with regard to relief sought too were refuted with a prayer that complaint deserves to be dismissed with costs.

5                                  On receipt of notice, OP-2 and OP-3 filed written reply taking preliminary objections that complaint filed by complainant is false, frivolous and vexatious and it is an abuse of process of law. It is averred that complainant has tried to mislead and misguide the Forum by filing the present complaint as no cause of action arises against answering OPs and even this Forum has no jurisdiction to hear and try the present complaint. As per OP-2 and OP-3, complainant has concealed the material facts from this Forum and did not disclose the correct information and suppressed the material information regarding health and habits from them and as acting upon terms and conditions of the Insurance Contract, they have rightly repudiated the claim of complainant. On the basis of information given by deceased, insurance policy in question was issued on 31.03.2017 and OPs were informed that after 37 days of release of policy, deceased life assured died on 6.05.2017 i.e just after few days of commencement of policy.  After investigation of Discharge Summary Card issued by Dayanand Medical College and Hospital, Ludhiana where date of admission is mentioned as 10.03.2017 and date of discharge is written as 13.03.2017, it was observed deceased  was a known case of Cirrhosis, Portal Hypertension, Ascities, Jaundice, Hepatic Encephalopathy, DM-T2 and he was undergoing treatment for these diseases prior to the date of proposal and

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commencement of insurance policy in question. Life Assured gave wrong information about his health and suppressed the material facts regarding his ailments from answering OPs. On the basis of medical history and due to concealment and suppression of real facts regarding health and illness by life assured, answering OPs have rightly repudiated the claim of complainant vide letter dated 6.09.2017.

6                                                 Parties were given proper opportunities to prove their respective case. The complainant tendered in evidence his affidavit Ex.C-1 and documents Ex C-2 to C-8 and then, closed the evidence.

7                                                In order to rebut the evidence of the complainant,  ld counsel for OP-1 tendered in evidence affidavit of Deepak Kumar Ex OP-1/1 and documents Ex OP-2 to OP-5 and then, closed the evidence. Ld Counsel for OP-2 and 3 tendered in evidence affidavit of Shakil Ahmad Ex OP-2, 3/1 and documents Ex Op-2, 3/2 to 6 and then, closed the same on behalf of OP-2 and OP-3.

8                                                        We have heard the arguments advanced by ld counsel of both the parties and have also gone through the pleadings and evidence led by respective parties.             

9                                                          From the careful perusal of record placed on record and after thoroughly considering the pleadings made by parties it is observed that grievance of complainant is that her husband

 

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was insured with Ops vide insurance policy “Kotak Assured Saving Plan” bearing no.0961856 for sum assured of Rs.1,47,241/- and guaranteed maturity benefit of Rs.2,88,014.70. Policy commenced on 31.03.2017 with annual premium of Rs.20,999/-. Term of policy was for 15 years. At the time of purchasing the policy, Nachattar Singh deceased husband of complainant completed all formalities and submitted the documents demanded by OPs and complainant was nominee in said policy. Husband of complainant paid premium of Rs.21,000/- on 27.03.2017 and next premium was to be paid on 27.03.2018, but life assured / husband of complainant died on 6.05.2017 and after his death, complainant gave due intimation regarding his death to OPs and also submitted death certificate and other relevant documents for processing the insurance claim on account of death of her husband. OPs assured to pass the claim, but thereafter, Ops repudiated the claim of complainant without any reason. Complainant also served legal notice to OPs, but OPs did not pay any heed to genuine requests of complainant, which caused her great harassment and mental agony. In reply, OP-1 stressed mainly on the point that OP-1 is a bank and they only assisted in availing the said policy. Amount deposited by life assured is not received by them and they have no role in making payment of insurance claim as  sought by complainant. OP-1did not advise deceased Nachatter Singh to purchase the policy in question, rather he himself purchased the same with his own free will after fully understanding all the terms and conditions of the policy and being an educated person he himself duly

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signed the proposal form and paid the premium to OP-2 and OP-3 and not to OP-1. There is no deficiency in service on their part.

10                                          Ld Counsel for OP-2 and OP-3 brought our attention towards document Ex OP-2, 3/2 i.e copy of proposal form wherein the deceased life assured has declared that he is free from all ailments and is not suffering from any disease and has no illness of any kind. Ex OP-2, 3/ 5 is copy of complete medical record of deceased life assured which clearly depicts that prior to commencement of policy in question, Nachhatar Singh/ deceased life assured was diagnosed for Cirrhosis, Portal Hypertension, Ascities, Jaundice, Hepatic Encephalopathy, DM-T2 and he was undergoing treatment for these diseases prior to the date of proposal and commencement of insurance policy in question from Dayanand Medical College and Hospital, Ludhiana. He was admitted in Dayanand Medical College and Hospital, Ludhiana on 10.03.2017, remained there for treatment and was discharged therefrom on 13.03.2017 and he purchased the present policy from OPs on 31.03.2017 by suppressing the real facts about his illness and there is a concealment of major health issues on the part of deceased life assured.

11                                                 From the above discussion and in the light of documents produced by OPs, it is made out that there is no deficiency in service on the part of OPs and they have rightly repudiated the claim of complainant. Complainant has failed to prove her case. We

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are fully convinced with the arguments of OPs and therefore, complaint in hand is hereby dismissed being devoid of any merits. However, in peculiar circumstances of the case, there are no orders as to costs. Copy of order be supplied to parties free of cost under rules. File be consigned to record room.

Announced in Open Forum

Dated : 8.04.2019         

(Param Pal Kaur)                (Ajit Aggarwal)                                 Member                              President