Punjab

Bhatinda

CC/18/341

Sukhwinder Kaur - Complainant(s)

Versus

Mahindra Finance Co. - Opp.Party(s)

Sh.Amrinder Singh

31 Jan 2022

ORDER

Final Order of DISTT.CONSUMER DISPUTES REDRESSAL COMMISSION, Court Room No.19, Block-C,Judicial Court Complex, BATHINDA-151001 (PUNJAB)
PUNJAB
 
Complaint Case No. CC/18/341
( Date of Filing : 17 Dec 2018 )
 
1. Sukhwinder Kaur
Village.Neor,Teh.Phul,Distt.Bathinda.
...........Complainant(s)
Versus
1. Mahindra Finance Co.
ist floor,SCF-5-6,Phase-1,Urban Estate,Model Town,Near T.V,Tower,Bathinda.
............Opp.Party(s)
 
BEFORE: 
 HON'BLE MR. Kanwar Sandeep Singh PRESIDENT
 HON'BLE MR. Shivdev Singh MEMBER
 HON'BLE MRS. Paramjeet Kaur MEMBER
 
PRESENT:Sh.Amrinder Singh , Advocate for the Complainant 1
 
Dated : 31 Jan 2022
Final Order / Judgement

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

BATHINDA

 

C.C. No. 341 of 17-12-2018.

Decided on : 31-01-2022

 

  1. Sukhwinder Kaur aged about 57 years, W/o Late Balvir Singh S/o Malkit Singh

  2. Sukhbir Singh aged about 30 years S/o Late Balvir Singh

  3. Gurdhian Singh aged about 24 years S/o Late Balvir Singh

  4. Ravandeep Kaur aged about 22 years D/o Late Balvir Singh.

- All residents of Village Neor Tehsil Phul, District Bathinda.

......Complainants

    Versus

     

    1. Mahindra Finance Company, Ist Floor, SCF 5-6, Phase-1, Urban Estate, Model Town, Near T.V. Tower, Bathinda.

    2. Kotak Mahindra Life Insurance Limited, Registered Office, 2nd Floor, Plot C-12, G Block, BKC, Bandra (E), Mumbai through its Regional Officer/Authorised Signatory

    .......Opposite parties

       

      Complaint under Section 12 of the Consumer Protection Act, 1986

       

      QUORUM

       

      Kanwar Sandeep Singh, President

      Sh. Shivdev Singh, Member.

      Smt. Paramjeet Kaur, Member

      Present

      For the complainants : Sh. Amrinder Singh, Advocate

      For the opposite parties : Sh. K K Vinocha, Advocate, for OP No. 1

      Sh. Vinod Garg, Advocate, for OP No. 2

       

      ORDER

       

      Kanwar Sandeep Singh, President

       

      1. The complainants Sukhwinder Kaur and others (here-in-after referred to as complainants) have filed this complaint U/s 12 of Consumer Protection Act, 1986 (Now C.P. Act, 2019, here-in after referred to as 'Act') before this Forum (Now Commission) against Mahindra Finance Company Limited (here-in-after referred to as opposite parties).

      2. Briefly stated, the case of the complainants is that Balvir Singh husband of the complainant No. 1 and father of complainants No.2 to 4 purchased Tractor bearing Registration No.PB-03AT-3562 through financial assistance of opposite party No.1 on 07.09.2017 vide loan agreement/loan account No.4950604 with financed amount of Rs.6,40,000/-. The said amount of loan is to be paid in 10 half yearly installments of Rs.96,600/-.

      3. It is alleged that at the time of finance of said vehicle, the life of deceased Balvir Singh was got insured by opposite party No.1 against certificate of Cover Kotak Mahindra Old Mutual Life Insurance bearing No.CR0000200516Z00 against loan agreement No.4950604. It was assured that in case of death of deceased Balvir Singh, there will be insurance cover of Rs.6,40,000/- and complainants will not be liable to pay any loan amount. At the time of commencement of insurance, the deceased Balvir Singh specifically informed the opposite parties that he is suffering from liver diseases, even the opposite parties agreed to insure the deceased. The opposite parties in collusion and connivance with each other did not issue any insurance policy or its terms and conditions and even the copy of proposal form till date although it is mandatory.

      4. It is alleged that unfortunately deceased Balvir Singh, expired on 24-1-2018. Thereafter complainants intimated the opposite parties regarding death of Balvir singh and furnished/completed all the formalities for processing the claim.

      5. It is alleged that as per assurance of the opposite parties and as per terms of said insurance certificate, the complainants were entitled to get a claim of Rs. 6,40,000/-. The complainants were entitled to get adjusted/paid the entire loan amount against the said tractor, out of insurance claim and thereafter they were entitled to get the balance amount of insurance claim after adjustment of loan amount. The complainants are also entitled to get no due certificate (N.O.C).

      6. It is alleged that Balvir Singh, during his life time paid first half yearly installment of Rs.96,600/- with opposite party No.1, but after the death of Balvir Singh, the opposite party forced the complainants to pay other installments and the complainants under compelling circumstances also paid 2nd installment of Rs.96,600/- vide receipt No. 09.07.2018.

      7. It is alleged that complainants repeatedly contacted the opposite parties for processing the insurance claim but the opposite parties illegally and arbitrarily forcing the complainants to deposit the remaining installments. The opposite parties did not pay the said insurance claim rather vide letter dated 26.06.2018 repudiated the claim of the complainants by taking false plea, due to non-disclosure of the material facts of sufferings deceased Balvir Singh prior to commencement of insurance policy. The said letter is illegal, null and void and is not binding on the rights of complainants. The opposite parties instead of releasing the insurance claim, issued letters for payment of loan amount illegally and arbitrarily and used pressure tactics for recovering the loan amount, although the complainants are not liable to pay any loan amount against tractor in question.

      8. It is alleged that the act and conduct of the opposite parties is so deficient that they have not even bothered to decide the claim of the complainants till date. The deceased Baivir Singh was and even complainants are illiterate and rustic villagers. The opposite parties are not supposed to take undue benefit of their ignorance under the technicalities of law especially after death of the insured. Non-payment of the claim by the opposite parties, caused agony, pains and sufferings for which they claim compenstion to the tune of Rs. 1,00,000/-.

      9. On this backdrop of facts, the complainants have prayed for directions to the opposite parties to make payment of Rs. 6,40,000/- with interest @ 18% p.a. with damages to the extent of Rs. 1,00,000/- and Rs. 20,000/- as litigation expenses. The opposite parties be also directed to pay balance amount after adjustment of loan amount and issue No Due Certificate against said loan account and also refund Rs. 96,600/- paid after the death of deceased Balvir Singh. Hence, this complaint.

      10. Upon notice, the opposite parties put an appearance through their respective counsel and filed written reply. The opposite party No. 1 in its written reply, taken legal objections that the complainants have not come to this Commission with clean hands and have suppressed true facts knowingly, intentionally and deliberately.

      11. It is pleaded that the true facts are that as per policy, practice & procedure prevalent, opposite party No. 1 do not use to grant any type of financial assistance/loan to over-aged persons or persons suffering from chronic diseases and to persons having bad financial track history etc., Balvir Singh as borrower and one of his nearer and dearer Mr. Ajmer Singh, as Guarantor, approached opposite party No. 1 for grant of loan for purchase of New Sawraj Tractor and their request was considered and they were told about the terms and conditions of loan/financial assistance to which they agreed. Accordingly aforesaid Balvir Singh as borrower purchased new Swaraj Tractor now having Registration No. 13B-03-AT-3562 after availing loan/finance of Rs. 6,40,000/- from opposite party No. 1. Ajmer Singh stood guarantor for the same. They agreed to repay the aforesaid loan/finance amount of Rs. 6,40,000/- plus Rs. 3,26,000/- as finance charges i.e. totaling Rs. 9,66,000/- in 10 half yearly installments & other charges, but in case of any default, to pay additional finance charges as well. For the purpose aforesaid Balvir Singh as Borrower and Ajmer Singh as Guarantor submitted required documents & executed loan document, which included Loan Agreement No. 4950604 dated 07.09.2017.

      12. It is pleaded that opposite party No. 2 had entered into a contract of Insurnce under a group Policy i.e. Kotak Credit Term Group Plan with opposite party i.e. Mahindra & Mahindra Financial Service Ltd., In group Insurance Policies as per policy contract, a group of members as specified by financier in the member data submitted by the financier; availing any loan from the financier for specific purposes as specified in the schedule of the policy contract and willing to avail insurance cover on the same, may be covered by the insurer for the period and amount as specified in the certificate of insurance issued to every such specified member. The Insurer was to receive a premium amount from the financier on behalf of the group member/borrower seeking subscription to the said cover for the specified period and for specific number of group members/borrowers. As a pre-requisite, for availing the said Insurance cover, the group member/borrower has to provide duly signed declaration of Good Health (DOGH) thereby assuring the insurer that the member is medically fit for availing the said Insurance Cover. The said arrangement contract was made by opposite party no. 1 with opposite party No. 2 to save the heirs of group members in case of any mis-happening is occurred to the life of group member/borrower during loan repayment period subject to aforesaid terms and conditions.

      13. It is further pleaded that borrower Balvir Singh was told about the aforesaid arrangements in between opposite party No. 1 and opposite party No. 2 and he (Balvir Singh now deceased) at his choice and voluntarily opted to purchase Insurance policy in question of opposite party No. 2 as per aforesaid arrangements. A sum of Rs. 6657/- was charged in his loan account and same has been paid to opposite party No. 2. He also executed and signed required forms including a Declaration of Good Health Form on dated 16.09.2017, which were read-over and explained to him in his simple Puniabi Language by the subscriber of the DOH Form namely Mr. Pankaj Kum Kumar who also signed the aforesaid form in conformation thereof. At the time of purchasing policy, Balvir Singh neither told nor disclosed about his suffering from any disease/ailment especially mentioned in DOGH form. Balvir Singh also appointed his nominee. It is denied that Balvir Singh disclosed to the financier, insurer or subscriber of the DOGH form regarding his alleged suffering from liver ailment, as is now being projected/mentioned in complaint, which fact is totally wrong, false, cooked and after thought. In the said Form, he has declared himself of having good health.

      14. It is also pleaded that opposite party No. 1 and 2 are two different companies having their two different sphere of business, registration, entity, governing body, profit and loss. They have nothing to do with business of each other. The rights and obligations regarding loan in question between the parties are duly incorporated in Loan Agreement, which borrower and other co-executants i.e. Guarantor; have duly executed and signed the same after reading & understanding its terms and conditions to be correct and true and agreed to abide by the same. After death of borrower, the complainants who are L.Rs. of the borrower are bound by the same.

      15. It is also pleaded that since, insurance claim has been repudiated by opposite party No. 2, so, dispute if any is to be adjudicated in between the complainants and opposite party No. 2 and opposite party No.1 is not at fault in any manner whatsoever.

      16. Further legal objections are that the complaint against opposite party No. 1 regarding insurance claim is not maintainable at all as opposite party No. 1 has paid the insurance premium amount to the opposite party No. 2 and dispute if any is in between complainants and opposite party No. 2. The opposite party No. 1 has nothing to do with passing of or repudiation of insurance claim. That if for one and another reason, if repudiation of insurance claim by opposite party No. 2 is concluded to be wrong or false and complainants are found entitled to the insurance claim, then same may please ordered to be paid to opposite party No. 1 because a sum of Rs. 6,76,200/- is future outstanding amount and Rs. 3357/- is due on account of additional finance charges due to opposite party No. 1 in said loan account against borrower/his L.R.s, including guarantor.

      17. It is admitted that opposite party No. 1 received Rs. 96,600/- on 19-12-2017, Rs. 96,000/- on 9-7-2018, Rs. 600/- on 13-7-2018 and Rs. 96,600/- on 21-12-2018. In this way, the opposite party No. 1 has received Rs. 2,89,900/- in said loan account.

      18. It is pleaded that the claim amount is also payable to opposite party No. 1 in terms of insurace policy as well. If excess, amount out of concluded insurance claim is found, then opposite party No. 1 undertake to pay such excess amount to the complainant.

      19. On merits, the opposite party No. 1 has reiterated its version as pleaded in legal objections, detailed above. After controverting all other averments, the opposite party No. 1 prayed for dismissal of complaint.

      20. The opposite party No. 2 filed separate written reply and took preliminary objections that the present complaint is false, frivolous and vexatious; that this Commission has no jurisdiction to entertain the present complaint; that there is no deficiency of service or negligence on the part of opposite party No. 2.

      21. It is pleaded that in the present case, the claim of the complainants was repudiated on the basis of intentional non-disclosure of material facts and false declaration made in the Declaration of Good Health (DOGH) by the Life Assured i.e., the late husband of Complainant No. 1 Balvir Singh/member. The deceased Balvir Singh was suffering from Chronic liver disease with ascites for a long time, before signing the DOGH on 06/09/2017 prior to issuance of the policy/much prior to availing the said insurance cover. Despite the same, Balvir Singh intentionally gave a false declaration while answering regarding his health. Had the opposite party No. 2 been aware of the pre-existing ailment of Balvir Singh, the subject insurance cover would not have been provided at all. Thus the opposite party No. 2 has repudiated the claim of the complainants in a fair and just manner. Further it is pertinent to note that the complainants themselves have admitted in her complaint that the Balvir Singh was admitted in hospital prior to issuance of the policy. The said fact was material in nature and Balvir Singh was bound to disclose the same to the opposite party.

      22. Further preliminary objections are that this Commission has no jurisdiction to entertain the present complaint. That the contract of insurance is based on a foundation of utmost good faith i.e. principle of uberrima fides. The Life Insured/Member has to maintain and observe a complete good faith while entering into an insurance contract with the insurer. The Life Insured/Member is under solemn obligation to make full, complete, true and correct disclosure of the material facts which may be relevant for the insurer to take into account while deciding whether the proposal for issuance of cover should be accepted. If the Life Insured/Member failed to disclose true and correct material facts to the insurer or gives any false declaration to that effect, then the cover obtained by the Life Insured/ Member stands vitiated and the Member or any person claiming under it is not entitled, for any benefits under the said policy.

      23. It is pleaded that in the present case, the Balvir Singh/Member was diagnosed of Chronic Liver Disease with ascites much prior to the signing of the Proposal and Risk Commencement of the policy. It is further noteworthy that it was well in the knowledge of Life Insured/ Member and his family as he was taking treatment in a big hospital. The said intentional non-disclosure of the material fact of pre-existing medical history of the Member at DOGH stage clearly indicates that the Member obtained the subject cover only with an intention to induce the opposite party No. 2 to issue the insurance cover on his life. He mislead the opposite party No. 2 into believing that he was medically fit to avail the said insurance cover by giving a false declaration in the DOGH regarding his medical history. Had the Life Assured disclosed information sought in a truthful manner, the opposite party No. 2 would not have issued the subject. insurance cover to the Life Assured. The said intentional non-disclosure of the material facts goes root of the matter vitiating the subject policy and rendered it invalid, void and unenforceable.

      24. Further preliminary objections are that the complaint is not maintainable either in law or on the facts and circumstances; that the policy is a contract between the policy holder and the insurer and parties to it is bound by its terms and conditions. Admittedly, the proposal form was signed by the spouse of the complainant and on the basis of the said membership cum declaration of Good Health Form, the subject certificate of insurance was issued by the opposite party. That as per Clause 10 of certificate of Insurance, in case of Fruad/Miscrepresentation, Certificate of Insurance shall be cancelled immediately by paying surrender value subject to the provisions of Section 45 of the Insurance Act, 1938. In the present case the information provided by the member pertaining to his health was inaccurate, false and was not made in good faith.That it is further submitted that, the COI issued to the Member also specifically mentions that the cover shall be forfeited if it is found that any material information/statement has been concealed from the Opposite Party. That on receipt of duly filled and signed DOGH on the part of deceased member and as an acknowledgment of extending insurance cover to the Member/DLI, a Certificate of Insurance was issued to him which clearly stated the prime features of the said insurance cover including the cover commencement date i.e. 6-9-2017.

      25. That following details were specifically averred under the form :

       

      Policy No.

      KC00522/CR00020

      Master Policy Holder

      Mahindra & Mahindra Financial

      Service Ltd.

      Plan

      Kotak Credit Term Group Plan

      Life Insured

      Mr. Balvir Singh

      Date of DOGH

      06/09/17

      Date of Issuance of Certificate of Insurance

      07/09/17

      Claim Amount

      Rs. 6,40,000/-

      Date of Death

      24/01/18

      Claim Duration

      With 5 months

      Claim Intimation received

      23/04/18

      Status

      Repudiation of claim

       

      1. That on receipt of the death claim intimation, the opposite party No. 2 immediately initiated the process of investigation in order to verify the authenticity of the claim as the death had occurred within 1 year from the policy issuance. During the process of claim investigation, following facts were discovered: (A) The medical documents from Max Health Care Hospital dated 23.06.2017 (Pre RCD) clearly indicates that the member was a diagnosed case of CLD ( Chronic Liver Disease) prior to signing the DOGH. (B) The address mentioned on the invoice cum receipt Issued by pharmacy OP Max Health care matches with our records and the invoice number mentioned therein matches with as per IP number in the discharge summary. (C) The Ultra sound report dated 06.12.2017 issued from Kalra Hospital is self attested by the Nominee.

      2. It is pleaded that above findings clearly indicates that Balvir Singh/ Member with a malafide intention concealed the actual facts regarding the pre-existing diseases thereby vitiating the moot principle of insurance contract i.e. good faith which is serious enough for the denial of the insurance cover to the insured if the condition would have been known.

      3. On mertis, the opposite party No. 2 also reiterated its stand as taken in preliminary objections, detailed above. After controverting all other averments, the opposite party No. 2 prayed for dismissal of complaint.

      4. In support of his complaint, the complainant has tendered into evidence photocopy of RC (Ex. C-1), photocopy of installment structure (Ex. C-2), photocopy of certificate (Ex. C-3), photocopy of death certificate (Ex. C-4), photocopy of receipt (Ex. C-5), photocopy of letter (Ex. C-6) and affidavit of Sukhbir Singh dated 17-12-2018 (Ex. C-7) and closed the evidence.

      5. In order to rebut the evidence of complainant, the opposite party No. 1 has tendered into evidence affidavit dated 11-4-2019 of Anurag Sharma (Ex. OP-1/1), photocopy of loan agreement (Ex. OP-1/2), photocopy of account statement (Ex. OP-1/3), affidavit dated 11-4-2019 of Pankaj Kumar (Ex. OP-1/4).

      6. The opposite party No. 2 has tendered into evidence photocopy of membership form (Ex. OP-2/1), photocopy of certificate of insurance (Ex.OP-2/2), photocopy of claim intimation form (Ex. OP-2/3), photocopy of death certificate (Ex. OP-2/4), photocopy of discharge summary (Ex. OP-2/5), photocopy of prescription slip (Ex. OP-2/6), photocopy of letter (Ex. OP-2/7), affidavit dated 30-1-2019 (Ex.OP-2/8), photocopy of investigation report (Ex. OP-2/9), photocopy of affidavit dated 27-3-2018 of Sukhbir Singh (Ex. OP-2/10), affidavit of Varinder Singh, Investigator (Ex. OP-2/11) and closed the evidence.

      7. Learned counsel for the parties reiterated their stand as taken in their respective pleadings.

      8. We have heard learned counsel for the parties and gone through the record as well as written arguments filed by parties.

      9. In the case in hand, there is no dispute between the parties that Balvir Singh, now deceased, husband of complainant No. 1 and father of complainants No. 2 to 4, purchased Tractor bearing registration No. PB-3AT-3562 by availing financial assistance from opposite party No. 1 vide Loan Agereement No. 4950604 (Ex. OP-1/2) to the tune of Rs. 6,40,000/-. The loan amount of Rs. 6,40,000/- was to be paid in 10 half yearly installment of Rs. 96,600/-. The deceased Balvir Singh was got insured by opposite party No. 1 from opposite party No. 2 vide Kotak Mahindra Old Mutual Life Insurance bearing CR0000200516Z00 against Loan Agreement No. 4950604 (Ex. OP-2/1). The said Balvir Singh, life assured died on 24-01-2018. After death of Balvir Singh, his LRs filed claim with the opposite parties, which was repudiated vide letter dated 26-6-2018 (Ex. C-6).

      10. A perusal of repudiation letter (Ex. C-6) reveals that claim of the complainants was repudiated on the ground of non-disclosure of material facts by the member (deceased - Balvir Singh) in DOGH. As per opposite parties deceased Balvir Singh was suffering from Chronic lever disease with Ascites for a long time and in the Form/Declaration of Good Health, Balvir Singh, had declared that he had never suffered from any serious disease.

      11. The opposite parties, to prove that deceased Balvir Singh was suffering from chronic disease, placed on file two documents Ex. OP-2/5 & Ex. OP-2/6. Ex. OP-2/5 is the Discharge Summary of Max Hospital dated 23-6-2017 which reveals diagnosis GLD/PY/NON Bleeder with ascitis with AK... with recurrent UTI. Ex. OP-2/6 is prescription slip issued by Kalra Hospital on 6-12-2017 with reveals Final IMP – Parenchymal disease of liver (Cirrhosis). The prescription Ex. OP-2/6 is dated 6-12-2017 whereas insurance in question was effective from 7-9-2017. Moreover, perusal of documents (Ex. OP-2/5 and Ex. OP-2/6) does not reveal name of father of patient. So, it cannot be said that person named in these documents is the same person. Even the opposite parties have not examined the treating doctor. The opposite parties failed to bring on record any evidence to prove that deceased Balvir Singh, died because of alleged (liver) disease.

      12. It is pleaded case of the complainant that deceased Balvir Singh specifically told the opposite parties that he is suffering from liver disease. So, it was upon the opposite parties either to not to issue policy or to get Balvir Singh medically examined to know about his health before issuance of policy. Once the opposite parties issued the policy after receiving premium, then they cannot be allowed to find excuses for repudiation of claim on hyper technical grounds.

      13. Ex. C-3 Certificate of Insurance do find mentioned under heading 3(b) - “Declartion of Good Health (DOGH) cum Membership Form' in the format required by the insurer at the time of availing of the cover. It may be noted that the cover shall be declined, if the member is not able to provide satisfactory evidence of good health as required under the policy contract.”

      14. This Commission should not succumb to niceties or technicalities in such matter and attempt should be to equate, as far as possible, the misery on account of accident with the relief entitled.

      15. Moreover, the deceased Balvir Singh was illiterate person and all the documents placed on file by the opposite parties show that Balvir Singh signed the document in punjabi language. No evidence placed on file by the opposite parties to prove that terms and conditions of policy in question were supplied to complainant. Even Certificate of Insurance (Ex. C-3) reveals that it does not bear signature of complainant to prove that he was made aware of any declaration. It has been specifically mentioned on this document that this document is just for information and applicable terms and conditions are attached with policy are separate, but policy alongwith terms and conditions were not supplied to complainant. Membership Form Cum Declaration of Good Health (Ex. OP-2/1) is in english language and bears signatures of deceased Balvir Singh in punjabi. There is no certificate of agent of opposite parties that the contents of said document were read over and explained to Balvir Singh in punjabi language.

      16. Hon'ble State Commission, Haryana, in the case titled Star Health and Alied Insurance Co. Ltd., Vs. Asha and others 2015 (1) CLT 590 has held that :

        It is well settled that the company, who is taking specific plea about repudiation of any claim, has to prove that the exclusion clause was explained to the consumer – Once the insurer failed to prove this fact, it cannot take any benefit from such an exclusion clause.”

      17. Hon'ble National Commission in the case titled National Insurance Co. Ltd., Vs. Radhey Shyam Balwada and another 2014(2) CPJ 201 held :

        Insurer is under obligation to act in good faith, which obliges him to enter into contract without concealing material fact like exclusion clause.”

      18. Admittedly deceased Balvir Singh availed loan facility from opposite party No. 1 and opposite party No. 1 to secure loan amount got insured loanee member from opposite party No. 2 under contract between opposite party No. 1 & opposite party No. 2. It is not the case where deceased Balvir Singh obtained medi-claim policy for reimbursement of medical expenses by concealing any fact. As per practice, Insurance Companies, before issuing any health policy, get the person medically checked and thereafter issue insurance policy. Therefore, at the stage of payment of claim to sufferer, such pleas taken by the Insurance Companies are not justified.

      19. Hon'ble National Commission in the case titled New India Assurance Co. Ltd., Vs. Suresh Garg 2015(3) 799 has held :

        Repudiation of medi-claim on ground of suppression of pre-existing ailment and wrong information at the time of obtaining policy/cover – Accepting premium and then issuing policy without medical examination as required in proposal form, completely nails case set out by appellant – Since medical examination of respondent was not conducted by the petitioner company, which was the most important part while giving an insurance policy on medical terms, therefore, there is a fault on the part of the petitioner company – Respondent has been made to suffer by non-settlement of his claim...”

      20. As discussed above, the opposite parties have not placed on file to prove that terms and conditions were ever made known to deceased Balvir Singh or complainants. Further more, the opposite parties themselves were at fault for not getting medical examination of deceased Balvir Singh, conducted before inception of insurance policy in question. Therefore, at this stage, denial of claim to complainants/LRs of deceased Balvir Singh without any fault on the part of deceased Balvir Singh, amonts to deficiency in service on the part of the opposite parties.

      21. In the result, this complaint is partly allowed against the opposite parties as per directions given below :

        a) Allowed against opposite party No. 2 with Rs. 10,000/- as cost and compensation. The opposite party No. 1 has admitted in para No. 7 of written reply that it has received Rs. 2,89,800/- against loan account in question. The opposite party No. 2 is directed to pay outstanding loan amount out of assured sum of Rs. 6,40,000/- to opposite party No. 1 and remaining amount of out of sum assured of Rs. 6,40,000/- be paid to complainants in equal share with interest @9% p.a. from the date of repudiation of claim i.e. 26-6-2018 till payment.

        The compliance of this order be made by opposite party No. 2 within 30 days from the date of receipt of copy of this order.

        b) Allowed against opposite party No. 1 without any cost and compensation. The opposite party No. 1 is directed to issue No Ojbection Certificate against loan account in question to complainants after receipt of loan amount from opposite party No. 2.

        The compliance of this order be made by opposite party No. 1 within 15 days from date of receipt of loan amount from opposite party No. 1.

      22. The complaint could not be decided within the statutory period due to heavy pendency of cases.

      23. Copy of order be sent to the parties concerned free of cost and file be consigned to the record.

        Announced :

        31-1-2022

        (Kanwar Sandeep Singh)

        President

         

         

        (Shivdev Singh)

        Member

         

        (Paramjeet Kaur)

        Member

         

       
       
      [HON'BLE MR. Kanwar Sandeep Singh]
      PRESIDENT
       
       
      [HON'BLE MR. Shivdev Singh]
      MEMBER
       
       
      [HON'BLE MRS. Paramjeet Kaur]
      MEMBER
       

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