DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA

CC.No.128 of 02-05-2018

Decided on 07-05-2019

1.Sudha aged about 50 years widow of Ashok Kumar S/o Mohan Lal;

2.Anjali aged about 26 years D/o Ashok Kumar S/o Mohan Lal;

3.Ajay Goyal aged about 23 years S/o Ashok Kumar S/o Mohan Lal;

All residents of H.No.21905 Near Shiv Mandir, Power House Road, Bathinda.

........Complainants

Versus

1.United India Insurance Co. Limited, Registered Office: 24, Whites Road, Chennai-600014, through its Managing Director.

2.United India Insurance Co. Limited, Branch Office: 2090-B, The Mall, Kanwar Market, Bathinda, through its Branch Manager.

.......Opposite parties

Complaint under Section 12 of the Consumer Protection Act, 1986

QUORUM

Sh.M.P Singh Pahwa, President.

Sh.Manisha, Member.

Present:-

For the complainants: Sh.Maninder Singh Chauhan, Advocate.

For opposite parties: Sh.Tejinder Singh, Advocate.

ORDER

M.P Singh Pahwa, President

1. The complainants Sudha and Others (here-in-after referred to as complainants) have filed complaint U/s 12 of Consumer Protection Act, 1986 against opposite parties United India Insurance Co. Limited and Other (here-in-after referred to as opposite parties).

2. Briefly, the case of the complainants is that Ashok Kumar S/o Mohan Lal was husband of the complainant No.1 and father of complainant Nos.2 and 3. He was employee of M/s Bansal Bus Service. The employer of Ashok Kumar purchased one 'Group Personal Accidental Policy bearing No.2004004216P106721564 in respect of 10 employees including complainants. It was valid w.e.f. 22.5.2016 to 21.5.2017, having sum assured of Rs.1,00,000/-. This amount is payable to the family of the deceased employee in case of accidental death of the insured employee of M/s Bansal Bus Service.

3. It is alleged that Ashok Kumar died in the accident on 26.7.2016 due to the fall of electric pole upon him near St.Josephis Convent School, Bathinda within the area of P.S. Civil Lines, Bathinda. DDR No.20 dated 27.7.2016 was also got lodged with P.S., Civil Lines, Bathinda by Nirmal Gupta W/o Sh.Prem Chand i.e. sister of deceased Ashok Kumar. The postmortem of Ashok Kumar was conducted in Civil Hospital, Bathinda.

4. It is further alleged that the complainant No.1 and her children were not aware about the Group insurance policy of deceased Ashok Kumar. As such, they could not intimate opposite parties about the same. They were under the shock of their life due to untimely death of Ashok Kumar. When they came to know about the 'Group Insurance Policy', the complainant No.1 immediately approached opposite party No.2 in its office at Bathinda and informed it about the death of Ashok Kumar in the accident and lodged the insurance claim and supplied copies of all the relevant documents viz. copies of the group insurance policy, DDR, postmortem report of the deceased, death certificate of Ashok Kumar and Aadhaar Cards of the complainants and requested opposite parties to pay amount of insurance claim of Rs.1,00,000/-, but they have failed to pay insurance claim to the complainants till date. The complainants repeatedly approached opposite parties and requested to admit their lawful claim and to pay insurance claim, but to no effect.

   On this backdrop of fact, the complainants have alleged that they have suffered from great mental tension, agony, botheration, harassment and financial losses. They have claimed insurance claim of Rs.1 lakh; compensation to the tune of Rs.50,000/- and litigation expenses to the tune of Rs.5500/-. Hence, this complaint.

5. Upon notice, opposite parties appeared through their counsel and contested the complaint by filing written version. In the written version, opposite parties have raised the legal objections that the complaint is not maintainable. There are serious violations of Insurance Act and policy terms and conditions. Ashok Kumar was not an employee of Bansal Bus Service on the date of alleged accident. The complainants have no locus-standi to file this complaint. The accident took-place on 26.7.2016. Opposite parties have not received even notice or any other document from the complainants till date. 'Group Personal Accident Policy was issued in the name of M/s Bansal Bus Service (insured). Conditions clearly states that upon happening of any event, which may give rise to a claim under this policy, written notice with full particulars must be given to the company immediately. In case of death, written notice also of the death must, unless reasonable cause be shown be so given before internment, cremation and in any case, within on calendar month after the death'. In this case, the accident took-place on 26.7.2016. Opposite parties did not receive even notice or any other document from the complainants till date.

   Further legal objections are that the complainants are also guilty of their own wrongs. They did not inform about the death of Ashok Kumar to opposite parties. As such, the complaint deserves dismissal.

6. On merits also, opposite parties have denied all the averments of the complainants mainly for want of knowledge. In the end, they have prayed for dismissal of complaint.

7. Parties were asked to produce the evidence.

8. In support of their claim, the complainants have tendered into evidence photocopy of policy, (Ex.C1); photocopy of death certificate, (Ex.C2); photocopy of DDR, (Ex.C3); photocopy of postmortem report, (Ex.C4); photocopies of Aadhaar cards, (Ex.C5 to Ex.C8); affidavit of Sudha dated 31.8.2018, (Ex.C9); affidavit of Sunita Bansal dated 18.9.2018, (Ex.C10); photocopy of identity card, (Ex.C11) and submitted written arguments.

9. To rebut the claim of the complainants, opposite parties have tendered into evidence affidavit of Baldev Singh dated 3.10.2018, (Ex.OP1/1); photocopy of policy, (Ex.OP1/2) and submitted written arguments.

10. We have heard learned counsel for parties and gone through the file as well as written arguments submitted by learned counsel for parties.

11. Learned counsel for parties have reiterated their stand as taken in their respective pleadings and detailed above.

12. We have given careful consideration to these rival submissions.

13. The complainants have pleaded that Ashok Kumar was got insured by their employer M/s Bansal Bus Service. Copy of insurance policy, (Ex.C1) proves that M/s Bansal Bus Service was insured by opposite parties for their employees including Ashok Kumar. As per complainants, Ashok Kumar died. This fact is not disputed. The averments of the complainants is that opposite parties failed to pay insurance claim qua Ashok Kumar.

14. The categorically version of opposite parties is that the complainants have not lodged any claim with them.

15. Of-course, opposite parties have also pleaded that the claim was to be lodged within one month from the date of accident, but at this stage, it is to be seen that whether the complainants have lodged the claim or not.

16. Although, in the complaint, the complainants have pleaded that they lodged the the claim and supplied all the documents, but there is no documentary evidence to prove this fact. Of-course, they have produced number of documents, but none of these documents prove that they have submitted the claim with opposite parties. Therefore, in these circumstances, it is to be inferred that the complaint is premature.

17. For the reasons recorded above, the complaint is hereby dismissed without any order as to cost being premature.

18. However, this order will not effect the right of the complainants to lodge the claim with opposite parties.

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

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

    Announced:-

    07-05-2019

    (M.P Singh Pahwa)

    President

     

     

    (Manisha)

    Member