DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BARNALA, PUNJAB.

Complaint Case No : CC/158/2022

Date of Institution : 06.06.2022

Date of Decision : 20.03.2024

Jaswinder Kaur widow of Balwinder Singh son of Niranjan Singh, resident of Chahal Patti, Karamgarh, District Barnala.   

                     …Complainant

        Versus

1. United India Insurance Company Limited, SCO 72, Second Floor, Phase 9, SAS Nagar, Mohali-160062 (Punjab) through its Branch Manager;  

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

3. State of Punjab, through Deputy Commissioner, Barnala;

    …Opposite Parties.

4. Malkeet Singh son of Balwinder Singh son of Naranjan Singh residents of Chahal Patti, Karmgarh, District Barnala.

5. Gurmeet Singh son of Balwinder Singh son of Naranjan Singh residents of Chahal Patti, Karmgarh, District Barnala.

…Performa Opposite Parties.

Complaint under section 35 of the Consumer Protection Act, 2019

Present: Sh. P.S. Aulakh Adv counsel for complainant.

Sh. NK. Garg Adv counsel for opposite party No. 1.

Sh. Lokeshwar Sewak Adv counsel for opposite party No. 2 & 3.

Sh. Puneet Pabby Adv counsel for opposite party No. 4 & 5.

Quorum.-

1. Sh. Jot Naranjan Singh Gill : President

2.Smt. Urmila Kumari : Member

3.Sh. Navdeep Kumar Garg : Member

 

ORDER

JOT NARANJAN SINGH GILL, PRESIDENT

1.    The complainant namely Jaswinder Kaur has filed the present complaint under Section 35 of the Consumer Protection Act 2019, (amended upto date) against United India Insurance Company Limited and others (in short the opposite parties). 

2. The facts leading to the present complaint as stated by the complainant are that the complainant is the permanent resident of village Karamgarh District Barnala and the deceased Balwinder Singh husband of the complainant was the member of Bhagat Puran Singh Sehat Bima Yojna, which is being run by Government of Punjab, who issued Card No. 0305-4001-8488-0028-4 to the husband of the complainant and his insurance policy No. 11210048161800000106 which was valid upto 31.5.2021. It is alleged that under the said scheme the beneficiary and his/her family can get the medical reimbursement amount of Rs. 50,000/- and also entitled to get Rs. 5 Lacs on account of accidental death of card holder and any of his family members enrolled under the said scheme. Except the card, no separate terms and conditions of the policy. It is further alleged that on 20.3.2019 deceased Balwinder Singh was proceeding towards his fields on bicycle for irrigating his fields. It was at about 7:00 pm, Balwinder Singh was going on bicycle on his left side, then one Innova Car of white colour came from the side of village Nangal being driven at a very high speed and driver hit the same with bicycle of Balwinder Singh from back side. As a result of this accident, Balwinder Singh fell into the dug adjoining the road and died on the spot due to injury on the head and striking of his left leg with the trees. The Car driver ran away from the spot alongwith Car while dragging the bicycle and registration number of the Car was noted by Malkiat Singh. People gathered on the spot and Malkiat Singh with the help thereof brought dead body of Balwinder Singh to Civil Hospital, Barnala. Thereafter, on the statement of Malkiat Singh son of Balwinder Singh a FIR No. 11 dated 21.3.2019 U/s 304-A, 279, 427 IPC was registered in Police Station, Thulliwal. It is further alleged that postmortem of husband of the complainant was conducted at Civil Hospital, Barnala on 21.3.2019. Thereafter, the complainant being the nominee and beneficiary lodged claim to the opposite party No. 1 on the customer care No. 104 on account of death of her husband and later on sent registered letter alongwith requisite documents for releasing the claim and the claim file number is 2172. But till date the opposite parties failed to release the claim amount to the complainant despite the repeated requests. It is alleged that the death of the husband of the complainant has taken place during the policy period. The complainant approached the opposite party No. 1 many times and made many requests to release the amount of compensation and the complainant even sent legal notice dated 10.2.2022 through counsel but the opposite parties have not accede the request of the complainant and still do not to do needful. The act of the opposite parties is deficiency in service. Hence, the present complaint is filed seeking the following reliefs.-

1) The opposite parties may be directed to make the payment of Rs. 5,00,000/- as compensation to the complainant on account of death of Balwinder Singh alongwith interest @ 18% per annum from the date of death till realization.   

2) To pay Rs. 50,000/- to the complainant due to the mental torture agony harassment inconvenience suffered by the complainant and Rs. 20,000/- as litigation expenses. 

3. Initially the opposite party No. 1 was proceeded against exparte vide order dated 27.7.2022 due to non appearance and later on vide order dated 25.8.2022 the exparte order dated 27.7.2022 was set aside subject to costs of Rs. 3,000/-. Thereafter, the opposite party No. 1 filed written version taking preliminary legal objections on the grounds that the complaint has been filed by the complainant only and have not filed by the legal and natural heirs of the alleged deceased Balwinder Singh and the complainant is not nominee in the policy. The above said claim has not been rejected/repudiated till date by the answering opposite party and is under consideration. The Motor Accident claim has already been received by the complainant/legal heirs of the deceased. The complainant has no locus-standi or cause of action to file the present complaint at this stage and the same is pre mature. This Commission has no jurisdiction to try and entertain the present complaint. The complaint is false and frivolous and devoid of any merits etc. 

4. On merits, it is submitted that the Government of Punjab issued Card No. 0305-4001-8488-0028-4 to the husband of the complainant and his insurance policy No. 112100481800000106. It is denied that the beneficiary and his family can get the medical reimbursement amount of Rs. 50,000/- and also entitle to get Rs. 5 Lacs on account of accidental death of card holder and any of his family members enrolled under the said scheme. It is further denied that complainant being nominee and beneficiary lodged claim to the opposite party No. 1 on the customer care number 104 on account of death of her husband and later on sent registered letter alongwith requisite documents for releasing the claim and the claim file number is 2172. It is further submitted that the claim is under consideration, so the complaint is filed as pre-mature and is liable to be dismissed. All other allegations of the complaint are denied and prayed for the dismissal of complaint with special costs. 

5. The opposite parties No. 2 & 3 filed reply by taking legal objections on the ground that the complainant has no locus-standi to file the present complaint. The complainant dragged the answering opposite parties No. 2 & 3 in a false and frivolous litigation, so they are entitled for Rs. 10,000/- as compensation/special costs from the complainant. It is further submitted that the complainant filed claim before opposite party No. 1 and opposite party No. 1 has not considered the claim of the complainant but in the entire scene there is no role of the answering opposite parties No. 2 & 3 to pass the claim of the complainant nor any deficiency in service on the part of answering opposite parties, nor the complainant had issued legal notice to the opposite party No. 2 & 3 but later on made party in the present complaint. The complainant has not come with clean hands and suppressed the material facts etc. On merits, the opposite parties No. 2 & 3 submitted that there is no deficiency in service on their part and have denied the case of the complainant and prayed for the dismissal of complaint. 

6. In reply the performa opposite parties No. 4 & 5 have submitted in the legal objections that the complainant has not approached this Commission with clean hands and has concealed the material facts from this Commission. On merits, it is submitted that the answering opposite parties are real sons of deceased and death of the deceased has devastated the answering opposite parties alongwith the complainant psychologically and economically and death of the deceased has caused huge financial loss to the answering opposite parties. It is further submitted that the answering opposite parties alongwith complainant approached the opposite party No. 1 many times and made many requests to make the payment of Rs. 5,00,000/- as compensation on account of death of Balwinder Singh alongwith interest @ 18% per annum from the date of death. The opposite party No. 1 had already appointed the investigator namely Mr. Ashok Kumar to investigate and submit his report and Mr. Ashok Kumar had already visited the house of the answering opposite parties and complainant and submitted his report of investigation, but till date no claim amount was released. So, it is prayed that the complaint of the complainant may kindly be accepted and opposite parties may kindly be directed to make the payment of Rs. 5,00,000/- as compensation to the answering opposite parties alongwith complainant alongwith interest @ 18% per annum from the date of death of Balwinder Singh. 

7. In order to prove the case the complainant tendered into evidence copy of Smart Card Ex.C-1, copy of postmortem report Ex.C-2 (containing 4 pages), copy of FIR Ex.C-3 (containing 3 pages), copy of legal notice Ex.C-4 (containing 3 pages), postal receipts Ex.C-5 & ExC-6, copy of Adhaar Card Ex.C-7, copy of application Ex.C-8 (containing 18 pages), affidavit of complainant Ex.C-9 and closed the evidence. 

8. The complainant also filed rejoinder to the written version of opposite parties No. 1, 2 & 3 and denied the averments of the written version. Ld. Counsel for complainant suffered the statement that I do not want to file any rejoinder against the version of opposite parties No. 4 & 5. 

9. To rebut the case of the complainant the opposite party No. 1 tendered into evidence copy of order dated 10.4.2021 Ex.O.P1/1, copy of terms and conditions Ex.O.P1/2 and closed the evidence. 

10. The opposite parties No. 2 & 3 tendered into evidence affidavit of Dr. Gurminder Kaur Ex.O.P2.3/1 and closed the evidence. 

11. The opposite parties No. 4 & 5 tendered into evidence affidavit ofMalkiat Singh Ex.O.P4.5/1, copy of insurance scheme card Ex.O.P4.5/2, copy of postmortem report Ex.O.P4.5/3 (containing 8 pages), copy of FIR Ex.O.P4.5/4 (containing 3 pages), copy of legal notice Ex.O.P4.5/5 (containing 3 pages), copy of adhaar card of Jaswinder Kaur Ex.O.P4.5/6, copy of letter Ex.O.P4.5/7 and closed the evidence. 

12. We have heard the learned counsel for the parties and have gone through the record on the file. Written arguments filed by opposite parties No. 2 & 3.

13. It is an admitted fact between the complainant and opposite party No. 1 that husband of complainant, Balwinder Singh was insured with opposite party No. 1 for Rs.5,00,000/- in case of accidental death (as mentioned in the copy of terms and conditions Ex.O.P1/2). It is also not disputed that deceased Balwinder Singh died on 20.3.2019 as is evident from the copy of death certificate, which is on record as Ex.C-8 at Page No. 10. Further in FIR number 11 dated 21.3.2019 U/s 279, 304-A, 427 IPC of Police Station, Thulliwal regarding the accident of Balwinder Singh and copy of the same is on record Ex.C-3, wherein the statement of Malkiat Singh son of deceased Balwinder Singh recorded that his father Balwinder Singh on 20.3.2019 was going to his fields at about 7:00 pm on his bicycle, an Innova Car of white colour came from the side of Village Nangal at very high speed and hit the bicycle of my father from back side due to which my father fell into the dug adjoining the road and suffered injury on his head and striking of his left leg with the trees and died on the spot. Moreover, this fact is also corroborating/supported by the copy of postmortem Ex.C-2 at Page No. 4 it is mentioned in the column of OPINION cause of death “Cause of death in this case is ploytrauma due to injuries No. 1 to 4, which are sufficient to cause death in ordinary course of nature. Injuries are ante mortem in nature”. On the other hand the opposite party No. 1 has taken the stand that the claim has not been rejected/repudiated till date and is under consideration, so the complaint is pre-mature one, but the opposite party No. 1 has failed to settle the claim despite lapse of sufficient period and submission of the required documents for settlement of the claim.

14. Further to prove her case the complainant has placed on record her detailed affidavit Ex.C-9, copy of Smart Card Ex.C-1, copy of postmortem report Ex.C-2, copy of FIR Ex.C-3, copy of legal notice Ex.C-4 for settlement of claim but all in vain, copy of Adhaar Card Ex.C-7 and copy of application Ex.C-8 written to the Branch Manager United India Insurance Company Limited Mohali, for taking death claim of her husband. 

15. The opposite party No. 1 has placed on record copy of order dated 10.4.2021 Ex.O.P1/1 of National Lok Adalat, which shows that the Ld. Counsel for the claimants/DH has withdrawn the execution on behalf of claimants/DH. Further, the opposite party No. 1 has placed on record copy of terms and conditions of scheme Ex.O.P1/2, vide which it is mentioned in the column of Insurer Cover that “Accidental Death & Permanent Total Disability Sum Insured Rs. Five Lakh per Main Member, Accidental Death 100% of Sum Insured”. But the opposite party No. 1 has failed to prove that why they did not settle the claim of the complainant. Moreover, the opposite party No. 1 has failed to place on record any affidavit of Branch Manager to support their contention.  In the above said circumstances, we find it to be a clear cut case of deficiency in service on the part of the opposite party No. 1. Therefore, we are of the view that the deficiency in service on the part of the opposite party No. 1 is writ large, as they intentionally and willfully did not settle the rightful claim of the complainant for such a long time and even during the present proceedings opposite party No. 1 did not choose to settle the claim nor they cited any reason for the same nor they demanded any documents from the complainant for settlement of the claim during the present proceedings.  

16. In view of our above discussion, we allow the complaint against the opposite party No. 1 and directed the opposite party No. 1 to pay to the complainant and all the other legal heirs of the deceased Late Balwinder Singh in equal share an amount of Rs.5,00,000/- along with interest @ 7% per annum from the date of filing of the present complaint i.e. 6.6.2022 till realization in full. If any legal heir is minor then the amount shall be kept in the shape of FDR in a nationalized bank till he/she attains the majority. We further directed the opposite party No. 1 to pay an amount of Rs. 5,000/- in lieu of compensation for mental tension, agony and harassment as well as an amount of Rs. 5,000/- on account of litigation expenses. 

17. Compliance of the order be made within the period of 45 days from the date of the receipt of the copy of this order.

18. Copy of this order be supplied to the parties free of costs as per rules. File be consigned to the records after its due compliance. 

ANNOUNCED IN THE OPEN COMMISSION:

        20th Day of March, 2024

 

            (Jot Naranjan Singh Gill)

            President

              

(Urmila Kumari)

Member

 

(Navdeep Kumar Garg)

Member