State Consumer Disputes Redressal Commission
Joginder Kaur vs New India Assurance Co. Ltd. on 4 December, 2017
FIRST ADDITIONAL BENCH
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.
First Appeal No.562 of 2017
Date of Institution: 26.07.2017
Reserved on : 27.11.2017
Date of Decision : 04.12.2017
Smt.Joginder Kaur aged about 79 years widow of late Shri Fateh
Singh resident of House No.452, Gher Sodhian, Patiala, Punjab.
.....Appellant/Complainant
Versus
1. The New India Assurance Co. Ltd., Divisional Office-1,7, Chhoti
Barandari, The Mall, Patiala-147001.
2. M/s.Chardi Kala Publication Pvt.Ltd., through Shri Jagjit Singh
Dardi, Editor in Chief, H.O 593, SST Nagar, Rajpura Road,
Patiala-147003.
.......Respondents/Opposite Parties.
First appeal against order dated
17.05.2017 passed by the District
Consumer Disputes Redressal
Forum Patiala.
Quorum:-
Sh. J.S. Klar, Presiding Judicial Member.
Present:-
For the appellant : Sh.R.K.Shukla, Advocate For respondent No.1 : Sh.Vinod Gupta, Advocate For respondent No.2 : Ex-parte ................................................... J. S. KLAR, PRESIDING JUDICIAL MEMBER:-
The appellant has directed this appeal against order dated 17.05.2017 of District Consumer Disputes Redressal Forum Patiala (in short the "District Forum"), dismissing the complaint of the First Appeal No.562 of 2017 2 appellant. Appellant of this appeal is complainant in the original complaint before the District Forum and respondents of this appeal are opposite parties therein and they be referred as such, hereinafter, for the sake of convenience, as arrayed in the original complaint.
2. Complainant filed the complaint under Section 12 of the Consumer Protection Act, 1986 against OPs on the averments that she is 77 years widow and resident of H.No.452, Gher Sodhian, Patiala Punjab. Her deceased husband was working with OP No.2 as Manager(Judicial Matters) since 01.04.1990 and had worked till 02.03.2013. He was insured with Group Insurance Scheme by OP No.2 and OP No.1 had issued a Group PA(unnamed) Policy to OP No.2, covering their 25 employees including the husband of the complainant. Husband of the complainant met with an accident with unknown vehicle at 10 P.M. on 02.03.2013 and succumbed to the injuries on 03.03.2013 at Rajindra Hospital, Patiala. Sh.Manpreet Singh son of complainant lodged an FIR on 03.03.2013 with the police regarding accident of his father and his statement was recorded by the police authorities in this regard. OP No.1 received information regarding the death of her husband through Op No.2. OP No.1 deputed an investigator to procure the requisite documents/statements from the complainant. The requisite documents demanded by OP No.1 from the complainant were supplied to the investigator, appointed by OP No.1 for this purpose. The statements of complainant and her son were also recorded at First Appeal No.562 of 2017 3 her residence. The dealing hand of the office of OP No.1 demanded employment certificate in respect of deceased husband of the complainant and the same was also handed over in original to the dealing hand of OP No.1. The employment certificate was issued by OP No.2. She applied for the insurance claim of her deceased husband on 07.02.2014, but to no effect. She issued notice on 27.11.2014 for claiming the insurance of her deceased husband. On 11.12.2014, OP No.1 sent reply to the notice dated 27.11.2014, expressing its inability to allow the insurance due to non-submission of requisite documents by OP No.2. Husband of the complainant rendered services with OP No.2 for almost 23 years and certificate regarding the same was also issued by OP No.2 on 31.12.2013. Objection raise for non-payment of insurance claim by OP No.1, is alleged to be without any force. The documents like attendance register, salary details and other pertinent documents demanded by Op No.1 from OP No.2 were provided. She has been facing hardships for the last two years for non-payment of insurance claim of her deceased husband. She filed complaint praying that OPs be directed to make payment of insurance claim to her with interest @ 18% per annum and also further prayed for compensation for mental harassment caused to her.
3. Upon notice, OP No.1 filed its written reply and contested the complaint of the complainant vehemently. Preliminary objections were raised that complaint is not maintainable. Any deficiency in service by OP No.1 was denied. It was further pleaded that First Appeal No.562 of 2017 4 insurance claim of the complainant has been repudiated, vide letter dated 31.03.2014, as per terms and conditions of the policy, as his employer failed to supply any documentary proof to show the employability of deceased. She was asked through letter dated 10.02.2014 to approach the said firm M/s Chardikala Publications Pvt. Ltd. by providing the necessary documents, such as salary statement, attendance register, appointment order of the deceased with the insured. The certificate attached with the complaint is on the letter pad of Daily Chardikala Patiala Delhi, which is the sister concern of the insured firm. The deceased was working with the firm Chardikala Newspaper, where as the concern insured with OP is Chardikala Publications Pvt. Ltd. OP No.1 is still ready to settle the claim, if the complainant produced the salary statement, attendance register, appointment order of the deceased, as required under the policy terms and conditions. The OP has issued Personal Accident Insurance Group unnamed policy for the period from 23.03.2012 to 21.03.2013 of 25 employees and the liability under the policy shall be as per wage register of the insured. If number of employees in wage register exceeds the number, as declared in the policy, the company shall not be liable for any claim under the policy. The non- production of the wage register and other relevant record of the employment of the deceased amounts to violation of terms and conditions of the policy. On merits, it was pleaded by Op No.1 that complainant and OP No.2 failed to produce attendance register, salary certificate of deceased to show his employment with the insured firm. It was denied that deceased was an employee of OP First Appeal No.562 of 2017 5 No.2 and was covered under the policy issued by the OP. On receipt of intimation of loss on 07.06.2013, the OP has immediately appointed Sh.Baljit Singh Investigator of Patiala for investigation into the matter, who found that the complainant and employer of the deceased failed to produce the employment record in the form of attendance register, salary record details, appointment letter and record of employment of number of employees but the complainant and the insured has failed to supply the same. OP No.1 prayed for dismissal of the complaint.
4. The complainant tendered in evidence her affidavit Ex.C- A, and documents Ex.C-1 to Ex.C-22 and closed the evidence. As against it, OP No.1 tendered in evidence affidavit of Ramesh Pandita, Sr.Divisional Manager Ex.OP-A and affidavit of Sh.Baljit Singh, Investigator Ex.OP-B, and documents Ex.OP-1 to Ex.OP-6 and closed the evidence. On conclusion of evidence and arguments, the District Forum dismissed of the complaint of the complainant, as referred to above. Dissatisfied with the above order of District Forum Patiala dated 17.05.2017, the complainant now appellant has directed this appeal against the same.
5. We have heard the learned counsel for the parties at considerable length and have also examined the record of the case. The District Forum has dismissed the complaint of the complainant on the primary ground that husband of the complainant namely Fateh Singh was not proved to be an employee of OP No.2 and as such he was not insured with OP No.1 and hence no insurance claim First Appeal No.562 of 2017 6 can be released to the complainant in this case. The matter can be adjudicated with the aid of evidence on the record by us. The complainant filed her affidavit and testified that she is the widow of Fateh Singh and he was insured with Group Insurance Scheme by OP No.2 and OP No.1 had issued a Group PA(unnamed) Policy to OP No.2 covering their 25 employees including husband of the complainant. She further deposed that her husband met with an accident with an unknown vehicle on 02.03.2013 and was admitted at Rajindra Hospital, Patiala for his treatment. Manpreet Singh son of the complainant lodged an FIR on 03.03.2014 with the police regarding the accident of his father. OP No.1 had received information regarding death of her husband through OP No.2. OP No.1 deputed an investigator to procure the requisite documents from her. The requisite documents demanded by OP No.1 from her were supplied to the investigator appointed by OP no.1. The dealing hand of OP No.1 demanded employment certificate in respect of deceased employee and the same was also handed over in original to the dealing hand of OP No.1. After getting no reply from Op no.1, she issued legal notice dated 27.11.2014 for claiming the insurance claim of her husband, but to no effect. Ex.C-1 attendance register has been perused and the name of Fateh Singh does not figure in 22 employees names given in it. This attendance register is from April 2009 to March 2013. The pay bill register has also been perused by us and the name of Fate Singh deceased is not shown in it. Ex.C-2 is with regard to payment of Rs.6500/- at serial No.34. The amount of Rs.6500/- is against account number of Fateh Singh. Ex.C-3 to First Appeal No.562 of 2017 7 Ex.C-13 are the payment receipts of Rs.6500/- pertaining to premium and account numbers are mentioned in it. Ex.C-14 is statement of bank account No.10006124142. Ex.C-15 is postmortem report regarding death of Fateh Singh. Ex.C-16 is FIR, Ex.C-17 is certificate that S.Fateh Singh was working in the institution as Manager (Judicial Matters) with Chardikala Patiala w.e.f 04.01.1990 to 02.03.2013. Ex.C-18 is legal notice. Ex.C-19 is letter regarding accidental death of Late Sh.Fateh Singh, as addressed to the complainant. Ex.C-21 and Ex.C-22 are identity cards of Fateh Singh. OP No.1 also tendered the counter affidavit of Ramesh Pandita, Sr.Divisional Manger, New India Assurance Company Ltd. He stated that the claim of the complaint has already been repudiated, vide letter dated 31.03.2014, as per terms and conditions of the policy, as the claimant and his employer failed to supply any documentary proof to show the employablilty of the deceased and claimant was asked through letter dated 10.02.2014 to approach the said firm M/s Chardikala Publications Pvt. Ltd by providing the necessary documents, such as, salary statement, attendance register, appointment order of the deceased with the insured. The certificate attached with the complaint is on the letter pads of Daily Chardikala, Patiala Delhi, which is the sister concern of the insured firm and in the complaint, the claimant herself says that deceased was working with firm Chardikala Newspaper, where as the firm insured with the OP is Chardikala Publications Pvt. Ltd. Op No.1 is still ready to settle the claim, if the claimant and OP no.2 produced the salary statement, attendance register, appointment order of the deceased, First Appeal No.562 of 2017 8 as required under the terms and conditions of the policy from the complainant. OP further denied that husband of the complainant was working as employee of M/s. Chardikala Publications Pvt. Ltd. and was working with it since 01.04.1990 and there was no relation insured and insurer between them. Affidavit of Baljit Singh Investigator is Ex.OP B on the record. Ex.OP-1 is the salary statement of the deceased for the month of September 2009 of Chardikala Publications Pvt. Ltd. Patiala, wherein the name of Fateh Singh is not recorded.
6. From perusal of above referred evidence on the record, we have come to this conclusion that Group PA(unnamed) Policy was taken from Op No.1 by Chardikala Publications Pvt. Ltd. for the period 22.03.2012 to 21.03.2012 for its 25 employees. Version of the complainant is that her husband was not the employee of Chardikala Publications Pvt. Ltd., but he was the employee of its sister concern i.e. Daily Chardikala Patiala. Vide insurance policy in question, OP No.1 insured 25 unnamed employees of Chardikala Publications Pvt. Ltd. and not of its sister concern Daily Chardikala Patiala. It is clear from certificate Ex.C-17 and the identity card of Fateh Singh Ex.C-21 that he was an employee of Daily Chardikala Patiala-Delhi and not of employee of Chardikala Publications Pvt. Ltd., which was insured in this case under the master plan of insurance policy with OP No.1. The documents Ex.C-17, Ex.C-21 of the complainant show that he was the employee of Daily Chardikala, Patiala. Ex.C-17, has thus proved that this document was issued by Daily Chardikala Patiala- First Appeal No.562 of 2017 9 Delhi to Fateh Singh. It was not issued by Chardikala Publications Pvt. Ltd, which was insured under the master plan with OP No.1 in this case. Identity card Ex.C-21 cannot be taken to be a fake document ex facie in this case. Complainant alleged copy of attendance register, as fake, but failed to establish any evidence on the record to the contrary. Complainant has not brought any evidence to establish the fact that Fateh Singh was an employee of Chardikala Publications Pvt. Ltd. The sister concern Daily Chardikala has no relation with Op No.1 and it is Chardikala Publications Pvt. Ltd., which obtained the insurance policy for its unnamed 25 employees from OP No.1. Consequently, we find that District Forum correctly held that Fateh Singh, the husband of the complainant, was not proved to be the employee of OP No.2 and he was not insured with Op No.1 under the policy and thereby rightly dismissed the complaint of the complainant. We have nothing to disagree with the findings of District Forum, as recorded in the order under challenge in this appeal.
7. As a corollary of our above discussion, we find no illegality or material infirmity in the order of District Forum and the same is affirmed in this appeal. Finding no merit in the appeal, the same is hereby dismissed.
8. Arguments in this appeal were heard on 27.11.2017 and the order was reserved. The certified copies of the order be communicated to the parties under rules.
First Appeal No.562 of 2017 10
9. The appeal could not be decided within the statutory period due to heavy pendency of court cases.
(J. S. Klar) Presiding Judicial Member December 04, 2017 Rupinder-2