State Consumer Disputes Redressal Commission
Oriental Insurance Company Limited vs Varinder Singh on 11 May, 2012
2nd Bench
STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PUNJAB
SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.
First Appeal No.1176 of 2009.
Date of Institution: 20.08.2009.
Date of Decision: 11.05.2012.
Oriental Insurance Company Limited through its Branch Manager, Branch
Office No.3, 26 Kennedy Avenue, Court Road, Amritsar.
.....Appellant.
Versus
1. Varinder Singh (minor) son of late Sh. Amarjit Singh;
2. Harmeet Kaur (Minor) daughter of late Sh. Amarjit Singh;
Both through their Uncle Manjit Singh, as next friend and guardian of
minors, Residents of Patti Mastu Ki, Village & Post Office Varpal,
District Amritsar.
3. Dharam Parchar Committee through its Secretary, Teja Singh
Samundari Hall, Amritsar.
...Respondents.
First Appeal against the order dated
14.07.2009 of the District Consumer
Disputes Redressal Forum, Amritsar.
Before:-
Shri Inderjit Kaushik, Presiding Member.
Shri Piare Lal Garg, Member.
Present:- Sh. Rahul Sharma, Advocate, for Ms V.A. Talwar, Advocate counsel for the appellant.
Ms Aparna Jain, Advocate, counsel for the respondents no.1&2. Sh. Mrigank Sharma, Advocate for Ms P.K. Sekhon, Advocate Counsel for respondent no.3.
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INDERJIT KAUSHIK, PRESIDING MEMBER:-
Oriental Insurance Company Limited, appellant (In short "the appellant") has filed this appeal against the order dated 14.07.2009 passed by the learned District Consumer Disputes Redressal Forum, Amritsar (in short "the District Forum").
2. Facts in brief are that Sh. Varinder Singh and Harmeet Kaur (minors), respondents no.1 & 2/complainants (hereinafter called as "the First Appeal No.1176 of 2009 2 respondents no.1 & 2") filed a complaint under section 12 of the Consumer Protection Act, 1986 (in short, "the Act"). It was pleaded that they are the minor son and daughter of late Sh. Amarjit Singh S/o Sh. Raghbir Singh. Smt. Kamaljit Kaur, mother of the respondents no.1 & 2 had already died prior to the death of their father. Sh. Amarjit Singh father of the respondents No.1 & 2 died on 22.10.2007 due to slip of foot from the stairs at his residence early in the morning. Both the respondents are in custody and care of their uncle Sh. Manjit Singh, who is looking after their interest and the present complaint has been filed through him and he has no adverse interest against the respondents no.1 & 2.
3. Sh. Amarjit Singh father of the respondents no.1 & 2 was an employee of respondent no.3 and took Group Insurance Accident Policy on 12.01.2007 for a period of one year ending on 11.01.2008 and respondent no.3 deducted Rs.248/- from his salary. The deceased was insured for a total sum of Rs.7,50,000/- as per the cover note. Respondents no.1 & 2 through their uncle Manjit Singh informed immediately to the respondent no.3, being employer, and requested to lodge insurance claim with the insurance company. Respondent no.3 told respondents no.1 & 2 that the claim has been lodged with the appellant and the same will be settled shortly. It was the duty of respondent no.3 to lodge the claim of deceased employee Amarjit Singh with the insurance company, as respondent no.3 had taken the group insurance policy from the insurance company. After waiting for a long time, the uncle of respondents no.1 & 2 himself lodged the claim with the appellant at their Regional Office at Chandigarh on 16.07.2008 under registered cover.
4. Respondents no.1 & 2 requested respondent no.3 number of times to arrange insurance claim of the deceased, but the appellant and respondent no.3 have neither paid the insurance claim, nor repudiated the same. A legal notice dated 16.10.2008 was served upon the appellant and respondent no.3, but no reply was given. Respondents no.1 & 2 are the minors and have no source of income and are facing hardship due to First Appeal No.1176 of 2009 3 negligence and deficiency in service on the part of the appellant and respondent no.3 and prayed that the appellant be directed to pay Rs.7,50,000/- i.e. the sum assured to respondents no.1 & 2 along with interest @ 18% p.a. and Rs.25,000/- as compensation and litigation expenses.
5. In the reply filed on behalf of the appellant, preliminary objections were taken that the present complaint has been filed on the basis of Group Personal Accident Insurance Policy obtained by respondent no.3 for its employees from the appellant. Under the personal insurance policy, the claim is only payable when the death has been caused on account of accident but in the present case, there was no symptoms of any injury or the accident and in order to verify, the matter was referred to M/s Royal Associates, who carried out detailed investigation and concluded that Sh. Amarjit Singh died of heart attack and not on account of personal accident. He was found lying dead on his bed on 22.10.2007 in the morning, as confirmed by different persons whose statements have been recorded and he suffered heart attack in the night of 21.10.2007. Sh. Kirpal Singh, who is neighbourer of the deceased, also saw him lying dead on the bed and respondents no.1 & 2 are not entitled to any claim under the personal accident policy and the claim was rightly repudiated. No relief of compensation and interest can be granted. The present complaint has been filed by the minors, but no permission of the Guardian Court has been obtained. In the present case, neither any intimation was given to the police nor any postmortem examination was conducted and in the absence of these documents, the cause of death of deceased cannot be decided.
6. On merits, similar pleas as taken in the preliminary objections were repeated and denying other allegations of the complaint, it was prayed that the complaint may be dismissed.
7. In the reply filed on behalf of respondent no.3, preliminary objections were taken that respondents no.1 & 2 are not the consumers qua First Appeal No.1176 of 2009 4 respondent no.3, in respect of Group Personal Accident Insurance Policy of the Oriental Insurance Co. Ltd. issued in respect of 1218 employees of Dharam Parchar Committee of SGPC, Amritsar with regard to whom, an amount of Rs.2,50,631/- was received as premium by the insurance company vide cover note no.175850 dated 11.01.2007. The name of Amarjit Singh S/o Raghbir Singh appears at serial no.36 at schedule no.2 at page-1 of the list of employees covered under the said policy. The appellant insured the employees and issued the Group Personal Accident Insurance Policy in respect of such employees and is also liable to pay the amount of insurance covered under the said policy. The answering respondent is not the insurer and the complaint is liable to be dismissed. No cause of action has arisen to respondents no.1 & 2 to file the complaint against the answering respondent, nor there is any deficiency in service on its part.
8. On merits, it was admitted that respondents no.1 & 2 are the minor son and daughter of deceased Amarjit Singh, who died on 22.10.2007. The insurance company i.e. the appellant was informed about the death of Amarjit Singh on 22.10.2007. Thereafter, reminders dated 18.12.2007 and 08.01.2008 were written by the answering respondent to the appellant to pay the claim amount in respect of the accidental death of Amarjit Singh. The appellant should honour its commitment under the said insurance policy of 1218 employees of the Dharam Parchar Committee, SGPC, Amritsar. The appellant is jointly and severally liable to pay the insurance amount. Other allegations of complaint were denied and dismissal of the complaint against the answering respondent was prayed.
9. Parties led evidence in support of their respective contentions by way of affidavits and documents.
10. After going through the documents and material placed on file and after hearing the learned counsel for the parties, the learned District Forum observed that investigator examined Sh.Manjit Singh, Kirpal Singh, Jaimal Singh, Gurmeet Singh, Kuldip Singh and Amrik Singh and only Kirpal First Appeal No.1176 of 2009 5 Singh and Amrik Singh stated that deceased died due to heart attack, whereas other four persons stated that he died due to fall from the stairs of his house and he suffered head injury. The report of the investigator is defective and is liable to be ignored. Relying upon the affidavits of Kuldip Singh, Nambardar and Jaimal Singh and other relevant factors, allowed the complaint, directing the appellant to pay Rs.7,50,000/- along with interest @ 6% from the date of complaint till payment and Rs.10,000/- as compensation.
11. Aggrieved by the impugned order dated 14.07.2009, the appellant has come up in appeal.
12. We have gone through the pleadings of the parties, perused the record of the learned District Forum and have heard the arguments advanced by the learned counsel for the parties.
13. It was contended on behalf of the appellant that there is no evidence on record to prove that deceased Amarjit Singh died due to accident. The matter was neither reported to the police about any accident, nor any postmortem examination was conducted to find out the cause of the death. The appellant was liable to pay the claim only in case the assured was involved in an accident and not otherwise. It was further contended that in the present case, Sh. Amarjit Singh died due to heart attack on 22.10.2007 while lying on the bed. He was not taken to any hospital for postmortem examination, nor any injury on his person was proved. The appellant insurance company appointed the investigator, who investigated the matter and concluded that the deceased died because of the heart attack and no accident took place. The claim was rightly repudiated and the order of the District Forum, being against the facts and the evidence on record, is liable to be set aside.
14. On the other hand, it was contended on behalf of the respondents no.1 & 2 that the deceased life assured took the personal accident insurance policy in Group Personal Accident Insurance Policy through respondent no.3. Respondent no.3 obtained the personal accident First Appeal No.1176 of 2009 6 insurance policy for its 1218 employees of Dharam Parchar Committee of SGPC, Amritsar and paid Rs.2,50,631/- as premium to the appellant vide cover note dated 11.01.2007. The appellant was bound to honour the terms and conditions of the policy and to pay the claim amount.
15. It was further contended that the deceased Amarjit Singh died due to fall from the stairs and could not be taken to any hospital. The investigator of the appellant recorded the statements of six witnesses, out of which only two witnesses supported the version of the appellant, whereas the remaining four witnesses supported the version of respondents no.1 & 2 and clearly stated that deceased Amarjit Singh died due to fall from the staircase. The report of the investigator is not fair and impartial and no reliance can be placed on the same. It was further contended that the case of respondents no.1 & 2 is further supported by the affidavit of Kuldip Singh, Nambardar Ex.C-10 and Jaimal Singh of the same village Ex.C-11. The District Forum has rightly appreciated the evidence on record and has passed a detailed and speaking order and there is no ground to interfere with the same and the appeal deserves dismissal.
16. We have considered the respective submissions advanced by the learned counsel for the parties and have carefully examined the entire record placed on the file.
17. The appellant insurance company mainly relied upon the report of the investigator in repudiating the claim of the minors, but the appellant insurance company has read the report of the investigator Ex.R-3 in piecemeal manner. The evidence which was in favour of the appellant insurance company was relied, but the evidence which was against the appellant insurance company was discarded. As per the report Ex.R-3, the investigator recorded the statements of Sh.Manjit Singh, Kirpal Singh, Jaimal Singh, Gurmeet Singh, Kuldip Singh and Amrik Singh. Out of these six witnesses, only two witnesses stated before the investigator that the deceased Amarjit Singh died of heart attack at night, whereas the other four First Appeal No.1176 of 2009 7 witnesses stated that he fell from the stairs of his house and died. Thus, the report of the surveyor is not impartial and has been rightly discarded by the District Forum. Although, the deceased was not taken to any hospital, nor there is any postmortem examination report, yet the evidence of the respondents which is supported by the evidence of Kuldip Singh, Nambardar and Jaimal Singh, who submitted their affidavits Ex.C-10 and Ex.C-11 and the report of the investigator Rx.R-3 if read together, go to prove that deceased Amarjit Singh fell from the staircases on 21.10.2007 and died in the morning of 22.10.2007. The repudiation of the claim of the minors by the appellant insurance company was not justified and the District Forum has passed a detailed and speaking order and there is no ground to interfere with the same.
18. In view of above discussion, the appeal being without any merit is dismissed and the impugned order under appeal dated 14.07.2009 passed by the District Forum is affirmed and upheld. No order as to costs.
19. The appellant had deposited an amount of Rs.25,000/- with this Commission at the time of filing of the appeal. This amount with interest accrued thereon, if any, be remitted by the registry to the respondents no.1 & 2 in equal shares, by way of a crossed cheque/demand draft after the expiry of 45 days under intimation to the learned District Forum and to the appellant.
20. Remaining amount shall be paid by the appellant to respondents no.1 & 2 in accordance with the order of the District Forum within two months of the receipt of copy of the order.
22. The arguments in this appeal were heard on 08.05.2012 and the order was reserved. Now the order be communicated to the parties.
23. The appeal could not be decided within the stipulated timeframe due to heavy pendency of court cases.
(Inderjit Kaushik) Presiding Member (Piare Lal Garg) Member May 11, 2012.
(Gurmeet S)