State Consumer Disputes Redressal Commission
Bajaj Allianz Life Insurance Co. Ltd. vs Smt. Sarla Devi. & Anr. on 6 March, 2017
H. P. STATE CONSUMER DISPUTES REDRESSAL
COMMISSION SHIMLA
First Appeal No. : 254/2016
Date of Presentation: 28.07.2016
Order Reserved On : 01.03.2017
Date of Order : 06.03.2017
......
Bajaj Allianz Life Insurance Company Limited
Branch Office Mandi District Mandi H.P.
through its Branch Manager Bajaj Allianz Life Insurance Co.
Shimla Branch Aggarwal Bhawan Opposite Gurudwara Sahib
Sanjauli Shimla-171006 Himachal Pradesh.
...... Appellant/Opposite Party No.1
Versus
1. Sarla Devi w/o Shri Bhagat Ram
Resident of Village Nadgran Post Office Mohal
Tehsil Bhuntar District Kullu H.P.
......Respondent/Complainant
2. Himachal Gramin Bank Branch Office Dohra Nala
Post Office Mohal Tehsil Bhuntar
District Kullu Himachal Pradesh.
...... Respondent/Opposite Party No.2
Coram
Hon'ble Justice P.S. Rana (R) President
Hon'ble Mr. Vijay Pal Khachi Member
Hon'ble Mrs. Meena Verma Member
Whether approved for reporting?1 Yes.
For Appellant : Mr. Jagdish Thakur Advocate.
For Co-respondent No.1 : Mr. Maan Singh Advocate.
For Co-respondent No.2 : Mr. Jagat Shyam Advocate.
JUSTICE P.S. RANA (R) PRESIDENT:
O R D E R:- Present appeal is filed under section 15 of Consumer Protection Act 1986 against order passed by learned District Forum in consumer complaint No.69/2014 1 Whether reporters of the local papers may be allowed to see the order? Yes. Bajaj Allianz Life Insurance Co. Ltd. Versus Sarla Devi & Anr. (F.A. No.254/2016) title Sarla Devi Versus Bajaj Allianz Life Insurance Co. Ltd. & Anr. decided on 16.05.2016.
Brief facts of Case:
2. Complainant Sarla Devi filed complaint under section 12 of Consumer Protection Act 1986 pleaded therein that her deceased husband namely Bhagat Ram was insured with Bajaj Allianz Life Insurance Co. Ltd. under 'Swayam Shakti Suraksha' policy. It is pleaded that name of master policy holder was 'Himachal Gramin Bank' and master policy was commenced w.e.f. 09.03.2009. It is further pleaded that deceased Bhagat Ram was insured vide membership No.9995095208 for a sum of Rs.50000/- (Fifty thousand). It is pleaded that annual premium was Rs.2000/- (Two thousand). It is further pleaded that Bhagat Ram died on 30.12.2013. It is further pleaded that after death of Bhagat Ram complainant submitted all relevant documents to insurance company but insurance company only paid Rs.5000/- (Five thousand) and denied payment of balance amount. Complainant sought following reliefs (i) Payment of Rs.100000/- (One lac) (ii) In addition complainant sought costs of complaint amounting to Rs.25000/- (Twenty five thousand) and complainant also sought special damages to the tune of Rs.10000/- (Ten thousand).
2
Bajaj Allianz Life Insurance Co. Ltd. Versus Sarla Devi & Anr. (F.A. No.254/2016)
3. Notice was issued to Bajaj Allianz Life Insurance Co. Ltd. by District Forum Kullu for 07.08.2014. Service upon Bajaj Allianz Life Insurance Co. Ltd. was effected through process server namely Desh Raj. Process server namely Desh Raj also filed affidavit alongwith service report to the effect that Bajaj Allianz Life Insurance Co. Ltd. was duly served by him. None appeared on behalf of Bajaj Allianz Life Insurance Co. Ltd. before District Forum despite service. Learned District Forum proceeded Bajaj Allianz Life Insurance Co. Ltd. ex-parte on dated 07.08.2014.
4. Per contra version filed on behalf of opposite party No.2 Himachal Gramin Bank pleaded therein that agent of insurance company used to come to bank for collecting premium of policy in the month of September every year and opposite party No.2 Himachal Gramin Bank used to debit premium from saving bank account of insured. It is pleaded that in the year 2013 agent of insurance company did not come to branch of opposite party No.2 Himachal Gramin Bank in the month of September 2013 but came in the month of November 2013 and collected premium of insurance policy from Himachal Gramin Bank on dated 07.11.2013. It is pleaded that opposite party No.2 Himachal Gramin Bank supplied all relevant documents to opposite party No.1. It is 3 Bajaj Allianz Life Insurance Co. Ltd. Versus Sarla Devi & Anr. (F.A. No.254/2016) pleaded that claim would be settled by opposite party No.1 i.e. Bajaj Allianz Life Insurance Company Ltd.
5. Learned District Forum ordered opposite party No.1 Bajaj Allianz Life Insurance Company Ltd. to pay Rs.45000/- (Forty five thousand) alongwith interest @9% per annum. Learned District Forum further ordered that insurance company would pay compensation to the tune of Rs.5000/- (Five thousand). Learned District Forum further ordered that insurance company would also pay litigation costs to the tune of Rs.3000/- (Three thousand).
6. Feeling aggrieved against order passed by Learned District Forum Bajaj Allianz Life Insurance Co. Ltd. filed present appeal before State Commission.
7. We have heard learned advocate appearing on behalf of appellant and we have also heard learned advocates appearing on behalf of respondents and we have also perused entire record carefully.
8. Following points arises for determination in present appeal.
1. Whether appeal filed by the appellant is liable to be accepted as mentioned in memorandum of grounds of appeal.
2. Final order.
4 Bajaj Allianz Life Insurance Co. Ltd. Versus Sarla Devi & Anr. (F.A. No.254/2016) Findings upon point No.1 with reasons:
9. Complainant Sarla Devi filed affidavit by way of evidence. There is recital in affidavit that husband of deponent Shri Bhagat Ram was enrolled as member of Group Insurance Scheme and was insured in the amount of Rs.50000/- (Fifty thousand). There is further recital in affidavit that Bajaj Allianz Life Insurance Co. Ltd. issued policy. There is further recital in affidavit that annual premium of insurance policy was Rs.2000/- (Two thousand).
There is further recital in affidavit that on 30.12.2013 insured Bhagat Ram died. There is further recital in affidavit that after death of Bhagat Ram complainant submitted all relevant documents before insurance company but insurance company only paid Rs.5000/- (Five thousand) and did not pay balance insurance amount. There is further recital in affidavit that complainant visited office of insurance company many times but insurance company prolonged the matter on one pretext or the other.
10. None appeared on behalf of Bajaj Allianz Life Insurance Co. Ltd. despite service. Bajaj Allianz Life Insurance Co. Ltd. did not file any version and also did not adduce any evidence.
5 Bajaj Allianz Life Insurance Co. Ltd. Versus Sarla Devi & Anr. (F.A. No.254/2016)
11. Opposite party No.2 i.e. Himachal Gramin Bank filed affidavit of Branch Manager by way of evidence. There is recital in affidavit that agent of opposite party No.1 used to come to Himachal Gramin Bank for collecting premium of policy in the month of September every year and Himachal Gramin Bank used to debit premium from saving bank account of insured. There is further recital in affidavit that in the year 2013 agent of Bajaj Allianz Life Insurance Co. Ltd. did not come to Himachal Gramin Bank in the month of September but came in the month of November 2013 and collected premium of insurance policy from Himachal Gramin Bank on 07.11.2013. There is further recital in affidavit that Himachal Gramin Bank supplied all relevant documents to Bajaj Allianz Life Insurance Co. Ltd. for settlement of claim.
12. Submission of learned advocate appearing on behalf appellant that learned District Forum proceeded ex- parte against Bajaj Allianz Life Insurance Co. Ltd. illegally and on this ground appeal be allowed is rejected being devoid of any force for reasons hereinafter mentioned. We have carefully perused order of learned District Forum. It is proved on record that notice was issued to Bajaj Allianz Life Insurance Co. Ltd. for 07.08.2014. It is proved on record that process server namely Desh Raj effected service upon Branch Manager of insurance company and Branch Manager of 6 Bajaj Allianz Life Insurance Co. Ltd. Versus Sarla Devi & Anr. (F.A. No.254/2016) insurance company received summons on dated 25.07.2014 with signatures and endorsement of Bajaj Allianz Life Insurance Co. Ltd. It is also proved on record that process server has also filed affidavit that he has served notice alongwith copy of complaint to Branch Manager of insurance company. Insurance company did not file any affidavit of Branch Manager in order to prove that service was not effected upon insurance company. Even insurance company did not examine process server who has effected service in order to prove that Branch Manager was not properly served. Insurance company also did not file any affidavit of process server on record in order to prove that Branch Manager of insurance company was not properly served. Report submitted by process server upon notice is supported with affidavit. It is held that insurance company did not prove the fact that insurance company was not duly served by learned District Forum. Plea of insurance company relating to service is defeated on the concept of ipse-dixit (An assertion made without proof).
13. Submission of learned advocate appearing on behalf of appellant that Manager was not having good relations with management of insurance company and he resigned from service in the year 2015 without bringing any such case to the notice of insurance company and on this 7 Bajaj Allianz Life Insurance Co. Ltd. Versus Sarla Devi & Anr. (F.A. No.254/2016) ground appeal be allowed is rejected being devoid of any force for reasons hereinafter mentioned. Submission of appellant that Assistant Manager was not having good relations with management is an issue of fact and not issue of law. Insurance company did not file any evidence on record in order to prove the fact that Assistant Manager was not having good relations with management. Even insurance company did not file any application in order to implead Assistant Manager as co-party in the present case. It is well settled law that no one should be condemned unheard on the concept of Audi Altem Partem. We are of opinion that no finding against Assistant Manager can be given in the present case because Assistant Manager is not co-party in the present case.
14. Submission of learned advocate appearing on behalf of appellant that terms and conditions of insurance policy were flouted and premium due on 28.09.2013 was not paid and policy comes to an end automatically after non- payment of premium due on 28.09.2013 and on this ground appeal be allowed is also rejected being devoid of any force for reasons hereinafter mentioned. Shri D.D. Dhiman Branch Manager Himachal Gramin Bank has specifically mentioned in affidavit produced in evidence that agent of insurance company collected premium on behalf of insurance company on 07.11.2013. It is held that company is liable for the act of 8 Bajaj Allianz Life Insurance Co. Ltd. Versus Sarla Devi & Anr. (F.A. No.254/2016) agent. Insurance company did not file any affidavit of agent by way of evidence in order to prove that agent of company did not collect premium on dated 07.11.2013. It is held that when premium was collected by agent of insurance company on 07.11.2013 then conditions mentioned in insurance policy waived by insurance company through its agent. Affidavit filed by Branch Manager Himachal Gramin Bank remained un-rebutted on record. Insurance company did not file any counter affidavit in order to dispute the fact alleged by Branch Manager Himachal Gramin Bank in affidavit placed on record. It is proved on record that Shri Bhagat Ram died on 30.12.2013. It is held that insurance company cannot be exonerated from liability because agent of insurance company had received premium prior to death of Bhagat Ram on behalf of insurance company. It is well settled law that party cannot be allowed to approbate and reprobate at the same time. See AIR 1993 Apex Court 352 R.N. Gosain Versus Yashpal Dhir. It is well settled law that master is liable for act done by his agent relating to financial irregularities. See 1998(1) CPC 185 HP Chairman-cum-Managing Director Golden Forests India Ltd. Versus Smt. Champa Devi & Ors. It is well settled law that Consumer Protection Act 1986 is beneficial legislation and it should receive liberal 9 Bajaj Allianz Life Insurance Co. Ltd. Versus Sarla Devi & Anr. (F.A. No.254/2016) construction. See 2007(4) SCC 579 Apex Court Kishore Lal Versus Chairman Employees State Insurance Corporation.
15. It is well settled law that breach of policy condition should be proved by insurer to establish fundamental breach. It is also well settled law that burden to prove to establish the breach of policy condition lies on insurer. In the present case insurance company did not discharge the burden by way of evidence as required under law. In the present case none appeared on behalf of insurance company before District Forum despite service of notice of complaint. Insurance company did not file any written version before learned District Forum and even insurance company did not adduce any evidence in support of its case before learned District Forum. In the present case complainant is a widow lady. Fact of violation of condition of insurance policy is issue of fact not issue of law. Issue of fact should be proved by insurance company through positive evidence. See 2016(3) SCC 100 Apex Court Lakhmi Chand Versus Reliance General Insurance Company. In view of above stated facts point No.1 is answered in negative.
Point No.2: Final Order
16. In view of findings upon point No.1 appeal is dismissed. Order of Learned District Forum is affirmed. Parties are left to bear their own costs. File of learned District 10 Bajaj Allianz Life Insurance Co. Ltd. Versus Sarla Devi & Anr. (F.A. No.254/2016) Forum alongwith certified copy of order be sent back forthwith and file of State Commission be consigned to record room after due completion forthwith. Certified copy of order be transmitted to parties forthwith strictly as per rules. Appeal is disposed of. Pending application(s) if any also disposed of.
Justice P.S. Rana (R) President Vijay Pal Khachi Member Meena Verma Member 06.03.2017.
GAURAV} 11