State Consumer Disputes Redressal Commission
United India Insurance Company Ltd. vs Bhawal Jain on 4 June, 2024
ADDITIONAL BENCH
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, CHANDIGARH
First Appeal No.558 of 2022
Date of Institution : 04.07.2022
Date of Reserve : 14.05.2024
Date of Decision : 04.06.2024
United India Insurance Company Limited through its Branch
Manager, Branch Office, Gaushala Road, Mansa, Tehsil & District
Mansa, Punjab.
Now represented through the duly authorized signatory of Legal
Cell at 3rd Floor, Surya Tower, 108 The Mall, Ludhiana-141001.
....Appellant/opposite party
Versus
Bhawal Jain S/o Sh.Hem Raj R/o Ward No.3, Punjab National
Bank Street, Bareta, Tehsil Budhlada, District Mansa, Punjab.
.....Respondent/complainant
First Appeal under Section 41 of the
Consumer Protection Act, 2019 against the
order dated 28.04.2022 of the District
Consumer Disputes Redressal Commission,
Mansa.
Quorum:-
Mr.Harinderpal Singh Mahal, Presiding Judicial Member
Mrs. Kiran Sibal, Member Present:-
For the appellant : Sh.Nitin Gupta, Advocate For the respondent : Sh.Deepak Aggarwal, Advocate
HARINDERPAL SINGH MAHAL, PRESIDING JUDICIAL MEMBER This appeal has been preferred by the appellant/opposite party- United India Insurance Co. Ltd. against the order dated First Appeal No 558 of 2022 2 28.04.2022 passed by the District Consumer Disputes Redressal Commission, Mansa (in short 'District Commission') whereby the complaint filed by the complainant under Section 12 of the Consumer Protection Act, 1986 (in short 'the Act') was partly accepted with costs of Rs.1,000/- and opposite party was directed to pay Rs.3,64,000/- to the complainant along with compensation @9% per annum from the date of repudiation of the claim till actual realization.
It would be apposite to mention that hereinafter the parties will be referred, as have been arrayed before the District Commission.
2. In nutshell, the facts of case are that the complainant is the owner of car "Chevrolet Sail" bearing Registration No. PB31M 3784 of 2013 Model and the same was insured with the opposite party, vide Insurance Policy No.2004033117P113216289 for the period 16.12.2017 to 15.12.2018. On 29/30.06.2018, the vehicle met with an accident with the divider, near Tinkoni, Mansa due to non available of light and signboards on the over-bridge. At the time of accident, it was driven by Bhawal Jain, son of the complainant. Sh.Bhawal Jain has valid driving license at the time of accident. The intimation of accident was given to police station on 02.07.2018 as well as opposite party. The Surveyor Sh.Chhatwal was appointed by the opposite party to assess the loss and as per the surveyor the loss was Rs.3,64,000/-. After the surveyor's report, the complainant submitted the claim with proper documents to the opposite party to make the compensation but ultimately the First Appeal No 558 of 2022 3 opposite party, vide letter dated 27.02.2019 repudiated his claim on the ground of breaching the policy terms and conditions, specially Condition No.9. It is further alleged that merely that the Insurance Policy is social security measure to provide some relief in the time of distress and merely on the breach of condition No.9, claim cannot be repudiated and the complainant is entitled to recover this amount and the complainant approach the District Commission by filing the present complaint seeking following reliefs:
i) to pay the compensation of Rs.3,64,000/- along with interest @12% per annum from 01.07.2018 till realization;
ii) to pay Rs.50,000/- as compensation for mental harassment; and
iii) to pay Rs.10,000/- as litigation charges.
3. Upon notice, opposite party appeared and filed their written reply taking preliminary objection that the complainant is not a consumer as per the Consumer Protection Act and the complainant is not the natural legal heir of deceased Sh.Hem Raj because there are other legal heirs of Sh.Hem Raj. The complainant has no cause of action and locus standi to file the present complaint. The complainant has filed a false and vexatious complaint on false grounds just to harass the opposite party. The complainant himself has violated the terms and conditions of the policy. It is further pleaded that the complainant has not impleaded the daughters of Sh.Hem Raj as a party, who are one of the legal heirs. It is further pleaded that at the time of accident Bhawal Jain was driving the First Appeal No 558 of 2022 4 vehicle and the vehicle is in the name of Sh.Hem Raj, who was the father of the present complainant but Sh.Hem Raj died on 29.12.2017 i.e. 6 months prior to the date of alleged accident. Further pleaded that even after lapse of 6 months, the policy has not been transferred in the name of legal heirs, which is a clear violation of the policy terms and conditions because policy was enforced from 16.12.2017 to 15.12.2018 and Sh.Hem Raj expired on 29.12.2017 and the policy was supposed to be transferred within three months from the date of death of the insured. On merits, it is pleaded that the LRs of the deceased failed to comply with the terms and conditions of the policy and that is why the claim was repudiated. Other averments of the complainant averred in the complaint were denied and prayed for dismissal of the complaint.
4. The parties led their evidence in support of their respective contentions before the District Commission and after hearing the contentions of the parties, the complaint was partly allowed, vide impugned order dated 28.04.2022.
5. Aggrieved by the said order, this appeal has been filed by the appellant/opposite party for setting aside the impugned order dated 28.04.2022 and to allow their appeal.
6. We have heard the contentions of the parties and have carefully gone through the record as well as written arguments filed by the parties and have given our thoughtful consideration to the same.
First Appeal No 558 of 2022 5
7. The appellant/opposite party submitted their written arguments and orally submitted that the District Commission has failed to appreciate the objections raised by the appellant/opposite party that the claim was repudiated merely on the ground of violation of terms and conditions of the policy and specifically condition No.9 of the policy.
8. Learned counsel for the appellant submitted that the transfer of the policy in the name of legal heirs is not merely technicality but this is mandatory because the Insurance claim was to be paid in equal portion to all the legal heirs and a single legal heir cannot claim whole of the insurance amount. We agreed with the law laid down by the Hon'ble Supreme Court that the insurance claim should not be in rejected merely on technical grounds but has ascertained that this transfer of the policy is not a technical ground but this is a serious matter, which has to be taken into consideration while ascertaining the disbursement of the insurance amount. The name of the incumbent of the deceased can only be seen from the Succession Certificate.
9. On the other hand, learned counsel for the respondent/ complainant urged that though as per condition No.9 of the policy, it is mentioned that after the death of the insured, the policy is to be transferred in the name of the legal heirs but he asserted that in the policy word 'may' has been used that the policy may be transferred in the name of legal heirs but it is not mandatory to get the policy transferred. So, it was not incumbent on the legal heir/s to get the First Appeal No 558 of 2022 6 policy transferred and the District Commission has rightly decided the matter in favour of the respondent/complainant.
10. It is very much important to have a look into condition No.9 of the policy, which is reproduced as under:
"9. In the event of the death of the sole insured, this policy will not immediately lapse but will remain valid for a period of three months from the date of the death of insured or until the expiry of this policy (whichever is earlier). During the said period, legal heir(s) of the insured to whom the custody and use of the Motor Vehicle passes may apply to have this Policy transferred to the name(s) of the heir(s) or obtain a new Insurance Policy for the Motor Vehicle."
11. No doubt, as per this condition, it has been specifically mentioned that the legal heir(s) may apply for the policy and it is totally discretion of the legal heir(s) to get the policy transferred or not but if they do not get it transferred then they cannot claim the relief after three months of the death of the policy holder because after death of the insured, policy ceased to exist and there is no contract between the Insurance Company and the legal heirs because the consumer who obtained the policy is not in existence and it is not mere a technicality but this makes it mandatory for the legal heirs to get their name incorporated in the policy if they want any claim. It is so held by the Hon'ble National Commission in its judgment passed in Revision Petition No. 877 of 2011 titled New India Assurance Co. Vs. Smt. A.Kalavathi, decided on 08.08.2012, wherein it has been held as under:
"After the death of her husband (insured), the complainant should have got the vehicle transferred in her name. It must First Appeal No 558 of 2022 7 be borne in mind that on his death, the husband of the petitioner cesed to be a consumer and their relationship as a consumer and the insurance company as a service provider came to an end. This is not a fact of mere technicality. It is incumbent on the part of the petitioner to get the policy transferred in her name and the insurance company was justified in not settling the claim."
12. Moreover, in our opinion, such objections raised by the appellants-Insurance Company that as per condition No.9, the amount is to be disbursed to the other legal heirs equally and that can only be specified if the legal heirs are impleaded in the policy on the basis of Succession Certificate.
13. In the present case, no Succession Certificate has been adduced by the respondent/complainant to show that he is the only legal heirs of deceased Hem Raj and no other legal heir can claim any amount as prescribed in the policy. Since the Insurance Policy is a contract as similar to the other contracts and the appellant- Insurance Company are very cautious while fulfilling the condition as specified in the terms and conditions of the policy and are strictly construed to those terms and conditions without any further deletion or addition. So, we are fully in agreement of the arguments of the learned counsel for the appellant/opposite party that without fulfilling condition No.9 of the policy, the claim cannot be settled and other heirs should also be disclosed by the respondent/ complainant.
14. The facts of the judgment titled "Om Parkash Vs. Reliance General Insurance" IV(2017) CPJ 10 (SC), as referred by the First Appeal No 558 of 2022 8 respondent/complainant in support of his contentions are quite different from the present set of facts as in the said authority it has been specifically held that the claim should not be rejected merely on the technical grounds in a mechanical manner which will result in loss of confidence of policy holder in the Insurance Company. However, as discussed above, the incorporation of the other legal heirs is not a technical issue but this is purely a legal and mandatory issue which requires to be fulfilled before granting any claim to the legal heirs of the deceased.
15. In view of this, we do not find any merit in the order of the District Commission, where they only granted the claim to one legal heir of deceased Hem Raj by ignoring the mandatory condition of the policy, as such, the order of the District Commission is hereby set aside and the case is remanded back to the District Commission to decide the same afresh after giving the opportunity to the respondent/complainant to produce the Succession Certificate of Hem Raj and by impleading the legal heirs of Hem Raj and to decide the issue on merits.
16. The appellant/opposite party had deposited a sum of Rs.25,000/- at the time of filing of the appeal. It deposited another sum of Rs.2,12,771/-, in compliance of the order 07.07.2022. Both these sums, along with interest accrued thereon, if any, shall be remitted to the appellant/opposite party, after the expiry of 45 days of the sending of certified copy of the order to them, in accordance with law.
First Appeal No 558 of 2022 9
17. The appeal could not be decided within the statutory period due to heavy pendency of the court cases.
(HARINDERPAL SINGH MAHAL) PRESIDING JUDICIAL MEMBER (KIRAN SIBAL) MEMBER June 4th,2024 parmod