Are you looking for a legal research tool ?
Get Started
Do check other products like LIBIL, a legal due diligence tool to get a litigation check report and Case Management tool to monitor and collaborate on cases.

Parvati Devi v. Icici Lombard General Insurance Company Limited And Ors

Parvati Devi v. Icici Lombard General Insurance Company Limited And Ors

(Haryana State Consumer Disputes Redressal Commission, Panchkula)

First Appeal No: 335 of 2019 | 07-04-2022

T.P.S. MANN, J.

1. Delay in filing of the appeal is condoned for the reasons specified in the miscellaneous applications.

2. Complainant Parvati Devi has filed the present appeal against the order dated 25.01.2019 passed by the District Consumer Disputes Redressal Forum, Panipat, whereby complaint filed by her against ICICI Lombard General Insurance Company Limited and others, was dismissed.

3. In her complaint, complainant Smt. Parvati Devi pleaded that her husband Sharawan Kumar alias Sharawan Prasad got himself insured with opposite party No.2 vide insurance policy dated 07.01.2013 under Personal Protect Policy Schedule through opposite party No.4 and the policy was to mature on 06.01.2018. The sum assured was Rs.10 lakhs. The husband of the complainant died on 11.12.2014 in an accident at Patna (Bihar). The complainant informed the opposite parties about the death of her husband and submitted all the requisite documents. As per the complainant, she had again submitted all the documents with opposite party No.3 in June, 2015 and May, 2016 but her claim was not paid, which amounted to deficiency in service on the part of the opposite parties. Accordingly, she filed the complaint alleging deficiency in service on the part of the opposite parties and prayed for payment of claim of Rs.10 lakhs along with compensation for mental harassment caused to her besides litigation expenses.

4. Upon notice, opposite parties No.1 and 2 appeared and filed written version disputing the claim of the complainant. Preliminary objections regarding maintainability and cause of action were also raised. On merits, issuance of the insurance policy in question and death of husband of the complainant was admitted. However, it was submitted that the complainant neither spent Rs.67,200/- on the treatment of her husband nor she immediately informed the opposite parties. The complainant could not supply the documents for processing the claim. Accordingly, the claim could not be settled and was repudiated. The present complaint was pre-mature. There was no deficiency in service on the part of the opposite parties and therefore dismissal of the complaint was sought.

5. Opposite party No.3 was duly served but did not put in appearance and was accordingly proceeded against ex parte.

6. Opposite party No.4 appeared and filed written version disputing the claim of the complainant. Preliminary objections were raised that the complaint was not maintainable. The complainant had not come to the District Forum with clean hands. The complainant had no cause of action to file the complaint and the District Forum had no jurisdiction to entertain and decide the complaint. On merits, holding of bank account by the complainant with opposite party No.4 was stated to be a matter of record. However, death of Sharawan Kumar was denied for want of knowledge. It was also submitted that the insurance policy was a contract between the complainant and opposite parties No.1 to 3 concerning terms and conditions of the policy and it was not related with the business and affairs of opposite party No.4. All other allegations made in the complaint were specifically denied. It was further stated that there was no deficiency in service on the part of opposite party No.4.

7. After hearing counsel for the parties and going through the case file, the District Forum observed that the complainant had not led any evidence to show that she had supplied the various documents to the opposite parties required for settling the claim. Even no effort was made by the complainant to produce the documents during the proceedings. When the complainant failed to supply the required documents to the opposite parties, the opposite parties could not be said to be at fault in closing the claim file of the complainant and as such no deficiency in service could be attributed to the opposite parties. Accordingly, there was no merit in the complaint and the same was, therefore, dismissed.

8. Counsel for the appellant has submitted that while filing the claim, the appellant had supplied all the relevant documents to the opposite parties. As such the opposite parties were at fault in closing the claim file of the complainant on the ground that the relevant documents were not submitted by the appellant. There was also deficiency in service, which could be attributed to the opposite parties. As such, the appeal be accepted, impugned order be set aside and the complaint preferred by the appellant be allowed.

9. Having heard counsel for the appellant on the one hand and respondent No.4 on the other, the State Commission finds that when the appellant had submitted the claim, she had not supplied the necessary documents to the opposite parties. Even no effort was made by the appellant to produce those documents during the complaint proceedings. When the appellant had failed to supply the required documents to the opposite parties then in that situation, the opposite parties cannot be said to be at fault in closing the claim file of the complainant.

10. Counsel for the appellant submitted that along with the complaint preferred by her before the District Forum, she had supplied all the relevant documents and in case the appellant had not supplied those documents to the opposite parties for settlement of the claim then the documents attached with the complaint can be considered by the opposite parties.

11. Be that as it may, it would be just and proper to require the opposite parties to settle the claim of the appellant on the basis of documents, which were attached with the complaint at the time of its filing with the District Forum. After going through those requisite documents, the opposite parties No.1 to 3 can take final decision in order to settle the claim of the appellant.

12. Resultantly, opposite parties No. 1 to 3 shall consider all the relevant documents submitted by the appellant at the time of filing of the complaint before the District Forum and take a fresh and conscious decision within a period of three months so as to settle the claim.

13. The appeal is accordingly disposed of.

Advocate List
  • Shri R.K. Choudhary

  • Shri Tushar Arora

Bench
  • T.P.S. Mann (President)
Eq Citations
  • 2 (2022) CPJ 157
  • LQ/SCDRC/2022/440
Head Note

A. Consumer Protection — Services — Insurance — Claim settlement — Documents required for — Complainant failed to supply documents to opposite parties — Opposite parties closed claim file — Held, opposite parties cannot be said to be at fault — No deficiency in service on part of opposite parties — However, State Commission directed opposite parties to settle the claim on the basis of documents attached with the complaint — Consumer Protection Act, 1986, Ss. 2(1)(o), 2(1)(z) and 2(1)(t) B. Consumer Protection — Services — Insurance — Claim settlement — Complainant submitted all relevant documents to District Forum — Documents not submitted to opposite parties — Held, documents submitted to District Forum can be considered by opposite parties — Opposite parties directed to take fresh decision within three months — Consumer Protection Act, 1986, Ss. 2(1)(o), 2(1)(z) and 2(1)(t)