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HIMACHAL PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Justice P.S. Rana (R), President, Mr. Vijay Pal Khachi, Member and Mrs. Meena Verma, Member
BAJAJ ALLIANZ LIFE INSURANCE COMPANY LIMITED - Appellant
Versus
SARLA DEVI - Respondent
First Appeal No. 254 of 2016
Decided on : 06-03-2017
Consumer Protection Act - Insurance Claim - 12, 15 - The court discussed the provisions of the Consumer Protection Act 1986, emphasizing the burden of proof on the insurer to establish the breach of policy conditions and the liberal construction of the Act. The court held that the insurance company failed to discharge the burden of proof and upheld the order of the District Forum.
Fact of the Case:
The complainant filed a complaint under section 12 of the Consumer Protection Act 1986, seeking payment of the balance insurance amount after her husband's death. The insurance company only paid a partial amount, leading to the complaint.
Finding of the Court:
The court found that the insurance company failed to prove the breach of policy conditions and upheld the order of the District Forum, dismissing the appeal.
Issues: The issues included the acceptance of the appeal, determination of the final order, and the breach of policy conditions by the insurance company.
Ratio Decidendi: The burden of proof to establish the breach of policy conditions lies on the insurer, and the Consumer Protection Act 1986 should receive liberal construction.
Final Decision: The appeal was dismissed, and the order of the District Forum was affirmed, with parties bearing their own costs.
ORDER
Justice P.S. Rana (R) President—Present appeal is filed under section 15 of Consumer Protection Act 1986 against order passed by learned District Forum in consumer complaint No.69 of 2014 title Sarla Devi v. 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).
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 along with 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 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) along with 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.
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 Insura
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