H. P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION SHIMLA.

First Appeal No.: 190/2024 Date of Presentation: 03.09.2024 Reserved on: 06.05.2025 Date of Decision: 19.05.2025 ………………………………………………………………………

Care Health Insurance Limited, (Formerly Known as Religare Health Insurance Company Limited), Regd. Office 5^th Floor, 19 Chawla House, Nehru Place, New Delhi-110019, Through its Manager (Legal), Vipul Tech Square, Tower C, Sector 46, Golf Course Road, Gurgaon, Haryana-122009, Through its Manager (Legal)

…....... Appellant/Opposite party No.2 Versus

1. Bidhi Chand, Son of Ranu Ram, Resident of Chouki, Post Office Bhatwan, District Hamirpur, H.P.

.......... Respondent/Complainant.

2. Kangra Central Cooperative Bank Limited, Branch Office Bhaleth, Tehsil Sujanpur, District Hamirpur, H.P., Through its Branch Manager.

.......... Respondent/Opposite Party No.1 ………………………………………………………………………

Coram Hon’ble Justice Inder Singh Mehta, President.

Whether approved for reporting?¹ Yes.

1 Whether Reporters of the local papers may be allowed to see the order?

For the Appellant: Mr. Jagdish Thakur, Advocate.

For the Respondent No.1: Mr. Karam Pal, Advocate.

For the Respondent No.2: Mr. Sameer Chandel, Advocate, vice Mr. S.S. Rathour, Advocate.

……………………………………………………………………………

Justice Inder Singh Mehta, President O R D E R:

Present appeal is preferred against the order dated 14.06.2024 of learned District Consumer Disputes Redressal Commission Hamirpur, passed in Consumer Complaint No.81/2019, titled Bidhi Chand Versus Kangra Central Cooperative Bank Limited & Anr., whereby the complaint filed by the complainant was allowed and the opposite party No.2 was directed to pay an amount of Rs.2,00,000/- to the complainant within 45 days from the date of receipt of copy of order, failing which, it will incur an interest @9% per annum from the date of complaint, till realization. The opposite party was also directed to pay litigation costs to the complainant, quantified at Rs.10,000/-

Brief facts of the Case:

2. Brief facts of the case are that complainant/respondent No.1 took loan from the respondent No.2/Bank and at the time of sanctioning and releasing of loan, he was required to take health insurance policy from the appellant, which was obtained by the complainant/respondent No.1. As per policy, the appellant was liable to pay Rs.2,00,000/- at the time of accidental death of son of complainant/respondent No.1. The son of complainant namely Mr. Rinku Kumar died in an accident on 27.07.2018 near Hem Kund at Uttrakhand. Requisite documents were supplied to the appellant/insurance company, but appellant refused to take cognizance of accidental death of son of complainant on the ground that without copy of FIR the claim is not tenable. Rinku was driving the vehicle when it met with an accident and no person was with him and in the absence of any suspicious circumstance, no FIR was lodged. By alleging deficiency in service on the part of the appellant, the respondent No.1/complainant filed the complaint.

3. The opposite party/respondent No.2-Bank filed reply to the complaint and stated that loan was taken by Rinku Kumar and not by the complainant Bidhi Chand and Rinku Kumar was insured with appellant/insurance company. The policy was effective till 21.12.2018 and sum insured was Rs.2,00,000/- and in the said policy, the complainant was nominee. The opposite party/Bank deducted Rs.504/- as annual premium and paid to appellant/insurance company. There was no deficiency in service or unfair trade practice on the part of the Bank. A prayer for dismissal of complaint was made.

4. The appellant/insurance company filed reply to the complaint and stated that complainant has never submitted his claim to the insurance company and insurance company has not received any claim from complainant till date, and as such, the complaint is premature. There was no deficiency in service or unfair trade practice on the part of the appellant/insurance company. A prayer for dismissal of complaint was mad