Case No. CC/55/2021
COMPLAINANT :1. Rahidul Sekh,
S/O. Jamat Sekh,
Vill- Khidirpur Uttar Para,
P.O. Bethuadahari,
P.S. Nakashipara,
Dist. Nadia, Pin-741126.
V-E-R-S-U-S
OPPOSITE PARTIES / 1.Branch Manager,
State Bank of India,
Bethuadahari Branch,
IFSC Code-(SBIN0006985)
Vill-Bethuadahari, P.O. Bethuadahari,
P.S. Nakashipara, Dist. Nadia, Pin-741126.
2.Branch Manager,
SBI Life Insurance,
Krishnagar Branch,
2nd Floor, Udayaan Bldg 20 M M, Ghosh St
P.O. Krishnagar, P.S. Kotwali, Pin-741101.
3. Chairman,
Reserve Bank of India,
No. 15, Nataji Subhas Road,
Fairley place B.D Bagh
Kolkata – 700001.
Ld. Advocate(s)
For Complainant: Makbul Rahaman
For OP/OPs : Suvankar Bhattacharya
(2)
Date of filing of the case :07.07.2021
Date of Disposal of the case :12.10.2023
Final Order / Judgment dtd.12.10.2023
Pith and substance of the case of the complainant is that the mother of the complainant Late Bachhiran Bibi Sekh alias Bachhiran Bibi had opened an account bearing No.34358668537 through SBI Kiosk Banking. On 11.04.2019 the mother of the complainant had purchased an insurance policy being PMJJBY through SBI Bethuadahari Branch, date of commencement of 11.04.2019 and ending on 31.05.2019, premium 86 per annum and the next policy was issued on 01.06.2019-31.05.2020. The OP Bank did not give any policy bond or policy number to the deceased account holder. The mother of the complainant had sound health at the time of purchasing the policy. Suddenly the policy holder Bachhiran Bibi Sekh alias Bachhiran Bibi died on 07.12.2019 when the policy was in running condition. After her death the complainant being the son of the policy holder informed to the SBI, OP verbally and thereafter submitted all documents like Death Certificate, Voter Card and Aadhar Card of the deceased along with bank account of the nominee. Thereafter, the OP NO.1 bank called for an affidavit from the nominee which the complainant duly complied on 15.06.2020. But the OP did not settle the claim of the complainant nor did respond to the matter. The complainant also requested the OP NO.1 to give certificate of PMJJBY insurance scheme against, which the OP No.1 asked the complainant to contact with SBI Life Insurance, Krishnagar Branch. Subsequently, the complainant contacted with SBI Life Insurance OP No.2 to inform that the PMJJBY master policy is valid from 01.06.2019 to 31.05.2020 and also gave Xerox copy of master policy and papers informing that the nominee and claimant are different against which affidavit was submitted. Thereafter, the complainant informed the bank about enrolment form but the bank authority misbehaved with the complainant. The Ops thus violated the IRDA Rules and Regulations. Although the OP deducted the premium amount yet did not give any PMJJBY scheme within time. The OP has thus caused of harassment and mental agony to the complainant. The cause of action arose on and from 07.12.2019 and continued till the filing of this case. The complainant therefore prayed for an award for Rs.2,00,000/- towards sum assured on death benefit, interest at the rate of 35% on the said sum of Rs.2,00,000/-, Rs.1,00,000/- towards harassment and mental pain and agony and litigation cost. The OP No.2 contested the case by filing W/V denying each of every allegation of the complainant. The positive defence case of OP NO.1 in brief is that the present case is barred by limitation, bad for mis-joinder and non-joinder of parties. The name of the nominee is different and the petitioner submitted an affidavit but the OP No.2 asked this OP No.1 to confirm that Kalo Sekh and Rahidul Sekh are same person which is not possible for the OP NO.1. SBI Life Insurance and OP Bank are completely separate entity. SBI Life Insurance is to
(3)
give the claim amount direct to the account of the nominee. There is no latches on the part of the OP bank. The OP NO.1 is not liable to pay the compensation.
The positive defence case of OP NO.2 in brief is that in the PMJJBY Group Insurance a person within the age group of 18-50 years is eligible for enrolment. In the instant case the date of birth of the DLA was mentioned as 01.01.1970 which means in April, 2019 she was 49 years while applying for the insurance. During assessment of claim it was revealed that she was more than 50 years at the time of applying for insurance. So, she was not eligible to get the insurance coverage and the complainant also is not entitled to get the sum assured. The age of the DLA was misstated and thereby deliberate misrepresentation was made so the contract of insurance is void. DLA is reported to have died on 07.12.2019. During the assessment of claim, it is revealed that the age of the DLA at the time of enrolment into the scheme was 59 years. So she was not eligible for the enrolment of DLA into the said scheme. As per the death certificate submitted at the time of claim the age of deceased is 59 years. While assessing the claim it was observed that the correct age of DLA was not 49 years, she was much older than the age stated. She was not eligible to take the insurance policy. The understatement of age clearly violated the doctrine of utmost of good faith. The OP NO.2 therefore claimed that the case is liable to be dismissed with cost.
The dispute raised in the pleadings of both the parties led this Commission to set the following points for determination.
Points for determination
- Whether the case is maintainable in its present form and prayer.
- Whether the complainant is entitled to get the relief as prayed for.
- To what other relief if any the complainant is entitled to get.
Decision With Reasons
Point No.1
It is the admitted fact that the complainant purchased an insurance under the OP No.2 vide policy no. PMJJBY under master policy number 76001000135 under account number 34358668537 for a sum assured Rs.2,00,000/- on 11.04.2019.
Thus the relation between the complainant and the OP is purchaser and seller.
The amount of total claim raised by the complainant is well within the pecuniary jurisdiction of this Commission. The OPs could not make out any specific case as to why the case is not maintainable. Thus having perused the pleadings of the parties and evidence on the case record the Commission is also view that the case is maintainable in its present form and prayer.
- Is accordingly answered in favour of the complainant.
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Point No.2 & 3
Both the points are very closely interlinked with each other. So these are taken up together for brevity and convenience of discussion.
The complainant Rahidul Sekh happens to be the son of deceased insured Bachhiran Bibi Sekh @ Bachhiran Bibi. He as a legal heir filed this case claiming the death benefit of sum assured in the name of his mother.
The complainant in order to substantiate the case adduced both oral and documentary evidence by filing affidavit in chief and the documents.
Annexure-1 is the duplicate identity card of Bachhiran Bibi.
Annexure-2 is the death certificate of the deceased insurer Bachhiran Bibi.
Annexure-3 is the certificate of insurance for the aforesaid policy no. 76001000135 in the name of Bachhiran Bibi.
Annexure-4 is the receipt by SBI Life Insurance OP e-Sampark.
Annexure-5 is the affidavit of the complainant Rahidul Sekh @ Kalo Sekh.
Annexure-6 is the Voter identity card of the complainant.
Annexure-7 is the Aadhar Card in the name of the complainant.
Annexure-8 is the copy of Pass Book in the name of the complainant Rahidul Sekh.
The allegation of the complainant is that despite death of the complainant during the validity of the policy period the OP did not pay the death benefit to the complainant as legal heir.
The OP No.1 denied the claim of the complainant on the ground that the complainant made mis-statement regarding his actual date of birth and as such due to mis-representation of fact the complainant is not entitled to get the benefit of the deceased.
After perusing all the documents it transpires that the date of birth of the deceased insured Bachhiran Bibi is stated as 01.01.1970. The policy was commenced on 11.04.2019. So the age of the deceased insured Bachhiran Bibi at the time commencement was 49 years.
As per the documents proved by the complainant the age of the insured Bachhiran Bibi was 49 years at the time of commencement of the said policy.
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It is also the defence case of the OP that in the master policy, the entry age for the said policy is 18 years to 50 years.
The OP challenged the age of the deceased Bachhiran Bibi on the basis of death certificate of the insured Bachhiran Bibi wherein the age of the insured is stated as 59 years.
As per the Annexure-2 the age of the deceased Bachhiran Bibi is mentioned as 59 years as on 07.12.2019.
Her date of birth is recorded as 01.01.1970 in the receipt of e-Sampark SBI Life document. The date of birth of the insured is also recorded as 01.01.1970. In that case the age of deceased at the time of commencement of the policy should be considered as less than 50 years which is the main criteria for registration of the policy of PMJJBY.
It is the settled position of law that either school leaving certificate or birth certificate are the main document to prove the age of a person.
The complainant seems to have purchased the said policy on fulfilment of the conditions for purchasing the said insurance policy. During the lifetime of the said policy holder the OP NO.1 did not claim any document to prove her age. The certificate of policy issued signifies that the OP was duly certified with the declaration and the documents of the deceased Bachhiran Bibi regarding her age.
After the death of the insured the complainant raised the death benefit claim as a legal heir by filing the death certificate. The said death certificate was issued by Gram Panchayet Bethuadahari. This document was issued by the Gram Panchayet without any supporting documents like birth certificate or school leaving certificate. So , it is unilaterally issued without the knowledge of the complainant regarding the date of birth. There is no mentioning in the said death certificate that the information has been taken from the original record of birth or birth registration or any other authenticate document.
Another important aspect is that the OP did not demand any document from the complainant to prove his age in record to refusal of the claim. It is the specific argument on the part of the Ld. Advocate for the complainant that the OP never repudiated the scheme of the complainant either in writing or in any form. There is no document within the four-corners of the case record that the OP repudiated the claim of the complainant. So also the OP could not prove any document to establish that the claim of the complainant was repudiated in writing.
Even the OP demanded the documents of nominee on the ground that the nominee and claimant are different. The complainant also
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in order to meet the demand of the OP vide specific affidavit before the first class Magistrate to establish that complainant Rahidul Sekh and Kalo Sekh is one and same and identical person.
So the complainant proved all the documents in this the case. Ld. Advocate for the OP, however, referred to some case law reported in revision petition number 3390 of 2013 and RP number 469 by 2006 in the case United India Insurance Company Vs. Subhash Chandra wherein held that had insured disclosed her actual age at the time of purchasing the policy. The said proposal would not have been accepted by the insurance company.
The said case law is not applicable on the ground that the OP company after being satisfied with the age of the insured commenced the insurance policy.
Ld. Defence Council also argued that due to misstatement and suppression of fact u/s 17 of Indian contract act. The complainant is not entitled to get the death benefit.
The said argument is not acceptable in as much as the case record disclosed that before commencement of the policy. The insured Bachhiran Bibi disclosed all the facts but the OP did not claim any document to prove her age. Even the OP never asked for any document before repudiation of the claim. In fact there is no document to show that the OP repudiated the claim of the complainant.
On the contrary Ld. Advocate for the complainant relied on two case laws reported in 2011 (2) CPJ 7 wherein it was held that in absence of any conclusive evidence it would be assumed that the assured had gradually mentioned his age in proposal form.
The said case law is relied on.
Another case law referred by the Ld. Advocate for the complainant reported in 2008 (IV) CPJ 326 wherein it was held that date of birth is wrong was not known to the insured. School leaving certificate not demanded by the insurer. Contention that wrong date of birth had been given in proposal form is not acceptable. Appeal dismissed.
the case law is relied on.
Thus denied assessed the entire evidence in the case record and in view of the discussion in the fore-going paragraphs vis-a-vis the observation made her in above, the Commission is of the view that the complainant prove the case upto the hill. But opposite parties acted in the manner with the complainant which tantamount to deficiency in service.
In the result, the complainant case succeeds on contest. Point 2 & 3 are accordingly answer in favour of the complainant.
(7)
Hence,
It is
Ordered
that the CC Case No.55/2021 be and the same is allowed on contest with cost of Rs.5,000/-(Rupees five thousand). The complainant Rahidul Sekh do get an award for sum of Rs.2,00,000/-(Rupees Two lakh) as sum assured/death benefit sum assured under PMJJBY against the OPs and Rs.10,000/-(Rupees Ten thousand) towards harassment and mental agony from the opposite parties.
Both the opposite parties are jointly and severally liable to pay the award money to the complainant. The OPs are directed to pay Rs.2,15,000/- (Rupees Two lakh fifteen thousand) to the complainant within 30 days from the date of passing the final order failing which the entire award money shall carry an interest at the rate of 8% per annum from the date of passing the final order till the date of its realisation.
Dealing Assistant to note in the trial register.
The case is accordingly disposed of.
Let a copy of this order be supplied to both the parties as free of costs.
Dictated & corrected by me
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PRESIDENT
(Shri HARADHAN MUKHOPADHYAY,) ................ ..........................................
PRESIDENT
(Shri HARADHAN MUKHOPADHYAY,)
I concur,
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MEMBER
(NIROD BARAN ROY CHOWDHURY)
