DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BARNALA, PUNJAB.

Complaint Case No : 496/2016

Date of Institution : 21.03.2016

Date of Decision : 06.10.2016

Saroj Rani widow of Late Sh. Birbal Dass Goyal R/o H. No. B-XIII-1688, Lakhi Colony, Barnala. …Complainant

Versus

1. PNB MetLife India Insurance Company Limited, Brigade Seshamahal 5, Vanivilas Road, Basavanagudi, Banglore-560004 Through its Managing Director.

2. PNB MetLife India Insurance Company Limited, Hazirattan Chownk, Bathinda through its Branch Manager.

3. Punjab National Bank, Sanghera, District Barnala through its Branch Manager.

…Opposite Parties

Complaint Under Section 12 of Consumer Protection Act, 1986.

Present: Sh. RK Jain counsel for the complainant.

Sh. PS Aulakh counsel for opposite party No. 1.

Opposite party No. 2 exparte.

Sh. Vinod Kumar Goyal counsel for opposite party No. 3.

Quorum.-

1. Shri S.K. Goel : President

2. Shri Karnail Singh : Member

3. Ms. Vandna Sidhu : Member

ORDER

(SHRI S.K. GOEL PRESIDENT):

The complainant Saroj Rani (hereinafter referred as complainant) has filed the present complaint under Consumer Protection Act, 1986 (hereinafter referred as Act) against PNB Metlife India Insurance Company Limited opposite parties No. 1 and 2 and Punjab National Bank opposite party No. 3 (hereinafter referred as opposite parties).

2. The facts leading to the present complaint are that the complainant is the widow of Late Sh. Birbal Goyal who had taken a house loan from the opposite party No. 3. The said Birbal Goyal took a Group Housing Insurance from the opposite party No. 2 and paid a premium of Rs. 10,910/- on 30.8.2013 and he was insured under policy No. 21155077.

3. It is further submitted that husband of the complainant died due to illness on 20.1.2015. Then, complainant lodged a claim with the opposite party No. 1 and she was assured vide letter dated 17.2.2015 that claim would be settled within 15 days. It is further submitted that, the complainant completed all the formalities for the payment of the claim. Even, the discrepancies pointed out by the opposite parties were removed and all the formalities for adjustment of claim against house loan were completed. It is alleged that, despite this, the opposite parties failed to adjust the outstanding loan and it is an unfair trade practice and deficiency of service on the part of the opposite parties. Hence the present complaint is filed seeking the following reliefs.-

1) To pay a sum of Rs. 5,00,000/- alongwith interest at the rate of 12% per annum.

2) To pay Rs. 1,00,000/- as compensation and Rs. 15,000/- as litigation expenses.

4. Upon notice, the opposite party No. 1 appeared through their counsel but written version has not been filed by the opposite party No. 1 despite availing three opportunities.

5. Further, the opposite party No. 2 has not appeared despite service and therefore, the opposite party No. 2 was proceeded against exparte.

6. The opposite party No. 3 appeared and filed written version taking legal objections interalia on the ground of maintainability and estoppal. On merits, it is submitted that the premium of Rs. 10,910/- was paid to PNB Metlife under Policy No. 21155077 through opposite party No. 3. It is also submitted that the house loan is outstanding against the deceased Birbal Dass Goyal and interest accrued is also due on the outstanding house loan. It is also submitted that the claim is to be settled by the opposite parties No. 1 and 2 as the insurance was done by them. It is also pleaded that there is no deficiency of service on their part and the present complaint be dismissed qua the opposite party No. 3.

7. In order to prove her case, the complainant has tendered into evidence her own affidavit Ex.C-1, copy of certificate of insurance Ex.C-2, copy of death certificate Ex.C-3, copy of acknowledgment Ex.C-4, copy of letter dated 27.8.2015 Ex.C-5, copy of letter dated 7.7.2015 Ex.C-6, copy of condolence letter dated 17.2.2015 Ex.C-7, copy of letter dated 6.3.2015 Ex.C-8 and closed the evidence.

8. To rebut the case of the complainant the opposite party No. 3 has tendered affidavit of Dilbag Singh Ex.OP-3/1 and closed the evidence.

9. We have heard the learned counsel for the parties and have gone through all the record on the file carefully.

10. The first question is to determine whether Late Sh. Birbal Dass Goyal got insurance policy from PNB Metlife Insurance Company opposite party No. 1 through Punjab National Bank opposite party No. 3 for housing loan. In order to prove this point the complainant who is wife of the deceased Birbal Goyal has specifically stated in her affidavit that her Late Husband namely Birbal Goyal opted for housing insurance to save the family from the tough times and paid premium of Rs. 10,910/- on 30.8.2013 and insured was covered under policy No. 21155077. She further stated that her husband died due to illness on 20.1.2015 and to support this plea the complainant has placed on record death certificate of her husband Ex.C-3. Thereafter, she lodged a claim with opposite party No. 1. She further stated that, she had completed all the formalities for the payment of the claim and even the discrepancies were removed pointed out by the opposite parties. She further stated that the claim amount has not been released for payment of the outstanding loan.

11. The material document is the policy Ex.C-2 placed on record by the complainant. Perusal of the same shows that it was issued in favour of Birbal Goyal and it was a Group Insurance Policy issued by PNB Metlife Insurance Company Limited opposite party No. 1 through Punjab National Bank (in short called Group Policy Holder). This certificate of insurance further shows the name of Birbal Goyal as insured member with date of birth 1.3.1963.

12. On the second page of this certificate it further shows as.-

13. This further shows that this certificate is issued based upon the contract of insurance between PNB Metlife and Punjab National Bank. Further, relevant features of this policy are as.-

“1. Extent of cover

For a loan covered under this Group Policy, the extent of cover is restricted to the Scheduled Outstanding Loan Amount as shown under the Coverage Amount section of this Certificate of Insurance.”

4. Part Prepayment of Loan

................................................

In case of death of an Insured Member who had made part prepayment towards the outstanding loan amount, the company shall, subject to the completion of its claim assessment process and admission of the claim as valid, make the payment to the Group Policy Holder. On receipt of the Coverage Amount, the Group Policy Holder shall give a full and final discharge to the Company with respect to the claim concerned and shall also undertake to remit any amount in excess of its own insurable interest, with respect to the deceased Insured Member covered under the Policy, to the nominee/legal heir of the deceased Insured Member.

5. Payment of Premium

This is a single premium policy and there is no need to pay future premiums to continue this coverage.

6. Termination of Cover:

As against the Group Policyholder, upon:-

(a) Death of the Insured Member; or

(b) The earlier of the Date the Insured Member attains age 70 years last birthday and the date the full Outstanding Loan Amount is scheduled to be repaid i.e. the Date of Cessation of Cover as mentioned in the Certificate of Insurance issued to the concerned Insured Member.”

There is no dispute that the parties are bound by the terms and conditions of the ibid policy.

14. It is worth mentioning here that the opposite party No. 1 through their counsel appeared, however opposite party No. 1 not placed on record any written version despite availing many opportunities.

15. Even, the case of the complainant is not disputed by the Punjab National Bank opposite party No. 3. Sh. Dilbag Singh Manager Punjab National Bank in his affidavit Ex.OP-3/1 has specifically mentioned that the deceased Birbal Dass availed a house loan from Punjab National Bank, Sanghera and deceased Birbal Dass was having Account No. 347800LH00000066 in their branch at Sanghera. He further stated that the deceased Birbal Dass husband of the complainant took a Group Housing Insurance from PNB Metlife Insurance Company vide policy No. 21155077 and premium of Rs. 10,910/- was paid from the account of the deceased Birbal Dass on 30.8.2013 and said policy was duly issued by PNB Metlife in favour of Birbal Dass. The Manager further stated that Proposal Form duly completed alongwith all papers as required by rules was sent to opposite parties No. 1 and 2 and thereafter opposite parties No. 1 and 2 issued policy for the said house loan in favour of Birbal Dass.

16. Apart from the affidavit the Punjab National Bank opposite party No. 3 placed on record certificate Ex.C-6 showing that the Late Birbal Dass obtained house loan on 28.9.2012 and the balance including interest is shown as Rs. 4,67,019/- on 7.7.2015.

17. As the opposite parties No. 1 and 2 insurance company failed to file written version as well as any document on the record, therefore, presumption of truth relies to the unrebutted evidence produced by the complainant.

18. As a result of the above discussion, we are of the opinion that the complainant has succeeded in proving her case, therefore, the present complaint is accepted against opposite parties No. 1 and 2. In view of the ibid condition No. 4 of the Group Insurance Policy as referred to above, opposite parties No. 1 and 2 are directed to make payment of Rs. 5,00,000/- the sum assured as mentioned in the insurance policy to the opposite party No. 3 who is the Group Policy Holder alongwith interest at the rate of 9% per annum from the date of death of Sh. Birbal Dass Goyal i.e. 20.1.2015 till payment. Out of the deposited amount, the opposite party No. 3 is directed to adjust the house loan including interest outstanding on the date of death of Sh. Birbal Dass Goyal i.e. 20.1.2015 (as per condition No. 6 i.e. Termination of Cover on the death of insured Member). The opposite party No. 3 is further directed that the excess amount after adjusting the loan amount including interest be paid to the complainant. The opposite parties No. 1 and 2 are also directed to pay Rs. 5,000/- as compensation and Rs. 2,100/- as litigation expenses to the complainant. This order shall be complied with within 45 days from the date of the receipt of copy of this order. Copy of this order be supplied to the parties free of costs. The file be consigned to the records.

ANNOUNCED IN THE OPEN FORUM:

6^th Day of October 2016

(S.K. Goel)

President

(Karnail Singh)

Member

(Vandna Sidhu)

Member