Heard learned counsel for the appellant. None appears for the respondent.
2. This appeal is filed U/S-15 of erstwhile Consumer Protection Act,1986(herein-after called the Act). Hereinafter, the parties to this appeal shall be referred to with reference to their respective status before the learned District Forum.
3. The unfolded story of the complainant, is that the husband of the complainant being account holder of OP No.1-Bank and as such under Abhaya Savings Bank scheme introduced by OP No.1-Bank, had purchased a policy under group insurance scheme for sum assured of Rs.25,000/- from OP No.2 & 3. The arrangement between the OP is that whoever is the account holder of the OP-Bank will have the insurance coverage of that loan amount by OP No.2 & 3. It is alleged inter-alia that on 26.05.2001 the husband of the complainant died. Thereafter claim was made to the OP No.1 and OP No.1 intimated the facts to OP No.2. The OPs repudiated the claim on the ground that policy condition have not been complied by the complainant and OP No.1. It is alleged that within 90 days of the accident the matter should have been informed to the OP No.2 & 3 but it has not observed in this case, resultantly the OP repudiated the claim. Challenging such repudiation, the complaint was filed.
4. The OP No.1 filed written version stating that the complainant has opened an account under Abhaya Savings Scheme and has also purchased the insurance policy for sum assured of Rs.25,000/- from OP No.2 & 3. It is also stated by the OP No.1 that the complainant’s husband died at MKCG Hospital, Berhampur but for the first time after 1 ½ years of death the complainant made request to OP No.1 to extend benefit. Thereafter OP No.1 sent all the documents with letters to OP No.2. OP No.2 repudiated the claim by sending a letter dtd.14.012.2003 on the ground that it was not intimated within 90 days of accident as per terms of policy. Therefore, OP No.1 has no fault in this case.
5. OP No.2 filed the written version admitting that the husband of the complainant is covered under the Abhaya Savings Bank Scheme and he has also purchased policy for sum assured of Rs.25,000/-. They admitted that the husband of the complainant died in a road accident but his claim is not covered under policy in question due to late intimation. They have no deficiency in service on their part.
6. After hearing both the parties, learned District Forum passed the following order:-
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“In the result we direct the opposite parties who are jointly and severally liable to pay insurance claim of Rs.25,000/- to the complainant within one month of receipt of this order. No costs.”
7. Learned counsel for the appellant-bank submitted that they have received the claim of course 1 ½ years after the death of husband of the complainant and same has already forwarded to OP No.2 who rejected the claim. So, this OP No.1 has no fault but learned District Forum has committed error in law fixing the joint liability of OP No.1 & 2. Learned District Forum ought to have considered the written version of OP No.1.Since, the OP No.1 has no fault, the impugned order passed against him to have jointly liable with OP No.2 to pay the sum assured is absolutely illegal. Therefore, he submitted to set-aside the impugned order by allowing the appeal.
8. Considered the submission of learned counsel for appellant, perused the DFR and impugned order.
9. It is admitted fact that the complainant’s husband is covered under the group insurance scheme which is otherwise styled as Abhaya Savings Scheme duly floated by the Op No.1. It is also admitted that the claim petition alongwith the documents submitted after the death of policy holder to OP No.1 were immediately sent to OP No.2 who repudiated same on the ground that they have received same violating the policy condition. The only issue in this case to determine whether present appellant has joint liability alongwith OP No.2 & 3 to pay insurance claim of Rs.25,000/- to the complainant.
10. We have already discussed that OP No.1 is a banker and he is only to facilitate to purchase policy by the husband of the complainant from OP No.2 & 3. Further, there is no evidence neither adduced by the OP No.2 & 3 nor by OP No.1 to show that the claim should be filed within 90 days from the date of accident. There is no evidence produced by OP No.1, 2 & 3 to show that the policy condition of filing claim within 90 days has not been served on the policy holder or complainant. It is worthwhile to note that the policy bond is very clear to show that the insurer has got authority for settlement and it is also averred that the OP No1-Bank is not responsible whatsoever.
11. In view of aforesaid discussion, we are of the view that the OP No.1 has got no deficiency in service is proved by the complainant because it has not all documents and clear to OPNo.2. We are of the view that it is only OP No.2 & 3 who have repudiated the claim in flimsy ground. It is well settled in law that insurer should not repudiate claim on flimsy grounds. it is found in the instant case that the policy condition is not being served to the complainant and the benefit under the scheme not extended on flimsy ground or inappropriate ground the OP No.2 & 3 are fully responsible for repudiation of claim. OP No.1 has hardly any deficiency in service.
12. In view of above, while confirming the impugned order with regard to deficiency in service on the part of OP No.2& 3 we set aside the order against OP No.1 and as such modified the impugned order by directing OP No.2 & 3 to pay Rs.25,000/- sum assured to the complainant within 45 days from the date of order, failing which interest @ 9 % will be charged from the date of impugned order till date of payment.
The appeal is disposed of accordingly.
Free copy of the order be supplied to the respective parties or they may download same from the Confonet or website of this Commission to treat same as copy of order received from this Commission.
DFR be sent back forthwith.
