Haryana

Ambala

CC/86/2022

Smt Kamla Devi - Complainant(s)

Versus

The Oriental Insurance Co Ltd Ltd - Opp.Party(s)

Anmol Verma

01 Jun 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, AMBALA

 

Complaint case no.	:	86 of 2022.
Date of Institution	:	17.03.2022.
Date of decision	:	01.06.2023

1.       Smt. Kamla Devi wife of Late Sh.Karnail Singh s/o Sh.Biru Ram, aged 62 years (UID No.9844-1065-0935).

2.       Chander Mohan s/o Late Sh.Karnail Singh, aged 42 years (UID No.3092-7428-0818).

3.       Samrat Singh s/o Late Sh.Karnail Singh, aged 40 years (UID No.7610-2457-       0119).

4.       Sohan Lal s/o Late Sh.Karnail Singh, aged 37 years (UID No.8384-5414-   4698).

All R/o Racheri, P.O.Ganeshpur, Tehsil Mullana, Distt. Ambala.

 

                                                                                      ……Complainants

                                                Vs.

 

1.       The Oriental Insurance Co. Ltd. Through its Regional Manager, 2^nd floor Jeevan Jyoti Building, Jagadhri Road, Ambala Cantt-133001.

2.       Punjab National Bank, Branch Dosarka, through its Branch Manager, Village Dosarka, P.O. Dheen, Ambala Haryana-133202.

                                                                            ….…. Opposite Parties.

Before:       Smt. Neena Sandhu, President.

                             Smt. Ruby Sharma, Member,

          Shri Vinod Kumar Sharma, Member.           

 

Present:      Shri Aadesh Verma, Advocate, counsel for the complainant.

                    Shri R.K Jindal, Advocate, counsel for the OP No.1.

                   OP No.2 already ex-parte.

 

Order:        Shri Vinod Kumar Sharma, Member.

 

1.                The complainant has filed this complaint under Section 35 of the Consumer Protection Act, 2019,  against the Opposite Parties (hereinafter referred to as ‘OPs’), making prayer to direct the OPs to release policy amount of Rs.200000/- along with 18% p.a. interest and to pay Rs.20000/- as compensation and Rs.25000/- as cost of litigation. Further any other relief which this Commission deems fit.

2.             Brief facts of the case are that deceased Karnail Singh was having account bearing No.4825000100055691 with the OP No.2, wherein the complainant No.1 was nominee. The deceased Karnail Singh opted for insurance policy under Pardhan Mantri Suraksha Bima Yojna (for short PMSBY) on 12.6.2018 issued by the OP No.1 i.e. OIC and the same was continuously renewed from time to time and last premium of Rs.12/- as paid by the complainant for the year 2020-21, fact is clear from statement of account Annexure C.4/A.  The deceased Karnail Singh when he was going to roof of his residential house on 3.6.2020, he fell down from staircase and succumbed to death due to his injuries on 3.6.2020.  The deceased was taken to the Primary Health Centre, Pathreri Ambala for his medical treatment, where treating doctor declared him dead due to injuries. After some days the complainant came to know about policy No.1650319 under PMSBY duly issued by the OP No.1. The complainant No.1 lodged death claim qua deceased Karnail Singh along with all the relevant documents and claim form on 19.6.2020, facts are clear from documents Annexure C.5, Annexure C.6, Annexure C.6/A, Annexure C.7, Annexure C.8 & Annexure C.8/A and Annexure C.9, but the OP No.1 has not settled the claim of the complainants. The complainants got served registered Ad. Legal notice upon the OP No.1, fact is clear from Annexure C.10 & Annexure C.11.The act of the OP No.1 is negligent and deficient, causing mental pain and agony to the complainants. Hence, this present complaint.
3.           Upon notice, the OP No.1 appeared through his counsel and filed written version, while raising some preliminary objections that the complaint is not maintainable; complaint is false and frivolous; not come with clean hands and concealed the true and material facts; the complaint is bad for non-joinder and mis-joinder of necessary party; complicated question of law is involved and this Hon’ble Commission having no jurisdiction; for the settlement of the accidental death, original policy bond, death certificate of deceased, Post Mortem Report, Police Inquest Report, FIR, the details of all legal heirs of the deceased, the record of treatment taken by the deceased and the last Medical Attendant Certificate, Duly filled claim form, Discharge Form are necessary to be submitted by the complainant or any other legal heir of the deceased as per terms and conditions of the insurance policy under PMSBY, but in the present case in hand, neither the complainant nor the other legal heir of deceased Karnail Singh nor the OP No.2 PNB have supplied the above said documents/particulars to the answering OP No.1 and in the absence of the above said documents, the OP No.1 is unable to settle the claim of the complainant.  It is further pleaded that the policy No.1650319 has never been issued by the answering OP in favour of deceased Karnail Singh.  On merits, the OP No.1 reiterated to the version made into the preliminary objections and prayed for dismissal of complaint with costs.
4.           The OP No.2 failed to appear before this Commission, despite receipt of notice, hence, it was proceeded against ex-parte vide order dated 26.5.2022 passed by this Commission.
5.           In the course of evidence, learned counsel for the complainant tendered affidavit of complainant as Annexure CW.1/A along with documents as Annexure C-1 to C-16 and closed the evidence on behalf of complainant. On the other hand, learned counsel for the OP No.1 tendered affidavit of Ashish Bhatnagar, Divisional Manager as Annexure R.1 and closed evidence on behalf of OP No.1.
6.           We have heard the learned counsel for complainant & learned counsel for the OP No.1 and have also carefully gone through the case file.
7.           Learned counsel for the complainant during the course of his arguments reiterated to the version made into the complaint and submitted that as per the scheme of the Government of India, it is auto debit insurance policy wherein the bank transmitting the premium to the insurance company with whom the bank is tying up and in the account of the complainant auto debit option was activated and premium was deducted by the bank. Since, the complainant had paid the premium then, his legal heirs are entitled for the claim either from OPs.
8.           On the other hand the learned counsel for OP No.1 reiterated to the version made into the written statement and particularly stressed upon the version that the OP No.1 has never issued any police in the name of deceased Karnail Singh.
9.           The only point of adjudication which is to be adjudicated by this Commission, whether the complainant is entitled for the relief as prayed or to what extent and against whom?
10.           From the perusal of statement of account Annexure C.4 it is evident that the bank-OP No.2 continuing to deduct the premium amount of Rs.12/- from the account of the complainant, firstly for issuance of insurance policy and then, for renewal of the same. As pleaded by the OP No.1 in para No.6 of preliminary objection that it has not issued policy No.1650319 and as annexure C.6 the policy which was issued by the OP No.2 in the name of deceased Karnail Singh was bearing No.272200/48/2022/665 (Oriental Insurance Company Ltd).  Since, the annexure C.6 is telling the policy No.272200/48/2022/665, then, from where the policy No.1650319 has come in hands of the complainant.  The certificate issued by the OP No.2-bank is also not bearing the period of policy and it is the duty of the bank being agent received the amount of premium from the account of the complainant as to who it had sent the same, but the OP No.2-bank instead of clarifying all the aspects, sit idle in its office, even after receiving the notice from this Commission.
11.           From the facts and circumstances discussed above, this Commission of the firm view the bank is negligent and deficient in proving its faithful services to the deceased Karnail Singh and his legal heirs after his death and it case the bank-OP No.2 is held liable to make the payment of claim amount of Rs.200000/- it will suffice the purpose and ends of justice will meet. It is significant to mention here that, as stated above, notice of this complaint was sent to OP No.2 seeking its version, yet, nobody appeared on its behalf, despite service,  as a result whereof, it was  proceeded against ex parte vide order dated 26.05.2022. This act of OP No.2 draws an adverse inference against it. The non-appearance of OP No.2 shows that it has nothing to say in its defence against the allegations made by the complainant. Therefore, the assertions of the complainants went unrebutted & uncontroverted against OP No.2. However, this Commission is also inclined to give rider to the bank to get reimburse the above said amount from the insurer to whom, it had transferred the amount.
12.           Since, the complainants have failed to place on record any insurance, then, in that eventuality, the OP No.1 cannot be fastened for any liability in any manner and complaint is liable to be dismissed against OP No.1.
13.           In view of the aforesaid discussions, we hereby dismiss the present complaint against OP No.1 and allow the same against OP No.2 and direct it, in the following manner:-

(i) To make payment of insurance claim of Rs.2,00,000/- being sum assured to the complainant qua death claim of deceased Karnail Singh along with interest @4% p.a. from the date of filing ofcomplaint i.e 17.03.2023, till actual realization.

(ii) To pay Rs.3,000/- as compensation for the mental agony and physical harassment suffered by the complainant.

(iii) To pay Rs.2,000/- as litigation expenses.

 

The OP No.2 is further directed to comply with this order within the period of 45 days from the date of receipt of certified copy of this order. It is made clear the OP No.2 is bank and acting as agent of the Insurance company and he is at liberty to get the above said award amount reimbursed from the insurance company concerned to whom it had transferred the amount. Certified copy of the order be supplied to the parties concerned, forthwith, free of costs as permissible under Rules. File be indexed and consigned to the record-room.

Announced:- 01.06.2023

 

 

(Vinod Kumar Sharma)	(Ruby Sharma)	(Neena Sandhu)
Member	Member	President