PRESIDENT DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR

                                             CONSUMER COMPLAINT NO. 143/2023

Present-Dr. Ramakanta Satapathy, President,

  Sri. Sadananda Tripathy, Member,

Prafulla Sahu, Aged about 45 years,

S/O- Late Kantha Sahu,

R/O- Village Balaram, Po-Kelo Balam, Ps-Kisinda

Dist-Sambalpur-768106.                                                         …….…......Complainant.

                                    -Vrs.-

1. The Regional Manager, National Insurance Company Ltd..

Office at-6^th floor, IDCO Tower, Janapath,

Bhubaneswar, Odisha-751022.

2. The Branch Manager, Utkal Grameen Bank, Naktideul Branch,

Office at/Po/Ps-Naktideul,

Dist-Sambalpur,Odisha-768118.                         …………........Opp.Parties

Counsels:-

1. For the Complainant         :- Sri. B.K. Shroff & Associates
2. For the O.P. No.1                           :- Sri. B.K. Purohit, Adv.
3. For the O.P. No.2                           :- Dr. M. Panda.

Date of Filing:15.09.2023,  Date of Hearing :30.04.2024,  Date of Judgement :27.05.2024

  Presented by Dr. Ramakanta Satapathy, PRESIDENT

1. The case of the Complainant is that mother of the Complainant namely Chaturi Sahu was having an S.B. A/C No. 84023234234 with O.P. No.2 Bank and Chaturi Sahu is insured under Pradhan Mantri Surakhya Yojana(PMSBY) since 20.02.2016 till her death i.e. 07.09.2020. From time to time Rs. 12/-premium has been deducted by O.P. No.2 and remitted to insurer, O.P. No.1.

On 06.09.2020 chaturi Sahoo met a vehicular accident and died on 07.09.2020 at VIMSAR, Burla Dist-Sambalpur, Kisinda P.S. Case No. 048 dated 09.09.2020 was initiated corresponding G.R. Case No. 453/2020 of the court of of S.D.J.M., Rairakhol. Post Mortem was made by Dr. Nath. V.S.S. Medical college, Burla.

Death claim was made through O.P. no.2 before O.P. No.1. O.P. No.2 issued letter dated 12.04.2021 for compliance of documents and the Complainant complied the same. The O.P. no.2 vide letter No. UGB/PMSBY/47 informed the Complainant that the insurer vide letter No. 160000/BBRO/PMSBY/2021 repudiated the claim on the ground that Chaturi Sahu is more than 70 years as on her enrolment in the scheme.

From 20.02.2016 to 24.05.2020 the O.P. no.1 auto deducted the premium of Rs. 12/- from the account of Chaturi Sahoo. On 26.08.2023 a pleader notice was sent to O.P. no.1 but no any reply received. Being aggrieved complaint was filed alleging deficiency in service and unfair trade practice.

2. The insurer, O.P. No.1 in reply submitted that as recorded by O.P. No.2 Bank date of birth of deceased Chaturi Sahu is 01.01.1948. Under PMSBY scheme 18 to 70 years age group account holder are eligible to join the scheme who give their consent to join and enable auto-debit on or before 31^st May for the coverage period 1^st June to 31^st May as on an annual renewal basis. Said Chaturi Sahu had already attended 71 years 5 months 29 days as on date of her death. She completed her 70^th year on 31.12.2017.

The case is not maintainable and barred by limitation. The insurer has replied to the advocate notice issued by Complainant. The Complainant is not entitled for any relief.

3. The O.P. no.2 Bank in reply submitted that the case is barred by limitation. The answering O.P. intimated the Complainant about repudiation of the claim vide letter No. UGB/PMSBY/47 dated 17.08.2021. There is no any unfair trade practice. The medical certificate produced by the Complainant is fabricated.
4. The Complainant filed the following documents:

1. Copy of UGB passbook A/C No. 84023234234 wherein deduction have been made Rs. 12/- on 20.02.2016, 20.05.2019 and 24.05.2020 respectively.
2. Burla U.D. Case No. 811 dated 07.09.2020 post-mortem report of Chaturi Sahoo.
3. Death Certificate of Chaturi Sahoo.
4. Letter No. 83 dated 12.04.2021 of the insurer to the O.P. No.2 Bank.
5. Letter No. UGB/PMSBY/47 dated 17.08.2021 of the O.P. no.2 Bank to Complainant.
6. Letter No. 460 dated 20.07.2021 of the O.P. no.1 to O.P.No.2
7. Advocate notice dated 26.08.2023 served to O.P. No.1

The O.Ps have not filed any documents.

5. Before going to other issues in this complaint it is necessary to examine whether the Complaint is barred by limitation?

The Complainant filed the limitation petition on 12.12.2023 and the O.Ps have filed their respective objections. From the correspondences made between the Complainant and O.Ps it reveals that vide letter No. UGB/PMSBY/47 dated 17.08.2021 the O.P. no.2 informed the Complainant that Chaturi Sahu is more than70 years as on date of his enrolment in the scheme. Vide Advocate notice dated 26.08.2023 the Complainant informed the insurer to settle the claim and the notice was received by O.P. no.1 on 28.08.2023 and thereafter on 15.09.2023 the Complaint was filed. The Complainant filed OPD Regd.No. 7922 dated 31.07.2023 and 11045 dated 10.09.2023. The Complainant submitted that due to prolonged illness the complaint could not be filed and after recovery filed the Complainant. The O.Ps simply objected the ground of limitation.

Period of filing a consumer complaint is two years. From 17.08.2021 if the period is taken than limitation period is taken than limitation period ends on 16.08.2023. The Complainant was suffering from 31.07.2023 to 10.09.2023 and after recovery the complaint was filed. The Complainant cited Rasheem Shah & another Vs Govind Singh & others, Civil Appeal No. 4628/2023 wherein the hon’ble Supreme Court observed, “when substantial justice and technical consideration are pitted against each other, cause of substantial justice deserves to be preferred for the other side can not claim to have vested right injustice being done because of a non-deliberate delay.

During pandemic 2019-20 and consequent upon the delay in normal life in common man this Complaint seems to be delayed and grounds shown by the Complainant is acceptable. On mere technical ground delay in filling consumer complaint can not be rejected, thereby there will be miscarriage of justice. The delay in filing complaint in condoned and the complaint is accordingly maintainable before this Commission.

6. Taking into consideration the documents filed and pleadings of the parties following issues are framed:
103606587.  

1. Whether deduction of Rs. 12/- to-wards premium after 70 years age of the insured and rejection of the claim is proper?
2. Whether deduction of Rs. 12/- from the account of deceased amounts to unfair trade practice?
3. What relief the Complainant is entitled to get?

ISSUE NO.1 & 2 Whether deduction of Rs. 12/- to-wards premium after 70 years age of the insured and rejection of the claim is proper?

                                                &

Whether deduction of Rs. 12/- from the account of deceased amounts to unfair trade practice?

It is admitted by both the parties that the date of birth of the deceased is 01.01.1948 recorded in Aadhar No. 619409535763. Chaturi Sahu died on 07.09.2020 and last premium deducted on 24.05.2020 for Rs. 12/-. The PMSBY Scheme covers the age group 18 to 70 years. On 24.05.2020 age of Chaturi Sahu was 72 years 4 months and 23 days. PMSBY scheme and allowing a consumer to enter into contract by payment of premium is the sole question to decide in this complaint. As the scheme is up-to age group 70 years, there is no any valid contact between the deceased and insurer. Accordingly, the Complainant/beneficiary is not entitled for the insurance coverage under the scheme.

The second point of consideration is that when the deceased was not covered under the scheme deduction of Rs. 12/- to-wards premium is illegal and unfair. The O.P. No.2 in the auto debit system not given instruction to the computer system thereby Rs. 12/- is automatically deducted from the account which is a loss of the account holder. The O.P. No.2 on contravention of the scheme deducted the premium and remitted to the insurer O.P. No.1. The O.P. no.1 only after the claim pointed out that the deceased is above 70 years. There is no scope for O.P. no.1 to know regarding age of the insured as it is feeded by the Bank.

Acts of the O.P. no.2 is not only illegal but also amounts to unfair trade practice. The O.P. no.2 must have taken deductions hundreds of customers in the Bank in such manner.

The issue is answered accordingly.

ISSUE NO.3 What relief the Complainant is entitled to get?

From the Supra discussion it is clear that the Complainant is entitled for the relief partly.

Accordingly, it is ordered:

ORDER

The complaint is partly allowed against the O.P. No.2 and dismissed against O.P. no.1. The Complainant is not entitled for the death claim. The O.P. no.1 is directed to refund Rs. 24/- to the Complainant to-wards illegal deduction of premium with 12% interest P.A. w.e.f 20.05.2019 and 24.05.2020 respectively (Rs. 12/- + Rs. 12/-). For unfair trade practice the Complainant is entitled for compensation of Rs. 50,000/- and litigation expenses of Rs. 20,000/-

Order pronounced in the open court on 27^th day of May, 2024.

Supply free copies to the parties.