ORDER BY HON’BLE PRESIDENT- MR. P.K. PADHI:
JUDGMENT
Complainant has filed this consumer complaint U/s.12 of C.P. Act, 1986 seeking following reliefs;
“Direct the opposite parties to pay the insurance amount of Rs.5,00,000/- under Policy No.11270046131300000002 and in respect of Debit Card No.5497519004344014 of Late Pradip Kumar Barik to the complainant with interest @ 12% p.a. since 12.02.2014”.
The brief fact of the case is that, the complainant’s son namely Pradip Kumar Barik was working as H.R. Assistant in IIEPL at Refinery, Paradeep and he was saving bank A/c and current bank account with the opposite party No.1 having A/c No.910010041792154 and he was allotted a debit card No.5497519004344014. The son of complainant was an account holder of axis Bank Ltd., Paradeep Branch and he was allotted a Gold Debit Card and said card covers personal accident insurance amounting to Rs.5,00,000/-. While matter stood thus, the son of the complainant namely Pradip Kumar Barik met an accident on 06.02.2014 at about 1.30 P.M. along with his Company Manager, Rakesh Roshan and expired on 12.02.2014. FIR was lodged before Kendrapara Town Police Station having No.21 on 20.02.2014 U/s.279/337/304(A) I.P.C. and same was converted to G.R. vide G.R. case No.163/2014. The complainant being the mother (nominee) and legal heir of deceased Pradip Kumar Barik and came to know from the bank that her son having account number in Axis Bank Ltd., Paradeep Branch and he was allotted a debit card covering insurance of Rs.5,00,000/- of personal accident insurance. After obtaining the relevant documents complainant submitted before the opposite party No.1 claiming assured amount of Rs.5,00,000/- under the policy in respect of the debit card holder and the opposite party No.1 after receipt of the documents asked the complainant to submit the original death certificate (for PA claim) and the attested copy of driving license in case of motor/ vehicular accident where the deceased was driving (for PA claim). In response to the said letter on 26.10.2014, the complainant submitted the documents with an affidavit received by the opposite party No.1 on 31.12.2014. The opposite party No.1 intimated to the complainant to submit more documents like original death certificate and other documents and same was also submitted by the complainant on 30.12.2014 being acknowledged by the opposite party No.1. So, no delay caused on the part of the complainant but the opposite parties knowing fully well that the debit card covering the personal accident insurance of Rs.5,00,000/- and the complainant being the nominee and legal heir she is entitled such amount, the opposite parties avoid making payment such claim amount repudiated claim as “No Claim” on the ground of delay in submission of claim papers 307 days. Hence, the rejection of the claim is illegal and unjustified in the eye of law.
Opposite parties No.1 & 2 (Axis Bank) has filed their written version stating as under;
The policy holder namely Pradip Kumar Barik died and the complainant submitted the claim application 15.12.2014 and 05.01.2015 and on scrutiny of the claim papers it is found that the claim was not intimated to the opposite party No.1 & 2 within the stipulated time as mentioned in the policy as the intimation received on 15.12.2014 and the accident took place on 12.02.2014. As there was inordinate delay in submission of the claim papers, the claim of the complainant is not considerable as per the terms of the policy.
Notice to opposite party No.3 was sent on 16.9.2017 but opposite party No.3 (New India assurance Co. Ltd.) has not appeared and set ex-parte on 25.01.2018. This case was heard by our predecessors and reserved for orders on 18.6.2019 but order could not be pronounced. Both parties are also absent we have gone through the records and found that complainant is the mother of deceased credit card holder. Facts of case not in disputed. The sole ground for rejection of claim is delay in submission of claim, which is reflected as under in the rejection letter of opposite party No.3.
“We have received the claim document on 15.12.2014 and on 05.01.2015. On scrutiny of the claim papers we observed that claim was not intimated to us immediately and papers were not submitted to us within the stipulated time as mentioned in our policy. Claim intimation is received only on 15.12.2014 where as the date of accident is 12.02.2014, hence there is inordinate delay in submission of claim papers of almost 307 days.”
Complainant is a widow lady of 77 years as the time of filing none appeared for both parties. We are in doubt regarding the stat us of complainant and whether she is alive. This case was heard and order reserved on 18.6.2019 but unfortunately order was not pronounced. The very purpose of Consumer Protection Act, 1986 so also 2019 are frausted in this case by keeping the matter pending for years together. Registry is directed to give top priority to the case of senior citizen in listing and placing the matter.
Taking into consideration the entire fact and circumstances of the case we held that marginal delay in submitting the claim by a widow lady of 77 years cannot be a ground to reject the claim. The son of complainant was insured by virtue of taking the credit card for which premium has been received by opposite party No.3. Opposite party No.1 & 2 are also equally incompassionate with their customer after the death. It is not practically possible on the part of a 77 years widow lady to know about the credit card for which rejection of claim by opposite party No.3 is not sustainable and held that opposite parties No.1 & 2 are deficient in service by not intimating the legal heir/complainant about the benefit of credit card after knowingly the death of card holder and opposite party No.3 is negligent not only in settling the claim but also not responding the claim.
We therefore direct the opposite party No.3 to pay the insurance value/amount of Rs.5,00,000/- with 5% simple interest from the date of death to till date of payment within a period of 15 days from the date of receipt of the order, failing which the interest rate shall be 6% instead of 5% as directed above. We also award cost of Rs.20,000/- towards mental agony and Rs.5,000/- towards cost of litigation, which shall be borne 50% by opposite parties No.1 & 2 and 50% by opposite party No.3 and the same shall be paid within 45 days of passing of the order and if it is not paid it shall be enhanced to triple i.e. Rs.60,000/- & Rs.15,000/- in respect of the opposite parties who fails to carry out the order within the stipulated time given above. With the aforesaid observation and direction consumer complaint is disposed of. Send copy of the order to all parties.
Pronounced in the open Commission on this 08th Sept.,2023.
