Orissa

Dhenkanal

CC/67/2016

Sushila Sahoo - Complainant(s)

Versus

Branch Manager, Oriental Bank Of Commerce , Kakudibhag Branch & Others - Opp.Party(s)

26 Sep 2017

ORDER

BEFORE THE DIST. CONSUMER DISPUTES REDRESSAL FORUM, DHENKANAL

                                                 C.C.Case No. 67 of 2016

Sushila Sahoo, aged about 62 years

Wife of Nishakar Sahoo, village: Similipatna,

 PO: Kakudibhag, P.S: Sadar, Dist: Dhenkanal             ………….Complainant

                                                                Versus                                                                                     

1) Branch Manager,

    Oriental Bank of Commerce,

    Kakudibhag Branch, At/Po: Kakudibhag,

     P.S: Sadar, Dist: Dhenkanal

2) Branch Manager,

     Oriental Insurance Company Ltd,

     At/Po/Dist: Dhenkanal                                            …………..Opp. Parties

Present: Sri  Badal Bihari Pattanaik, President,

                 Miss Bijayalaxmi Satapathy, Member

                 Sri Purna Ch. Mishra, Member

Counsel: For the complainant:  Harihar  Gauda & Associates

                  For the Opp. Party No.1: Bharat Hati & Associates

                 For the Opp. Party No.2: Dayanidhi Mishra

Date of hearing argument: 20.9.2017

Date of order: 26.9.2017

                                                                                JUDGMENT

Sri Badal Bihari Pattanaik, President

                In the matter of an application U/s 12 of Consumer Protection Act, 1986 filed by the complainant alleging deficiency of service on the part of the Opp. Parties.

                1)  Very briefly, the case of the complainant stated are that the complainant is the mother of Prabina Sahoo, D/o Nishakar Sahoo who died on 29.8.2015 at the age of 37 years.    It is stated that as per Scheme of the Central Government all the depositors were included in the Insurance Plan PMSBY on payment of a sum of Rs. 12/- per annum towards premium.  As per the Insurance Scheme, the account holder namely  Prabina Sahoo was  covered under the said scheme, the legal heirs of the deceased depositor will be entitled to receive a sum of Rs. 2,00,000/-  for the death of the deceased during one year from the date of the deposit of the premium.  The deceased Prabina Sahoo during her life time had opened an account in the O.P No.1 . Bank on 30.5.2015 vide Account No. 20482121004848 . The complainant has been selected as nominee which was accepted by the Bank.  After the death of the account holder the complainant informed the Branch Manager, Oriental Bank of Commerce, Kakudibhag Branch as regards to the death of the account holder.  It is further stated that the deceased was also covered under the PMJBY Scheme and also paid the premium of Rs. 330/- to the O.P. Bank.  After the death of the account holder the petitioner is entitled to receive the insured amount from the Bank.  On the instruction of the Opp. Parties the complainant submitted all the relevant documents along with death certificate of the deceased.  The complainant submitted death claim application in the prescribed proforma before the Branch Manager in the month of November-2015 along with P.M report and all other relevant document.  The complainant also submitted the copy of the F.I.R as regards to unnatural death  of the deceased and also submitted original death certificate  along with certified copy of the F.I.R, in U.D. Case No. 4/2015 of Bhapur Police Out Post.  On 25.4.2016 the present petitioner submitted a letter of request to the Branch Manager, Oriental Bank of Commerce, Kakudibhag Branch to look after the matter.   On 7.6.2016 the O.P.No.1 vide his letter No.481/2016-17 dated 7.6.2016 intimated the complainant to submit translated copy of the F.I.R in English/Hindi along with report of viscera.  On 22.4.2016 the Oriental Insurance Company intimated the complainant vide letter No. Nill Dt. 22.4.2016 that the complainant failed to comply the requirements for which the claim was closed.   The complainant is the nominee and entitled to receive the insurance amount.  It is alleged that the deceased had paid the required premium of Rs. 330/- under the PMJBY Scheme and the complainant being the nominee under the policy is entitled to get the benefits.  The Opp. Parties have committed deficiency in service by not settling the claim of the complainant which is also a gross negligence and for that the complainant sustained financial loss and suffered from mental agony.  Therefore, the complainant has come up before this Forum seeking for a direction to the O.Ps to pay a sum of Rs. 2,00,000/-  under the Insurance Scheme.  Besides, the complainant claims compensation, cost of the litigation of Rs. 60,000/-.  The contents of the petition are supported by affidavit.

                2) The Opp. Parties appeared and filed their written version. It is in the version of the O.P.No.1 that the case is not maintainable and this Forum has no jurisdiction to decide the dispute.  The case is liable to be dismissed for misjoinder of party as the O.P.No.1 has no link with the present case.  The case is barred by law of limitation.   The cause of death is to be proved by the petitioner so as to get the benefits which is to be seen by the Opp. Party No.2.  The Opp. Party No.1 duly intimated the matter to the Opp. Party No.2 and the Opp. Party No.2 by verifying all necessary documents will finalize the matter in question. .  The Opp. Party No.1 has not committed any deficiency in service.   The documents as asked for are necessary for verification.  As the complainant failed to comply the requirements, her application was closed.  The Bank O.P.No.1 has no role to play for settlement of dispute.  As the petitioner could not  produce the relevant documents it is not possible on the part of the O.P.No.2 to settle the dispute.  Since there is no deficiency in service on the part of the Opp. Party No.1 the case is liable to be dismissed.  The contents of the written version are supported by affidavit.

                3) The Opp. Party No.2 in his written version has stated that the case is not maintainable and there is no cause of action to file the case.   The complainant has not come to the Forum with clean hands and she has suppressed the material facts for which the claim is not entertainable.  The complainant has failed to produce her identity by producing necessary documents.  The complainant has no relation with regard to payment of premium to the Insurance Company.  The Opp. Party No.2 is unaware of the death of the deceased.  It is denied that the deceased was covered under the Insurance scheme.  The allotment of the Bank account to the deceased and nomination to the complainant are beyond the knowledge of the Opp. Party No.2.  The allegation of the complainant is solely against the Bank so the case is liable to be dismissed as against the Opp. Party No.2.  The receipt of premium and coverage under the PMJBY scheme is only known to the Bank and the O.P.No.2 is no way involved in the present dispute.  The O.P.No.2 is not responsible and liable for the alleged amount to be paid to the complainant.  The Opp. Party No.2 is not aware about the unnatural death of the deceased, police case, proforma claim application, submission of relevant documents before the Bank, U.D. Case, letter of request,  viscera report etc.  The complainant never approached the Opp. Party No.2 with the relevant documents so as to establish her claim against it for which there is no opportunity on the part of the O.P.No.2 to settle the claim of the complainant.  The complainant approached the Bank without having the necessary insurance particulars.  Since there is no deficiency in service on the part of the Opp. Party No.2 it is pleaded the case is liable to be dismissed with cost.

4)            On the aforesaid pleadings of the respective parties following issues are framed for determination.

                1) Whether the complaint is maintainable?

                2) Whether the Opp. Parties are in deficiency of service?

                3) To what relief, if any, the complainant is entitled?

5)  Issue No.1

                It is not disputed that the deceased   Prabina Sahoo during her life time had opened one S.B Account bearing No. 20482121004848  on 30.5.2015  in the O.P. No.1 Bank  and  the O.P.No.1 Bank has deducted a sum of Rs. 330/-  towards Insurance Premium under PMJBY Scheme.  Therefore, the complainant is a consumer who has hired the services of the Opp. Parties being a beneficiary.  There is no dispute as regards to the death of the account holder namely Prabina Sahoo  on 29.8.2015 and  submission of claim for settlement of the benefits under the scheme. There is no dispute as regards to that the complainant is the mother of the deceased account holder and nominee.  The complainant after death of the deceased account holder submitted the required documents for settlement of her claim which has not been redressed for which the complainant has come up before this Forum alleging deficiency in service.   Since the complainant who is a consumer has filed the present case on 19.8.2016 alleging deficiency in service on the part of the Opp. Party for non-settlement of her claim, we are of the view that the case is maintainable as this Forum has jurisdiction to adjudicate upon the case and the case is not barred by limitation.

6)  Issue No.2

       The Opp. Party No.1 Bank in its written version has not denied the deduction of Rs. 330/- from the S.B. Account of the deceased Miss Prabina Sahoo   on 30.5.2015. The complainant is also the nominee   as evident from the S.B.Account of the deceased Miss Prabina Sahoo. The deceased Prabina Sahoo died on 29.8.2015 as evident from the Xerox copy of certificate of death issued by the competent authority.   As the required premium was paid and during the validity period of the insurance the account holder died, the complainant being the nominee to the policy submitted all the required documents for settlement of claim.  Despite her prompt efforts in submitting all the required documents, the claim has not been settled for which the complainant has come up before this Forum seeking for Redressal of her grievance.  The Opp. Party No.1 does not dispute the deduction of the premium and receipt of intimation regarding the death of the account holder and receipt of claim form along with the documents as asked for from the nominee complainant. Accordingly, it is pleaded by the O.P.No.1 that there is no deficiency in service in settlement of the claim as preferred by the complainant more particularly when the O.P.No.2 is the competent authority for settlement of the claim. The Opp. Party No.2 strongly denied as regards to deduction of premium, entitlement of Rs. 2,00,000/- for the death of the deceased, and the O.P.No.2 is unaware of the death of the deceased.  It is also denied that the deceased was covered under the Insurance Scheme.  The allotment of the Bank account to the deceased and nomination to the complainant are beyond the knowledge of the O.P.No.2.  It is further pleaded that   the O.P.No.2 has not receipt the premium and coverage under the PMJBY scheme and the O.P.No.2 is no way involved in the present dispute.  The complainant has raised false and vexatious allegations against the Opp. Party No.2.

   7)               On the aforesaid rival pleadings of the respective parties we have perused the documents available on record.  On our perusal of the documents we find that O.P.No.2 in his letter dated 7.6.2016 has intimated the complainant   stating that   as she could not comply the requirement sought for  vide letter dated 22.4.2016 the claim has been closed.  The Certificate of Insurance under Pradhanamantri Surakshy Bima Yojna disclosed that the name of the Master Policy Holder is Oriental Bank of Commerce vide Master Policy No. 271700/48/2016/229  and the Name of the insured is Smt. Prabina Sahoo having Savings Bank Account No.20482121004848 and  Sushila Sahoo was   selected as nominee.  From the above documents which have been filed by the Opp. Party No.2 it is crystal clear that the Opp. Party No.2 in his written version has taken false stands as regards to receipt of claim form along with documents.  The  acknowledgement cum-certificate of Insurance vide Exbt-A discloses that the Bank O.P.No.1 has acknowledge receipt of Consent-cum-Declaration form from Mrs. Prabina Sahoo consenting and authorizing auto-debit from the specified Savings Bank account to join the Pradhan Mantri Surakshya Bima Yojana with the Oriental Insurance Company Limited under Master Policy No.271700/48/2016/229 certifying cove rage as per the scheme.   The letter Dt. 8.2.2016 vide Exbt-B of the O.P.No.1 Bank addressed to the Asst. General Manager, Sector-32, Gurgaon, Harayana-122001 discloses   the PBSBY Claim Form of Late Prabina Sahu duly filled in for further course of action and reference and remaining document has already been submitted. Exbt –C is the claim form   of the complainant containing the discharge voucher which has not been filled in completely submitted by the complainant.  On 7.6.2016  vide Exbt-D  sent to the complainant discloses that the O.P. Bank has  intimated the complainant  requesting her to provide the required paper mentioned therein at the earliest for further processing of her PMSBY Claim. The O.P.No.2 vide his letter dated 7.6.2016 sent to the complainant discloses that    as the  complainant could not file the FIR and English/Hindi Translation of the investigation report of Police and Chemical analysis of the VISCERA  the claim was closed.  On our careful scrutiny of the letter dated 7.6.2016 of the O.P.No.2 addressed to the complainant and the letter of the O.P.No.1 dated 7.6.2016 we find that both the letters are contradictory to each other.  Besides, the letter dated 22.4.2016 referred in letter dated 7.6.2016 of O.P.No.2  is not available on record as to whether the O.P.No.2 has called for any such documents as stated in letter dated 7.6.2016.  From the above documents as discussed in details and after careful examination of those documents we find that there  is no   controversy and doubt  as regards to  the deduction of premium of Rs. 330/- from the S.B.Account of the deceased policy holder, nomination of the complainant as nominee to the policy, acceptance of premium by the Opp. Party No.2 and issuance of insurance Policy, death of the deceased account holder during the validity period of the policy, submission of claim form along with all the required documents as asked for  and non-settlement of the claim of the complainant.   On our careful examination of letter dated 7.6.2016 issued by the Opp. Party No.2 in the name of the complainant we find that the complainant has been intimated with reference to her claim documents submitted by her through OBC Bank and ongoing through the documents it was observed that the documents like FIR and English/Hindi Translation of the investigation report of Police and Chemical analysis of the VISCERA the claim of the complainant was closed.  Now therefore, one vital  and important point  strikes our mind as to whether the Opp. Party No.2 is justified in closing the claim file of the complainant or not.  The complainant in order to support her claim has filed the documents.  The complainant has filed the Xerox copy of death certificate obtained from the competent authority.  The S.B.Account of the deceased Prabina Sahoo  vide No. 20482121004848 is also available  with deduction of Rs. 330/- on 30.5.2015  under PMJBY scheme.  A copy of paper cutting dated 30.8.2015 regarding the death of the deceased. The Xerox copy of claim form duly filled in by the complainant is also available on record.  The complainant has also submitted the required documents as asked for in the claim form under Sl. No.10. The complainant also filed the Xerox copy of the discharge voucher which is signed but not filled up.  The Xerox copy of Adhar Card, Votar Identity card are also avalable.  The complainant has also filed the U.D. Case Diary of ASI Bhapur O.P dated 18.11.2015.  The Xerox copy of the Post Mortem Report is also available on record.  On our perusal of the above documents we find that the complainant has already complied all the requirements as asked for.  From the Police report and the Post Mortem report we find that the cause of death of the insured was due to accidental drowning and there is no suspicion of any foul play. The Post Mortem report dated 29.5.2015 clearly discloses that the cause of death was due to drawning.   On a careful examination of the Police report and the Post Mortem report we find that there was no suspicion of any foul play as regards to the death of the Policy holder and the cause of the death was only for drowning.  But it is not understood why and what for the Opp. Party No.2 asked for the Viscera report when the claim form does not discloses any requirement of such documents nor the Opp. Party No.2 has ever asked for such report earlier as asked in his letter dated 7.6.2016.  After careful examination of the documents filed by the complainant, complaint petition supported by affidavit, documents filed by the Opp. Party No.1 Bank and the documents filed by the Opp. Party No.2 along with the written version available on record filed by the Opp. Parties we are of the view that the Opp. Party No.2 in order to shift his responsibility has unnecessary asked for additional documents which are not relevant for the purpose of the present case.  The written version filed by the Opp. Party NO.2  is totally  not acceptable in view of the documentary evidence brought on record as against the O.P.No.2 as discussed above in details.  It is significant to make a mention here that men may lie but document does not lie.  Therefore, we are of the opinion that the Opp. Party No.2 is not justified in closing the claim file of the complainant and the complainant is entitled to get the benefits under the scheme as prayed for. We do not find any deficiency of service on the part of the Opp. Party No.1 Bank.   Accordingly, all the issues are answered in favour of the complainant.  Hence ordered.

                                                                                ORDER

                The complaint is allowed on contest against the O.P.No.2 and dismissed as against the O.P.No.1 in the light of the observations made in the preceding paragraphs.  The Opp. Party No.2 is directed to pay a sum of Rs. 2,00,000/- (Rupees two lack) only  towards the death claim under the Policy  along with interest @ 9% per annum from the date of closure of the claim i.e. 7.6.2016 till its payment.  Besides, the Opp. Party No.2 is directed to pay cost of the litigation of Rs. 5,000/- (Rupees five thousand) only to the complainant.  The compliance of the direction shall be made within one month from the date of receipt of this order by the O.P.No.2 failing which  the rate of interest shall be charged @ 12% instead of 9%.

 

 (Purna Chandra Mishra)       (Miss Bijayalaxmi Satapathy)     (Badal Bihari Pattanaik)

             Member                                      Member                                President