Complainant Ms.Mohinder Kaur has filed the present complaint against the opposite parties U/S 12 of the Consumer Protection Act (for short, C.P.Act.) seeking necessary directions to the opposite party to  pay/disberse the insurance claim amount to her alongwith interest @ 18% as a compensation for mental harassment and mental agony, suffered a huge business loss of family affair by her and also to pay Rs.15,000/- as litigation expenses, in the interest of justice.

2.      The case of the complainant in brief is that her husband Prem Singh was employee of opposite party no.1, he was serving as a Accountant Branch Kala Afghana. He was insured by the opposite party no.2 through opposite party no.1 under group term insurance policy. He  died on 8.01.2011 during his service. The complainant lodged insurance claim through opposite party no.1. The complainant has further pleaded that opposite party no.2 settled the insurance claim of deceased Prem Singh and paid  through R.T.G.S. amounting to Rs.15,00,000/-. The opposite party no.1 took undertaking that he will disberse the claim amount to the beneficiary, but till date the opposite party no.1 illegal, without any justification retained her amount. She has given written request to the opposite party no.1 on 27.04.2015 but till date the opposite party no.1 not disberse the claim amount. Thus, there is clear cut deficiency in service on the part of the opposite party. Hence this complaint.

3.       Upon notice, opposite party no.1 appeared and filed its written reply through its counsel by taking preliminary objections to the effect that  this Ld.Forum has got no jurisdiction to try and decide the present matter; there is no relationship of consumer and service provider between  them hence the present complaint does not lie before this Ld.Forum; the complainant has got no locus standi to file the present complaint because the employee of the Bank i.e. Sh. Prem Singh has not made the payment of his contribution for purchase of the policy in question as such he was not having any right over the benefits of that policy as the Bank has made the payment of the premium for purchasing this policy. Moreover the insurance policy in question was not a group insurance policy as said and was rather protecting House building loan which were taken by the employees of the Bank who died before repayment of the same and this was done as per instruction of Government of Punjab. On merits, it was submitted that the amount was not paid to the complainant/alleged beneficiary because the premium which was to be paid to the OP2 was not paid by concerned employee rather it was paid by the Bank. Due to compassionate grounds matter has  been referred to the Board of Directors of the bank and the matter is still pending there. All other averments made in the complaint has been vehemently denied and lastly prayed that the complaint may be dismissed with costs.

4    Opposite party no.2 appeared and filed its written reply through its counsel by taking preliminary objections to the effect that the present complaint is not maintainable and is liable to dismissed qua opposite party no.2 as no cause of action ever arose in favour of complainant; the present contract of insurance is between the opposite party no.2 and Gurdaspur Central Cooperative Bank Ltd, therefore, it is clear that the complainant did not get any cause of action against the opposite party no.2 to file the present complaint and hence the complaint under reply is an abuse of the process of law and as such the same is liable to be dismissed qua opposite party no.2; the opposite party no.1 i.e. Gurdaspur Central Cooperative Bank Ltd. had obtained a “    GROUP TERM LIFE INSURANCE POLICY’ having policy no.GMDDE00552 for getting its employees insured; Sh.Prem Singh son of Sh.Makhan Siongh “Deceased Life Assured” was working with opposite party no.1  and his life was insured by opposite party no.1 by purchasing the aforementioned group life insurance policy. The sum assured was Rs.15,00,000/-. The policy holder in this group policy was OP No.1; opposite party no.2 received an application form for death claim on 23.05.2011 that unfortunately the husband of the complainant i.e. Sh.Prem Singh son of Sh.Makhan Singh expired on 08.01.2011.  However, vide letter dated 27.6.2012, opposite party no.1 wrote a letter to opposite party no.2 and requested to disburse the claim amount and make the claim benefits payment directly to opposite party no.1 Opposite party no.1 further undertook to pay the entire claim amount to the nominated beneficiary of the deceased and would also send the proof of the payment to opposite party no.2 in for of discharge receipt signed by the authorized signatory of opposite party no.1 bank. Upon receipt of the aforesaid death claim intimation, the opposite party no.2 got the said claim investigated and vide letter dated 07.04.2015, opposite party no.1 was intimated that the said death claim was accepted by the opposite party no.2 and an NEFT fund transfer of claim payout to the  tune of  Rs.15,00,000/- was made in the account of opposite party no.1 i.e. Account No.494010200001106 on 30.03.2015 being full and final settlement of the claim under the policy. The aid transaction was having UTR No.4440U15090034045. Once payment of death claim amount to the tune of Rs.15,00,000/- has already been made by opposite party no.2 that too in full and final settlement of the claim under the policy, therefore, present complaint is not maintainable. All averments made in the preliminary objections have been repeated on merits and prayed that the complaint may be dismissed with special costs.

5.      Counsel for the complainant tendered into evidence affidavit of complainant Ex.C1, alongwith other documents Ex.C2 to Ex.C4 and closed the evidence. 

6.       Counsel for the opposite party no.1 tendered into evidence affidavit of Sh.Manbir Singh Khehra District Manager Ex.OP-1/1 alongwith other document Ex.OP-1/2 and closed the evidence.

7.     Counsel for the opposite party no.2 tendered into evidence affidavit of Sh.Harsimran Singh Manager Legal Ex.OPW2/A, alongwith other documents Ex.OP-2/1 to Ex.OP-2/3 and closed the evidence.

8.      We have carefully examined and thoroughly considered the evidence along with its supporting documents (and statutory merits etc) as available on records of the proceedings in the backdrop of the arguments as put forth by the learned counsels for the participating litigants and also the scope of ‘adverse inference’ that may be discretionarily drawn on account of the non-production of some vital documents ignored to be produced during the proceedings. We find that the complainant has successfully proved through her deposition vide affidavit Ex.C1 duly supported by other documents (Ex.C2 to Ex.C4) that her husband Prem Singh DLA (deceased life assured) during his life time had been the insured member of Group Term Life Insurance Policy # GMDDE00552 and at his demise the complainant (DLA’s widow) had filed claim # 4055 for Rs.15.00 Lac with the OP2 insurers through the OP1 Bank who did receive full claim amount of Rs.15 Lac in its A/c # 494010200001106 on 30.03.2015 through NEFT vide UTR # 4440U15090034045 for making payment to the complainant against a valid receipt/ discharge of course after deducting of any outstanding balances in the DLA’s loan A/cs etc. The OP2 insurers vide its affidavit Ex.OPW2/A and documents Ex.OP2/2 & Ex.OP2/3 have duly confirmed the authenticity of above statement/observation(s) with additional information that the OP1 Bank have failed to dispatch back the requisite discharge/receipt of claim amount from the complainant beneficiary. The related communiqué (Ex.OP2/2) from the OP1 Bank to the OP2 insurers duly supports the above observation/proposition in which the OP1 Bank has categorically confirmed the above situation.

9.       We find that the OP1 Bank has somehow omitted to clarify/produce (vide its written statement & lone affidavit Ex.OP1/1) any clarification of ‘facts’ (in issue) pertaining to the receipt of claim amount of Rs.15 Lac at its end and its further ‘non-payment’ to the real ‘beneficiary’ nominee complainant and/or other ‘means’ of just appropriation of the claim amount received by the OP1 Bank. It has never been the case of the OP1 Bank that any amount was ‘due’ to the DLA in its ‘Books of Accounts’ and the insurance claim have been appropriated towards the same. The OP1 Bank has simply re-raised the objections as to the valid ‘jurisdiction’ of the forum and the absence of ‘consumer’ relationship with the present complainant; which were also raised earlier vide application dated 25.04.2016 and dismissed vide the forum’s orders dated  24.06.2016. To remove all ambiguity, it needs be clarified here that the OP1 Bank received the insurance claim amount from the OP2 insurers in trust and on behalf of the nominee/legal-heir widow-beneficiary/present complainant and had been liable to ‘render’ its appropriating accounts (if any) along with its ‘payment’ against a valid ‘receipt/discharge’ return to the OP2 insurers; but that has not to be so as is evident from the available evidence/documents produced/ignored to be produced on records by the OP1 Bank who has somehow been noticeably silent as to what transpired to the ‘settlement’ of the claim amount received at their end. The OP1 Bank has neither produced any evidence of follow-up appropriation towards settlement of the impugned claim amount nor rejection/repudiation of the same. The OP1 Bank has been suo-moto but un-necessarily expressing unasked for opinions on ‘issues of law’ whereas it was desired to reveal simply the bare ‘facts’ in issue. It has been almost ‘18’ months since the ‘receipt’ of the claim amount by the OP1 Bank and till date it has failed to convey/conduit ‘fate’ of the impugned amount and/or its appropriation to the complainant and that itself speaks volumes of infringement of her (complainant’s) consumer rights & OP1 Bank’s unfair trade practice/deficiency in service.       

10.     In the light of the all above, we find that the OP1 Bank has indeed bruised the consumer rights of the present complainant and that lines it up for an adverse award under the applicable statute. We, therefore, partly allow the present complaint and thus ORDER the OP1 Bank to pay back/refund the full receipted claim amount of Rs.15.00 Lac to the complainant along with interest @ 9% PA from the date of filing of present complaint till actual payment besides to pay her Rs.5,000/- as cost of litigation within 30 days of the receipt of the copy of these orders otherwise the interest shall accrue from the date of receipt of claim amount i.e., 30.03.2015. The OP1 Bank shall be at its liberty to take disciplinary action and/or to claim reimbursement or otherwise recover the award-amount from its delinquent officer/staff as per its own discretionary prerogative. 

11.     Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record.           

                   (Naveen Puri)

                                                                                      President   

Announced:                                                             (Jagdeep Kaur)

October,25 2016                                                              Member

*MK*