Delhi

North East

RBT/CC/169/2022

PINKI & ORS. - Complainant(s)

Versus

HDFC BANK LTD. - Opp.Party(s)

18 Mar 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

Complaint Case No. 169/22

 

 

 

In the matter of:

 

	1. 2.	Ms. Pinki Ms. Pinki on behalf of minor children Mansha & Nirbhay R/o H.No. 4-5 Block E 4, Sultan Puri, Delhi-110086		Complainants
		Versus
	1.       2.	HDFC Bank Ltd. Sector 5, Rohini,  Delhi 110085   HDFC Ergo General Insurance Co. Ltd. 3rd floor, Pearl Best Height 11, Netaji Subhash Palace, C 9, Block N.P Poorvi, Pitampura, Delhi-110034		Opposite Parties
			DATE OF INSTITUTION:         JUDGMENT RESERVED ON:                           DATE OF ORDER:		22.10.18 02.11.23 18.03.24

 

CORAM:

Surinder Kumar Sharma, President

Anil Kumar Bamba, Member

Adarsh Nain, Member

 

ORDER

 Ms. Adarsh Nain, Member

 

The Complainant has filed the present complaint under Section 12 of the Consumer protection Act, 1986 against Opposite Party No. 1 i.e. HDFC Bank Ltd. and Opposite Party No. 2 i.e. HDFC Ergo General Insurance Co. Ltd.

 

 

Case of the Complainant

1. The case of the Complainant as revealed from the record is that the husband of Complainant took auto loan from Opposite Party No.1 Bank under loan agreement 28987712 for vehicle Maruti Swift Car bearing no. DL8C 1289. The vehicle was insured by Opposite Party No.2 i. Insurance company for 5 years under policy no. 295020081221900000 valid for a period from 25.07.14 till 24.07.19 midnight. It is stated that the deceased had paid 43 instalments out of 60 of Rs. 10,948/- from account no. 50100016008340. Due to timely repayment of auto loan by husband of Complainant and looking his creditworthiness, the Opposite Party No.1 Bank further financed of Rs. 5,00,000/- on the same vehicle which was also  covered under another Insurance policy valid w.e.f. 04.07.17 to 03.08.22 midnight issued by Opposite Party No. 2. The husband of Complainant died on 12.02.18 due to critical condition as per medical report of RML Hospital on 24.04.18 and the brother of Complainant had informed Opposite Party No.2 on 24.03.18 about death of his brother, prior to the medical report received from the hospital. The Opposite Party No.2 had registered insurance clam vide claim no. C295017013597/1 against policy no. 2950201864840300001 on 26.03.18. Thereafter, surveyor Sh. Suhash Hande was appointed by Opposite Party No.2 and Complainant submitted all the required documents as desired by the Opposite Party No.2 through speed post bearing no. ED 648238192IN and ED648238189IN dated 02.04.18. The Complainant had served notice to Opposite Parties as legal heirs of the deceased on 27.09.18 through speed post. Despite intimation of death Opposite Party, surveyor had not contacted claimant and bank has also sent notice on 07.08.18 for non-payment of auto loan for the month of July 2018. The reply of said notice was sent through legal heirs by speed post. Complainant has prayed for the insurance claim of the death of her husband under the said policies and further direction to Opposite Party No.1 for non initiate any legal proceeding in respect of auto loan availed by Lt. Sh. Sunil Kumar till finalizing death insurance claim. Complainant has further prayed to restrain Opposite Party No.1/ financer of auto loan not to take the possession of four wheeler vehicle.

Case of the Opposite Party No.1 i.e.HDFC Bank Ltd.

2. The Opposite Party No. 1 contested the case and filed written statement. While admitting that Complainant’s husband availed two loan facilities from Opposite Party No. 1 which are still active, it has been contended that Opposite Party No. 1 and Opposite Party No. 2 are two separate entities and the Complainant husband was customer of both the Opposite Parties by availing loan from Opposite Party No. 1 and availing insurance policies from Opposite Party No. 2. It is submitted that either of the parties cannot be made liable for the default, if any, of other as one has not say in the affairs of other. It is contended that it is wrong to alleged  that HDFC ergo is subsidiary of HDFC bank. It has been stated by Opposite Party No. 1 that if any claim amount is received by the claimant under the policies, it should be adjusted towards the outstanding due in the loan accounts.

Case of the Opposite Party No.2 i.e. HDFC Ergo General Insurance Co. Ltd

3. The Opposite Party No. 2 appeared and filed written statement. While admitting the subject policies, it has been contended that the as per the documents filed by the Complainant, the cause of death was not accidental but he died due to disease, It is submitted that as per the death summary, the patient died due to sudden cardiac arrest which is not covered under Critical illness in the subject policy. It has been contended by the Opposite Party No. 2 that the claim of the Complainant is neither covered under personal accident or under critical illness, hence rightly rejected under the terms and conditions of the subject insurance policy.

Rejoinder to the written statements of Opposite Parties

4. The Complainant filed common rejoinder to the written statements of Opposite Parties wherein the Complainant has denied the pleas raised by the Opposite Parties and has reiterated the assertion made in the complaint.

Evidence of the Complainant

5. The Complainant in support of her complaint filed her affidavit wherein she has supported the averments made in the complaint.

 

 

Evidence of the Opposite PartyNo.1

6. In order to prove its case, Opposite Party No.1 filed affidavit of Ms. Bharti Thakur, Attorney of Opposite Party No.1 wherein the averments made in the written statement of Opposite Party No.1 have been supported.

Evidence of the Opposite PartyNo.2

7. The Opposite Party No. 2 has not filed their evidence, hence failed to prove their case.

Arguments & Conclusion

8. We have heard the Ld. Counsels for the parties. We have also perused the file and the written arguments filed by the parties.
9. It is the case of the Complainant that her husband (since deceased) availed two loan facilities from Opposite Party No. 1 bank on the same vehicle. The Complainant’s husband had two policies covering his life and the loan amount. It is stated that upon intimation of death, Opposite Party No. 2 had registered insurance clam vide claim no. C295017013597/1 against policy no. 2950201864840300001 on 26.03.18. It is alleged that Opposite Party No. 2 has not paid the insurance claim to the Complainant and prayed for insurance claim of the death of her husband under the said policies and further direction to Opposite Party No.1 for non initiate any legal proceeding in respect of auto loan availed by Lt. Sh. Sunil Kumar till finalizing death insurance claim. Complainant has further prayed to restrain Opposite Party No. 1/ financer of auto loan not to take the possession of four wheeler vehicle.
10. On the other hand, Opposite Party No. 1 i.e. Bank has contested the claim and contended that the claimant has raised an insurance claim under the insurance policy issued by Opposite Party No. 2 Insurance company and Opposite Party    No.  1 has no liability as they are separate entities and they have no say in affairs each other’s affairs.
11. Opposite Party No. 2 i.e. Insurance company has not put any defence forward as they have not filed their evidence in support of their case put up in their reply/written statement. Hence, the reply of Opposite Party No. 2 cannot be read for deciding the present dispute.
12.  The case of the Complainant is that there were two policies in existence at the time of death of the Complainant’s husband and the Insurance claim was also registered by Opposite Party No. 2 on 26.03.18 under one of the policies i.e policy no. 2950201864840300001.  It is alleged that Opposite Party No. 2 had not paid the said Insurance claim despite submitting all the required documents.
13.  On perusal of material on record, we find that the medical record of the patient including the death summary clearly show that the patient Sunil Kumar (Complainant’s deceased husband) was continuously undergoing the treatment for a brain infection caused by Neuocysticercosis (NCC) in Ram Manohar Lohia Hospital. The most common parasitic disease of brain, which led to sudden cardiac arrest of the patient, is very well covered under the definition of Critical illness and as such covered under the subject policy which is a comprehensive Sarv Suraksha Policy.
14.  The Complainant has filed copy of policy no. 2950201864840300001 under which the Complainant’s claim was admittedly lodged. The Complainant has also filed a welcome letter sent by Opposite Party No. 2 while confirming the issuance of policy.  The perusal of the policy document with the letter shows that Opposite Party No. 2 had assured the Insured that subject insurance plan covered four wheeler loan. Therefore, it is evident that the policy secured loan upto the limit of Rs.5,00,000/- under the coverage Credit shied insurance. Moreover, Opposite Party No. 2 has failed to file the evidence and has not rebutted the Complainant’s averment, hence, the Complainant version on oath is to be believed.
15. It is pertinent to mention here that the though, the Complainant has prayed for the insurance claim of the death of her late husband under the two policies which were effective at the time of death, but the claim was lodged under one policy no. 2950201864840300001. 
16. The Complainant has further prayed for direction to Opposite Party No.1 for non initiate any legal proceeding in respect of auto loan availed by Lt. Sh. Sunil Kumar till finalizing death insurance claim and to restrain Opposite Party No.1/ financer of auto loan not to take the possession of four wheeler vehicle. On the other hand, it has been argued by Opposite Party No. 1 that if any claim amount is received by the claimant under the policies, it should be adjusted towards the outstanding due in the loan accounts.
17.  With that regards, we are of the considered view that such prayer asto direction to Opposite Party No.1 for non initiate any legal proceeding in respect of auto loan cannot be allowed since no one can be restrained from taking course of law. So far as the claim of Opposite Party No. 1 that the claim amount be adjusted towards the outstanding due in the loan accounts cannot be allowed as Opposite Party No. 1 has not filed any counter claim in this regards before this commission.
18. In view of above discussion and unrebutted testimony of the Complainant, we are of the considered view that Opposite Party No. 2 i. e. HDFC ergo Insurance company ltd. has been deficient in services by not paying a valid claim of the Complainant.
19.  Thus, the present complaint is partly allowed and Opposite Party No. 2 which is HDFC Ergo General Insurance Co. Ltd  is directed to pay to the Complainant     Rs. 1,00,000/- (sum insured under the head death due to Critical Illness) and        Rs. 5,00,000/- (under Credit shield Insurance) under the subject policy alongwith interest @ 9% p.a. from the date of filing of claim i.e. 26.03.18 till recovery. The Opposite Party No. 2 is further directed to pay Rs. 25,000/- towards compensation and litigation cost along with 9 % interest from the date of this order till its recovery.
20. Order announced on 18.03.24.

Copy of this order be given to the parties free of cost.

File be consigned to Record Room.

 

(Anil Kumar Bamba)           Member

(Adarsh Nain) Member

(Surinder Kumar Sharma) President