S.K. Aggarwal filed a consumer case on 03 May 2023 against HDFC Bank Ltd in the Patiala Consumer Court. The case no is CC/17/79 and the judgment uploaded on 02 Jun 2023.
HDFC Bank Ltd., Chhoti Baradari, Patiala, through its Branch Manager.
Yogesh Kulkarni, HDFC Bank Ltd., 1-Think Techno Campus Building, Alpha, Next to Kanjur Marg, Railway Station (East) Kanjur Marg (E), Mumbai.
HDFC ERGO General Insurance Company Chhoti Baradari, Patiala through its Branch Head.
…………Opposite Parties
Complaint under the Consumer Protection Act
QUORUM
Hon’ble Mr.S.K.Aggarwal, President
Hon’ble Mr.G.S.Nagi,Member
PRESENT: Sh.Hemant Nanda, counsel for complainant.
Sh.B.B.Gupta, counsel for OPs No.1&2.
Sh.Amit Gupta, counsel for OP No.3.
ORDER
The instant complaint is filed by S.K.Aggarwal (hereinafter referred to as the complainant) against HDFC Bank Ltd. and others (hereinafter referred to as the OP/s) under the Consumer Protection Act ( for short the Act).
The averments of the complainant are as follows:
That Nikhil Aggarwal, son of the complainant was maintaining saving bank account No.50100047332855 with HDFC Bank at Patiala i.e. OP No.1. OPs issued him Platinum ATM card bearing No.4363 0301 1647 1954, and holder of card was covered under personal accident insurance of Rs. 10 Lacks.
Son of the complainant expired in a road accident on 17.1.2016.After his death complainant approached OP No.1 for his death claim. He also sent e-mail to the OPs in this regard. On 28.10.2016 OP No.2 rejected the claim on the ground that “No transaction upto three months prior to the date of loss” was done by Nikhil Aggarwal. Complainant approached OP No.1 and shown all the transactions made by late Nikhil Aggarwal but of no avail.Thus , the OPs have wrongly and illegally rejected the accidental death claim of the complainant on false and flimsy grounds, which amounts to deficiency in service on their part. Consequently, prayer has been made for acceptance of complaint.
Initially, complaint was filed against OPs No.1&2 & Sh. B. B. Gupta, advocate appeared on behalf of OPs No.1&2. Ld. counsel for complainant filed an application for impleading HDFC Ergo General Insurance Company Ltd. as OP, which was allowed and amended complaint was filed. Upon notice, OP No.3 appeared through counsel and filed written statement having contested the complaint.
In the written statement filed by OPs No.1&2, it is admitted that saving bank account No.50100047332855 was opened in the name of Nikhil Aggarwal with OP No.1 on 21.5.2014. He was also issued a Platinum Debit ATM Card No.4363 0301 1647 1954, as per the scheme prevalent at the relevant time. On the basis of this card, the account holder was granted personal accident insurance coverage to the extent of Rs.5 Lakh, subject to fulfillment of terms and conditions of the policy. Death claim so lodged by the complainant was duly forwarded to the Insurance Company i.e. HDFC ERGO General Insurance Company Limited, which was duly processed and considered and it was found that the account holder failed to fulfill the terms and conditions required to be fulfilled for such personal accident death insurance coverage. It is submitted that complainant is not entitled to claim any relief from OPs No.1&2 and the complaint is liable to dismissed against OPs No.1&2.
In the written statement by OP No.3, it raised certain preliminary objections. It is pleaded that OP No.1 i.e. HDFC Bank obtained one cardsure Package Policy No.2999200570315102000 covering their Debit Card Holders i.e. Platinum Card/Gold Debit card, Women Advantage, World Business and Titanium, subject to terms and conditions. There was also a clear and mandatory condition that with effect from 1st July,2014, all the Debit Card Holders were required to use their Debit Card at retail OR online stores at least once every 30 days to keep the free personal death insurance cover active, on their debit card.
That death claim so lodged by the complainant was duly processed and considered. It was found that the account holder failed to fulfill the terms and conditions for such personal accident death insurance coverage, because there was no POS transaction done within 3 months prior to 17.1.2016 i.e. date of death, despite the fact that he was bound to use the Debit Card at least once in every 30 days to keep the insurance risk coverage, active. Since there was a breach of the policy’s special condition No.8, therefore, free personal death insurance cover risk was not covered on the date of alleged accident of the Debit card holder Nikhil Aggarwal. Thus the complainant is not entitled for any claim from OP No.3 and the same has been rightly repudiated by OP No.3.
It is admitted that deceased being the holder of Platinum ATM card was covered under the above said policy, subject to terms and conditions of the same. The deceased died in a road accident on 17.1.2016 and the complainant through OP No.1 lodged a claim under the aforementioned policy vide letter dated 7.10.2016. Complainant also submitted claim form, death certificate, FIR, PMR, statement of account etc.. His claim was duly processed by the OP. After the perusal of all the documents, it was observed by the OP that deceased had not done any POS(Point of sale) transaction within 3 months before his accident/death, which amounts to non-fulfillment of Special Condition No.8 of the policy terms and conditions. Since the mandatory requirement for the said cover was not complied with, therefore, the claim was rightly repudiated vide letter dated 28.10.2016 .
On merits, OP reiterated the facts as has been raised in the preliminary objections which are not repeated for the sake of brevity. After denying all other averments, OP No.3 prayed for dismissal of complaint.
In order to prove the case, ld. counsel for the complainant tendered in evidence, Ex.CA, affidavit of the complainant alongwith documents, Exs.C1 to C6 and closed evidence.
Ld. counsel for OPs No.1&2 has tendered in evidence Ex.OPB, affidavit of Sanjeev Jindal, Branch Manager, HDFC Bank and closed evidence.
Ld. counsel for OP No.1 has tendered in evidence Ex.OPA affidavit of Sh.Pankaj Kumar , Ex.OP1 copy of policy with terms and conditions, Ex.OP2 copy of claim form, Ex.OP3 copy of bank passbook, Ex.OP4 copy of letter dated 7.10.2016,Ex.OP5 copy of repudiation letter and closed evidence.
We have heard ld. counsel for the parties and have also gone through the record of the case, carefully.
From the perusal of record, it is evident that Nikhil Aggarwal was the Debit Card Holder, issued by HDFC Bank i.e. OPs No.1&2, copy of which is Ex.C1 and was insured for Personal Accident Insurance of Rs.5 Lakhs/10 Lakh under the said card with OP No.3. Copy of policy is Ex.OP1. Nikhil Aggarwal was using the debit card, issued by OPs No.1&2. The case of the complainant is that Nikhil Aggarwal died in an accident on 17.1.2016. Copy of death certificate is Ex.C2. Complainant lodged claim with OPs and also sent mail dated 20.8.2016,Ex.C4 but the claim was repudiated by OP No.3, vide letter dated 28.10.2016, on the ground that no POS transaction as per the terms and conditions of the policy was done within 3 months prior to the date of death.
It is not the disputed fact that Nikhil Aggarwal was the holder of Platinum ATM Card, Ex.C1 and was covered under the Package policy,Ex.OP1 for the sum insured of Rs.5 Lakh/10 Lakh for Personal Accident Insurance.
Ld. counsel for OPs No.1&2 has argued that policy was issued by OP No.3 and they have no concern with the settlement of the claim.
Ld. counsel for OP No.3 has argued that claim has been rightly repudiated due to non compliance of terms and conditions of the policy in question i.e. on the ground that NO POS Transaction was done within 3 months prior to date of loss.
In support of his case, ld. counsel for the complainant relied upon the judgment Anju Kalsi Vs. HDFC General Insurance Company Limited and Another in Civil Appeal Nos. 1544-1545 of 2022, decided on 21.2.2022 issued by the Hon’ble Supreme Court of India, wherein the issue regarding the compliance of the conditions of insurance policy with reference to ATM Swipe Transactions within the stipulated period prior to the date of event, the ground on which the claim of the complainant has been repudiated by the OPs has been discussed, wherein reference of Special conditions 5 & 9 of the insurance policy is made, the same are reproduced as under:
Step 1:Base cover- Rs.50,000/- per card by doing one POS transaction in the last three months.
Step II:Accelerated cover upto Rs.5,00,000/-(Total of up to Rs.10,00,000/-) for cover Rs. 1 spent on purchase through the Platinum Debit Card, sum assured increased by five times the spent amount (subject to minimum spends of Rs.20,000/-) in the last 12 months as per the latest bank statement of the customer”.
And claim of Rs.5,00,000/- i.e. sum insured alongwith interest& compensation has been awarded.
In view of the discussions above, we are of the opinion that the claim of the complainant has been wrongly repudiated by the OPs and the complainant is entitled for a compensation of Rs.5,00,000/- ie. the sum insured. Accordingly, we partly allow the complaint and direct OP No.3 to settle the claim of the complainant for Rs.5,00,000/- alongwith interest @ 6% per annum from the date of repudiation i.e. 28.10.2016 till realization within 30 days from the date of receipt of certified copy of this order, failing which it shall pay interest @ 9% per annum on the said amount from 28.10.2016 till realization. No order as to costs and compensation.
The instant complaint could not be disposed of within stipulated period due to Covid protocol and for want of Quorum from long time.
G.S.Nagi S.K.AGGARWAL
Member President
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