BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMBALA.
Complaint case No.: 148 of 2018.
Date of Institution : 10.05.2018.
Date of decision : 01.08.2019.
- Smt. Anita aged about 51 years, wife of Late Shri Chaman Lal,
- Atul Saini aged about 23 years, s/o late Shri Chaman Lal,
- Anjali Saini aged about 21 years, daughter of late Shri Chaman Lal,
All residents of H.No.516, village Shehzadpur Majra, Post Office Shehzadpur Majra, Tehsil Naraingarh, Distt. Ambala.
...…. Complainants.
Versus
- IDBI Bank Limited, 41, Old Anaj Mandi, Mullana, Distt. Ambala through its Authorized Signatory.
- The New India Assurance Co. Ltd., 6269, Nicholson Road, Ambala Cantt through its Branch Manager/Authorized Signatory.
….…. Opposite Parties
Before: Smt. Neena Sandhu, President.
Smt. Ruby Sharma, Member.
Shri Vinod Kumar Sharma, Member.
Present: Shri J.P.S. Chauhan, Advocate, counsel for complainant.
Shri N.S. Malhotra, Advocate, counsel for the OP No.1.
Shri Dev Batra, Advocate, counsel for the OP No.2.
Order: Smt. Neena Sandhu, President
Complainants have filed this complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’) against the Opposite Parties (hereinafter referred to as ‘OPs’) praying for issuance of following directions to them:-
- To pay Rs.5,00,000/- to the complainants, on account of Accidental Insurance cover given to Late Shri Chaman Lal Saini, being ATM card holder of the OP No.1 bank.
- To grant interest @18% per annum on the amount covers under Personal accident w.e.f. the date of death of Shri Chaman Lal i.e. from 08.09.2015 till date of payment to the complainants being his LRs.
- To pay Rs.1,00,000/- as compensation for the mental agony and harassment suffered by it.
- To pay Rs.22,000/- as litigation charges.
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Any other relief which this Hon’ble Forum may deem fit.
Brief facts of the case are that Shri Chaman Lal Saini (herein referred to as deceased) was legally wedded husband of complainant No.1 and father of complainants No.2 & 3, who was maintaining his account with the OP No.1 and was having an ATM. At the time of taking the ATM, by Chaman Lal Saini, OP No.1 given insurance of Rs.5,00,000/- on personal accident death and Rs.20,000/- on purchase of protection. Unfortunately, on 08.09.2015, Shri Chaman Lal Saini succumbed to accidental injuries caused by the driver of Truck/Tipper bearing Registration No.HR-37D-1646 namely Umed Pal and a case bearing FIR No.146 dated 08.09.2015 u/ss 279, 304-A of IPC was registered in this regard with the PS Shehzadpur. After the death of Shri Chaman Lal Saini, the complainants came to know about the Personal Accident Cover of Rs.5,00,000/- in the said ATM of OP No.1 of Account No.1303651100000453 against Policy No.13130046151300000001 issued by the OP No.1. They approached the OPs for taking the payment of personal accidental amount, upon which, they demanded the documents of death of Shri Chaman Lal Saini. The complainants furnished all the requisite documents with the OPs. The OPs repeatedly called the complainants in their bank at Mullana and assured that the amount of personal accident cover amounting Rs.5,00,000/- would be made to them, but they did not pay the same. The complainants issued a legal notice dated 12.09.2016 to the OPs in this regard, but all in vain. Earlier the complainants filed a complaint before the President, Learned District Consumer Forum, Ambala, against the OP No.1, but during the pendency of the complaint, they came to know that said complaint had some legal defect as insurance company are required to be impleaded in the array of OPs as subsequent respondent in the complaint. So, their counsel had withdrawn the said complaint by recording the statement and accordingly, the complaint was decided dismissed as withdrawn with the permission to file the fresh complaint on same cause of action before the appropriate Forum. The learned Forum has exempted the period during which the complaint remained pending before the Forum. As such, fresh complaint is being filed before the Hon’ble Forum. By not paying the claim amount, the OPs have committed deficiency in service.
2. Upon notice, OP No.1 appeared through counsel and filed written version and have raised preliminary objections regarding maintainability and cause of action. On merits, it is stated that complainants or deceased Chaman Lal do not comes under the definition of consumer qua the answering OP No.1 in respect of the insurance claim. Furthermore, in the claim form, the card holders specifically acknowledged that the bank will not be liable in any manner whatsoever by virtue of any insurance cover provided and the insurance company will be solely liable and card holder shall not hold the bank liable for any matter arising out of or in connection with such insurance cover, recovery or payment of compensation, processing or settlement of claim or otherwise howsoever and all such matters shall be addressed to and sorted out directly with the insurance company. No insurance cover has been issued for account No.1303651100000453. The deceased Chaman Lal also availing Kissan Credit Card Scheme (KCC) to the extent of Rs.6,50,000/- from Branch Mullana of OP bank. This credit facility was sanctioned on 20.03.2015. The KCC was attached with a scheme of personal insurance claim of Rs.50,000/-. Beside the KCC, the deceased was also operating a Saving Account with OP. In this Saving bank account, the deceased availed the facility of ATM Gold card, which was connected with an insurance scheme of personal accident cover and protection subject to terms and conditions of the insurance policy. As per term of the insurance policy, the card holder has to admit all the terms & conditions of insurance company and bank qua insurance and thereafter, for insurance claim, beneficiary/ LRs of deceased (insured) had to apply for claim in writing to insurance company within prescribed period of one month from the death of card holder alongwith the required mandatory duly notarized documents. These documents contains (1) A request letter from the legal heir claiming the compensation on behalf of deceased person with all details (2) Death certificate of the deceased customer (3) Panchnama from police giving the accident details (4) Certificate of doctor giving details of medical treatment such as when the person was admitted, duration of hospitalization, treatment given, ailment of death etc. (5) A proof showing the relationship of claimant with the deceased person. The factum of death of Chaman Lal was not conveyed to the OP. The factum of death was neither conveyed within prescribed period nor thereafter till 05.05.2018. When complainants themselves not intimated to bank, then how can OP bank got the information of death of deceased. It is pertinent to mention here that the deceased had availed KCC on 20.03.2015 from the OP No.1 and as per terms of KCC, it is required to bring the account on credit once in a year. After passing of one year, when the account was not brought to credit, the officials of OP bank approached the complainants, then they came to know about the death of Chaman Lal. The officials of OP, at their own immediately informed the proceeding for death claim of Rs.50,000/- connected with above KCC. Thereafter, the complainants had received this amount of Rs.50,000/-. So far as insurance claim of bank account (Gold Debit Card) is concerned; the complainants never applied for the same with the OP bank or insurance company nor intimated the OP bank even at the time of processing for insurance of KCC. However, as per terms & conditions, the claim should be lodged within one month of incident, in prescribed form, but the complainants did not do so. Furthermore, complainants had not bothered to close the saving bank account of deceased after the settling of the death claim. The OP No.1 has not committed any deficiency in service, thus the complaint filed against it, deserves dismissal with cost.
Upon notice, OP No.2 also appeared through counsel and filed written version stating therein that there is no privity of contract between the OP No.2 and the complainant. Neither any amount as premium was ever received from the complainant by the OP No.1 nor any master insurance policy was issued to the complainant. Nobody including the OP No.1, on behalf of OP No.2 was ever authorized to receive any premium or to issue such insurance policy. As per term & condition of the policy, intimation of loss is to be made within 2 working days, which has not been complied with. No details of alleged FIR had ever been reported to the OP No.2 and the said FIR is manipulated one. Neither any such loss was intimated nor any bank account details etc. had been provided. No claim had been registered with the OP No.2 till date. There are different types of cards issued by the bank and all such types of card have their separate “Annual Limit”, “Per Card Limit” etc., so it is not that all card holders are insured for Rs.5 lacs and all claims are payable. The admissibility of any claim is subject to fulfilment of these terms & conditions. There is a “process of lodging” claim for such like claims. No claim is ever entertained by the insurance company directly. The claim is to be lodged with the insurer, which registers and processes the same and then recommends the same to insurance company alongwith details of insurance, facts of claim. The amount under claim and to settle the same as per T&C of alleged policy etc. But nothing of this sort had ever happened in this case. So, there is no deficiency on the part of the OP No.2 and prayer has been made for dismissal of the present complaint.
3. The ld. counsel for the complainant tendered affidavit complainant as Annexure CW1/A alongwith documents Annexure C-1 to C-11 and closed the evidence on behalf of complainant. On the other hand, learned counsel for OP No.1 tendered affidavit of Nancy Aggarwal, Assistant Manager, IDBI Bank, Ambala as Annexure R-1/A alongwith documents Annexure R1/1 to R1/18 and closed the evidence on behalf of OP No.1. The learned counsel for OP No.2 tendered affidavit of Rajiv Singhal, Sr. D.M., The New India Assurance Co., Ambala Cantt as Annexure OP2/A and closed the evidence on behalf of OP No.2.
4. We have heard the learned counsel of the parties and carefully gone through the case file and also the case laws referred by the ld. counsel for the complainant as well as by OP No.2.
5. The learned counsel for the complainant has argued that late Shri Chaman Lal Saini, was maintaining his account with the OP No.1 and was having ATM card. Being an ATM holder, a personal accidental cover of Rs.5 lacs was given to him. Unfortunately, on 08.09.2015, late Shri Chaman Lal Saini died in a roadside accident. The complainants, being the legal heirs of late Shri Chaman Lal, approached the OP No.1 to get the claim and submitted all the requisite documents, but the OPs did not pay the claim amount, hence, they committed deficiency in service. In support of his contention, the ld. counsel for the complainant has placed reliance on the case, titled as Punjab National Bank Vs. Vidya Sagar Kamal, IV (2017) CPJ 40A (CN)(HP).
On the contrary, the learned counsel for OP No.1 has argued that the OP No.1 had purchased insurance cover from the New India Assurance Co. Ltd. i.e. OP No.2 for its customer for the period from 01.08.2014 to 31.07.2015. Late Shri Chaman Lal had taken the ATM cum Debit Card from the OP No.1. The OP No.1 had sent the said ATM cum Debit Card to late Shri Chaman Lal alongwith terms & conditions of the insurance policy. He was well aware of this fact that insurance cover so provided, would be available to the card holder only as per terms of the relevant policy in force. As per terms of the policy, there should be minimum two purchase transaction using the debit card in the last 3 months prior to the event date. Since no transaction was made by the late Shri Chaman Lal Saini in the last 3 months prior to his death, therefore, as per terms & conditions of the policy, complainants were not eligible for the personal accident claim and they were duly informed vide email dated 14.01.2019 by the OP No.1 bank. Since, the OP No.1 had not committed any deficiency in service, therefore, the present complaint filed against it, may be dismissed with heavy costs.
Learned counsel for the OP No.2 has argued that the OP No.2 has no privity of contract either with late Shri Chaman Lal nor with the complainants. Even otherwise, complainants had lodged their claim with the OP No.1, which was declined by the OP No.1 only, as such, nothing had been done by the OP No.2, therefore, the present complaint filed against it, may kindly be dismissed with costs. The learned counsel for the OP No.2 has referred the judgments titled as Anju Kalsi Vs. HDFC Ergo General Insurance Company, Revision Petition No.2974-2975 of 2016, decided on 24.03.2017 (NC); Kurra Maroni Vs. The Branch Manager, Axis Bank & Anr., Revision Petition No.289 of 2013, date of decision 31.03.2015 (NC); Gompa Appalakonda Vs. Bajaj Allianz General Insurance, Revision Petition No.2944 of 2013, date of decision 31.03.2015 and Export Credit Guarantee Corpn. Of India Ltd. Vs. M/s Garg Sons International, Civil Appeal No.1557 of 2004, date of decision 17.01.2013.
6. From the policy document Annexure R1/1, it is evident that OP No.1 was duly insured with the OP No.2 for the period from 01.08.2015 to 31.07.2016. From the Annexure C/2, it is evident that late Shri Chaman Lal Saini was holding a Gold Debit Card of IDBI Bank. From the Schedule of facilities of IDBI Bank (Annexure C/3), it is evident that the gold debit card holder was having insurance of Rs.5 lacs on personal accidental death and Rs.20,000/- on purchase protection. This fact is also mentioned in the insurance policy card (Annexure R1/3). In ‘Terms & Conditions Classic Debit-Cum-ATM Card/Gold Debit-cum-ATM Card’ of IDBI Bank’ (Annexure R-1/17), under the head ‘Insurance Benefits’, it has categorically been mentioned that ‘For insurance claims to be accepted and processed, there should be a minimum of 2 purchase transaction using the Debit Card in last 3 months prior to the event date’. From the perusal of Transactions Inquiry (Annexure R1/11), it is revealed that late Shri Chaman Lal Saini had not made any purchase transaction using the debit card in question, in the last three months prior to his death. Even the complainants have not produced any document to show that late Shri Chaman Lal Saini had made purchase transactions, using the debit card within three months prior to his death. Since the complainants have failed to prove that late Shri Chaman Lal Saini had made two purchase transactions, using the debit card within three months, prior to his death, therefore, as per terms & conditions of Classic Debit-Cum-ATM Card/Gold Debit-cum-ATM Card of IDBI Bank, the complainants are not entitled to get the claim amount. In the case of Anju Kalsi Vs. HDFC Ergo General Insurance Company, decided on 24.03.2017, the Hon’ble National Commission has held that the card holder did not use the debit card even once in three months before his death. Therefore, the condition subject to which the accident cover could be available did not stand fulfilled.
7. In view of the aforesaid discussion, we do not find any merits in the present complaint. Consequently, we dismiss the same with no order to costs. Certified copy of this order be supplied to the complainant, forthwith, free of cost as permissible under Rules. File be indexed and consigned to the Record Room.
Announced on :01.08.2019.
Sd/- Sd/- Sd/-
(Vinod Kumar Sharma) (Ruby Sharma) (Neena Sandhu)
Member Member President
