Date of Filing      : 16.03.2020

                                                                                                                 Date of Disposal: 27.08.2022

 

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION

THIRUVALLUR

 BEFORE  TMT. Dr.S.M. LATHA MAHESWARI, M.A.,M.L, Ph.D (Law)                      .…. PRESIDENT

                 THIRU.P.MURUGAN,B.Com.                                                                           ....MEMBER-II

CC. No.21/2020

THIS SATURDAY, THE 27TH DAY OF AUGUST 2022

 

N.Govindaswamy, S/o.Nallaiya,

No.333, Telungu Colony,

Perumal Koil Street,

Amanampakkam Village,

Thiruvallur Taluk & District – 601 103.                                                   .........Complainant. 

                                                                          //Vs//

1.The Branch Manager,

    Equitas Small Finance Bank,

    No.24, 2nd Floor, HVF Road,  Avadi, Chennai -54.

 

2.The Authorized Officer,

    HDFC Life Insurance Company Limited,

    11th Floor, Lotha Excells,

   Apollo Compound, N.M.Joshi Road,

   Maharashtra, Mumbai – 400011.                                                      ...Opposite parties.

 

Counsel for the complainant                                                           :   Party in person.

Counsel for the 1st opposite party                                                :   Mr.S.Sushilkumar, Advocate. 

Coulsel for the 2nd opposite party                                                : Exparte.

                         

This complaint is coming before us on various dates and finally on 03.08.2022 in the presence of complainant appeared in person and Mr.S.Sushilkumar counsel for the 1st opposite party and upon perusing the documents and evidences of both sides, this Commission delivered the following: 

ORDER

PRONOUNCED BY THIRU P.MURUGAN, MEMBER.

 

This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act, 1986 alleging deficiency in service against the opposite parties in not settling the insurance claim along with a prayer to direct the opposite parties  to pay a sum of Rs.2,35,000/- in total towards compensation for the mental agony due to the deficiency in service on the part of the opposite parties. 

Summary of facts culminating into complaint:-

 

The complainant states that his wife namely G.Santhi has obtained loan from 1st opposite party namely Equitas Small Finance Bank, Avadi Branch, Chennai with his name as nominee.  The complainant’s wife, the loanee, expired on 07.10.2018.  While availing the loan of Rs.35000/- an amount of Rs.679/- was paid as insurance premium and Rs.413/- as loan process fees.  It is stated by the complainant that the documents of 1.Original death certificate of G.Santhi, 2.Aadhaar Card copy of G.Santhi, 3. Loan card regarding loan availed, 4. Nominee Aadhaar card, 5. Ration Card copy, 6. Nominee bank Pass Book was given on 24.10.2018 to the 1st opposite party in the presence of group pleader Tmt.R.Mahalaxmi.  The complainant was informed by the 1st opposite party that on or before 40 days settlement would be made.  It is alleged by complainant that collection agents of the first opposite party has visited the place of residence of complainant even after her death for collection of instalments with whom the complainant has raised the issue of insurance settlement and for which there is no proper reply received.  Therefore on 13.02.2019 the complainant has issued a legal notice which was not served but returned.  Therefore the complainant has sent a notice to Zonal office of the 1st opposite party which sent an enquiry team to enquire the issue.  The team instructed the complainant to submit the documents including death certificate for process.  But the complainant could not produce the death certificate since the original certificate was submitted to 1st opposite party and the VAO deny to give a fresh one.  The complainant states that there is no other go but to approach this Commission for remedy to settle the claim of Rs.2,35,000/- towards insurance amount of Rs.35,000/- and compensation of Rs.2,00,000/- 

Crux of the defence put forth by the 1st opposite party:-

The 1st opposite party in their written version stated that the complainant’s wife Shanthi Govindasamy availed loan from them vide customer ID 2126631, Loan id LD1720810722 for Rs.35000/-.  The loan was disbursed on 29.07.2017 and the loan tenure completion date was 07.10.2018.  Last EFI paid on 25.10.2018.  The total on standing amount Rs.17,293/- and the EFI paid principle amount was Rs.19273/-.  As a member of micro insurance, the complainant’s wife Shanthi Govidasamy insured with 2nd opposite party vide certificate of insurance member G50000093488001 commencing the risk from 09.07.2017 to cover expiry date on 28.07.2017 with cover time of two years.  Further, the premium detail of instalment is Rs.515/20 and the mode of payment is single with premium payment term for two years.  As per the terms and conditions of the insurance policy, the complainant shall submit relevant documents within 30 days in support of his claim for the process.  Further the procedure for registering the claim as laid down in the insurance cover is reproduced as below;

Procedure for registering the claim “the following should be undertaken within 30 days to register a claim on this membership;

1.contact master policy holder or contact person who will provide HDFC life’s required claim forms, submit the completed claim forms and any accompanying documentation to master policy holder or contact person who will pass all the detail to HDFC life.

2. On payment of a claim, no further benefit be payable and the membership will terminate.

3. In case the master policy holder cannot be contacted, claims may be submitted to HDFC life at Group operations department, HDFC life insurance company limited 2nd floor, Loha Excells, Apollo Compound, N.M.Joshi Road, Maharastra, Mumbai 400011.  The 1st opposite party stats that the complainant has not intimated along with relevant documents towards death of his wife.  As per the insurance company, in case of death the insurance claim may be processed by the insurance company after adjusting further loan repayment by the borrower i.e., the deceased account settlement of loan.  The complainant was duly informed by the 1st opposite party to produce relevant valid documents for the purpose of claim from the insurance company.  It is strongly denied by the opposite party the visit of one Smt. Mahalaxmi on 26.11.2018 as it is concocted story.  The 1st opposite party issued a letter dated 10.12.2020 to the complainant calling upon the complainant to produce relevant documents such as death certificate, Bank passbook of Nominee, ID proof of the Nominee for the purpose of KYC.  Till date the complainant has not submitted relevant documents nor replied to the said letter.  The 1st opposite party states that the letter/notice dated 13.02.2019 alleged to have sent by complainant not received by them.  The 1st opposite party refers the claim false as levelled by complainant.  As in the additional proof affidavit submitted before this commission the reply to complaint No.201819006010149 filed in the Banking Ombudsman by the complainant on 04.06.2019, it is mentioned that for the process of the death claim, the complainant should submit document of death certificate, Account Statement, Pass book of the nominee etc., to submit the said document.  In the said additional proof affidavit the 1st opposite party has submitted declaration of the group head of Micro loan party Tmt.R.Mahalaxmi dated 06.05.2019 stating that the death certificate shall be submitted in 10 days. 

The complainant has filed proof affidavit and documents Ex.A1 to Ex.A7 were marked.  On the side of 1st opposite party proof affidavit and documents Ex.B1 to Ex.B5 were filed. In spite of sufficient opportunities the 2nd opposite party did not appear before this Commission and hence he was set ex-parte on 16.10.2020 for non appearance and for non filing of written version.

 

 

Point for consideration:-

Whether the opposite parties had committed deficiency in service in realising the insurance amount even after death of the loanee towards the loan availed from the 1st opposite party and insured with the 2nd opposite party and in not settling the insurance claim and if so to what reliefs the complainant is entitled?

 Point

On the side of the complainant the following documents were filed in support of the complaint allegations;

Letter written by the complainant to the 1st opposite party and postal receipt for sending the letter dated 13.02.2019  were marked as Ex.A1 & Ex.A2;

Letter written by the complainant to Zonal Manger and post al receipt for sending letter were marked as Ex.A3 & Ex.A4;

Personal details of insured member was marked as Ex.A5;

Complainant’s Aadhaar Card and Family Card were marked as Ex.A6 & Ex.A7;

On the side of 1st opposite party following documents were filed in support of their contentions;

Notice given to the complainant by the 1st opposite party was marked as Ex.B1;

Online track consignment was marked as Ex.B2;

Request letter written by R.Mahalakshmi (Head of Group Loan) to the Branch Manager dated 06.05.2019 was marked as Ex.B3;

Reply by the Office of the Banking Ombudsman to the complainant’s complaint dated 04.06.2019 was marked as Ex.B4;

Letter written by R.Mahalakshmi (Head of Group Loan)to the Branch Manager dated 20.05.2022 was marked as Ex.B5;

The crux of the oral arguments advanced by the party in person/complainant is that they were made to run pillar and post to avail the insurance claim after death of the complainant’s wife.  It is the case that the loan was insured with the 2nd opposite party and inspite of submission of required documents the insurance claim was not honoured by the opposite parties.  Thus the party in person sought for the complaint to be allowed.

The crux of the arguments advanced by the 1st opposite party is that though the loan availed by the complainant’s wife with the 1st opposite party was insured with the 2nd opposite party and after the death of the complainant’s wife the nominee who is the present complainant had failed to submit the necessary documents as required by them for processing the insurance claim even after repeated demands and hence the insurance could not be processed. Thus he argued there is no deficiency in service on their part and sought for the dismissal of the complaint.

On perusal of the documents and evidence submitted by both the parties we could see that the loan was availed as a Group Loan and one Ms.Mahalakshmi is the Head of the Group.  We could see that vide letter dated 13.02.2019 the complainant had informed to the 1st opposite party about the death of the loanee and the insurance availed for the loan account was produced as Ex.A4.  Ex.B1 shows that they have intimated the complainant to provide the documents for processing the insurance claim.  They have sought for the death certificate of Mrs.Shanthi, Bank details and Bank pass Book copy of Nominee and KYC of Nominee.  Further the head of the group loan vide Ex.B3 had intimated the 1st opposite party about the death of Mrs.Shanth and also assured that the death certificate would be obtained from the VAO and submitted to the Avadi Office. As per Ex.B5 the letter given by the said Ms.Mahalakshmi it is seen that the required document as requested by the 1st opposite party was not furnished by the complainant and there is no error on the part of the opposite parties in processing the insurance claim.  On appreciation of the available documents, this Commission could see that no proof was submitted by the complainant to show that all the required necessary documents were submitted for processing the loan and that the opposite parties had failed to perform their duty.  In such circumstances we are of the view that no deficiency in service could be imposed upon the opposite parties for not processing the insurance claim. Thus we answer the point accordingly in favour of the opposite parties and against the complainant.

In the result the complaint is dismissed.  No order as to cost.

  Dictated by the Member -II to the steno-typist, transcribed and computerized by him, corrected by the Member-II and pronounced by us in the open Commission on this the 27th day of August 2022.

 

      Sd/-                                                 Sd/-                                                           Sd/-

MEMBER-II                                  MEMBER-I                                               PRESIDENT

 

 

List of document filed by the complainant:-

 

 

Ex.A1 13.02.2019 Letter written by the complainant to the 1st opposite party Xerox

Ex.A2 13.02.2019 Postal receipt for proof of sending. Xerox

Ex.A3 16.03.2019 Letter written by the complainant to Zonal Manger Xerox

Ex.A4 16.03.2019 Postal Receipt for proof of sending. Xerox

Ex.A5 ............. Personal details of insured member Xerox

Ex.A6 ............... Complainant’s Aadhaar Card Xerox

Ex.A7 ................ Family card of the complainant. Xerox

 

List of documents filed by the 1st opposite party:-

 

Ex.B1 10.12.2020 Notice given to the complainant. Xerox

Ex.B2 .............. Online tract consignment. Xerox

Ex.B3 06.05.2019 Request letter written by R.Mahalakshmi (Head of Group Loan) to the Branch Manager. Xerox

Ex.B4 04.06.2019 Reply by the Office of the Banking Ombudsman to the complainant’s complaint Xerox

Ex.B5 20.05.2022 Letter written by R.Mahalakshmi (Head of Group Loan)to the Branch Manager Xerox

 

 

 

       Sd/-                                                 Sd/-                                                          Sd/-

MEMBER-II                                  MEMBER-I                                               PRESIDENT