Complainants Smt.Sukhdeep Kaur and others through the present complaint filed under Section 12 of the Consumer Protection Act, 1986 (for short, ‘the Act’) has sought issuance of necessary directions to the opposite parties to make payment of Rs.2,00,000/- alongwith interest @ 18% P.A. from the date of death till its actual realization to them on account of death of deceased Gurnam Singh in road accident, as per the scheme being launched by the Prime Minister. Opposite parties be further directed to pay Rs.1,00,000/- as compensation to them due to harassment being suffered by them alongwith litigation expenses, in the interest of justice.
2. The case of the complainant in brief is that Sh.Gurnam Singh was husband of complainant no.1, father of complainants no.2 and 3 and son of complainants no.4 and 5 and as such all the complainants are legal heirs and dependents of deceased Gurnam Singh. Sh.Gurnam Singh has got opened his saving fund account with the opposite party no.1 bearing account no.2709000101158125 in the year 2014. Similarly the deceased Gurnam Singh has also got opened the account of his wife with the opposite party no.1 Bank bearing Account No.2709006900003101. The complainant no.5 is also having bank account in the opposite party no.1 Bank and as such they are hiring the services of the opposite parties, are consumers of the opposite parties. They have next pleaded that the Government of India through its Prime Minister, Sh.Narender Modhi has launched a Scheme known as “Jeewan and Durgatna Beema Yozna Jaan Surakhaya De Hit Wich”. The said scheme has been commenced from Ist June 2014 and as per the policy of the said scheme, the person who has got debited the amount of Rs.12/- for per year i.e. from 1 June 2014 to 31 May 2015 from his account from Nationalized Bank and in case he died in road accident, then the Bank authorities as per the policies of the Govt. of India should pay Rs.2,00,000/- to the legal heirs of the said deceased person. The husband of the complainant no.1 has visited the Branch office of the opposite party no.1 for availing the said scheme on 10.6.2015 and the Bank Manager and concerned staff had taken signatures of the deceased Gurnam Singh on the requisite papers. Ultimately an amount of Rs.12/- was debited by the Bank authorities from the Account of the deceased on 12.6.2015. They have next pleaded that on 13.6.2015 at about 7 A.M. Gurnam Singh deceased being driver has gone to New Delhi Airport with his vehicle i.e. Mohindra XLO bearing registration No.PB-06-S-8483 on account of boarding Arvind Singh son of Sh.Tarlok Singh for New Zealand alongwith their other relatives and when they were returning back at Bhogpur City in front of HDFC Bank, Branch Bhogpur, the driver Sh.Gurnam Singh had suddenly lost control over the vehicle and the vehicle was turned turtle and it was stuck into the wall of the Mathoot Finance Company Limited Office, Jalandhar. The deceased died at the spot, whereas other passengers sitting in the vehicle had also received injuries. Thereafter, the deceased Gurnam Singh was shifted to Civil Hospital, Jalandhar, where his Post Mortem was conducted by the concerned Medical Officer Jarnail Singh son of Sh.Puran Singh, resident of Village Bahadur, Post Office Pull Tibri, Tehsil and District Gurdaspur who was sitting on the front seat of the said vehicle have made his statement before the Police Station Bhogpur being eye witness of the said occurrence and the Police has initiated proceedings U/S 174 Cr.P.C. in the matter in hand. The Rapat in this regard bearing No.50 was lodged in Police Station on 14.6.2014. Thereafter, they being legal heirs of deceased Gurnam Singh have approached to the opposite parties with the request to make the payment of Rs.2,00,000/- to them on account of death of Gurnam Singh in road accident and even they have also submitted the requisite documents being demanded by the opposite parties, before them. Earlier the opposite parties have procrastinating the matter pending with one pretext or the other and ultimately they have flatly refused to admit their genuine and legal claim. Thus, there is deficiency in service on the part of the opposite parties. Hence this complaint.
3. Upon notice, the opposite parties No.1 appeared and filed its written reply submitting therein that Sh.Gurnam Singh son of Sh.Sarain Singh resident of village Pandher was maintaining saving fund account No.2709000101158125 in our branch. As per consent-cum-declaration form signed by Sh.Gurnam Singh on 11.6.2015, this account was debited with Rs.12/- on 12.6.2015 for insurance cover under PMSBY. Sh.Gurnam Singh had also accepted the condition available in consent-cum-declaration form dated 11.6.2015, while obtaining cover under the scheme that cover shall commence from the Ist of the month subsequent to the date of enrolment in the scheme. It has been further submitted that Mrs.Sukhdeep Kaur widow of the deceased also appointed as nominee by late Sh.Gurnam Singh, approached the branch on 20.09.2015, for settlement of death claim amount, under the PMSBY as Sh.Gurnam Singh died in an accident on 14.06.2015. The claim was forwarded to our HO on 22.09.2015 and was subsequently rejected by the Oriental Insurance Company Limited, with which our bank has tied up for operationalisation of this scheme, vide their letter dated 21.10.2015 addressed to our HO FI Division and copy thereof endorsed to us and the claimant, on the clause that “as per PMSBY the insurance starts from the Ist day of next month of proposal date, which means that commencement date of insurance of Sh.Gurnam Singh is 01.07.2015, as such the claim is not admissible. As these schemes were formulated by the government and is being governed by the guidelines issued by the Government of India. Our Bank in order to implement this scheme issued circular 08/2015 containing the guidelines of the scheme. In case where auto debit takes place after Ist June, the cover shall commence from the first day of the month following the auto debit. It has been further submitted that Sh.Gurnam Singh had also accepted this condition available in consent-cum-declaration form dated 11.06.2015, while obtaining cover under the scheme. Whereby he agreed and accepted that cover shall commence from the Ist of the month subsequent to the date of enrolment in the scheme. Thus, there has been no delay in processing the claim and this claim was rejected by the Insurance Company as per Rules for the Scheme and lastly the complaint has been prayed to be dismissed with costs.
4. Opposite party no.2 appeared and filed its written reply submitted therein that the account number mentioned in the complaint i.e. no.2709000101158125 and 2709006900003101 have been got opened in Punjab National Bank Branch Office New Shalla, Tehsil and District Gurdaspur. These accounts are being maintained at Branch Office at New Shalla. Thus, to take up the issue with Branch Office, New Shalla (GSP) as the issue does not pertain to their branch and lastly the complaint has been prayed to be dismissed.
5. Opposite party no.3 appeared through their counsel and filed its written reply taking the preliminary objections that the complaint is not maintainable in the present form and is without any merits and without any cause of action against the opposite party and the complainant has failed to set out any deficiency in service or unfair trade practice on the part of the opposite party. On merits, it was submitted that the complainants are not entitled to any compensation under the Pardhan Mantri Suraksha bima Yojna. The deceased Gurnam Singh was insured under the Pardhan Mantri Suraksha Bima Yojna through his banker i.e. opposite party no.1. The deceased was insured under the Pardhan Mantri Suraksha bima Yojna scheme on 11.06.2015 through opposite party no.1 and the same is evident from the consent-cum-declaration form. As per the terms and conditions of Pardhan Mantri Suraksha bima Yojna the risk cover is to commence from the Ist of the Month subsequent to the date of enrolment in the scheme and this very fact is very clearly mention in the consent-cum-declaration form signed by the deceased. It was next submitted that the opposite parties no.1 and 2 had forwarded the claim under Pardhan Mantri Suraksha bima Yojna in respect of the deceased Gurnam Singh to the opposite party and the opposite party vide letter dated 21.10.2015 had intimated the opposite party no.1 and the complainant that the claim in respect of death of Sh.Gurnam Singh has not payable under the Pardhan Mantri Suraksha bima Yojna as risk cover of the deceased was to commence from the Ist of the month subsequent to the date of enrolment in the scheme i.e. from July 2015 but unfortunately as per the version of the complainant the deceased Gurnam Singh died on 14.06.2015 prior to the commencement of the insurance, as such the complainants are not entitled to any claim. All other averments made in the complaint has been vehemently denied and lastly prayed that the complaint may be dismissed with costs.
6. Complainant tendered into evidence her own affidavit Ex.C1, alongwith other documents Ex.C2 to Ex.C7 and closed the evidence.
7. Sh.Devinder Vashisht Sr.Manager of opposite party no.1 tendered into evidence his own affidavit Ex.OP-1, alongwith documents Ex.OP1/1 to Ex.OP-1/5 and closed the evidence.
8. Counsel for the opposite party no.2 tendered into evidence affidavit of Sh.Som Raj Arya, Sr.Manager Ex.OP-2/1 and closed the evidence.
9. Counsel for the opposite party no.3 tendered into evidence affidavit of Sh.Karam Singh, Sr.Divisional Manager Ex.OP-3/1 alongwith other documents Ex.OP-3/2 and Ex.OP-3/3 and closed the evidence.
10. We have carefully examined and thoroughly considered the evidence along with its supporting documents as available on records of the proceedings in the backdrop of the arguments as put forth by the learned counsels for the participating litigants along with the scope of ‘adverse inference’ on account of the legal ‘acts & omissions’ committed by them. We find that the complainant (in line with her deposition Ex.C1) has successfully proved (Ex.C2) on record the purchase/joining (by the deceased SB A/c Holder) on 12.06.2015, the ‘membership’ of PMSBY Master Policy held by the OP1 Bank with the OP3 insurers and the subsequent road-side accident ‘death’ of the insured DLA (deceased life assured) through police Daily Diary Report DDR # 50 (Ex.C3), Death Certificate (Ex.C4) and Post Mortem Report PMR (Ex.C5) along with the identity of the complainants vide SDM’s Certificate (Ex.C6) & the DLA’s identity vide his Driving License DL (Ex.C7).
11. We further find that the complainant advised of the insured’s death to the OP1 Bank Branch vide her intimation dated 20.09.2015 (Ex.OP1/2) and her insurance claim under the PMSBY policy was admittedly filed (Affidavit Ex.OP1) by the OP1 Bank on 22.09.2015 (Ex.OP1/4) with the OP3 insurers who however repudiated the same vide its communiqué dated 21.10.2015 (Ex.OP1/3) stating therein that the commencement date of the related insurance has been 01.07.2015 whereas insured Gurnam Singh had expired on 14.06.2015 having entered the scheme on 11.06.2015 vide Consent cum Declaration Form (Ex.OP1/1). The OP1 Bank in order to justify ‘repudiation’ has produced its Circular # 08/ 2015 on the Special Security Schemes (Ex.OP1/5) of 28.04.2015 that duly entails to limit the Enrollment Modality/ Period (Annexure-B): “Premium: Rs 12/- per annum per member. The premium will be deducted from the account holder’s savings bank account through ‘auto debit’ facility in one installment on or before 1st June of each annual coverage period under the scheme. However, in cases where auto debit takes place after 1st June, the cover shall commence from the first day of the month following the auto debit.” Thus, the present repudiation may be technically valid but it shall not pass the legal-litmus test of natural justice measured against the latest legal propositions on consumer law.
12. First, we find that the policy ‘term-clause’ determining the applicability of insurance cover from the 1st of the succeeding month to the premium ‘auto-debiting’ date is not at all ‘consumer’ friendly in the otherwise a ‘citizen–welfare’ (and consumer friendly) scheme; and second, the opposite parties here have failed to produce any cogent evidence on records proving that the said insurance applicability (determining) clause was duly explained to the insured and he had duly acknowledged (signed) the same having accepted it (with free consent). We find that the illiterate insured (DLA) had signed the Consent cum Declaration English Scripted Form (Ex.OP1/1) in Punjabi with no independent ‘vernacular’ declaration. Further, the OP1 Bank’s forwarding the complainant’s claim (Ex.OP1/4) to the OP3 insurers surely indicates (though ironically) that even the OP1 Bank has been ignorant of the ‘insurance-cover applicability-clause’ from the 1st of succeeding month (to the premium paying date) otherwise it, instead of forwarding the claim, for certain, would have advised her (the complainant) accordingly.
13. Lastly, we are of the considered opinion that the DLA (deceased life assured) did not have the notice of the cover applicability clause (i.e., insurance to be effective from the 1st of succeeding month to the premium-paying date) hence the same cannot be equitably enforced upon the present complainant(s) during the settlement of the ensued claim. Moreover, we are strengthened to firm our above opinion by virtue of the legal proposition prompting out of the orders of the honorable NCDRC, New Delhi; as pronounced in RP # 186 & 187 of 2007 titled: National Insurance Co. Ltd. vs. D P Jain; duly emphasizing therein, the effects of the IRDA Regulations; of which Regulation No 03 reads as: “No 3(2). An insurer or its agent or other intermediary shall provide all material information in respect of a proposed cover to the prospect to enable the prospect to decide on the best cover that would be in his or her interest. No 3(4). Where, for any reason, the proposal and other connected papers are not filled by the prospect, a certificate may be incorporated at the end of proposal form from the prospect that the contents of the form and documents have been fully explained to him and that he has fully understood the significance of the proposed contract.” Finally, it shall be the OP1 Bank’s own prerogative as to how to manage/ subside the presently ‘cropped-up’ situation but that certainly entitles the present complainant to ‘one’ favorable award under the statutory provisions of the applicable statute i.e., the Consumer Protection Act’ 1986.
14. We find that the OP3 insurers have earnestly attempted to clarify its position vide its reply and supporting affidavit (Ex.OP3/1) that the said claim was forwarded to it in a pre-existing status unfit for ‘settlement’ but that does not relieve it from its ‘vicarious’ principal’s liability towards the acts & omissions of ‘agents/representatives etc’; but, surely it shall be an inter-se adjustment/accommodation matter between the two opposite parties and the present orders shall in no way interfere in the same. The OP1 Bank shall however be at liberty to settle the present claim as per its ‘inter-se’ arrangement/agreement with the OP3 insurers, in discharge of its sole liability to comply with the somewhat ‘adverse’ but judicious present award under the applicable statute.
15. In the light of the all above, we find that the OP1 Bank has indeed bruised the consumer rights of the present complainants and that lines them up for an adverse award under the applicable statute. We, therefore, partly allow the present complaint and thus ORDER the OP1 Bank to pay the PMSBY Claim proceeds (to its full benefits) to the complainants besides to pay her Rs. 5,000/- as cost and compensation within 30 days of the receipt of the copy of these orders otherwise the aggregate awarded amount shall attract interest @ 9% PA from the date of filling of the complaint till actual payment. The OP1 Bank shall however be at liberty to claim reimbursement or otherwise share/ recover the award-amount (so-paid in such-like situations) with the OP3 insurers/and/or from its delinquent officer employees as per their own discretion/prerogative/inter-se arrangements etc.
16. 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)
August 10, 2016 Member
*MK*
