Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 632
Instituted on : 07.11.2017.
Decided on : 07.04.2022.
Vinod s/o Sh. Ramphal R/o Kheri Meham Tehsil Meham District Rohtak.
.......................Complainant.
Vs.
- Punjab National Bank Branch Meham through its Manager.
- New India Insurance Company near medical Mor Rohtak through its Manager.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
DR. SHYAM LAL, MEMBER
Argued: Sh. Pardeep Goyat, Advocate for the complainant.
Sh.M.K.Vaid, Advocate for the opposite party no.1.
Sh.Anil Sharma, Advocate for the opposite party no.2.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that complainant’s mother was a consumer of the opposite party and died on 09.12.2016 and the complainant is the legal heir of deceased Smt. Murti Devi. Late Smt. Murti Devi has opened a Pardhan Mantri Jan Dhan Yojana Account on dated 06.01.2015 and with the alleged account, a life insurance of Rs.30000/- was given to the account holder who opened his account between 15.08.2014 to 31.01.2015. The complainant’s mother also opened her account on 06.01.2015. By this way she is also a beneficiary of account holder for life insurance of rupees Rs.30000/-. Unfortunately Smt. Murti Devi died on 09.12.2016 and her nominee Sh. Ramphal informed about her death to bank officials within time and requested for benefit given on death to Pardhan Mantri Jan Dhan Yojana Account holder. The bank officials asked him to came after one month because of demonetization they were with very busy schedule and not able to proceed any paper work for insurance. After that complainant approached the bank after one month and also given a written application on dated 03.04.2017 to the Bank but no action was taken by the bank despite approaching the bank hundred times. Hence this complaint and it is prayed that opposite parties may kindly be directed to pay the life insurance claim alongwith interest, compensation and litigation expenses as explained in relief clause.
2. After registration of complaint, notices were issued to the opposite parties. Opposite party No. 1 in its reply has submitted that the main relief of the complainant is against New India Insurance Company Ltd. which is necessary party of the present complaint because complainant will get his relief/claim from New India Insurance Company Ltd. by the central Govt. under the Pradhan Mantri Jan Dhan Yojana insurance scheme through the respondent no.1 i.e PNB bank(Meham). The role of the present respondent no.1 in the said scheme was as an agent of the central government. So agent is not responsible for giving any claim to the complainant. It is also submitted that the said scheme provides life insurance of Rs.30000/- and the said amount will also be provided by the insurance company which was under this scheme at that time. All the other contents of the complaint were stated to be wrong and denied and opposite party prayed for dismissal of complaint with costs.
3. Opposite party No.2 in its reply has submitted that complainant and respondent no.1 have not given any intimation to the answering respondent regarding the death of Smt. Murti Devi and the complainant has not submitted/lodged the claim of his mother in the Divisional office of the opposite party. So, the present complainant is liable to be dismissed. Neither the complainant nor the deceased are consumer of the answering opposite party as the death of deceased was not accidental/she was not died due to any motor accident. The opposite party is liable for the motor accidental claim only and FIR and postmortem report are necessary documents for the accidental claim under the policy. So the answering respondent is not liable to pay any claim amount nor the complainant is entitled for any claim amount from the answering respondent. All the other contents of the complaint were stated to be wrong and denied and opposite party prayed for dismissal of complaint with costs.
4. Ld. Counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A and documents Ex.C1 to Ex.C16 and has closed his evidence on dated 09.02.2022. At the time of arguments, ld. counsel for the complainant has placed on record a document i.e. Ration card of deceased Murti Devi, which is “Annexure-A”. Ld. Counsel for the Opposite party no.1 in his evidence has tendered affidavit Ex.RW1/A and document Ex.R1 to R6 and failed to concluded its evidence. Hence the evidence of opposite party no.1 was closed by the order dated 16.03.2022 of this Commission.. Ld. Counsel for the opposite party no.2 in his evidence has tendered affidavit Ex.RW2/A and documents R7 to Ex.R13 and closed his evidence on dated 16.03.2022.
5. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
6. In the present case grievance of the complainant is that Late Smt. Murti Devi has opened a Pardhan Mantri Jan Dhan Yojana Account on dated 06.01.2015 and with the alleged account, a life insurance cover of Rs.30000/- was given to the account holder who opened his account between 15.08.2014 to 31.01.2015. Unfortunately Smt. Murti Devi died on 09.12.2016 and after her death complainant approached the opposite parties for the alleged claim but despite his repeated requests, no claim amount is given to the complainant. To prove the fact, complainant has placed on record copies of letters Ex.C1, Ex.C2 & Ex.C6 written to opposite party No.1. He has also placed on record copy of legal notice Ex.C5 and information received under RTI Ex.C7. As per Ex.C7, a person who has opened his account between 15.08.2014 to 31.01.2016 under Pradhan Mantri Jan Dhan Yojana is entitled for life insurance amount of Rs.30000/-. As per the documents placed on record by the opposite parties i.e. Guidelines and Features of Life Cover under Pradhan Mantri Jan Dhan Yojana(PMJDY) Ex.R5, it is itself proved that : “The scheme provides for life cover of Rs.30000/- payable on death of the beneficiary due to any cause, subject to fulfillment of the eligibility conditions”. As per Ex.R6 under the head Basic Eligibility conditions, it is submitted that : “Person opening Bank account for the first time, with Ru-Pay Card in addition, during the period from 15.08.2014 to 31.01.2015 or any additional period as may be extended further by Government of India”.
7. In the present case, an application has been filed by the respondent no.1 on dated 16.10.2018 after submitting that the complaint is not maintainable in the present form against the respondent because Life Insurance Co. i.e. LIC should be impleaed as a mandatory/necessary party in the present complaint because the relief will be provided by the life insurance company. It is further submitted in this application that the premium has been paid regarding the insurance claim of the complainant to the insurance company i.e. LIC Ltd. by the Central Government through the respondent bank so the Life Insurance company should be impleaed as necessary party in the present complaint and further submitted that the complainant is not the nominee of late Smt. Murti Devi(account holder). Reply of the same was also filed. An another application has been moved before this Commission by the Manager PNB Meham on dated 27.02.2019 and submitted that due to clerical mistake the name of insurance company has been wrongly mentioned as Life Insurance Co. instead of New India Assurance Co. and further pleaded that earlier application may please be amended on this fact. He further submitted an amended rejection application after mentioning the New India Assurance Co. as necessary party. Further opposite party No.2 as per his written reply has submitted that the death of deceased was not accidental. Smt. Murti Devi was not died due to any motor accident. The opposite party is liable for the motor accidental claim only and FIR and postmortem report are necessary documents and required for settlement of the claim. It is further contended that the claim of the complainant is not covered under the policy.
8. We have perused the document Ex.R5, as per which under the head Funding, it is submitted that : “LIC will create a fund for Life Coverage under PMJDY with an initial corpus of Rs.100 crore from the Social Security Fund of government of India under Aam Aadmi Bima Yojana(AABY) being managed by LIC of India, to be recouped through budgetary provision by the Government. The fund will be replenished by Government of India from time to time within the stipulated premium amount to meet the outgo and administrative expenses. The fund is separate from the Controlled Fund of the Corporation Contribution due for next scheme year will be based on actual claim payment, administrative expenses & any other eligible/permissible expenses pertaining to the scheme incurred by LIC and will be provided by M/o Finance, Government of India. This would broadly be on the AABY pattern”. We have also perused Ex.R3. As per this document in condition no.6 it is mentioned that : “LIC will check eligibility under AABY of persons to be covered under life cover and register them under AABY if they are eligible, in which case the benefit will not accrue under the life cover. While servicing death claims under life cover, LIC will check enrollment of the deceased under AABY and service the claim under it when admissible and under life cover only if not admissible under AABY”. Meaning thereby, LIC is declared as a Nodal agency to check the eligibility of claim under AABY. It is crystal clear from the perusal of Ex.R5 that funds will be created by LIC under PMJDY and the claim will be settled accordingly as per the instructions of the Govt. of India.
9. In the present case opposite party No.1 failed to show any guidelines to the legal heirs of the deceased Murti Devi that how they should file their claim with the bank or with the LIC. They have not issued any guidelines regarding settlement of the claim of the deceased at any time. The complainant has submitted many applications and sought information under RTI Act and submitted all the required and requisite documents with the opposite party no.1 but the respondent no.1 failed to decide/settle the claim of the complainant till date. Moreover in the written statement and affidavit the respondent no.1 has mentioned that the life of the deceased was covered by the New India Insurance co. Ltd. But perusal of the documents placed on record by the respondent no.1 itself shows that the funds have been generated by the LIC and for settlement of the claim the nodal agency was also assigned by the Govt. under PMJDY . As such opposite party No.1 i.e. Punjab National bank is liable to pay the claim amount to the complainant.
10. In view of the facts and circumstances of the case we hereby allow the complaint and direct the opposite party No.1 to pay Rs.30000/-(Rupees thirty thousand only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 07.11.2017 till its realization and also to pay Rs.5000/-(Rupees five thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the legal heirs of the deceased as mentioned in Ration Card “Annexure-A’ i.e.Sh. Ramphal(husband of deceased), Sh. Vinod(son) and Sh. Ravinder(son) in equal share within one month from the date of decision. However, opposite party No.1 is at liberty to recover the alleged amount from the concerned insurance company as per rules.
11. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
07.04.2022.
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Nagender Singh Kadian, President
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Tripti Pannu, Member.
……………………………….
Shyam Lal, Member
