STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

(Complaint Case No.18 of 2009)

                                                                   Date of Institution: 10.06.2009

                                                                   Date of Decision  : 17.01.2011

1.      Smt. Ritu Sodhi aged about 36 years w/o Late Sh. Mohinder Pal Singh Sodhi S/o Sh. Swaroop Singh Sodhi resident of Flat. No.304, GH-7A, Sector 20, Panchkula.

2.      Master Kashish, aged about 13 years minor son of Late Sh. Mohinder Pal Singh Sodhi.

3.      Master Sparsh aged about 5 years minor son of Late Sh. Mohinder Pal Singh Sodhi.

4.      Both minors claimants No.2 and 3 through their mother next friend and guardian ad-litem Smt. Ritu Sodhi w/o Late Sh. Mohinder Pal Singh Sodhi resident of Flat. No.304, GH-7A, Sector 20, Panchkula.

……Complainants

V e r s u s

1.      Royal Sundaram Alliance Insurance Co. Ltd., through its Branch Manager, Sundaram Towers, 46 White Road, Chennai (Tamil Nadu).

2.      Citi Bank through its Branch Manager, SCO No.132-134, Sector 9-C, Madhya Marg, Chandigarh (U.T.).

              ....Opposite Parties.

BEFORE:            HON’BLE MR. JUSTICE PRITAM PAL, PRESIDENT.

                        S. JAGROOP SINGH MAHAL, MEMBER.

Argued by:          Sh. Arvind Sud, Advocate for the complainant.

                        Sh. R. K. Bashamboo, Advocate for OP No.1.

                        Sh. V. K. Diwan, Advocate for OP No.2.

PER JAGROOP SINGH MAHAL, MEMBER.

1.                     Briefly stated the case of the complainants is that the husband of complainant No.1 and father of complainants No.2 and 3 namely Sh. Mohinder Pal Singh Sodhi was a Gold Credit Card Holder bearing No.5546 1982 6359 0004 issued by OP No.2 – Citi Bank. OP No.2 introduced a package insurance policies of OP No.1 i.e. Royal Sundram Alliance Insurance Co. Ltd. for credit card holders covering various insurance benefits. Sh. Mohinder Pal Singh Sodhi opted for one such policy namely Suraksha Forever bearing Policy No.PAPLUS0326000, which also includes personal accident death claim to the tune of Rs.25 Lacs on account of death of the policy holder in an accident and Rs.18,75,000/- in case of death in a two wheeler accident. It is averred that complainant No.1 Smt. Ritu Sodhi was the nominee of this policy. Sh. Mohinder Pal Singh Sodhi was paying the premium regularly. Unfortunately, he expired in a road side accident on 11.6.2007 and F.I.R No.218 dated 11.6.2007 was registered and post mortem was conducted on 12.6.2007 at P.G.I. The complainants lodged the claim with the OPs under the policy and requested for releasing the entire claim amount but the OPs are not releasing the claim amount of Rs.18,75,000/-, which caused the complainants immense harassment and mental agony resulting into filing of the present complaint vide which the complainants have sought directions to the OPs to release the death claim of Rs.18,75,000/- pertaining to Sh. Mohinder Pal Singh Sodhi and to provide the Credit Shield and Protection Premium facilities as per the policy and further to clear the outstanding amount, if any, of OP No.2; to pay a sum of Rs.10,00,000/- as compensation for mental agony, torture and physical harassment; to pay interest @18% per annum on the claim amount from the date of death of Sh. Mohinder Pal Singh Sodhi till the actual realization of the entire amount besides Rs.11,000/- as costs of litigation.

2.                       OP No.1 in its reply has firstly challenged the maintainability of the present complaint before this Commission on the ground that the maximum sum insured for any accidental death is only Rs.7.5 Lacs and this Commission can entertain matters valued above Rs.20 Lacs and up to Rs.1 Crore only so the complaint was triable by a District Forum. This OP has also taken preliminary objection as regards the limitation of two years for filing the complaint. As per OP No.1, the complainants should have filed the present complaint up to 11.6.2009 as cause of action accrued to them on 11.6.2007 but the complaint was filed on 11.7.2009, which as per OP No.1 is time barred.

3.                     On merits, it is pleaded that Sh. Mohinder Pal Singh Sodhi was covered for a sum of Rs.7.5 Lacs under the policy in question, which was valid from 12.12.2006 to 11.11.2007 and the coverage was issued subject to the terms and conditions of the policy. It is next pleaded that as per the terms and conditions stipulated, the claim was to be made within 60 days from the date of the accident with documents like post mortem report, police report, death certificate, viscera report etc. but the complainants have not informed about the accident till date to OP No.1 and due to this reason of non filing of the claim, it is submitted that there is no deficiency in service on its part and the complaint be dismissed being premature.

4.                     OP No.2 in its separate reply has stated that it complied with the contractual obligations without any default or deficiency and the insurance claim is to be settled and paid by OP No.1 only, with whom all the requisite formalities for settlement of the claim were to be completed by the complainants. OP No.2 has admitted the issuance of Gold Credit Card to Sh. Mohinder Pal Singh Sodhi under the Good Health Plan-I Insurance Scheme by OP No.1. Pleading that the subject matter of the complaint pertains only to OP No.1, OP No.2 prayed for dismissal of the complaint qua it.

5.                     The parties adduced evidence in support of their contentions.

6.                     We have heard the learned counsel for the parties and have also gone through the record carefully.

7.                     The learned counsel for OP No.1 has argued that this Commission has no territorial jurisdiction to try this complaint. According to them, the office of OP No.1 is at Chennai where the agreement took place between the OPs inter se under which the policy was obtained by the Citi Bank (OP No.2) and therefore, the cause of action accrued at Chennai and the present complaint could not be filed at Chandigarh. This argument is devoid of merit. The contention of the complainant is that the deceased insured was having his account with OP No.2 at Chandigarh and the credit card facility was availed by him at Chandigarh where the insurance policy was given to him through OP No.2. It is further contended that the accident in which the deceased insured died also took place at Manimajra under the jurisdiction of this Commission regarding which FIR was registered in Police Station Manimajra. So far as the contention of OP No.1 thta the agreement between the OPs inter se took place at Chennai, the complainant being not a party to any such agreement would not be required to go to Chennai to file the complaint specially when the facility of the credit card was obtained by him at Chandigarh. This contention of the learned counsel for OP No.1, therefore, cannot sustain.

8.                     Otherwise also, since there is no objection raised by OP No.1 about lack of territorial jurisdiction, this plea cannot be taken at this stage also being beyond pleadings.

9.                     It is also argued by the learned counsel for OP No.1 that the complainant has filed an exaggerated claim to bring the complaint within the pecuniary jurisdiction of this Commission, which should be held bad in law, otherwise, the complainant was entitled only to a sum of Rs.7.5 Lacs, which was triable by the District Forum. His contention is that the complaint is liable to be returned on this score. This argument also is devoid of merit. The present complaint has been filed on the basis of the offer given by OPs to the complainant in view of which he was entitled to Rs.18.75 Lacs as compensation in case of death or permanent disability in a two wheeler accident as is clear from the website of OP No.1, copy of which is now marked as Annexure E. The complainant has also prayed for compensation for mental agony, torture, inconvenience and physical harassment. The pecuniary jurisdiction is to be determined from the averments in the complaint in so far as the same are supported by some documentary evidence, which in the present case is available. The complainant is claiming Rs.28.75 Lacs along with interest and litigation costs and if this complaint had been filed before the District Forum, it would not have been maintainable there. It, therefore, cannot be said if the complaint is not maintainable for want of pecuniary jurisdiction.

10.                   The learned counsel for OP No.1 has then argued that the complaint is barred by time. It was mentioned in Para No.4 of the reply that the complaint was filed after two years of the claim being repudiated i.e. when the cause of action arose. This is not the only misstatement of facts made by OP No.1 but there are some other false assertions also made by this OP, which would be discussed hereinafter. There is no dispute about it that the accident took place on 11.6.2007 regarding which the FIR was got registered. The Post Mortem report also shows that the death took place on 11.6.2007 in road accident. The present complaint was filed on 10.6.2009, which was well within the period of two years and therefore, it is not barred by time as alleged by OP No.1.

11.                   As regards the assertion of repudiation, the learned counsel for OP No.1 could not point out any document/letter to show if the claim was ever repudiated or if the repudiation was ever conveyed to the complainant. Needless to mention that the limitation period of two years would start from the date of repudiation, which has not so far taken place. It was on 27.3.2008 that OP No.1 asked the complainant for a certified copy of succession certificate issued by a competent court to release the settlement amount of Rs.15 Lacs to the Legal Heirs. The complaint was filed within less than a year from the said date. OP No.1 has, therefore, made a false assertion in Paras No.4 and 8 of the reply that the complaint was barred by time or it was filed after two years of the claim being repudiated.

12.                   Again in Para No.5 of the reply, OP No.1 has mentioned, though wrongly, that the complainant had not lodged any claim with it nor informed them in respect of the alleged death of Sh. Mohinder Pal Singh Sodhi. The documents on record, however, show otherwise. The case of the complainant is that after the death of Sh. Mohinder Pal Singh Sodhi, she informed OP No.2 about the same and the said letter (now marked as Annexure ‘F’) was received by the Bank on 30.6.2007 as mentioned in their letter dated 24.7.2007. Through this letter dated 24.7.2007 (now marked as Annexure ‘G’), a claim form was sent to the complainant for being completed and sent to them. The learned counsel for the complainant contended that the claim form was filled up by the complainant on 31.8.2007 and it was sent to the Citi Bank. A copy of the claim form filled up by the complainant is now marked as Annexure ‘A’. It appears, the complainant enquired from OP No.2 upon which Citi Bank informed through e-mail dated 22.1.2008 to contact Royal Sundaram Insurance at their Toll Free Number mentioned therein. A copy of the said e-mail is now marked as Annexure ‘B’. When contacted, OP No.1 informed the complainant through e-mail dated 28.2.2008 (now marked as Annexure ‘C’)  to the following effect:-

“The file has been put up to the appropriate financial authority with recommendations for sanctioning of Rs.15,00,000/-. We shall revert to you once the claim is approved.”

She was, thereafter, informed on 27.3.2008 vide a letter (now marked as Annexure ‘D’) as follows: -

“We acknowledge receipt of the claim documents and are expressing our thanks for your prompt assistance. Please be informed that your claim has been conferred a technical approval for Rs.15,00,000/-.

On processing your claim we observe that there was no nomination made by the insured under the policy. In the absence of nomination, we would require a certified copy of Succession Certificate for Rs.15,00,000/- issued by the Hon’ble court to release the settlement amount to the legal heir…”

13.                   It shows that the complainants had lodged a claim with OP No.1 well within time and the contention of OP No.1 that no claim was lodged with them or they had not been informed about the death of the insured is false. OP No.1 has, therefore,  taken a false stand in Para No.5 of the reply.

14.                   As mentioned above, the claim had been technically approved for payment of Rs.15,00,000/- to the complainant. However, in Para No.6 of the reply, a new ground is being taken that the insured amount of Rs.15 Lacs was for the complainant and his spouse and therefore, on the death of one of them, only a sum of Rs.7,50,000/- would be payable. Earlier it had never been the case of the complainant as referred to in the letters reproduced above, if the complainant was entitled only to Rs.7,50,000/-.  This new ground was introduced by OP No.1 falsely just to defeat the genuine claim of the complainant.

15.                   In order to support a false defence, OP No.1 produced Annexure R-1, which is alleged to be the copy of the Group Personal Accident Policy Schedule, in which policy for self and spouse was said to be of Rs.7,50,000/- each. The learned counsel also referred to the Schedule showing the name of Sh. Mohinder Pal Singh Sodhi in the list of persons insured by them. They, however, have not been able to explain as to why the policy was being projected to be for Rs.18.75 Lacs for two wheeler accident if they were only to pay Rs.7,50,000/- on the death of the insured. Definitely, it is an unfair trade practice adopted by OP Bank under which they initially mentioned the amount of Rs.18.75 Lacs so as to attract their customers in selling the policy. We are, however, of the considered opinion that the stand now being taken by OP No.1 is false and frivolous to their own knowledge. If a sum of only Rs.7,50,000/- was payable under the policy, they would have mentioned the same in their brochure, the details downloaded by the complainant from the Internet is now marked as Annexure ‘E’ by us. Thereafter, when the claim was lodged with respect to the death of only one person and the FIR as well as the Post Mortem Report of only one person was forwarded to them, they would not have mentioned in the letters Annexures C and D that the claim has been conferred a technical approval for Rs.15 Lacs. It all shows that OP No.2 is changing its stand in accordance with the situation arising at the particular time with the sole object of defeating the claim of the persons who got insured under the hope of getting the insured amount without any hassles.

16.                   So far as Annexure R-1 is concerned, it is argued by the learned counsel for the complainant that such like documents can be prepared by OP No.1 at any time in any manner they like. Had it been a genuine document, it would have been depicted as such through their advertisement, copy of which is Annexure ‘E’. The amount of Rs.18.75 Lacs for two wheeler accident cannot be reconciled in any manner from the figures given in Annexure R-1. It is, therefore, clear that Annexure R-1 does not relate to the policy issued to OP No.2 regarding the insurance of Sh. Mohinder Pal Singh Sodhi (deceased). This is yet another manipulation made by OP No.1 to avoid the payment of the claim amount to the complainant.

17.                   It is also argued by the learned counsel for OP No.1 that the amount would be payable only if a succession certificate is obtained by the complainant for the entitlement of this amount. It is argued that in the absence of the succession certificate, no payment can be made to her. As against it, the learned counsel for the complainant argued that there was no such term of the policy under which the heir of the deceased was liable to produce the succession certificate. This condition is being now introduced to delay the payment of the amount.

18.                   The OPs have not disputed if the complainants are the legal heirs of the deceased. The complainant No.1 is the wife whereas complainants No.2 and 3 are the minor sons of the deceased insured. There is no such assertion made by the OPs if apart form the three complainants, there is any other legal heir of the deceased who may be entitled to any share in the amount of compensation. We are, therefore, of the opinion that succession certificate is not required in the case. A similar question arose before the Hon’ble Madhya Pradesh State Consumer Disputes Redressal Commission, Bhopal in the case of Ishwar Chandra Gangrade & Ors. Vs. New India Assurance Co. Ltd. & Anr., 2000 (1) CLT 317. In that case, the insured had taken a mediclaim policy, fell ill and submitted the claim. The amount was not paid till the insured died. The claim was repudiated and when a complaint was filed, it was alleged on behalf of insurance company that the complainants should establish themselves as legal representatives of the deceased and ought to have produced an authenticated document (i.e. succession certificate). The Madhya Pradesh State Commission referred the law laid down by the Hon’ble Supreme Court of India in the case of Gujarat State Road Transport Corporation Vs. Ramanbhai Prabhatbhai & Anr., AIR 1987 SC 1690 to repel the said contention. We are, therefore, of the opinion that succession certificate is not needed to pay compensation amount under the policy of insurance.

19.                   The OPs had proclaimed through this website (now marked as Annexure ‘E’) to pay Rs.18.75 Lacs to the beneficiary in case of death of the insured credit card holder in a two wheeler accident. The Citi Bank (OP No.2), which has made the policy available to the complainant admitted this fact through Para No.2 of the reply that various insurance schemes were made available by OP No.1. The amount of Rs.18.75 Lacs was not disputed. However, when the complainants applied for compensation, the amount was brought down by OP No.1 to Rs.15 Lacs through letters (Annexures C and D). Now in the written reply, the amount has been further brought down to Rs.7.5 Lacs on a false assertion that Rs.15 Lacs were payable for both husband and wife and since only husband has died, therefore, Rs.7.5 Lacs are payable. The subsequent contentions cannot be accepted as correct and we are of the opinion that the OPs are liable to pay Rs.18.75 Lacs to the complainants as compensation under the insurance policy.

20.                   The OP No.1 has not only delayed the payment of the amount of compensation and thereby caused harassment to the complainant, one of whom is a woman and other two are minor sons of the deceased but also took false grounds in the written reply regarding limitation, date of filing of the complaint, non filing of the claim with them, the amount of compensation payable to the complainants and the factum of repudiation of the claim. It was all done by OP No.1 to dodge the Commission and to defeat the claim of the complainants for which purpose its Manager namely Sh. S. Srinivasan filed an affidavit taking these false grounds for which he can be prosecuted for giving false evidence.  However, instead of filing a complaint for perjury against Sh. S. Srinivasan, we deem it proper to direct OP No.1 to pay Rs.1 Lac as compensation to the complainant.

21.                   There is no dispute about it that the policy was procured for the complainant by OP No.2. Since the complainant was a member of the Credit Card issued by OP No.2, this policy by way of credit shield was provided to him by OP No.2. In this manner, both the OPs would be liable jointly and severally to pay the amount in question.

22.                   In view of the above discussion, we are of the opinion that the present complaint succeeds and the same is allowed against both the OPs. They are directed to pay the compensation amount of Rs.18.75 Lacs jointly and severally within 30 days from the date of receipt of certified copy of the order along with interest @ 9% per annum w.e.f. 1.12.2007 [three months after the submission of the claim (Annexure ‘A’)] till the amount is actually paid to the complainants. The OP No.1 shall also pay a sum of Rs.1 Lac as compensation as mentioned above, which shall also take care of mental and physical harassment caused by OP No.1 to the complainants in delaying the compensation claim and also creating hurdles in the prompt payment of the said amount. OP No.1 shall also pay Rs.11,000/- as costs of litigation. OP No.1 is also directed to provide credit shield and projection premium facility to the complainants by clearing the outstanding amount, if any, with respect to the credit card issued by OP No.2 to Sh. Mohinder Pal Singh Sodhi. The entire amount outstanding shall be paid by OP No.1 to OP No.2 and the complainants would not be liable to pay anything with respect to the account of the credit card aforesaid. If the amount is not paid within the aforesaid period of 30 days, the entire amount mentioned above shall be payable along with interest @12% per annum with effect from today till the amount is actually paid.

23.                   Copies of this order be sent to the parties free of charge.

Pronounced.

17^th January 2011.

[JUSTICE PRITAM PAL]

PRESIDENT

[JAGROOP SINGH MAHAL]

MEMBER

Ad/-

STATE COMMISSION

(Complaint Case No.18 of 2009)

Argued by:          Sh. Arvind Sud, Advocate for the complainant.

                        Sh. R. K. Bashamboo, Advocate for OP No.1.

                        Sh. V. K. Diwan, Advocate for OP No.2.

Dated the 17^th day of January, 2011.

ORDER

                        Vide our detailed order of even date recorded separately, this complaint has been allowed.

(JAGROOP SINGH MAHAL)                                      (JUSTICE PRITAM PAL)

                MEMBER                                                                PRESIDENT