Haryana

StateCommission

A/805/2015

PUNJAB NATIONAL BANK - Complainant(s)

Versus

SATWATI DEVI - Opp.Party(s)

R.S.BHATIA

01 May 2017

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

HARYANA PANCHKULA

 

 

First Appeal No.805 of 2015

Date of the Institution:11.09.2015

Date of Decision:01.05.2017

 

Punjab National Bank A body corporate constituted under Banking Companies (Acquisition and Transfer of Undertakings) Act, 1970., having its head office at 7 Bhikhaji Cama Place, New Delhi and one of its offices at Regional Office, Karnal.

                                                                             .….Appellant

Versus

1.      Smt.Satwanti Devi widow of Balwan Singh son of Lal Chand, resident of village Rasoi, Tehsil and District Sonepat.

2.      K.S. Raghvan Met Life Ins. Co. Ltd. Registered Office at Brigade Seshmahal, 5 Vani Vilas Road, Banavamagudi, Banglore-560004.

3.      FA Vikram Singh 99004643 son of Sultan Singh son of Ram Diay, resident of village Sewah Garhi, Tehsil and District Panipat.

4.      Met Life India Co.Ltd., 1^st Floor, SCF 50, Sector-11, HUDA, Panipat.

                                                                                                .….Respondents

Present:-    Mr.H.S.Bhatia, Advocate for the appellant.

                    Mr.B.R.Vohra, Advocate for the respondent No.1.

                   Mr.Vaibhav Jain, Advocate for respondent Nos.2 & 4.

                   None for respondent No.3.

 

First Appeal No.902 of 2015

Date of the Institution:16.10.2015

Date of Decision:01.05.2017

1.      K.S. Raghvan Met Life Ins. Co. Ltd. Registered Office at Brigade Seshmahal, 5 Vani Vilas Road, Banavamagudi, Banglore-560004.

2.      Met Life India Co.Ltd., 1^st Floor, SCF 50, Sector-11, HUDA, Panipat

                                                                                                .….Appellants

                                                Versus

1.      Smt.Satwanti Devi widow of Balwan Singh son of Lal Chand, resident of village Rasoi, Tehsil and District Sonepat.

2.      The Manager, Punjab National Bank, Regional Office, Karnal.

3.      FA Vikram Singh 99004643 son of Sultan Singh son of Ram Diay, resident of village Sewah Garhi, Tehsil and District Panipat.

                                                                             .….Respondents

 

 

Present:-    Mr. Vaibhav Jain, Advocate for the appellants.

                    Mr. B.R.Vohra, Advocate for the respondent No.1

                   Mr. H.S. Bhatia, Advocate for respondent No.2.

None for respondent No.3.

 

CORAM:    Mr.R.K.Bishnoi, Judicial Member

                    Mrs. Urvashi Agnihotri, Member

 

 

O R D E R

URVASHI AGNIHOTRI, MEMBER:

 

1.      This Order will dispose of Appeal 902 of 2015 filed by Metlife India Insurance Company Ltd. – OP-4 and Appeal No.805 of 2015 filed by Punjab National Bank- OP-2 against the Order dated 11.08.2015 passed by learned District Consumer Disputes Redressal Forum, Sonepat (for short ‘District Forum’), whereby complaint of Smt. Satwanti Devi has been allowed, by directing the OPs to make payment of Rs.8,06,400/- to complainant within  a period of one month from the date of passing of order.  

2.      Briefly stated, Balwan Singh, husband of the complainant, purchased a policy No.20820265 from the OPs i.e. Met Monthly Income Plan 7 pay through respondent No.3 and respondent No.4 for Rs.8,06,400/- Balwan Singh expired on 14.11.2012 and the OPs were immediately informed about the death. Even though, all the relevant documents were submitted, yet the OPs failed to process claim which amounted to grave deficiency in service on their part. Aggrieved against this, Smt. Satwanti Devi - complainant filed the complaint for the redressal of her grievance.

3.      OP Nos.1 and 4 pleaded that deceased Balwan Singh, after completely understanding the terms and conditions of Met Monthly Income Plan 7 pay submitted duly signed proposal form on 11.04.2012 and offered to pay Rs.99,892/- towards the initial premium against the sum assured of Rs.8,06,400/-. The policy was to be issued for a period of 7 years against the sum assured. The deceased had just paid one premium and he died on 14.11.2012 due to heart attack. After receipt of information regarding death of Balwan Singh, they got the matter investigated. During investigation it was revealed that the deceased was taking anti tubercular treatment since 4 years from Cardio Thoracic and Neuro Sciences Centre, AIIMS, New Delhi. The deceased was well aware about his health before filling up the proposal form by suppressing the material facts at the time of availing the policy in order to take undue advantage of the same. They rightly repudiated her claim and grounds for repudiation of the same were duly communicated by them vide letter dated 21.02.2013. However, they refunded fund value of Rs.108 available in the policy account vide cheque towards full and final settlement under the said policy. According to them, complainant was not entitled to any other amount and compensation from them and prayed for dismissal of complaint.

4.      However, learned District Forum rejected the plea of the OPs and allowed the complaint by awarding the aforesaid relief.

5.      Against the impugned Order, OP Nos.2 and 4/appellants have filed present appeals before us reiterating the same pleas, as raised before the District Forum and by submitting that they were not liable to pay the Claim amount.

6.      We have heard the learned counsel for the parties and have also gone through the record. Appeal No.805 of 2015 has been filed by Punjab National Bank - OP-2 mainly for the reason that even though neither any evidence was led against the bank by the complainant nor has any liability been fastened on it. Despite that inadvertently, the learned District Forum has allowed the complaint by directing all the OPs to pay the claim, whereas the name of the appellant bank should have been deleted. We have gone through the Order of the learned District Forum closely and find merit in the appeal of the Punjab National Bank. Hence, it’s appeal is allowed to the extent that it is not liable to pay any amount.

7.      So far as the Appeal 902 of 2015 filed by Metlife India Insurance Company Ltd. – OP-4 their principal contention is that at the time of taking out the policy in April, 2011, the insured did not disclose the material fact about his illness and the treatment taken by him. The contention of the appellant–insurance company is wholly without any merit firstly the insured survived for seven months after taking out the policy and even the cause of death was Heart Attack. Further, the Appellant – insurance company failed to prove beyond doubt that the person, who got the treatment from the hospital as alleged by them was the same i.e. Balwan Singh. In this regard the finding of the learned District Forum which is based on documentary evidence is reproduced:-

“We have perused the final investigation report dated 12.1.2013 submitted by investigator Total Transparency. In the investigation report, it is mentioned that –

We have visited at the Batra Nursing Home and there we meet Amit (Receptionist). Thereafter we enquired about LA’s treatment. He searched the medical record and told that Balwan Singh son of Dariya Singh, r/o VPO Baltana, Panipat, Haryana was admitted on 19.9.2011 in the said hospital for Coronary Angiography Test only. Whereas as the complainant, the deceased Balwan Singh was the son of Shri Lal Chand, resident of village Rasoi, tehsil and Distt. Sonepat. Meaning thereby, the investigator has investigated the claim case of any other person except Balwan Singh son of Lal Chand resident of Village Rasoi, tehsil and distt. Sonepat. So, the investigation report on which the respondents are relying upon, has no relevance in the eyes of law and the same is not helpful to the respondents in any manner. Further the statement dated 11.1.2013 of Satwanti also creats suspicion in the mind of this Forum, because this statement was got signed at the bottom of the paper and to cover the gap, the stamp was affixed”.

8.      In the face of this documentary evidence on record, the plea of the appellant-OP can not be accepted that there was any suppression of any material fact or fraud on the part of the insured at the time the insurance policy was taken. The principle of law as laid down by the Hon’ble Supreme Court that the contract of insurance is of faith remains fully applicable and binding but the facts and circumstances of the present case are totally distinguishable as the insured had taken out the policy without any fraud or suppression of material facts. Consequently, we do not find any merit in the appeal filed by the Metlife India Insurance Company Ltd. – OP-4 and we uphold the well reasoned and detailed Order passed by learned District Forum qua them. As we have already allowed the appeal Appeal No.805 of 2015 of the Punjab National Bank, the directions for payment of the amount awarded shall be confined to the remaining respondents.

9.      Statutory amount of Rs.25,000/- deposited at the time of filing the appeal No.902 of 2015  and Rs.25,000/- deposited at the time of filing of appeal No.805 of 2015 be refunded to the appellants against proper receipt and identification in accordance with rules, after the expiry of period of appeal and revision, if any filed in this case.

May 01st, 2017

Mrs.Urvashi Agnihotri, Member, Addl.Bench

R.K.Bishnoi, Judicial Member Addl.Bench

 

R.K.