Date of Filing : 31/05/2016
Order No. 14 dt. 09/03/2018
The case of the complainant in brief is that one Subhadip Chatterjee, since deceased, was insured under SBI Life Surakshya Plus Policy, Master Policy bearing no.63000000601 for a credit shield credit shield means that if any amount is due to SBI card upto Rs.1 lakh will be covered by the insurance company). The complainant has claimed Rs.7.5 lakhs under the Protection Plus Insurance Cover on account of accidental death of the deceased i.e. the card holder. The complainant being the widow of the deceased claimed the amount. The complainant after the demise of her husband applied in the prescribed manner before the office of SBI Life Insurance Co. Ltd. regarding disbursement of death claim against the said policy relating to credit card no.4006661037605719. The Asstt. Manager, SBI issued a letter to the complainant admitting the death claim, but paid only an amount of Rs.5607/- against SBI Group Insurance Scheme, but they did not disburse the amount of Rs.7.5 lakhs against the policy Protection Plus which the complainant was entitled to get. The complainant thereafter contacted Royal Sundaram Insurance Co. Ltd. but nom fruitful result was achieved for which the complainant sent a lawyer’s noticed, in spite of receiving the said letter no step was taken and the amount was not disbursed for which the complainant filed this case praying for direction upon the o.ps. to pay an amount of Rs.7.5 lakhs relating to the said policy arose out of the said credit card as well as compensation of Rs.2 lakhs and litigation cost of Rs.50,000/-.
The o.ps. contested this case by filing w/v and denied all the material allegations of the complaint. In their w/v o.p. nos.1 and 2 stated that o.p. nos.1 and 2 made the payment amounting to Rs.5607/- which was the outstanding amount on credit card as on the date of death. As per the terms and conditions of the said policy these o.ps. are not liable to pay any amount towards personal accident cover or any other cover and which was informed to the complainant on 3.4.14, but the case was filed in the year 2016 after the lapse of two years. The o.ps. grant insurance coverage to individuals, through individual assurances and to group of individuals. In case of individual assurances it is the individual to be insured or his proposer who submits the proposal to the insurance company. In case of groups schemes, the individual members do not make any proposal for insurance. But it is the group policy holder viz. financial institute which submits a single proposal to the company on behalf of all individual members of the group and accordingly a master policy bearing no.63000000601 was issued as the evidence of contract. The initial deceased life assured was insured under Protection Plus Group Insurance Scheme under Master policy noi.830010000105 with effect from 18.1.07. In 2010 the Master Policy bearing no.830010000105 was discontinued and the Master Policy holder SBI card and the insurer entered into an another agreement for insurance cover for the eligible credit card holders of SBI card i.e. SBI Life Surakshya Policy in March, 2010 and a Master Policy bearing no.63000000601 was issued. The group personal accident cover is independently administered by Royal Sundaram Insurance Co. Ltd. and credit shield cover will be administered by SBI Life Insurance Co. Since the accident took place on 15.10.13 after 2010 while the agreement was entered into between the bank and insurance company, therefore the insurance company will be liable to pay the death claim in case of accidental death of the card holder covered under insurance policy. In view of the said fact o.p. nos.1 and 2 prayed that they are not responsible for withholding the payment as claimed by the complainant. On the basis of the said fact o.p. nos.1 and 2 prayed for dismissal of the case against them.
In their w/v o.p. nos.3, 4 and 6 stated that the complainant had filed one certificate of policy of insurance issued by SBI Life Insurance Co. Ltd. wherein she has been shown as nominee of the said policy. The answering o.ps. have no connection with the said company as well as the said policy. They further stated that Late Subhadip Chatterjee had as personal accident policy with o.ps. under certificate no.PASBI00001000103 with his mother Smt. Indulekha Chatterjee a nominee. A claim was made with the answering o.ps. under the said policy alleging the death of insured Subhadip Chatterjee, the answering o.ps. appointed Mack Insurance Auxiliary Service Pvt. Ltd. to investigate the claim and collect the documents. The investigator vide its report dt.6.5.14 confirmed the death and accordingly after completion of the scrutiny of the claim of the nominee the amount was discharged and discharge voucher was duly executed by the nominee. There was no question of withholding any payment of the insurance company, thereby the insurance company cannot be held liable for any compensation.
The o.p. no.5 almost adopted the w/v submitted by o.p. nos. 1 and 2 and further stated that the claim was settled and transferred in favour of the nominee by E Transfer (Indulekha chatterjee) amount was Rs.7.5 lakhs and the said amount was disbursed on 8.7.14. In view of the said fact o.p. no.5 stated that there was no deficiency in service on their part and the complainant will not be entitled to get any claim whatsoever. Apart from the said fact, the complainant did not make Indulekha Chatterjee as a party to this case to bring the actual fact before this Forum and on this score also o.p. no.5 stated that the case must fail due to non joinder of necessary party. Having regard to the said fact o.p. no.5 prayed for dismissal of the case.
On the basis of the pleadings of parties the following points are to be decided:
- Whether the complainant’s husband was insured with insurance company?
- Whether he died in an accident?
- Whether after demise of the policy holder the nominee claimed the amount from insurance company?
- Whether the amount was disbursed?
- Whether there was any deficiency in service on the part of o.ps.?
- Whether the complainant will be entitled to get the relief as prayed for?
Decision with reasons:
All the points are taken up together for the sake of brevity and avoidance of repetition of facts.
Ld. lawyer for the complainant argued that one Subhadip Chatterjee, since deceased, was insured under SBI Life Surakshya Plus Policy, Master Policy bearing no.63000000601 for a credit shield credit shield means that if any amount is due to SBI card upto Rs.1 lakh will be covered by the insurance company). The complainant has claimed Rs.7.5 lakhs under the Protection Plus Insurance Cover on account of accidental death of the deceased i.e. the card holder. The complainant being the widow of the deceased claimed the amount. The complainant after the demise of her husband applied in the prescribed manner before the office of SBI Life Insurance Co. Ltd. regarding disbursement of death claim against the said policy relating to credit card no.4006661037605719. The Asstt. Manager, SBI issued a letter to the complainant admitting the death claim, but paid only an amount of Rs.5607/- against SBI Group Insurance Scheme, but they did not disburse the amount of Rs.7.5 lakhs against the policy Protection Plus which the complainant was entitled to get. The complainant thereafter contacted Royal Sundaram Insurance Co. Ltd. but nom fruitful result was achieved for which the complainant sent a lawyer’s noticed, in spite of receiving the said letter no step was taken and the amount was not disbursed for which the complainant filed this case praying for direction upon the o.ps. to pay an amount of Rs.7.5 lakhs relating to the said policy arose out of the said credit card as well as other reliefs.
Ld. lawyer for the o.p. nos.1 and 2 argued that o.p. nos.1 and 2 made the payment amounting to Rs.5607/- which was the outstanding amount on credit card as on the date of death. As per the terms and conditions of the said policy these o.ps. are not liable to pay any amount towards personal accident cover or any other cover and which was informed the complainant on 3.4.14, but the case was filed in the year 2016 after the lapse of two years. The o.ps. grant insurance coverage to individuals, through individual assurances and to group of individuals. In case of individual assurances it is the individual to be insured or his proposer who submits the proposal to the insurance company. In case of groups schemes, the individual members do not make any proposal for insurance. But it is the group policy holder viz. financial institute which submits a single proposal to the company on behalf of all individual members of the group and accordingly a master policy bearing no.63000000601 was issued as the evidence of contract. The initial deceased life assured was insured under Protection Plus Group Insurance Scheme under Master policy noi.830010000105 with effect from 18.1.07. In 2010 the Master Policy bearing no.830010000105 was discontinued and the Master Policy holder SBI card and the insurer entered into an another agreement for insurance cover for the eligible credit card holders of SBI card i.e. SBI Life Surakshya Policy in March, 2010 and a Master Policy bearing no.63000000601 was issued. The group personal accident cover is independently administered by Royal Sundaram Insurance Co. Ltd. and credit shield cover will be administered by SBI Life Insurance Co. Since the accident took place on 15.10.13 after 2010 while the agreement was entered into between the bank and insurance company, therefore the insurance company will be liable to pay the death claim in case of accidental death of the card holder covered under insurance policy. In view of the said fact o.p. nos.1 and 2 prayed that they are not responsible for withholding the payment as claimed by the complainant. On the basis of the said fact o.p. nos.1 and 2 prayed for dismissal of the case against them.
Ld. lawyer for the o.p. nos.3. 4 and 6 argued that the complainant had filed one certificate of policy of insurance issued by SBI Life Insurance Co. Ltd. wherein she has been shown as nominee of the said policy. The answering o.ps. have no connection with the said company as well as the said policy. They further stated that Late Subhadip Chatterjee had as personal accident policy with o.ps. under certificate no.PASBI00001000103 with his mother Smt. Indulekha Chatterjee as nominee. A claim was made with the answering o.ps. under the said policy alleging the death of insured Subhadip Chatterjee, the answering o.ps. appointed Mack Insurance Auxiliary Service Pvt. Ltd. to investigate the claim and collect the documents. The investigator vide its report dt.6.5.14 confirmed the death and accordingly after completion of the scrutiny of the claim of the nominee the amount was discharged and discharge voucher was duly executed by the nominee. There was no question of withholding any payment of the insurance company, thereby the insurance company cannot be held liable for any compensation.
Ld. lawyer for the o.p. no.5 argued that that the claim was settled and transferred in favour of the nominee by E Transfer (Indulekha chatterjee) amount was Rs.7.5 lakhs and the said amount was disbursed on 8.7.14. In view of the said fact o.p. no.5 stated that there was no deficiency in service on their part and the complainant will not be entitled to get any claim whatsoever. Apart from the said fact, the complainant did not make Indulekha Chatterjee as a party to this case to bring the actual fact before this Forum and on this score also o.p. no.5 stated that the case must fail due to non joinder of necessary party. Having regard to the said fact o.p. no.5 prayed for dismissal of the case.
Considering the submissions of the respective parties it is an admitted fact that Shubhadip Chatterjee died in an accident and at the time of his death he was aged about 38 years. It appears from the materials on record that Subhadip Chatterjee was insured under SBI Life Surakshya Plus Policy and as per the terms of the said policy if any amount is due to SBI card upto Rs.1 lakh will be covered by the insurance company. The complainant claimed the amount of Rs.7.5 lakhs under the Protection Plus Insurance Cover on account of accidental death of deceased i.e. card holder. It appears from the materials on record that SBI Life issued a letter admitting the death claim and paid an amount of Rs.5607/- to SBI card for credit shield and paid Rs.7.5 lakhs on 8.7.14 to Mrs. Indulekha Chatterjee being the mother of the deceased Subhadip Chatterjee and also the nominee. The complainant has emphasized that before the death of said Subhadip Chatterjee, the husband of the complainant, he executed a will which was subsequently applied for obtaining probate from Hon’ble High Court and the probate was granted by Hon’ble High Court on the application filed by the complainant herself. On perusal of the photocopy of said probate granted by Hon’ble High Court it appears that it was executed by Subhadip Chatterjee on 23.8.13 and unfortunately he died on 15.10.13 i.e. within two months from the date of execution of the will the said testator died executing the will in favour of his wife and the will was executed at the age of 38 years which is abnormal thing since the will is generally executed by an aged person and at the age of 38 the execution of the will hardly to be seen. Be that as it may, it appears from the record that the mother was made nominee by said Subhadip Chatterjee and the amount was disbursed by the insurance company in respect of the amount of Rs.7.5 lakhs. The complainant in spite of knowing the said fact an intimation received from the insurance company filed this case praying for direction upont the o.ps. for releasing the amount of Rs.7.5 lakhs as well as compensation and other claims. Since from the materials on record it appears that the mother of the deceased who happens to be the mother in law of the complainant has not been made a party in this case and it appears from the record that a civil suit is pending before Ld. Civil Judge, Junior Division at Srerampore regarding the claim made by the complainant in respect of the amount left by deceased husband of the complainant. Since the civil court is in the midst of hearing of the matter and being this Forum dealing the matter in summary proceeding cannot enter into the civil dispute between the parties. Apart from the said fact recipient of the death claim of the deceased viz. mother Indulekha Chatterjee has not been made a party in this case. On the basis of the said facts and circumstances as stated above, we hold that the amount has already been paid to the nominee by the insurance company, therefore the further claim of the complainant for having the amount claimed by her cannot be entertained. Having regard to the facts and circumstances of the case we hold that the case filed by the complainant has got no merit and we do not find any deficiency in service on the part of o.ps. and the complainant will not be entitled to get any relief as prayed for. Thus all the points are disposed of accordingly.
Hence, ordered,
That the CC No.217/2016 is dismissed on contest without cost against the o.ps.
