Assam

Dibrugarh

CC/3/2023

Mr. Sabidul Islam Ali - Complainant(s)

Versus

Senior Divisional Manager, The Oriental Insurance Company Limited. - Opp.Party(s)

Shri Surya Narayan Yadav

12 Aug 2024

ORDER

Date of Argument: 27.07.23

                                                                                                Date of Judgement: 12.08.24

This complaint petition has been filed U/S 35 of the Consumer Protection Act, 2019 by the complainant praying for directing the O.P. i.e. Oriental Insurance Company Limited to pay the death claim under Pradhan Mantri Suraksha Bima Yojana of Rs. 2,00,000/- as the insurance company have received requisite amount of premium through the bank Account No. 13392282002000 of Oriental Bank of Commerce, A.T. Road, Dibrugarh Branch (presently Punjab National Bank) from the account of Late Monowara Begum along with compensation of Rs.1,00,000/- for giving mental and physical agony to the family members of the deceased.                                                  

JUDGEMENT

1. The brief fact of the complaint is that the complainant is the younger son of Mr. Arshad Ali and Late Monowara Begum, having residence at Tinkunia, Vistypatty Graham Bazar, Dibrugarh, Assam. Complainant’s mother Late Monowara Begum died on 10.01.2021 in a road traffic accident occurred on 10.01.2021 near Phoolbagan in Dibrugarh Town.

 

2. It is averred that Late Monowara Begum has insured her life under Pradhan Mantri Suraksha Bima Yojana and has paid the requisite amount of premium through her bank Account No. 13392282002000 of Oriental Bank of Commerce, A.T. Road, Dibrugarh Branch under the said scheme. The said Bank has now been merged with the Proforma Opposite Party who is managing and look after the entire affairs of the said bank under the banner of Punjab National Bank. The requisite premium of Rs.12/- was deducted from her aforesaid Account on 29.05.2015, 31.05.2016, 31.05.2017, 21,05.2018, 27.05.2019 and on 25.05.2020.

 

3. After the death of Late Monowara Begum, her daughter Mrs. Hasna Ara Begum has submitted an application before the Manager of Oriental Bank of Commerce for the claim under PMSBY as at that time the surviving legal heirs of Late Monowara Begum have no knowledge as who has been appointed as nominee by the deceased in her Bima Yojana (Insurance Policy). Complainant has stated that the policy holder Late Monowara Begum had appointed her daughter Mrs. Hasna Ara Begum as nominee of the said saving Account. Thereafter Mrs. Hasna Ara Begum has received a reply vide letter dated 03.08.2021 from the Opposite Party (Oriental Insurance Company Limited) on which the insurance company have asked Mrs. Hasna Ara Begum to submit legal heir certificate, KYC documents and they have also informed that Late Monowara Begum has appointed Mr. Sabidul Islam Ali (the complainant herein) as nominee in the said Bima Yojana.

 

4. After receiving the aforesaid reply on 03.08.2021 in the second week of August 2021, the family members of Late Monowara Begum have started the process of obtaining the legal heir certificate which could not be obtained till 22.10.2021. In the meantime the Opposite Party (Oriental Insurance Company Limited) have send another letter dated 01.09.2021 wherein they have intimated Mrs. Hasna Ara Begum that they are closing the claim due to non-submission of documents.  Complainant stated that the O.P. have send their second letter through dated 01.09.2021 just after 27 days of their first letter on which they have asked the claimant to submit requisite documents. And it was not possible for the claimant to obtain the Legal Heir Certificate in such a short period due to restrictive functioning of District Administration under Covid-19 restrictions. After obtaining the legal heir certificate, the complainant has submitted an application in the last part of the year 2021 before the Proforma Opposite Party for settlement of claim under PMSBY of his mother Late Monowara Begum (A/C-13392282002000) who died on 10.01.2021, but the O.P. have failed to settle the claim.

 

5. Thereafter the complainant has submitted another fresh application for settlement of death claim of Late Monowara Begum on 23.06.2022 before the Opposite Party through the Proforma Opposite Party by annexing all necessary documents but despite of receiving the said documents and application they have failed to settle the claim of the complainant till date although the complainant has approached the officials Proforma Opposite Party on several times.

 

6. The complainant having left no option has sent legal notice on 17.06.22 to the Proforma Opposite Party but they failed to comply with the demand of the said notice. Thereafter on 12.12.22 the complainant sent another notice to the Opposite Party as well as the Proforma Opposite Party and they received the said notice but again failed to settle the claim of the complainant. Due to non-settlement of the said insurance claim the complainant has to suffer immense mental and physical harassment for such negligent service of the Opposite Party. The O.P.s and its agents and employees have wilfully avoided settlement of the insurance claim of the complainant and this wilful negligency on their part caused huge monetary loss to the complainant besides mental pain, suffering and physical harassment. The complainant being highly aggrieved with such conduct of the Opposite Party is compelled to approach this Commission for relief. However complainant seeks no relief against the Proforma Opposite Party but if they prefer to contest the case by denying the statement made by the complainant, they shall be treated equally liable for the harm caused to the complainant. Complainant stated that he is a consumer within the meaning of Section 1(7) of the Consumer Protection Act, 2019 and since he has suffered harm, he has every right to initiate a proceeding U/S 34 of the said Act. Complainant seeks the following reliefs: -

 

1. To pay the insurance claim of Rs.2,00,000/- under Pradhan Mantri Suraksha Bima Yojana as they have received requisite amount of premium through the bank Account No. 13392282002000 of Oriental Bank of Commerce, A.T. Road, Dibrugarh Branch (presently Punjab National Bank) from the account of Late Monowara Begum.
2. To pay the compensation Rs.1,00,000/- being the cost of compensation for physical and mental harassment of complainant.

(c) Any other relief or reliefs for which the complainant is entitled in law and equity.

 

7. After registering the complaint, notices were issued to the Opposite Party as well as the proforma Opposite Party but they did not turn up before this Commission inspite of notices were duly served on 24.02.2022 and 20.02.23 as per track consignment report submitted by the complainant and hence this Commission passed ex-parte order on 24.03.24 against both the Opposite Parties. However on 22.06.23 the Learned counsel for the Opposite Party has filed petition No.102/23 under Order 9 Rule 13 r/w Section 151 CPC for vacating ex-partee order dated 24.03.2023 along with a prayer of condonation of delay under Section 5 of the Limitation Act, but both the petitions were dismissed by this Commission and uphold the earlier order dated 24.03.23 and accordingly the case was proceeded ex-parte against both the O.P.s.

 

8. In this case the complainant Mr. Sabidul Islam Ali has filed evidence in affidavit on 10.05.23 as P.W.1 and stated that he is the younger son of Mr. Arshad Ali and Late Monowara Begum, having residence at Tinkunia, Vistypatty Graham Bazar, Dibrugarh, Assam. Complainant’s mother Late Monowara Begum died on 10.01.2021 in a road traffic accident occurred on 10.01.2021 near Phoolbagan in Dibrugarh Town.

 

9. Complainant stated that his mother Late Monowara Begum insured her life under Pradhan Mantri Suraksha Bima Yojana and has paid the requisite amount of premium through her bank Account No. 13392282002000 of Oriental Bank of Commerce, A.T. Road, Dibrugarh Branch under the said scheme. The said Bank has now been merged with the Proforma Opposite Party who is managing and look after the entire affairs of the said bank under the banner of Punjab National Bank. The requisite premium of Rs.12/- was deducted from her aforesaid Account on 29.05.2015, 31.05.2016, 31.05.2017, 21,05.2018, 27.05.2019 and on 25.05.2020.

 

10. After the death of complainant’s mother, his elder sister Mrs. Hasna Ara Begum has submitted an application before the Manager of Oriental Bank of Commerce for the claim under PMSBY as at that time they have no knowledge as who has been appointed as nominee by the deceased Monowara Begum in her Bima Yojana (Insurance Policy). Thereafter Mrs. Hasna Ara Begum has received a reply in the second week of August 2021 from the Opposite Party (Oriental Insurance Company Limited) through their reply letter dated 03.08.2021. And in the said reply letter, the concerned insurance company has asked Mrs. Hasna Ara Begum to submit legal heir certificate, KYC documents and they have also informed that Late Monowara Begum has appointed Mr. Sabidul Islam Ali (the complainant herein) as nominee in the said Bima Yojana.

 

11. After receiving the said reply letter dated 03.08.21, the family members of Late Monowara Begum have started the process of obtaining the legal heir certificate which could not be obtained till 22.10.2021 due to restrictive functioning of District Administration in covid-19 period. In the meantime the Opposite Party (Oriental Insurance Company Limited) have send another letter dated 01.09.2021 wherein they have intimidated Mrs. Hasna Ara Begum that they are closing the claim due to non submission of documents.  Complainant stated that the O.P. have send their second letter through dated 01.09.2021 just after 27 days of their first letter on which they have asked the claimant to submit requisite documents. And it was not possible for the Claimant to obtain the Legal Heir Certificate in such a short period due to restrictive functioning of District Administration under Covid-19 restrictions. After obtaining the legal heir certificate the complainant has submitted an application in the last part of the year 2021 before the Proforma Opposite Party for settlement of claim under PMSBY of his mother Late Monowara Begum (A/C-13392282002000) who died on 10.01.2021, but the O.P. have failed to settle the claim.

 

12. Thereafter the complainant has submitted another application for settlement of death claim of his mother on 23.06.2022 before the Opposite Party through the Proforma Opposite Party by annexing all necessary documents and despite of receiving the said documents and application they have failed to settle the claim of the complainant till date although the complainant has approached the officials Punjab National Bank i.e. Proforma Opposite Party on several times.

 

13. The complainant having left no option has sent legal notice on 17.06.2022 to the Proforma Opposite Party but they failed to comply with the demand of the said notice. Thereafter on 12.12.2022 the complainant sent another notice to the Opposite Party as well as the Proforma Opposite Party and they received the said notice but again failed to settle the claim of the complainant. Due to non-settlement of the said insurance claim the complainant has to suffer immense mental and physical harassment for such negligent service of the Opposite Party. The O.P.s and its agents and employees have wilfully avoided to settle the insurance claim of the complainant and this wilful negligency on their part caused huge monetary loss to the complainant besides mental pain, suffering and physical harassment.

 

14. Since the Oriental Insurance Company has deliberately denied to settle the insurance claim hence it is a clear case of unfair trade practice as defined under Section 1(47) of the Consumer Protection Act as they declined to protect the complainant from the loss against which they have issued the policy. As such the Oriental Insurance Company Ltd. is legally liable to compensate the complainant to the extent of amount insured by the deceased and also for his physical and mental harassment. Hence the complainant has prayed for the relief as stated in his complaint petition. To support his case the complainant has filed 19 (nineteen) documents as exhibits which are as follows-

 

1. Voter ID Card of complainant’s mother Late Monowara Begum
2. Aadhaar Card of Late Monowara Begum.
3. Pan Card of Late Monowara Begum.
4. Police Report 18.02.2021 issued by Borbari Police Out-Post.
5. Death Certificate of Late Monowara Begum
6. Post Mortem Report of Late Monowara Begum
7. Bank passbook of Late Monowara Begum
8. Legal heir certificate of Late Monowara Begum
9. Reply of Oriental Insurance Company dated 03.08.2021.
10. Letter of Oriental Insurance Company dated 01.09.2021
11. Legal Notice dated 13.06.2022 sent on 17.06.2022.
12. Postal Registration receipt No. ES944089479IN dated 17.06.2022
13. Postal Registration receipt No. ES9440899465IN dated 17.06.2022
14. Legal Notice dated 12.12.2022.
15. Postal registration receipt No.RS565430507IN dated 12.12.2022
16. Postal registration receipt No. RS565430498IN dated 12.12.2022
17. Postal delivery report of letter No.RS565430507IN
18. Postal delivery report of letter No. RS5654305151IN

 

15. Learned counsel for the complainant has file written argument on 27.02.23 reiterated the same averments made in his complaint petition as well as evidence on affidavit. Learned counsel for the complainant has cited Ruling of the Hon’ble Supreme Court of India in suo moto Writ Petition(C) No.3 of 2020, Misc (Application) No.665 of 2021 and Misc. (Application) No.21 of 2022  in which Hon’ble Apex Court has passed an order that the limitation period for any proceeding shall not run during the period of covid-19 restrictions but despite of that the O.P.s closed the claim hurriedly and illegally. Being highly aggrieved with such conduct of the O.P.s the complainant is compelled to approach this Commission for relief.

Point to be decided

1. Whether the complainant is a consumer of the Opposite Parties under the Consumer Protection Act?
2. Whether the Opposite Parties are liable for deficiency of services towards the complainant.
3. Whether the complainant is entitled to reliefs prayed for in the complaint petition?

 

                                              Decisions and Reasons thereof

 

1. We have carefully gone through the averments of the complaint and the evidence produced and the documents marked as Exhibit No.1 to 19 in support of those averments as well as written argument. It is worthy to mention here that though the O.P.s remained ex-parte vide order dated 24.03.2023, this Commission wants to dispose this complaint fully on merits with available materials on record. On perusing the case record we have found that the complainant’s mother Late Monowara Begum insured her life under Pradhan Mantri Suraksha Bima Yojana(PMSBY) and has paid the requisite amount of premium through her bank Account No. 13392282002000 of Oriental Bank of Commerce, A.T. Road, Dibrugarh Branch under the said scheme and the said bank has now been merged with the Proforma Opposite Party who is managing and looking after the entire affairs of the said bank under the banner of Punjab National Bank. And as per statement of Oriental bank of Commerce saving bank pass book (Exhibit No.7) the requite premium of Rs.12/- was deducted from aforesaid Account on 29.05.2015, 31.05.2016, 31.05.2017, 21.05.2018, 27.05.2019 and on 25.05.2020 wherein the complainant was appointed as nominee by deceased Monowara Begum under the PMSBY scheme. Hence there is no iota of doubt that complainant is a consumer under the Opposite Parties.

 

2. Regarding deficiency in service as alleged by the complainant, it transpires from the pleadings and documents placed in this case that after the death of Late Monowara Begum her daughter Mrs. Hasna Ara Begum has submitted an application before the Manager of Oriental Bank of Commerce for insurance claim under Pradhan Mantri Suraksha Bima Yojana (PMSBY) as at that time the surviving legal heirs of Late Monowara Begum have no knowledge as to who had been appointed as nominee in the said insurance policy. The Opposite Party i.e. Oriental Insurance Company vide letter dated 03.08.2021 asked Mrs. Hasna Ara Begum to submit legal heir certificate, KYC documents and also informed that Late Monowara Begum had appointed her younger son i.e. the complainant, Mr. Sabidul Islam Ali as nominee in the said insurance policy. After receiving letter dated 03.08.2021 of Opposite Party, complainant has applied for legal heir certificate but due to restrictive function of District Administration under COVID-19 period, that could not be obtained till 22.10.2021. Immediately after that Opposite Party vide letter dated 01.09.2021 informed Mrs. Hasna Ara Begum that they have closed her claim due to non-submission of documents. Complainant has alleged that the Opposite Party sent their second letter dated 01.09.2021 just after 27 days of first letter i.e. on 03.08.2021 on which they had asked about the legal heirs of deceased Monowara Begum and to submit necessary documents. But the family members of Monowara Begum was unable to obtain the legal heir certificate within the short period of time due to restrictive functioning of District Administration under COVID-19 restrictions.  After obtaining the legal heir certificate on 22.10.2021, complainant put forward his insurance claim under PMSBY of his deceased mother in the last part of the year 2021, but the Opposite Party have failed to settle the claim. Again on 23.06.2022 complainant submitted another fresh application for settlement of death claim of his deceased mother before the insurance company through the Proforma Opposite Party by annexing all necessary documents but despite of receiving the said application along with documents the Opposite Party failed to settle the claim till date. Finding no way, complainant has sent legal notice on 17.06.2022 and thereafter on 12.12.2022 to the Opposite Party as well as Proforma Opposite Party but they did not settle the claim under PMSBY of the complainant. Learned Counsel for the complainant citing guidelines of Hon’ble Supreme Court of India has argued that limitation period for any proceeding shall not run during the period of COVID-19 restrictions.  

 

Considering the submission of the complainant it is evident from statement of account of Oriental Bank of Commerce saving bank pass book (Exhibit No.7) of Account No. 13392282002000 an amount of Rs.12/- was deducted on 29.05.2015, 31.05.2016, 31.05.2017, 21.05.2018, 27.05.2019 and on 25.05.2020 against the insurance premium of deceased Monowara Begum under Pradhan Mantri Suraksha Bima Yojana (PMSBY). As per complainant, deceased Monowara Begum died on 10.01.21 in a road traffic accident occurred on 10.01.2021 near Phoolbagan in Dibrugarh Town. To prove the same complainant has exhibited the police report dated 18.02.2021 (Exhibit No.4), death certificate of Monowara Begum (Exhibit No.5), post mortem report dated 11.01.2021 (Exhibit No. 6). Complainant also exhibited Next Kin Certificate dated 22.10.2021 issued by office of the Deputy Commissioner, Dibrugarh (Exhibit No. 8) showing his name as legal heir of deceased Monowara Begum. Further complainant has clearly stated that family members of deceased Monowara Begum was not aware as to who was appointed as nominee in her said insurance policy. In the saving bank account of Oriental Bank of Commerce deceased Monowara Begum had appointed her daughter Mrs. Hasna Ara Begum as nominee and as such initially Mrs. Hasna Ara Begum has submitted insurance claim of her deceased mother under PMSBY. But subsequently after receiving the letter dated 03.08.2021 from Opposite Party, they came to know that Late Monowara Begum had appointed her younger son i.e. the complainant as nominee in her aforesaid insurance policy. After obtaining the legal heir certificate, complainant has applied for insurance claim under PMSBY scheme of his deceased mother, however the Opposite Party rejected the insurance claim on 01.09.2021 immediately just after 27 days of their first letter i.e. 03.08.2021 on the ground of  non-submission of documents.

 

Therefore, we observed that delay in submission of necessary documents by the complainant is not intentional and deliberate but due to certain restrictions imposed on account of COVID-19 pandemic for which the legal heir of Late Monowara Begum were unable to collect the said legal heir certificate within the specified period of time. It is to be noted that as per statement of account the aforesaid insurance policy under PMBSY of deceased Monowara Begum has been continuously renewed and the Opposite Party have regularly received the premium of Rs. 12/- per year which was auto debited through saving bank Account No. 13392282002000 of Oriental Bank of Commerce. We have also seen that deceased Monowara Begum has the insurance coverage on the date of her accident i.e. on 10.01.2021 and the bank has also asserted that renewal premium amount for insurance of the deceased under PMSBY for the period 2020-2021 has been paid to the Opposite Party as such the complainant being the nominee is entitled to receive insurance benefits of his deceased mother and the Opposite Party cannot be absolved from its liability. Further there are bonafide reason with the complainant for not filling the claim in time and repudiation of genuine claim only on the ground of non submission of documents is against the principle of natural justice. Hence the Opposite Party has committed deficiency in service in not allowing the insurance claim of the complainant and is liable to pay the amount of insurance claim of the deceased insured to her nominee under the aforesaid PMSBY scheme.

 

Further so far as liability of the Proforma Opposite Party is concerned, the complainant has sought no relief from the bank and we also do not find any lack of duties on their part as being the bank, as an account holder of which the insurance coverage was obtained, it does not appear that they were negligent in discharging their duties in sending the insurance premium to the insurance company in time.

 

3. In view of above discussion, we hereby allow the complaint of the complainant and direct the Opposite Party i.e. the Oriental Insurance Company Limited, Azad Bhawan, Jhandewalan Extn, New Delhi to pay to the complainant : 

 

1. A sum of Rs.2,00,000/- (Rupees two lacs) only towards the insurance claim under PMSBY in respect of death claim of deceased policy holder Late Monowara Begum.
2. A sum of Rs.20,000/- (Rupees twenty thousand) only as compensation for physical and mental harassment.
3. A sum of Rs.5,000/- (Rupees five thousand) only for cost of litigation.

             All the above amounts be deposited into the credit of this Commission by the Opposite Party, Oriental Insurance Company Limited, 4E/14, Azad Bhawan Jhandewalan Extn., New Delhi within 30 (thirty) days from the date of receipt of this judgement and order, failing which an interest @ 9% per annum on the awarded sum till payment will have to be borne by the Opposite Party.

This instant C.C. No. 03/2023 is accordingly disposed on contest.

 Send copy of this judgement and order to the Opposite Party for compliance. Complainant is to take step.