Haryana

Kaithal

251/20

Smt Nirmala Devi - Complainant(s)

Versus

STATE Bank Of India - Opp.Party(s)

Sh.Sukhdeep Singh

11 May 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KAITHAL.

                                                     Complaint Case No.251/2020.

                                                     Date of institution: 20.08.2020.

                                                     Date of decision:12.05.2023.

Smt. Nirmala Devi Wd/o Pala Ram aged 49 years S/o Sh. Roop Chand, R/o near Govt. School, VPO Sirsal, Tehsil Pundri, Distt. Kaithal-136027, Haryana.

                                                                        …Complainant.

                        Versus

1. State Bank of India through its Branch Manager, Branch Habri having its office at Village Habri, Tehsil Pundri, District Kaithal, Haryana.
2. Head-Accident and Health Claims SBI General Insurance Company Ltd. through its office bearer/Manager, having its office at 3^rd & 4^th Floor, Lotus IT Park, Road No.16, Plot No.B-18, 18, Wagle Industrial Estate, Thane (W), Thane-400604.

….Respondents.

        Complaint under Section 35 of the Consumer Protection Act

CORAM:     SMT. NEELAM KASHYAP, PRESIDENT.

                SMT. SUMAN RANA, MEMBER.

                SH. SUNIL MOHAN TRIKHA, MEMBER.

       

Present:     Sh. Sukhdeep Singh, Advocate, for the complainant.   

                Sh. O.P.Gulati, Advocate for the respondent No.1.

                Sh. P.P.Kaushik, Adv. for the OP No.2.

               

ORDER

NEELAM KASHYAP, PRESIDENT

        Smt. Nirmla Devi-Complainant has filed this complaint under Section 35 of Consumer Protection Act, 2019 (hereinafter referred to as ‘the Act’) against the respondents.

                In nutshell, the facts of present case are that the husband of complainant namely Pala Ram was having a saving account bearing No.32935728065 with the OP No.1 and he purchased one SBI General Personal Accident Insurance Policy/Plan bearing No.143820-0000-01/0000000005812735 valid for the period w.e.f. 15.02.2017 to 14.02.2018.  It is alleged that a sum of Rs.100/- was also deducted from the saving account of husband of complainant and personal accident insurance policy was insured for a sum of Rs.2,00,000/-.  Unfortunately, the husband of complainant died after drowning in the canal (nehar) at Madhuban on 10.02.2018 and DDR No.0003 dt. 11.02.2018 was entered/lodged in Police Station Madhubhan, Karnal and thereafter, the dead body of husband of complainant was found floated in the area of Police Station Kharkhoda, District Sonipat and further investigation was carried out by the officials of Police Station Kharkhoda, District Sonipat and DDR No.49 was also registered in this regard.  The post-mortem was also conducted in Civil Hospital, Sonipat on 12.02.2018.  The complainant being nominee of her husband lodged the claim with the OP No.2 and submitted all the necessary documents but the OP No.2 did not settle the claim of complainant.  So, it is a clear cut case of deficiency in service on the part of respondents and prayed for acceptance of complaint.     

2.            Upon notice, the respondents appeared before this Commission and contested the complaint by filing their written version separately.  OP No.1 filed the written version raising preliminary objections with regard to locus-standi; maintainability; cause of action; mis-joinder and non-joinder of necessary parties; that SBI General Insurance Company is totally different legal entity and OP No.1 has no control and concern over business of OP No.2.  Accordingly, on the request of late Pala Ram during his life time, an amount of Rs.100/- was debited from his saving account on 15.02.2017 and remitted to OP No.2.  Issuance of personal accidental insurance policy against premium of Rs.100/- and processing & adjudication of claims, if any is sole act of OP No.2 only and OP No.1 has no concern over of it.  There is no deficiency in service on the part of respondent.  On merits, the objections raised in the preliminary objections are rebutted and so, prayed for dismissal of complaint.

3.             Op No.2 filed the written version raising preliminary objections that the present complaint is pre-mature, so, there is no deficiency in service on the part of answering Op; that after getting the intimation regarding the death of Sh. Pala Ram, the answering OP immediately appointed investigator to investigate the matter and requested the complainant vide letters dt.07.06.2019, 22.06.2019, 22.07.2019, 15.10.2019, 04.11.2019 and 15.02.2019 for submission of documents i.e. certified copy of final cause of death confirmation from the post-mortem centre on the basis of RFSL report and certified copy of General Policy Diary closure report/Final police investigation report with conclusion but complainant did not provide the same.  So, the answering OP closed the claim of complainant due to non-submission of relevant/required documents.  On merits, the objections raised in the preliminary objections are rebutted and so, prayed for dismissal of complaint.

4.             To prove his case, the complainant tendered into evidence affidavit Ex.CW1/A alongwith documents Annexure-C1 to Annexure-C14 and thereafter, closed the evidence.

5.             On the other hand, the respondent No.2 tendered into evidence affidavit Ex.RW2/A alongwith documents Annexure-R1 to Annexure-R9, respondent No.1 tendered into evidence affidavit Ex.RW1/A alongwith documents Annexure-R10 and thereafter, closed the evidence.

6.             We have heard the learned Counsel for both the parties and perused the record carefully.

7.             Ld. counsel for the complainant has argued that the husband of complainant namely Pala Ram was having a saving account bearing No.32935728065 with the OP No.1 and he purchased one SBI General Personal Accident Insurance Policy/Plan bearing No.143820-0000-01/0000000005812735 valid for the period w.e.f. 15.02.2017 to 14.02.2018 as per Annexure-C6.  It is further argued that a sum of Rs.100/- was also deducted from the saving account of husband of complainant and personal accident insurance policy was insured for a sum of Rs.2,00,000/.  Unfortunately, the husband of complainant died after drowning in the canal (nehar) at Madhuban on 10.02.2018 and DDR No.0003 dt. 11.02.2018 was entered/lodged in Police Station Madhubhan, Karnal, as is clear from Annexure-C4 and thereafter, the dead body of husband of complainant was found floated in the area of Police Station Kharkhoda, District Sonipat and further investigation was carried out by the officials of Police Station Kharkhoda, District Sonipat and DDR No.49 was also registered in this regard as per Annexure-C5.  The post-mortem was also conducted in Civil Hospital, Sonipat on 12.02.2018.  The complainant being nominee of her husband lodged the claim with the OP No.2 and submitted all the necessary documents but the OP No.2 did not settle the claim of complainant.  So, it is a clear cut case of deficiency in service on the part of respondents.

8.             On the other hand, ld. counsel for the respondent No.1 has argued that SBI General Insurance Company is totally different legal entity and OP No.1 has no control and concern over business of OP No.2.  Accordingly, on the request of late Pala Ram during his life time, an amount of Rs.100/- was debited from his saving account on 15.02.2017 and remitted to OP No.2.  Issuance of personal accidental insurance policy against premium of Rs.100/- and processing & adjudication of claims, if any is sole act of OP No.2 only and OP No.1 has no concern over of it.

9.             Ld. counsel for the respondent No.2 has argued that the OP No.2 immediately appointed investigator to investigate the matter and requested the complainant vide letters dt.07.06.2019, 22.06.2019, 22.07.2019, 15.10.2019, 04.11.2019 and 15.02.2019 for submission of documents i.e. certified copy of final cause of death confirmation from the post-mortem centre on the basis of RFSL report and certified copy of General Policy Diary closure report/Final police investigation report with conclusion but complainant did not provide the same.  So, the OP No.2 closed the claim of complainant due to non-submission of relevant/required documents.

10.            We have considered the rival contentions of both the parties.  The main objection raised by the OP No.2 is that several letters as per Annexure-R2 to R8 were sent to the complainant for submission of documents i.e. certified copy of final cause of death confirmation from the post-mortem centre on the basis of RFSL report and certified copy of General Policy Diary closure report/Final police investigation report with conclusion but complainant did not provide the same.  To rebut the said contention of OP No.2, ld. counsel for the complainant has stated that the report of FSLH, Madhuban, Karnal was provided to the OP No.2 and during the course of arguments, he has drawn our attention towards the report of FSLH, Madhuban, Karnal dt. 25.10.2018 as per Annexure-C14, the relevant portion of which is mentioned as under:-

                        “LABORATORY EXAMINATION

                Laboratory examinations were carried out to detect the presence of diatoms in the exhibits by performing Acid Digestion, Centrifugation & Microscopy Based upon these examinations, the results obtained are given below:-

1. Diatoms were detected in exhibit-1 (Sternum) & exhibit-2 (Water sample) found to be of similar type.”

11.            We have perused the report of Elevate Detectives as per Annexure-R1, wherein on the last page, abstract of said report is mentioned as under:-

                “Opinion of investigator (with summary of case)

                Pala Ram was crossing the divider and he slipped into a canal and drowned.”

                So, from the above-said report as-well-as facts and circumstances of the case, it is clear that the husband of complainant died due to drowning in the canal (nehar) and it was accidental death and not murdered case.  It has come into knowledge of this Commission that the OP-insurance company does not settle the petty and genuine claims of the customers whereas drag them to knock the doors of the court which clearly amounts to deficiency in service as-well-as unfair trade practice on their part and thereby harass the innocent and poor customers unnecessarily.  Hence, we are of the considered view that the OP No.2 has wrongly closed the claim file of complainant and there is deficiency in service on the part of OP No.2.

12.            Thus, as a sequel of aforesaid discussion, we direct the OP No.2-insurance company to pay the personal accident claim amount of Rs.2,00,000/- as per Annexure-C6 within 45 days from today and further to pay Rs.5,000/- as compensation on account of physical harassment and mental agony as-well-as Rs.5,000/- as litigation charges to the complainant.  However, it is made clear that if OP No.2 is failed to pay the aforesaid awarded amount of Rs.2,00,000/- to the complainant within stipulated period, then they shall be liable to pay interest @ 7% p.a. from the date of this order till its realization.  Hence, the present complaint is accepted according against OP No.2-insurance company and dismissed against Op No.1.                      

13.            In default of compliance of this order, proceedings against respondent-Op No.2 shall be initiated under Section 72 of Consumer Protection Act, 2019 as non-compliance of court order shall be punishable with imprisonment for a term which shall not be less than one month, but which may extend to three years, or with fine, which shall not be less than twenty five thousand rupees, but which may extend to one lakh rupees, or with both.  A copy of this order be sent to both the parties free of cost.  File be consigned to the record room after due compliance.     

Announced in open court:

Dt.:12.05.2023.

                                                                (Neelam Kashyap)

                                                                President.

 

(Sunil Mohan Trikha),           (Suman Rana),          

Member.                            Member.

 

Typed by: Sanjay Kumar, S.G.