Order No. 22 dt. 14/09/2016
The case of the complainant in brief is that the husband of the complainant had an account with UTI Bank and Ashok Kr. Bera, since deceased, being allured with the offer of an international debit card with the offer made by o.p. no.1 bank specially offering that the said card provides the accidental death insurance coverage for Rs.2 lakhs. The said bank issued an international debit card valid during the period from 2005-2010. The said insurance coverage was provided by M/s Bajaj Allianz General Insurance Co. Ltd. All on a sudden on 27.1.07 Ashok Kr. Bera, the husband of the complainant met with an accident and died. P.M. examination was held and FIR was lodged. After the demise of the husband of the complainant the claim was made and the said claim was repudiated by the insurance company with observation that the claim was not made within one month from the date of accident. Since the complainant was deprived of the insured amount through her advocate a letter was sent to o.ps. and no action was taken from their end for which the complainant had to file this case for the insured amount of Rs.2 lakhs and other reliefs including compensation for harassment of Rs.1 lakhs and litigation cost of Rs.10,000/-.
O.p. no.1 contested this case by filing w/v and denied all the material allegations of the complaint. It was stated by o.p. no.1 that whatever the policy was issued that was made by o.p. no.2. The complaint cannot be maintained against the o.p. no.1. The o.p. no.1 denied all the material allegations of the complaint and there was no deficiency in service on the part of o.p. no.1. Since the policy was issued by o.p. no.2 there was no privacy of contract between the complainant and o.p. no.1 and the bank cannot be held liable for the payment as claimed by the complainant. The dispute between the complainant and o.p. no.2 is to be resolved by themselves. The o.p. no.1 does not run the business of insurance. Bank is only for facilitator / referral agent and the actual insurance issued by Bajaj Allianz General Insurance Co. Ltd. and the bank being the facilitator cannot be held liable for the non payment of the insurance amount by o.p. no.2. In view of the said fact o.p. no.1 prayed for dismissal of the case.
The o.p. no.2 has not contested the case and as such, the case has proceeded ex parte against the o.p. no.2.
On the basis of the pleadings of parties the following points are to be decided:
- Whether the husband of the complainant had an insurance policy with o.p. no.2
- Whether the complainant’s husband died in an accident.
- Whether the policy was valid at the relevant point of time.
- 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 argued that the complainant had a salary account with o.p. no.1 and he was provided with an international debit card and the same was valid between the period from 2005-2010 and it was informed to the husband of the complainant that as per internal arrangement of o.p. bank with o.p. no.2 for providing the insured sum in case of death of the account holder. Since the husband of the complainant died on 27.1.07 and immediately after the said occurrence an FIR was lodged and a case was started u/s 279, 337, 338 and 304 IPC and after the demise of the husband of the complainant, the claim was made to o.p. no.2 but o.p. no.2 rejected the claim stating interalia that the claim was not made within 30 days from the date of incident. Ld. lawyer emphasized that o.p. no.2 has evaded their responsibility as o.p. no.2 did not contest the case and o.p. no.1 who insisted the husband of the complainant, since deceased, to have the benefit of international debit card with the allurement that the said card holder will have the benefit of insurance of accidental policy of Rs.2 laklhs. On the basis of the said fact the husband of the complainant accepted the terms and conditions of the said debit card and policy was covered by o.p. no.2 after making arrangement with o.p. no.1. In view of the said fact ld. lawyer prayed for relief as mentioned in the prayer portion of the petition of complaint.
Ld. lawyer for o.p. no.1 argued that the bank had no role to play in opening the said policy since the contract entered into between the husband of the complainant and o.p. no.2. Bank was only the facilitator. As such, bank cannot be held liable for non payment of the said amount.
Considering the submissions of the respective parties it appears that the husband of the complainant had an account with o.p. no.1 and he possessed the international debit card and the said card was valid during the period from 2005-2010 and at the time of holding the said card the bank assured the complainant that the holder of the card will have the facility to get the accidental insurance benefit of Rs.2 lakhs and a policy was issued by o.p. no.2 to that effect.
From the materials on record it is an admitted fact that the husband of the complainant died in an accident on 27.1.07 i.e. during the validity of the policy period the said accident took place, therefore the claim of the complainant cannot be denied that simply because the claim was made by the complainant one month after the said incident, being a widow it is not possible for her to know the terms and condition s of the policy and she claimed the policy amount after committing some delay. The o.p. no.2 only repudiated the claim of the complainant by stating interalia that the claim was not made within 30 days from the date of incident. Apart from the said fact o.p. no.2 in spite of receiving the notice did not contest the case and the case has proceeded ex parte against o.p. no.2. In view of such scenario, we hold that the o.p. no.2 in order to evade their responsibility / liability to pay the insured sum in case of accidental death of the policy holder o.p. no.2 did not come with their plea and did not contest the case for avoiding of delaying the disposal of the disposal of the case.
Considering all these aspects we hold that the complainant will be entitled to get the policy amount of Rs.2 lakhs since the husband of the complainant died in an accident during the validity period of the said policy. Thus all the points are disposed of accordingly.
Hence, ordered,
That the CC No.425/2013 is allowed ex parte with cost against the o.p. no.2 and dismissed on contest without cost against the o.p. no.1. The o.p. no.2 is directed to pay to the complainant a sum of Rs.2,00,000/- (Rupees two lakhs) only being the insured amount along with compensation of Rs.10,000/- (Rupees ten thousand) only for harassment and mental agony and litigation cost of Rs.2000/- (Rupees two thousand) only within 30 days from the date of communication of this order, i.d. an interest @ 10% p.a. shall accrue over the entire sum due to the credit of the complainant till full realization.
Supply certified copy of this order to the parties free of cost.
