Repudiation of death claim by SBI Life Insurance Company due to non renewal of Pradhan Mantri Jeevan Jyoti Bima Yojana by the SBI Patiram Branch for the policy of SBI Life insurance has obliged the heir of the deceased to lodge this complaint for redressal under section 12 of C.P. Act 1986.
The complainant has averred in his complaint that his brother, Sukumar Rabidas purchased a policy of SBI Life Insurance Company under Pradhan Mantri Jeevan Jyoti Bima Yojana from the master policy holder State Bank of India at their Patiram Branch. His brother maintained a S/B account bearing No. 34669108117 with SBI, Patiram Branch. The first premium of Rs. 330/- was debited from the said S/B account on 01.09.2015 and the next renewal date was 31.05.2016 with a grace period for 30 days from the date of renewal. On 29.06.2016 the account balance of the said S/B account was enough for debiting the premium for the scheme. Sukumar Rabidas the brother of the complainant deceased on 12.11.2016. The complainant made a prayer to the Op bank with all documents claiming the death value of Rs. 2 lakh in terms of the terms and conditions of the insurance policy on 03.01.2018. But after much persuasion with the bank authority the complainant has failed to get the legitimate claim of the policy and this has caused him much harassment and mental agony. Under the circumstances the complainant in his complaint petition has prayed for Rs. 2 lakh as the death claim with interest @ 12% p.a. and Rs. 15000/- as compensation and more 15000/- as litigation cost.
The Op-1 in his averment on 04.09.2018 has admitted that the deceased Sukumar Rabidas maintained the SBI Life Policy under Pradhan Mantri Jeevan Jyoti Bima Yojana with his Bank for a period up to 31.05.2016 and as there was no instruction for auto debit for the renewal of the said policy so the policy could not be renewed in due time. The Bank authority had sent all the documents to the concerned authority of SBI Life who had repudiated the claim on the ground that the policy was not in force at the time of death of the policy holder. But on 26.02.2019 the Ld. Lawyer for the Op-1 has filed a prayer of written version wherein he has requested to strike of para 13 of the W/V submitted on 04.09.2018 and He has rewritten the para 13 wherein it has been denied to receive any claim prayer with relevant documents for death benefits of the deceased Sukumar Rabidas and subsequently sending the same to the Op-2. So in the instant case they have no negligent attitude or deficiency in service.
The Op-2 through an affidavit has filed his W/V wherein he has denied receipt of any death claim intimation to check the admissibility from the policy holder through the Op-1. Moreover he has averred that the insurance coverage of the deceased Sukumar Rabidas lapsed with effect from 1.06.2016 due to non receipt of the renewal premium on due date including the grace period of 30 days. He has mentioned clause II of the policy regarding the death benefit “A death benefit of Rs. 2,00,000/- (Two Lakh) shall be payable to the nominee/beneficiary or legal heir on the death of the Insured member during the policy term.” So in the instant case they have no negligent attitude or deficiency in service.
The complainant has filed through affidavit 5 documents in a firisti. The Op-2 has also filed documents with annexure on affidavit but the Op-1 has filed not document. All these documents are kept in record.
All the parties have filed their respective written notes of argument. The Ld. Lawyer for the complainant in his written notes of argument and during argument hearing has stated that though the complainant in person had submitted prayer for the death claim with all documents to the Op-1 on 03.01.2017 but the office of the Op-1 has provided no stamped receipt of the same. But it is true that he has submitted the claim to the Op-1 as the photo copy of the filled-up claim form remains with him and this form is provided by the bank authority and this cannot be purchased in market. It is more argued that only a bank policy holder can come under this policy on his will but the renewal of the policy is auto linked and it is a responsibility of the Op-1 to renew the policy as there was enough fund for debiting the premium amount of the policy on 29.06.2016 which was within the grace period of renewing the said policy. But due to negligence on the part of the Op-1 the policy has not been renewed and the nominee has been deprived of his legitimate claim. This is a sheer deficiency in service on the part of the Op-1.
The Op-1 had filed written notes of argument on 21.12.2018 and additional written notes of argument on 18.07.2019 and had admitted that though the deceased Sukumar Rabidas had maintained a SBI Life Insurance Policy under Pradhan Mantri Jeevan Jyoti Bima Yojana which was valid up to 31.05.2016 and due to no instruction from the policy holder the policy had not been renewed by the Op Bank. They have denied of receipt any requisition of claim for death benefit from the present complainant who had failed to produce any document in support of deficiency in service on the part of the Op bank. The Op-2 in their written notes of argument has further asserted that due to lapse of the policy as well as no receipt of such claim from the master policy holder SBI they have no cause of action to go into the admissibility of any such claim. In this regard they have referred some decisions of the Apex court and the National Commission. So the complainant is not entitled to get any relief from the Op-2.
Points for discussion:
- Is the complainant a consumer to the opposite party?
- Is there any deficiency in service on the part of the opposite party?
- Is the complainant eligible to get any relief?
DECISION WITH REASONS
Regarding Point-1: It may be said that the complainant is a consumer to the Op bank who has not denied him as his customer.
The policy document of Pradhan Mantri Jeevan Jyoti Bima Yojana has been filed by the Op-2 . The point 4 (d) of part c of the policy document states “It shall be the responsibility of the insured member to ensure that his/her insurance premium is remitted to the Company. SBI Life shall not take any responsibility for non receipt of premium in respect of any member and shall have no liability whatsoever in respect of such members whose premiums are not received”. Accordingly no deficiency in service on the part of Op-1 & Op-2 can be noted
It is observed that the complainant has failed to produce any concrete evidence in support of his case regarding the deficiency in service on the part of the Op-1 or Op-2. So he is not entitled to get any relief.
Hence, it is
O R D E R E D
The instant case is dismissed on merits though contested.
Let a plain copy of this order be furnished to the parties forthwith free of cost.
