Ld Advocates for the parties are present. Judgement is ready and pronounced in open Commission in 8 pages and 4 sheet of paper. 

BY - SRI.SAURAV CHANDRA, MEMBER

1. Brief facts of the Complainant’s case are that the Opposite Party No.2 is a Nationalized Bank through which the Complainant’s husband insured his life under the PMJJBY Govt. Scheme with theOpposite Party No.1by way of auto deduction of insurance premiumfrom his Saving Bank A/c  23820110073001 towards necessary remittance to the Opposite Party No.1.

2. The husband of the Complainant died on 03.12.2019 left behind the Complainant along with his minor Son and Daughter. The Complainant being the registered nominee as well as legal and natural guardian of the said two minors, lodged insurance claim with all relevant papers before the Op No.2but, they did not settled the claim.After several time meeting with the Ops, no fruitful result came out.

3. Therefore, the Complainant lodged a complaint before the Assistant Director – Consumer Affairs Fair Business Practice (CA&FBP) on 08.12.2020 but, the Ops intentionally, willfully and deliberately not attended the mediation on 24.02.2022 and as a result the Mediation process was dropped with an advice to move before this Commission for remedy.

4. However, on 10.03.2022 the Complainant sent letters to the Ops vide Registered Post with the insurance claim against which the Op No.2 replied by giving an assurance to solve the problem shortly. But, all in vain and till filing of this suit they did not disbursed any amount to the Complainant.

5. Accordingly, the Complainant being harassed and neglectedpreferred to move before this Commission for necessary redressal.

6. The cause of action of this case arose on and from 24.02.2022and 20.03.2022 respectively.

      The complainant therefore prays for

1. To pay the ClaimAmountof Rs.2,00,000.00 with other benefit of schedule policy.

2. To pay compensation of Rs.20,000.00 for harassment, mental pain and agony.

3. To pay Interest @12% on the above claim amount.

4. To pay Litigation Cost of Rs.10,000.00 to the Complainant for conducting the case.

5. Any other reliefs as the complainant entitled to get as per the law and equity.

7. Notices were duly served upon the Opsagainst which both have contested the case by filing Written Versions.

8. While resisting the claim of the Complainant, the Op No.1in its Written Version stated inter alia that the Op No.2 being a banker is the Master Policy holder of PMJJBY policies purchased through them.Op No.2 has to deduct the annual premium as well as the yearly renewal premium from the Savings Bank A/c of their customers; those have exercised the option for Auto Debit to remit the same to the Op No.1 together with the Membership Data File for adjustment towards premium as per the MoU dated: 17.04.2015 between the Op No.1 and 2.

9. But, from the Bank Statement of the Complainant it is revealed that last premium deducted by Op No.2was for the Policy Year 2018-19 and thereafter no further premium was deducted and remitted to the Op No.1 by the Op No.2in which the unfortunate death of the complainant’s husband occurred.

10. Moreover, in the said MoU, it is clearly mentioned that on receipt of death information, Op No.2 will send the Claim Form, Death Certificate, Discharge Form and Certificate of Insurance to Op No.1 for settlement of Death Claim. But, in the instant case the Op No.1 has not received anything from the Op No.2 to process further. Even on receiving the Plaint from thisCommission against this Consumer Case No.60 of 2022,whenthe Op No.1came to know about the case, immediately contacted with the Op No.2 on 10.06.2022 over phone and email by requesting to send the Auto Debit Sheet and Claim Documents so that it can be proceed further. Getting no response, the Op No.1 again sent an email reminder on 22.06.2022 but, the Op No.2 not responded.Therefore, the Op No.1 has no Deficiency of Service in respect of such claim.

11. Under the above Op No.1 prays for rejection of the petition filed by the Complainant.

12. The Op No.2, while resisting the claim of the Complainantin its’ Written Versionstated inter alia, the claim is totally false, frivolous, baseless, illegal, incorrect and unwarranted in law and as such the petitioner is not entitled to have the relief as prayed for. Only to harass this opposite parties, Complainant have filed the instant case with false pretext. The Op No.2 is completely an innocent in this particular policy of the Op No.1 which is insured for the Complainant. The complainant had never informed to the Op No.2 about the death of her husband. Also the complainant did not submitted any documents against the death claim of her husband and never enquired before the Op No.2 about the Savings A/c of her deceased husband. Only the Complainant on 10.03.2022 by a registered letter dated: 10.03.2022 for the first time informed about the death claim of her husband to the Op No.2 by alleging false allegation against the bank which they trying to resolve.

13. The Op No.2 further states, it is a bank which acted merely as a facilitator/intermediary and the entire onus for any type of insurance claim lies on the insurance company i.e. Op No.1.The Op No.2is not responsible or liable for any kind of claims arising out of payment, part payment or non-payment of any insurance claim by the Op No.1 to an insured or her representative as per the terms and conditions of the policy by Op No.1 and has been agreed by Complainant and Op No.2 is nowhere part of such arrangement between the insurer and insured.Op No.2 has a very limited role to pay towards any insurance that is taken by its Customer’s from any Insurance Company. The Op No.2 has its role to extent of facilitating the payment of insurance premium where in the Complainant authorized Op No.2 to debit the account number of Complainant towards its premium for availing the Insurance from the side Insurance Company and forwarding the same to the Insurance Company.The Op No.2 as an intermediary/facilitator cannot be made responsible and therefore, the Op No.2 is neither on Deficiency of Service nor liable for Unfair Trade Practice in the present case.

14. Under the above Op No.2 prays for dismissal of the present case with costs.

15. Points for determination are:

1. Is the case maintainable in its present form and in law?
2. Is the Complainant entitled to the relief(s) as sought for?

16. Decision with reasons

1. Both the points I and II, being inter related to each other, are taken up together for discussion for sake of brevity and convenience.

2. We have carefully perused the materials on record includingComplaint on Affidavit,List of Documents dated: 11.04.2022, Written Versions of the Ops,Written Examination in Chief on Affidavit, Questionnaires, Reply alongwith all related papers and documents.

3. Having regards had to the facts and circumstances of the case in the light of evidence, it is evident that there is no dispute that Complainant is a consumer having grievances against the Ops, as such the case is maintainable in its present form and in law.

4. In the instant case, the Complainant produced the copy of Consent-cum-Declaration Form of Pradhan Mantri Jeevan jyoti Bima Yojona(PMJBY), where the deceased has duly consented the none but Op No.2only to Auto Debit - Annual Premium @Rs.330.00 with applicable taxes as well as Premium towards Yearly Renewal from his Savings A/c No.23820110073001 until further notice for insurance coverage up to Rs.2,00,000.00 only.

5. It is evident from the Bank Statement of the deceased, the Op No.2 duly debited the Insurance Premium against PMJBY Policy for the Policy Year 2015 on 24.06.2015, Policy Year 2016 twice on 01.01.2016 and on 25.05.2016, Policy Year 2017 on 24.05.2017 and Policy Year 2018 on 21.05.2018 but, unfortunately there is no such auto - deduction of Insurance Premium for the Policy Year 2019 in which the husband of the Complainant died and even in absence of any standing instruction towards discontinuation of Policy by the insured which is nothing but an extreme Deficiency of Service.

6. From the Mediation Report dated: 24.02.2022 as well as Notice under Memo No.51/CAPBM/39/PBM/20, dated: 02.02.2022 issued by the Assistant Director, Consumer Affairs & Fair Business Practice, Purba Medinipur it is evident, the Op No.2 is not interested to solve the grievances.

7. In the Acknowledgment Latter dated: 14.03.2022 issued by the Op No.2 against the Claim Letter dated: 10.03.2022 of Complainant is just contradictory with its’ submitted Written Version. In the said letter the Op No.2 assured the Complainant about the genuineness of her claim whereas in the Written Version it is claimed to be totally false, frivolous, baseless, illegal, incorrect and unwarranted in law. This is not only ridiculous but, not expected at all from a Nationalized Bank in repute of Op No.2.

8. Moreover, from the Written Version of the Op No.1, it is clear that the Op No.2 failed to perform its duty as per the agreed MoU between the Op No.1 & 2 by supplying the Auto Debit Sheet and Claim Documents to the Op No.1 even after given reminder in twice vide Telephone as well as Email on 10.06.2022 and 22.06.2022 respectively. Therefore, the Op No.2 is merely an intermediary/facilitator with limited role to play is not tenable at all. Although the Op No.2 has the limited role to play but it is a vital one towards extending the service of premium and document collection to forward the same to the Insurance Company towards necessary settlement. If the Op No.1 received the premium in due course, then only the question of settlement of claim from their end will arise.Therefore, the Op No.1 cannot be held responsible for the lapse committed by Op No.2 of which the Op No.2 tried to shift the burden from its’ shoulder. Rather, the Op No.2 not only harassed but caused mental pain and agony of a helpless needy Widow Nominee of the insured who left behind the Petitioner and his two minor child but, in absence of her husband deprivedthe legitimate claim during her financial crisis.

1. Now, coming to the matter of relief, the Op No.2 can’t get absolve themselves from mischief of harassment and Deficiency of Service. The Op No.2 is solely liable to pay the entireClaimof Rs.2,00,000.00; Compensation of Rs.20,000.00 andLitigation Costsof Rs.5,000.00 to the Complainant within 45 days from the date of this order;in default the Op No.2 will have to pay Simple Interest @ 10% per annum over the awarded amount from the date of filing of this petition till the date of actual realization.

1. Accordingly,both the points are decided in favour of the Complainant.

10.  Thus, the complaint case has succeeds.

Hence, it is

        O R D E R E D

That the CC-60 of 2022 be and the same isallowed against the Op No.2 and dismissed against Op No.1.

2. The Op No.2 is directed to pay the entire Claim amounting to Rs.2,00,000.00; to pay Compensation of Rs.20,000.00 and Rs.5,000.00 towards Litigation Costs to the Complainant within 45 days from the date of this order;  in default the Op No.2 will have to pay Simple Interest @ 10% per annum over the awarded amount from the date of filing of this Petition till the date of actual realization.

1. The Complainant would be at liberty to put the order into execution u/s 71 of the Consumer Protection Act, 2019 and to initiate a proceeding u/s 72 of the Consumer Protection Act, 2019.

2. Let a copy of this judgment be provided to all the parties free of cost expeditiously upon compliance of all legal formalities. The judgment be uploaded forthwith on the website of the Commission for the perusal of the parties.

3. File be consigned to record section along with a copy of this judgment.