CONSUMER DISPUTES REDRESSAL FORUM,PALAKKAD
Dated this the 15th June, 2016
PRESENT : SMT. SHINY.P.R, PRESIDENT
: SMT. SUMA. K.P, MEMBER
: SRI. V.P.ANANTHA NARAYANAN Date of filing : 09/7/2015
CC /99/2015
1. Chandrika Vijayan,
W/o.Late.Vijayakumar,
2. Veena Vijay,
D/o.Late Vijayakumar,
Both are residing at
Parvathy Nivas, Kavassery Post,
Alathur Taluk, Palakkad District : Complainants
(By Adv.M.R.Manikandan)
Vs
M/s.The New India Assurance Co.Ltd, : Opposite party
Belapur DO-170200, II Floor,
Vindhya Commercial Complex
Sector II-CBD Belapur,
Navi Mumbai-400 614
Represented by The Divisional Manager
(By Adv.P.R.Hariharan)
O R D E R
By Smt. Suma. K.P, Member,
The first and second complainant are the wife and daughter of Late. Vijayakumar, who was serving in the Defence under General Reserve Engineering Force. Mr.Vijayakumar met with an accident on 20/03/2013 near by Coimbatore Railway Station. While he was travelling in train, he alleged to have fell down from the train. An F.I.R was also registered by the Railway Police, Coimbatore with respect to the incident as crime No.181/13. The complainants are the survivors. The deceased Vijayakumar had availed loan facility of Rs.4 lakh through State Bank of India, DRASS Branch, Kargil Dist, Jammu and Kashmir and had also took a personal accident insurance policy extended to the salary package account holders as per policy No.17020042120100000493 valid from 04/01/2013 to 03/01/2014. As per the terms and conditions of the policy the opposite party will repay the loan arrears if any to the bank on the death of the insured within the period of the policy. The alleged incident was duly informed to the State Bank of India, DRASS Branch and also to the opposite party. The bank officials did not take any initiative to recover the amount from the opposite party, but, instead send communications to the first complainant to repay the amount immediately. In pursuance of the said communication the first complainant had repaid the outstanding amount of Rs.3 lakh on 14/03/2014 that too after realising the amount of Rs.1 lakh appropriated from the account of the deceased soon after his death. Thereafter the first complainant has sent several communications to the opposite party claiming the policy benefit and to reimburse the amount paid to the bank. But no positive response was received from the opposite party. On 03/12/2013 opposite party informed the complainant through their communications that information regarding the death and papers were received by them after 90 days and hence they are unable to process the claim and closing the file as “no claim”. It is alleged that the complainant had submitted all the necessary papers with respect to the death of her husband but the reason stated for the rejection is nothing but only a mockery of the entire democratic and judicial system of the country. It is the bounden duty and liability of the opposite party to pay the policy benefit and due compensations to the complainants for their inaction in the matter and the complainants is legally entitled for the same. The above act of the opposite party amounts to deficiency of service which causes mental agony and hardships to the complainants. Hence the complainants had approached before this forum with a prayer to direct the opposite party to pay the policy benefit of Rs.4lakh along with compensation of Rs.1lakh for the mental agony, deficiency of service and also to pay the entire cost of this proceedings.
Notice was issued to the opposite party for appearance. Opposite party entered appearance and filed version denying all the allegations in the complaint. The claim was closed owing to late intimation beyond 90 days from the date of death. As per the agreement between the opposite party and State Bank of India, information/intimation (death) would have to be submitted within 90 days and all documents have to be submitted within 180 days, since neither the information nor the documents were furnished within the stipulated time, the claim had to be closed. There has been absolutely no deficiency in service on the part of the opposite party as alleged in the complaint. The opposite party vide letter dated 21/05/2015 had called for the details of documents from the complainant but she has not produced it till date. The complainant has not furnished details required to process the claim. Only then the opposite party can proceed with regard to the settlement of the claim. Complainant is not entitled to any of the reliefs claimed in the complaint and hence complaint had to be dismissed.
Complainant and opposite party filed chief affidavit along with documents. Ext.A1 –A7 was marked from the part of the complainant and Ext.B1 –Ext.B2 was marked from the part of the opposite party. Evidence was closed and the matter was heard.
The following issues are to be considered.
- Whether there is any deficiency of service on the part of the opposite party?
- If so, what are the reliefs and cost?
ISSUES 1 & 2
We had perused the documents as well as affidavits filed by both the parties. It is very evident from the case of the parties that the accidental death of the Vijayakumar is not disputed and the policy coverage extended to him is also not disputed. The only contention of the opposite party was that the details of the documents to process the claim was not received and intimation was out of time hence the claim was rejected as evident from Ext.B1. It is very pertinent to note that the deceased was a Defence personnel and was serving the nation. The unexpected accidental death of Mr.Vijayakumar would definitely affect the complainants and there is no reason to disbelieve the version of the complainants that they took time to return to normalcy and that would have been the reason for them to furnish details to the opposite party. But on our view the same was not a ground to reject the claim of the complainants particularly when the other aspects were admitted by the opposite party. In the above case the opposite party has urged the complainants to file certain documents such as status of the compensation case filed before the Hon’ble Railway claims tribunal, status of the Court of Inquiry of the Military and the Legal heirship certificate. The complainants had submitted that in connection with the accident it was communicated to the complainants from the military headquarters that no court of inquiry was conducted by then in connection with the accident. The said document was produced before the forum which was marked as Ext.A5. According to the opposite party only a court of inquiry finding can ascertain whether the death can be treated as accidental death. But the nature of death is immaterial with respect to the settlement of the claim. Considering the above aspects we attribute deficiency of service on the part of the opposite party. However in the interest of justice and on humanitarian aspects we direct the opposite party to honour the claim of the complainant subject to the production of necessary documents for the settlement of the claims. The complainants shall produce all the necessary documents for the settlement of the claim before the opposite party within two weeks from the date of receipt of this order and the opposite party shall pay Rs.3,00,000/- (Rupees Three Lakh only) with 9% interest from 20/03/2013 till realization as the benefit of the policy No.17020042120100000493 within six weeks from the receipt of documents from the part of the complainants.
We also direct the opposite party to pay Rs.2,500/- (Rupees Two thousand Five hundred only) as cost of this proceedings. Complaint allowed partly as above.
Pronounced in the open court on this the 15th day of June, 2016.
Sd/-
Shiny.P.R
President
Sd/- Suma. K.P
Member
Sd/-
V.P. Anantha Narayanan
Member
A P P E N D I X
Exhibits marked on the side of complainant
Ext.A1 –Death certificate dtd.28/03/2013 issued from Coimbatore Municipality (Original)
Ext.A2– True copy of the Post Mortem certificate dtd.22/03/2013 issued from Coimbatore Medical College Hospital (Photocopy)
Ext.A3 – True copy of the FIR No.181/2013dtd.21/03/2013 from Railway Police Station, Coimbatore (Photocopy)
Ext.A4- True copy of the bank statement issued from SBI,Palakkad Branch
Ext.A5- Letter dtd.03/12/2013 issued by the opposite party to the 1st complainant (Photocopy)
Ext.A6- Legal Heirship Certificate issued by Taluk Office, Alathur dtd.31/01/2015 (Photocopy)
Ext.A7- Personal Accident insurance (Death) cover to salary package account holders of SBI dtd.27/10/2015
Witness marked on the side of complainant
Nil
Exhibits marked on the side of opposite party
Ext.B1 - Letter dtd.21/05/2015 issued by opposite party
Ext.B2- Personal Accident Insurance Policy No.17020042120100000493 issued by the opposite party (Photocopy)
Witness examined on the side of opposite party
Nil
Cost Allowed
Rupees 2,500/- as cost.
