FINAL ORDER/JUDGEMENT

Presented by:-

Shri Debasish Bandyopadhyay,  President.

Brief fact of this case:-This case has been filed U/s. 12 of the Consumer Protection Act, 1986 by the complainant stating that in the year 2015 said Nitya Mohan Rajbanshi (the husband of the complainant) opened a savings account vide account no. 59068556428 at Allahabad Bank Pipulpati Branch Hooghly. On 25.8.2015 Nitya Mohan Rajbanshi deposited Rs. 12/- before bank concern against Pradhan Mantri Bima Surakhkha Yojona and said bank concern (op no. 1) accepted the said amount from the husband of the complainant through auto debit system and thereafter said policy was renewed next two years and op no. 1 on 25.5.2017 and 24.5.2018 cancelled Rs. 12/- for each year against the said policy from said Nitya Mohan Rajbanshir through said bank account and said policy is valid till 23.5.2019. On 25.8.2018 said Nitya Mohan Rajbanshi when he was engaged in  work at Orient Steel & Industry Ltd. Liluah, Howrah fallen from high shed, received injury in his body/ person and he was shifted at TL Jaiswal Hospital, Liluah for treatment but due to grievous injury of said Nitya Mohan Rajbanshi, referred to Calcutta Medical College, where he was expired on 26.5.2018 due to said accident and PM examination was done accordingly.

The complainant being the nominee, after collected all necessary documents like as death certificate, PM report submitted claim against the said bima Yojona and claiming Rs. 2,00,000/- for accidental death certificate. But due to sudden death of husband, the complainant has to suffer a lot so at that time the complainant being a nominee failed to submit claim within time which is totally unintentional.

In the month of August, 2019 the complainant received ops’ notice vide reformation no. PIP/Misc./101/2019-20 dt. 24.7.2019 wherein op informed that due to delay of 262 days for filing/ submission of claim, op authority concern rejected the said claim on the ground of delay which was totally bad in law. Thereafter on 4.9.2019 the complainant requested the op to pay the said death benefit against the said policy but there were no fruitful result.

Complainant filed the complaint petition praying direction upon the opposite parties to pay a sum of Rs. 2,00,000/- along with interest and to pay a sum of Rs. 50,000/- as mental agony and to pay a sum of Rs. 50,000/- as compensation.

Defense Case:-The opposite party No. 2 contested the case by filing written version denying inter-alia all the material allegation as leveled against him and stated that the claim was time barred and as such there is no scope to indemnify. Moreover the complainant has not submitted relevant documents regarding their legal heirship to the company and fulfill the terms and conditions for which the claim is not payable. So, the instant case should be dismissed.

Issues/points for consideration

On the basis of the pleading of the parties, the District Commission for the interest of proper and complete adjudication of this case is going to adopt the following points for consideration:-

1. Whether the complainant is the consumer of the opposite parties or not?
2. Whether this Forum/ Commission has territorial/pecuniary jurisdiction to entertain and try the case?
3. Is there any cause of action for filing this case by the complainant?
4. Whether there is any deficiency of service on the part of the opposite parties?
5. Whether the complainant is entitled to get relief which has been prayed by the complainant in this case or not?

Evidence on record

The complainant and op no. 2 have filed separate petitions to treat their complaint petition and written version as their evidence on affidavit.

Argument highlighted by the ld. Lawyers of the parties

Complainant and opposite party no. 2 filed written notes of argument. As per BNA the evidence on affidavit and written notes of argument of both sides are to be taken into consideration for passing final order.

            Argument as advanced by the agents of the complainant and the opposite party no. 2 heard in full. In course of argument ld. Lawyers of both sides have given emphasis on evidence and document produced by parties.

DECISIONS WITH REASONS

The first three issues/ points of consideration which have been framed on the ground of maintainability and/ or jurisdiction, cause of action and whether complainant is a consumer in the eye of law, are very vital issues and so these three points of consideration  are  clubbed together and taken up for discussion jointly at first.

   Regarding these three points of consideration it is very important to note that the opposite parties even after appearance in this case and after filing written version, have not filed any petition on the ground of non-maintainability of this case due to the reason best known to them. Under this position this District Commission has passed the order of further hearing of this case. On this background it is also mention worthy that the opposite parties also have not filed any separate petition challenging the maintainability point, jurisdiction point and cause of action issue. The opposite parties in their written version have only pleaded the above noted points. This District Commission after going through the materials of the case record finds that the complainant is a resident of Chinsurah, Hooghly and op no. 1 has its office at Serampore, Hooghly which are lying within the territorial jurisdiction of this District Commission. Moreover, this complaint case has been filed with a claim of below 20 lakhs and this matter is clearly indicating that this District Commission has also pecuniary jurisdiction to try this case. Thus, the point of jurisdiction which has been alleged by the opposite parties cannot be accepted. Moreover, u/s 11 of the Consumer Protection Act, this District Commission has jurisdiction to try this case. The opposite parties also have raised the plea of limitation and in the written version it has been pointed out that this case is barred by limitation. But in this connection it is important to note that the provision of 24A of the Consumer Protection Act, 1986 is very important and according to the provision of Section 24A complaint case can be entertained by the District Commission or State Commission or National Commission even after expiry of 2 years if the complainant satisfies the ld. Commission that he or she has sufficient ground for not filing the case within two years. Moreover in this instant case the cause of action has been continued and thus the above noted plea of the opposite parties which has been pointed out in the written version is also not acceptable. On close examination of the pleadings of the parties it also transpires that there is cause of action for filing this case by the complainant side against the opposite parties. Moreover after going through the provisions of Section 2 (1) (d) of the Consumer Protection Act, 1986 it appears that this case is maintainable and according to the provision of Section 2 (1) (d) of the Consumer Protection Act, 1986. Complainant is a consumer in the eye of law. It is the settled principle of law that failure of the Insurance Company to comply with the contractual obligation to release claim amount in deficiency in service. This legal principle has been laid down by Hon’ble State Commission, Delhi and it is reported in 2022 (2) CPR 13 (Del).

   All these factors are clearly depicting that this case is maintainable and complainant is a consumer of the opposite parties and this District Commission has territorial/ pecuniary jurisdiction to entertain and try this case and there is also cause of action for filing this case by the complainant against the opposite parties. Thus, the above noted three points of consideration are decided in favour of the complainant.

            The point no. 4 is related with the question as to whether there is any deficiency in the service on the part of the opposite parties or not? The point no. 5 is connected with the question as to whether the complainant is entitled to get any relief in this case or not? These two pints of consideration are interlinked and/ or interconnected with each other and for that reason these two points of consideration are clubbed together and taken up for discussion jointly.

            For the purpose of deciding the fate of these two points of consideration and for the interest of getting answers of the above noted questions, there is necessity of scanning the evidence on affidavit filed by the parties and there is also necessity making scrutiny of the documents filed by the parties of this case.

            On comparative studies of the evidence on affidavit filed by the complainant with the evidence on affidavit filed by the opposite parties and on close compare of the documents filed by both parties it appears that on the following points of this case either there is admission on behalf of the both parties or the parties have not raised any dispute:

1. It is admitted fact that Nitya Mohan Rajbanshi of Olaichanditala Colony P.S. Chinsurah dies on 26.5.2018 at Calcutta Medial Collage and Hospital due to accident.
2. It is also admitted fact that said deceased Nitya Mohan Rajbanshi who is the husband of the complainant opened a savings account being account no. 59068556428 at Allahabad Bank, Pipulpapti Brach, Hooghly i.e. op no. 1.
3. There is no controversy over the issue that the deceased Nitya Mohan Rajbanshi on 25.8.2015 deposited Rs. 12/- in connection with Pradhan Mantri Bima Surakhkha Yojona of the said bank i.e. op no. 1 accepted the said amount from the deceased Nitya Mohan Rajbanshi through auto debit system.
4. There is no dispute over the issue that the said policy was thereafter renewed for 2 years and op no. 1 on 25.5.2017 and 24.5.2018 collected Rs. 12/- from the account of deceased Nitya Mohan Rajbanshi for each year.
5. It is admitted fact that on 25.8.2018 the deceased Nitya Mohan Rajbanshi was engaged in the work at Orient Steal and industries ltd., Liluah, Howrah and in course of discharging his work he had fallen down from the top most height of roof shed and sustained injury on his body.
6. It is also admitted fact that after sustaining injury said Nitya Mohan Rajbanshi was taken to T.L. Jaiswal Hospital, Liluah for treatment.
7. There is no controversy over the issue that due to severe and grievous injury of said Nitya Mohan Rajbanshi he was referred to Calcutta Medical Collage.
8. There is no dispute over the issue that said Nitya Mohan Rajbanshi expired on 26.5.2018 due to the said accident.
9. It is admitted fact that P.M. examination was done over the body of Nitya Mohan Rajbanshi.
10. It is also admitted fact that  the said P.M. examination report along with death certificate were submitted in the scheme of Pradhan Mantri Bima Surakhkha Yojona under op insurance company.
11. There is no controversy over the issue that the complainant who is the wife of deceased Nitya Mohan Rajbanshi submitted a claim of Rs. 2 lakhs for accidental death benefit.
12. There is no dispute over the issue that the op insurance company repudiated the said claim on the ground that there was delay of 262 days and heirship certificate has not been filed.                

Regarding the above noted admitted facts and information there is no necessity of passing any separate observation as it is the settled principle of law that fact admitted need not be proved. This legal principle has been embodied in Section 58 of the Evidence Act.

On the background of the above noted admitted  facts and circumstances the parties of this case are differing on the point and/ or apple of discord between the parties of this case is that the complainant is claiming that inspite of continuation of the scheme of Pradhan Mantri Bima Surakhkha Yojona by the deceased Nitya Mohan Rajbanshi, the op insurance company on flimsy grounds has repudiated the claim which indicates that the op insurance company has negligence and deficiency of service on their part but on the other hand, the op insurance company has pointed out that there was delay of 262 days in the  filing and/ or submitting of the claim by the complainant and no heirship certificate has been submitted by the complainant. For all these reasons the op insurance company has pointed out that they have no negligence or deficiency of service on their part.

            For the purpose of arriving at just and proper decision in respect of the above noted points of difference and/ or apple of discords between the parties and also for the interest of disposal of points of consideration nos. 4 and 5 this District Commission after making scrutiny of the evidence on record and also after examining the documents filed by the contesting parties of this case observed that at the time of death of deceased Nitya Mohan Rajbanshi the scheme of Pradhan Mantri Bima Surakhkha Yojona was in force and op no. 1 bank debited the amount in respect of the said scheme and for that reason the op nos. 2 and 3 cannot claim that they are not bound to pay the said claim amount of Rs. 2 lakhs to the complainant on the ground of delay of 262 days and non filing of heirship certificate. In this regard it is very important to note that the scheme Pradhan Mantri Bima Surakhkha Yojona is benevolent and/ or beneficiary scheme for the interest of the weaker section of society, day labours and daily workers and the complainant is an illiterate lady and for that reason the op insurance company has not any justification of claiming legal heirship certificate. Moreso, in the said scheme of Pradhan Mantri Bima Surakhkha Yojona there is nominee and  by considering nomination matter and also by considering other documents as such Aandhar card, PAN card and voters identity card the op nos. 2 and 3 insurance company has the scope of disbursing the said claim. In this connection the definition of service which is embodied in Section 2 (o) of the Consumer Protection Act, 1986 is very important. Over this issue it is the settled principle of law that service under Section 2(o) of the Consumer Protection Act, 1986 is wide enough to comprehend service of every description and the District Forum has the jurisdiction to entertain and try such complaint. This legal principle has been laid down by Hon’ble Apex Court and it is reported in 2022 (2) CPR 249 (SC). Thus, it is crystal clear that the ops have their fault, negligence and deficiency of service in the matter of not granting claim of Rs. 2 lakhs to the complainant. So, the above noted issues and/ or points of consideration nos. 4 and 5 which have adopted in this case are decided in favour of the complainant of this case.

In the result it is accordingly

ordered

that the complaint case being no. 18 of 2020 be and the same is allowed on contest against op nos. 2 and 3 and it is decided ex parte against op no. 1 but in part.

It is held that the complainant is entitled to get the claim of Rs. 2 lakhs from the op nos. 2 and 3 along with interest at the rate of 4% per annum from the op nos. 2 and 3.

Opposite party nos. 2 and 3 are directed to pay the said amount within 45 days from the date of this order otherwise complainant is given liberty to execute this order as per law.

            In the event of nonpayment/ non compliance of the above noted direction the opposite party nos. 2 and 3 are also directed to pay and/ or deposit Rs. 5000/- in the Consumer Legal Aid Account of D.C.D.R.C., Hooghly which is to be utilized for the purpose of poor litigant public.

Let a plain copy of this order be supplied free of cost to the parties/their ld. Advocates/Agents on record by hand under proper acknowledgement/ sent by ordinary post for information and necessary action.

            The Final Order will be available in the following website www.confonet.nic.in.