DATE OF DISPOSAL: 27.05.2019
Sri Karuna Kar Nayak, President.
The complainant V.Nageswar Patro, has filed this consumer complaint Under Section 12 of the Consumer Protection Act, 1986, alleging deficiency in service against the Opposite Parties ( in short the O.Ps) and for redressal of his grievance before this Forum.
2. Briefly stated the case of the complainant is that he is a physician, practicing at Berhampur and was working under City Hospital, Berhampur for years together. During his tenure at City Hospital with the advice of the O.P.No.1 the complainant has opened a Savings Account vide No. SSB A/C No. 10395 under the head of “SURAKSHYA” Savings Bank of Rushikulya Gramya Bank. Subsequently it was renamed as Utkal Grameen Bank corresponding to new Saving Account vide SSB A/C No. 13530039959. The said savings account was opened in the name of the complainant and his spouse namely Smt. V.Pramila Devi jointly. The complainant is the first holder and his spouse was the second account holder. The O.P.No.1 is a banking organization, expand its banking territory across the Ganjam District under the name and style of Rushikulya Gramya Bank and subsequently it is renamed as Utkal Grameen Bank. To expand its business with attractive activities and by implementing various proposals with collaboration other insurance sectors, the O.P.No.1 convey the same among the account holders. The O.P.No.2 is the said insurance sector on which assistance the said policy came to day light. While opening of the said savings account the O.P. No.1 has assured the complainant that the above account was meant for coverage of insurance for joint account holders. If one of the joint account holder met with untimely death then the other account holder is entitled for the insurance coverage of Rs.1,00,000/-. So the complainant being motivated by the O.P.No.1 and to secure his future opened the said account before the O.P.No.1 and paid the insurance premium up to 02.03.2015. As the matter stood thus the spouse of the complainant met with a burn accident on 19.08.2014 and the complainant being a physician treated his wife till 27.08.2014 and when the condition of his became serious then admitted at Institute of Medical Science & SUM Hospital, Bhubaneswar on 27.08.2014 at 07.50 P.M. but to complainant’s misfortune his wife succumbed to death because of septicemia, renal failure and cardiac arrest on 02.10.2014. The said fact is also intimated to the Registrar, Births and Deaths, Bhubaneswar Municipal Corporation for its registration and the authority has also issued death certificate vide No. 4934/2014 dated 23.12.2014 in the name of his wife. After passing out of the hard days of sad demise of his wife, the complainant searched for the insurance benefit of his wife, the complainant searched for the insurance benefit of the said ‘SURAKSHYA’ savings account and applied for the account statement of the said account. On receipt of the account statement the complainant came to know that the O.P.No.1 is regularly credited the insurance coverage amount from the savings account for Rs.1191/- till 02.03.2015. So, it is clear that the insurance coverage was in force till the death of joint holder of the said savings book. Thereafter the complainant made an application before the O.P.No.1 regarding the insured amount of Rs.1,00,000/- upon the said demise of the joint holder by condoning the delay on 30.07.2015 and the same was duly acknowledges on the same day by the O.P.No.1. On receipt of the claim application the O.P.No.1 has forwarded the same to the O.P.No.2 for its redressal and claim form for submitting death claim on 31.10.2015 vide letter No. UGB/BAM/173/2015-16. But no steps has been taken by the O.P.No.1 in respect of supply of the claim form and remain silent for two months, once again on 19.12.2015 the complainant made another application for early disposal of the same. After sleeping over the same for five months on the oral approach to the O.P.No.1 by the complainant, they handed over a paper by simply denying for consideration of the death claim of the joint holder on 07.04.2016. Non-compliance of the benefits covered under the “SURAKSHYA” savings pass book by the O.P.No.1 amounts to deficiency of service. So in due deficiency in service by the O.Ps, the complainant is put to irreparable loss and injury and deprived of getting the benefit of the savings pass book and fraud play by the O.Ps. For such deficiency in service the complainant put into unnecessary litigation and mental agony. Alleging deficiency in service on the part of the O.Ps the complainant prayed to direct the O.Ps to pay the sum assured as per the policy made at the time of opening of the account alongwith interest @18% per annum till realization and also award compensation of Rs.20,000/- for mental agony and Rs.10,000/- towards cost of litigation in the best interest of justice.
3. Upon notice, the O.P.No.1 filed version through his advocate. It is stated that the allegations made in the complaint petition filed by the complainant are all not true the complainant is put to strict proof of the same. The complainant has opened a SB A/C No. SSB 10395 with the O.P.No.1 is not correct. The complainant looking into his convenient, facility and service of the Bank on his own motion has opened the account. The other allegations made in the petition that the O.P.No.1 has assured the complainant that the above account was meant for coverage of insurance for joint account holder or that if one of the joint account holder met with untimely death then the other account holder is entitled to the insurance coverage of Rs.1,00,000/- or that the complainant being motivated by the o.P.No.1 paid the insurance premium up to 02.03.2015 are all false created for the purpose of this case. The Utkal Grameen Bank has only provided referrals to facilitate customers and to serve customers on good faith and also acting as policy holder on behalf of customers/account holders. In case of any valid claim the insurer whose liability is attached to him. There cannot be any liability by the Bank. The Bank has no license for insurance business. The bank has only banking business not the authority of insurance business. Once the account holder deposit the amount towards the premium as per the guide line of insurer and the insurer accepts such premium in such case the Insurance Company is liable for the valid and genuine claim. The agreement of insurance is in between the applicant and the insurer. The claim if any is enforceable by law is against the O.P.No.2/insurer, who is to indemnify the liability if any. The Bank always act as a policy Holder on behalf of customers and stands as same footing and same line with the policy holder. In case the applicant is legally entitled to get the legitimate amount, the O.P.No.2/Insurance Company Ltd. is to pay the required amount and is to indemnify the payment in case the claimant is legal entitled to get claim amount as the contract is well between insured and the Insurance Company and any infringement made there in is enforceable against the Insurance Company who is legally answerable and liable to pay the claim amount. The bank has only provided referrals to Insurance Company. The bank shall not make any warranties about the insurance product. The complainant being a doctor might have managed to create the documents as the later stage to claim, being shown as burnt injury. The complainant is a qualified doctor and is a literate person and the continuous suffering shall have to be intimated to the Bank and insurer. The death of the complainant’s wife could have been ascertained if Post Mortem report could have been brought, which the complainant knows very well. The injury if any caused to the deceased might have been nexus with death has to be proved. The complainant has to show by documentary evidence that there is burnt injury and for the said injury the death is caused. The complainant is also to disclose by documentary evidence as to whether the burnt injury is self-injury or suicidal or attempt to commit suicide or accidental or from her negligence etc. for the investigation by insurance company. The fact goes on record shows and concludes that the documents are created and produced after thought. As it discloses there the complainant has suppressed the facts and not come up with clean hands and the complaint petition is liable to be dismissed. The complainant very well know that the Bank as a social measures of providing insurance cover at reasonable and affordable cost to the customers. The insurance coverage was introduced called “PAI SB” with facility of personal Accidental Insurance w.e.f. 01.11.2013. In the said scheme in case of joint accounts the 1st name appearing in the account shall be the insured person. The account holder has to pay the amount of Rs.25/- towards premium and administrative charges. The premium amounts are being remitted to the Insurance Company/ The New India Assurance Company. The procedure for claim that the nominee should intimate about the event to the Insurance Company through the concerned branch within 30 days. In case of death the claim papers along with death certificate, Post mortem report and final investigation report of police with required documents are to be submitted within 90 days. The complainant has not done so. In the matter of the settlement of claim rest with the Insurance Company, Utkal Grameen Bank acts as a facilitator and takes no responsibility whatsoever in settlement of claims by the Insurance Company. So the Bank has no liability for such claim. The complainant submitted the application alongwith incomplete documents on 30.07.2015 at a late stage and assured to submit the other required documents but did not submit the required documents for his claim, then another letter submitted claiming compensation on 19.12.2015 without submitting the required papers. Since there is no insurance coverage to the deceased (the wife of the complainant) as she is not the 1st account holder, the O.P. number intimated vide letter dated 07.04.2016 stating that the insurance was done and premium was deducted for the 1st Holder- V.Nageswar Patro. As there is no insurance coverage for the 2nd Account Holder the claim will not be considered however the Bank has forwarded the application to the Insurance Company. The said letter was received by the claimant on 07.04.2016. So the complainant is not liable to get the insurance claim at all. In case any such claim is there the insurer- O.P.No.2 who is liable to indemnify the claim if any to the applicant. The Bank has well discharged his duty as a Banker with UTMOST GOOD FAITH and has not done any high handed action. The Bank has not done any deficiency of service. Hence the O.P.No.1 prayed to dismiss the case against him.
4. Upon notice the O.P.No.2 filed written version/written argument through his advocate. It is stated the averments made in the complaint are all not true and correct and the complainant is put to strict proof of the same. As per the policy agreement, the first name of the joint account holder is insured person. He is exclusively covered under the JPA policy. In the present case, the deceased’s name has mentioned as second in the joint account holder. Hence the deceased V.Pramila Devi’s name has not covered under the insurance policy. Hence the present claim is not maintainable and the same is liable to be dismissed. The O.P.No.2 has filed a list of documents containing letters, agreement, insurance policy and the copy of the joint S.B. Account issued in favour of the complainant. As the deceased is the second account holder of S.B. joint account, hence her risk is not covered under the insurance policy and agreement. The complainant is well aware about the exclusive coverage of his name as list. Account holder of S.B. joint account under the JPA policy. Inspite of this, the complainant has unnecessarily dragged the O.Ps to the present Forum. Keeping in view of the above facts and circumstance and insurance coverage of the 1st account holder as per the agreement and JPA insurance policy, the second account holder of SB Joint account is not covered. Hence the O.P.No.2 prayed the present claim is not maintainable and the same is dismissed.
5. On the date of hearing both parties are present. We heard arguments from both sides at length. We have gone through the case record and also perused the complaint petition, written version, written argument and documents available on the case record. It reveals that the complainant and his wife Smt. V.Pramila Devi are the joint account holder bearing account number S.S.B. 10395 of O.P.No.1’s Bank. It also reveals from the complainant’s joint account number that prior to 1.11.2013 the premium amount of insurance has been deducted from the complainant’s joint account number 13530039959. Further it reveals after amalgamation of Rushikulya Gramya Bank to Utkal Gramya Bank one agreement has been executed between the Bank Authority and Insurance Authority, wherein it is very clearly mentioned that in case of joint account holders, the first name appears in the account shall be the insured person. After perusal of the pass book it reveals that the present complainant V.Nageswar Patro, is the first account holder and his wife Smt. V.Pramila Devi is the second account holder of the joint account. It is pertinent to mention here that the wife of the complainant expired on 02.10.2014 after the agreement of the O.Ps came in to force.
6. From the foregoing discussion it is clear evident that the second account holder Smt. V.Pramila Devi has not been insured as per the terms and conditions of the agreement executed between the O.Ps on 01.11.2013. Hence, in our considered view the O.Ps are not negligent in rendering proper service to the complainant as such there is no deficiency in service on the part of the O.Ps.
Resultantly the case of the complainant is dismissed on contest against the O.Ps. No order as to cost.
The order is pronounced on this day of 27th May 2019 under the signature and seal of this Forum. The office is directed to supply copy of order to the parties free of cost and a copy of same be sent to the server of
