District Consumer Disputes Redressal Commission ,Faridabad.
Consumer Complaint No.105/2020.
Date of Institution: 18.02.2020.
Date of Order:09.09.2022.
Molly Antony W/o Antony Joseph, H.NO. 562, Sunlight colony – 1, Kilokari, Ashram, New Delhi – 110 014.
…….Complainant……..
Versus
1. The New India Assurance Co. Ltd., Mumbai LCBO-II (990000), New India Centre, Ground floor, 17 Cooperage Road, Mumbai – 400 039..
2. M/s. Axis Bank Limited, Represented by its Managing Director, Axis House, C-2, Wadai International Centre, .P.B.Marg, Worli, Mumbai – 400 025.
3. Branch Manager, M/s. axis Bank Limited, Neelam Batta Chowk, Faridabad.
…Opposite parties……
Complaint under section-12 of Consumer Protection Act, 1986
Now amended Section 34 of Consumer protection Act 2019.
BEFORE: Amit Arora……………..President
Mukesh Sharma…………Member.
Indira Bhadana………….Member
PRESENT: Sh. Jojo Jose, counsel for the complainant.
Sh. D.K.Gosain, counsel for opposite party NO.1.
Shri J.S.Yaduvanshi, counsel for opposite parties Nos.2 & 3.
ORDER:
The facts in brief of the complaint are that deceased Antony Joseph was an Axis Bank International Debit Card user with card number 4173490008923118 and account No. 91010065442180. He was a staff of R.G.Stone Hospital, Faridabad while he was using the Axis Bank International Debit Card. Complainant was the nominee of the deceased Antony Joseph. On 11.02.2019 at around 8 a.m. when the Antony was alighting from the bus to the road side, suddenly one i20 car came from Neelam Chowk side with high speed and in a rash and negligent manner, that too without adhering traffic rules hit against Antony Joseph and in the result the deceased fallen on the road and his head and body injured seriously. He was taken to the hospital and he succumbed to death on 28.04.2019 in AIIMS Trauma Centre. On 11.02.2019, the SHO of the concerned police station registered an FIR, a FIR No. 0074/11.02.2019 u/s 279/337 of IPC colony. Late Antony was an Axis Bank International Debit Card user, which was covered by Personal Accident Insurance of Rs.2,00,000/- as insured with the New India Assurance Company Limited. The complainant approached the opposite party No.3 and claimed the insurance amount covered by the debit card. The Branch Manager gave a check list for the submission of the form and documents required for the same. It was specifically mentioned in that check list that the form should be submitted within the 90 days of the death. The complainant submitted the application form on 26.07.2019 duly filled application form within the stipulated period as mentioned in the check list. Vide letter dated Nil opposite party rejected the claim on the ground that the claim documents were submitted with delay. It was submitted that the claim of the complainant was submitted within the stipulated period. The aforesaid act of opposite parties amounts to deficiency of service and hence the complaint. The complainant has prayed for directions to the opposite parties to:
a) pay a sum of Rs.2,00,000/- as personal accident insurance benefit with interest @ 18% from the date of accident.
b) pay Rs.50,000/ - as cost.
2. Opposite party No.1 put in appearance through counsel and filed written statement wherein Opposite party No.1 refuted claim of the complainant and submitted that the complainant had neither any cause of action nor locus standi to file the present complaint. It was submitted that on receipt of claim papers in respect of Antony Joseph, after going through the said claim paper, the replying opposite parties arrived to a conclusion that the claim was rejected on the grounds of delay in submissions of claim documents vide claim rejection letter sent Axis Bank Limited (Opposite party No.2) by the replying opposite party. Opposite party No.1 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
3. Opposite parties Nos.2 & 3 put in appearance through counsel and filed written statement wherein Opposite parties Nos.2 & 3 refuted claim of the complainant and submitted that regarding sustaining of injury on 11.02.2019, treatment and death of Antony Joseph at AIIMS Trauma Centre on 28.04.2019 were denied. It was further submitted that the Personal Accident Insurance was covered subject to the terms and conditions of the Insurance Policy. It was submitted that the complainant submitted the documents on 26.07.2019 and the opposite party No.3 uploaded the documents and sent the same on the portal of opposite party No.1 on 30.07.2019. It was submitted that the opposite party No.1 rejected the claim of the complainant on the ground that the documents were submitted after the expiry of stipulated period of 60 days from the date of death. In the present complaint deceased died on 28.04.2019, therefore, the claim form would have been filed on or before 27.06.2019, therefore the opposite party No.1 rejected the claim of the complainant. It was submitted that it was the duty of opposite party No.1 to decide the claim of the complainant and accordingly the opposite party No.1 rejected the claim of the complainant on the account of delayed submission of documents. Opposite parties Nos.2 & 3 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
4. The parties led evidence in support of their respective versions.
5. We have heard learned counsel for the parties and have gone through the record on the file.
6. In this case the complaint was filed by the complainant against opposite parties – New India Assurance Co. Ltd. with the prayer to : a) pay a sum of Rs.2,00,000/- as personal accident insurance benefit with interest @ 18% from the date of accident. b) pay Rs.50,000/ - as cost.
To establish his case the complainant has led in his evidence Ex.CW1/A – affidavit of affidavit of Molly Antony wife of late Shri Antony Joseph, Ex.C-1 – Adhaar card, Ex.C-2 – FIR, Ex.C-3 – Death certificate, Ex.C-4 – Check list, Ex.C-5 – Personal Accident Insurance Claim Form,, Ex.C-6 – Claim Rejection Letter, Ex.C-7 – letter written by the complainant to Axis Bank, Ex.C-8 – Postmortem report, Ex.C-9 – final report.
On the other hand counsel for the opposite party No.1 strongly agitated and opposed. As per the evidence of the opposite party No.1 , Ex.RW1/A – affidavit of Shashi Parkash – Sr. Divisional Manager, New India Assurance Co. ltd., Faridabad.
7. In this case, counsel for the complainant argued that deceased Antony Joseph was an Axis Bank International Debit Card user with card number 4173490008923118 and account No. 91010065442180. On 11.02.2019 at around 8 a.m. when the Antony was alighting from the bus to the road side, suddenly one i20 car came from Neelam Chowk side with high speed and in a rash and negligent manner, that too without adhering traffic rules hit against Antony Joseph and in the result the deceased fallen on the road and his head and body injured seriously. He was taken to the hospital and he succumbed to death on 28.04.2019 in AIIMS Trauma Centre. Late Antony was an Axis Bank International Debit Card user, which was covered by Personal Accident Insurance of Rs.2,00,000/- as insured with the New India Assurance Company Limited. The complainant approached the opposite party No.3 and claimed the insurance amount covered by the debit card. The Branch Manager gave a check list for the submission of the form and documents required for the same. The complainant submitted the application form on 26.07.2019 duly filled application form within the stipulated period as mentioned in the check list. Vide letter dated Nil opposite party rejected the claim on the ground that the claim documents were submitted with delay.
8. Counsel for opposite parties Nos.2 & 3 argued that the Personal Accident Insurance is covered subject to the terms and conditions of the insurance policy. Opposite party No.3 submitted did not provide check list to the complainant. The alleged document attached with the complaint does not bear and stamp signature of opposite parties Nos.2 & 3. He further argued that the complainant submitted the documents on 26.07.2019 and the opposite party No.3 uploaded the documents and sent the same on the portal of the opposite party No.1 on 30.07.2019. Opposite party No.1 rejected the claim of the complainant on the ground that the documents were submitted after the expiry of stipulated period of 60 days from the date of death.
9. After going through the evidence led by the parties, the Commission is of the opinion that the complainant submitted the documents on 26.07.2019 and the opposite party No.3 uploaded the documents and sent the same on the portal of the opposite party No.1 on 30.07.2019. Hence, opposite party No. 1 is liable to first pay to the complainant an amount of Rs.2,00,000/- and after that opposite party No.1 will recover the amount from opposite parties Nos.2 & 3. Resultantly , the complaint is allowed.
10. Opposite party No.1 is directed to pay:
a) pay Rs.2,00,000/- as personal accident insurance benefit alongwith interest @ 6% p.a. from the date of filing of complaint till its realization.
b) pay Rs.2200/- as compensation for causing mental agony and harassment.
c) pay Rs.2200/- as litigation expenses.
Opposite party No.1 is liberty to recover the above said amount from the opposite party No.2 &3. Compliance of this order be made within 30 days from the date of receipt of copy of this order. Copy of this order be sent to the parties concerned free of costs. File be consigned to the record room.
Announced on: 09.09.2022 (Amit Arora)
President
District Consumer Disputes
Redressal Commission, Faridabad.
(Mukesh Sharma)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
(Indira Bhadana)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
