Haryana

Karnal

80/2013

Meenakshi W/o Surinder Kumar - Complainant(s)

Versus

United India Insurance Company., State Bank Of India - Opp.Party(s)

M.K. Saini

18 Aug 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                          Complaint No.80 of 2013

                                                               Date of instt. 8.02.2013

                                                               Date of decision: 28.08.2015

 

Meenakshi widow of Sh.Surinder Kumar son of Isam Singh r/o Geeta Colony, Hansi Road,Karnal..                                                           ……….Complainant.

                             Versus

1.United India Insurance Co.Ltd.near Bus stand, Karnal through its Branch Manager.

 

2.State Bank of India, Main  Branch, Shakti colony, The Mall, Karnal through its Manager.

                                                           ……… Opposite Parties.

                   Complaint u/s 12 of the Consumer

                   Protection Act.

 

Before          Sh.K.C.Sharma……. President.

                   Smt. Shashi Sharma ………Member.

                   Sh.Anil Sharma…… Member.  

         

 Present:          Sh.J.P.Singh Advocate for the complainant.

                     Sh.V.K.Gupta Advocate for  OP no.1.

                     Sh.Pankaj Malhotra Advocate for OP No.2.

ORDER:

 

                        This complaint has been filed U/s 12 of the Consumer Protection Act, 1986, on the averments that her husband obtained  domestic/silver ATM Card and gold international ATM card bearing No.6220180392300139129.  According to the said facility  he was insured by  Opposite Party ( in short OP)  no.1 for a sum of Rs.3 lacs. The facility was provided by OP no.2 with OP No.1  as he was having  an account NO. 20045115568  in OP no.2 bank.  Her husband expired on 23.3.2012 in a road accident. She approached the Ops within a period of two months,  but they paid no heed to the genuine request  for releasing the compensation of the insured amount and postponed the matter on one pretext or the other. Ultimately, legal notice with reminder dated  18.10.2012 was sent  to the OPs. Thereafter, on 2.2.2013, Ops refused to admit  genuine claim of the complainant. Thus, there was deficiency in services on the part of the Ops which caused mental agony and harassment to the complainant apart from financial loss.

 

2.                Notice of the complaint was given to the OPs. OP no.1 filed written statement controverting the claim of the complainant. Objections have been raised that complaint is not maintainable in the present  form; that  complainant is estopped by her own acts and conduct from filing the present complaint; that this Forum has got no territorial jurisdiction to  adjudicate the present complaint; that the present complaint is an abuse of the process of law and that deceased was not a primary account holder  and that the complainant failed to fulfill the terms and conditions  of free PAI cover.

 

                   On merits, it has been submitted that OP no.1 had not insured  Surinder Kumar, rather as per particulars supplied by the complainant, the policy was issued by the Senior Divisional Manager, Mumbai and not by OP no.1. It has further been averred that no intimation of loss was received by the Senior Divisional Manager, of  United India Insurance Co. Ltd. Mumbai within a period of sixty days from the date of loss, therefore, claim of the complainant was repudiated.

 

3.                The OP no.2 filed separate written statement admitting that deceased was having account with the OP no.2. It has been submitted that there is no  cause of action against OP no.2 as the deceased had only savings account with OP no.2 and the amount of premium was provided from that account by the deceased,  when he purchased the insurance cover from OP no.1.  The claim lodged by the complainant had to be settled by OP no.1  alone and no  role is to be played by the OP no.2.

 

4.                In evidence of the complainant, she filed her affidavit Ex.C1 and documents Ex.C2 to Ex.C12.

 

5.                In evidence of the Ops, affidavit of Sh.S.S.Vasudeva  Deputy Manager, Ex.OP1 and documents Ex.OP2 to Ex.OP4 have been filed.

 

6.                We have heard  the learned counsel for the parties and have gone through the case file very carefully.

 

7.                There is no dispute between the parties that deceased Surinder Kumar husband of the complainant was having savings account with the OP no.2 and he obtained domestic/silver ATM Card and gold international ATM card and as per the facility, his life was insured by Op no.1 for a sum of Rs.3 lacs. Surinder Kumar died on 23.3.2012. OP no.1 has repudiated the claim only on the ground that complainant had not  put her claim within a period of sixty days from the date of death of her husband.

 

8.                The learned counsel for the OP no.1 put a great thrust upon the contention that as per Ex.C5 and Ex.C8 claim intimation letter was to be submitted to OP no.1 within a period of sixty days of the death of ATM debit card holder  but the complainant  submitted the claim on 29.6.2012, though her husband Surinder Kumar had died on 23.3.2012. As the claim was submitted by the complainant after a period of sixty days, therefore, as per condition  of the insurance cover, her claim was rightly repudiated by the OP no.1.

         

9.                The argument advanced by the learned counsel for the OP no.1 appears to be very attractive on the face of it, if seen technically as per language of the policy,  but the same cannot be accepted under the facts and circumstances of the present case. The complainant is a young lady and she has given her age in the affidavit as 26 years.  Her husband died on 23.3.2012 in a road accident. During course of arguments, the learned counsel for the complainant orally told that father-in-law and mother-in-law of the complainant also died in the said  accident. Therefore, under such a situation the complainant being a young lady might have remained under severe mental shock and  it could not be expected from her to think  about  complying with the condition of the policy regarding submission of  claim within a period of sixty days.

 

 

 

 

 

 

 10.                  The complainant  is not highly educated lady. She may not be knowing the condition that claim was to be submitted directly to the OP no.1. She might have remained under the impression that claim was to be submitted to OP no.2, because her husband was having  account in OP no.2  and domestic/silver ATM Card and gold international ATM card were obtained by him regarding the said account. The copy of the letter Ex.C2 shows that she had moved application to the OP no.2 on 18.5.2012 well within sixty days of death of her husband.   The copy of letter dated 16.5.2012 Ex.C7 indicates that Commanding Officer, 19 Punjab under whom deceased life assured was posted as Sepoy, sought information from State Bank of India and on that bank sent the book let to guide regarding process of claiming insurance cover. It was also  clarified in the said letter that all the documents as  per enclosed book let were to be sent to State Bank of India Karnal for further process as the account of deceased life assured was in the said bank.  As per letter dated 15.6.2012, the copy of which is Ex.C9, State bank of India,  Karnal pointed out some discrepancies in the claim application submitted by the complainant and thereafter all the papers were sent to Senior Divisional Manager, of OP no.1 on 21.6.2012 as is evident from Ex.C10.  Thus, from these facts and circumstances, it is abundantly clear that complainant had submitted the claim within 60 days  of the death of her husband to State Bank of India, may be due to wrong impression or information received by the Commanding Officer under whom deceased life assured was employed.  Therefore, it cannot be said in any manner that claim was not submitted by the complainant within a period of sixty days.

 

11.               Even if, for the sake of arguments, it is accepted that claim was submitted by the complainant to the OP no.1 beyond the period of sixty days of the death of her husband, then also  that could not be a valid ground for repudiating the claim by OP no.1.All the conditions for acceptance of the insurance claim except delay in submitting the  same were substantially fulfilled and delay in  giving intimation  was not   prejudicial  to the insurer because.   The   insurance company was not prevented, because of delay, from carrying out any investigation into facts and circumstances as to whether accident and subsequent death of insured fell within  substantive condition of insurance policy and cannot be imagined that complainant could not have cooked up the story  that her husband had died in the manner stated by her.  For such view sustenance may be sought from the judgment of Hon’ble National Commission in case Reliance General Insurance Co.Ltd. Vs.Sri Avvn Ganesh  2012 (2) CLT 664. Under such circumstances, repudiation of the claim of the complainant by OP no.1 was not legally justified. Consequently, there was deficiency in services on the part of OP no.1.

 

11.               As a sequel to the foregoing discussion, we accept the present complaint and direct the OP no.1 to make the payment of the sum assured i.e. Rs.3.00 lacs to the complainant alongwith interest @ 9% per annum from the date of filing of the present complaint i.e.  8.2.2013 till its final realization. The complainant shall also be entitled for a sum of Rs.10,000/- for the mental agony and harassment suffered by him together with a sum of Rs.5500/- towards legal fee and litigation expenses.  The OP no.1 shall make the  compliance of this order within a period of thirty days from the date of receipt of the copy of this order.  The parties concerned be communicated of the order accordingly and the file lbe consigned to the record room after due compliance.

 

Announced
dated:28.08.2015                                                                            

                                                                 (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

             

(Anil Sharma)   (Smt.Shashi Sharma)

Member                  Member.

 

Present:          Sh.J.P.Singh Advocate for the complainant.

                     Sh.V.K.Gupta Advocate for  OP no.1.

                     Sh.Pankaj Malhotra Advocate for OP No.2.

 

                   Arguments heard. For orders, the case is adjourned to 28.8.2015.

 

Announced
dated:27.08.2015                                                                            

                                                                 (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

             

(Anil Sharma)   (Smt.Shashi Sharma)

Member                  Member.

Present:          Sh.J.P.Singh Advocate for the complainant.

                     Sh.V.K.Gupta Advocate for  OP no.1.

                     Sh.Pankaj Malhotra Advocate for OP No.2.

 

                   Vide our separate order of the even date, the present coplaint has been accepted. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

 

Announced
dated:28.08.2015                                                                            

                                                                 (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

             

(Anil Sharma)   (Smt.Shashi Sharma)

Member                  Member