NEW INDIA ASSURANCE CO. LTD Vs. JAGDISH CHAND

JUDGEMENT

(1.) This revision petition under Sec. 21 (b) of the Consumer Protection Act, 1986 (in short, the 'Act') assails the order of the State Consumer Disputes Redressal Commission, Haryana, Chandigarh (in short, 'State Commission') in Appeal No. 863 of 2013 dtd. 25/2/2014 arising out of order dtd. 24/9/2013 of the District Consumer Disputes Redressal Forum, Panchkula (in short, 'District Forum') in Complaint No. 153 of 2012.

(2.) The brief facts of the case, as stated by the petitioner, are that late Manoj Kumar, son of respondents 1 and 2 had opened a Savings Bank account with respondent no.3 (Axis Bank) on 7/10/2011. As per the scheme of the respondent Bank, a Debit cum ATM card was issued to the said Manoj Kumar. Respondent nos. 3 and 4 had a credit card Package Insurance Policy with the petitioner covering the risk of lost card liability and personal accident insurance subject to eligibility criteria and exceptions of the policy. On 18/11/2011 the said Manoj Kumar died in a road accident. Respondent 1 approached the respondent no. 3/Bank for payment of the accident insurance claim as nominee and was informed of the procedure required to be followed. A legal notice dtd. 5/7/2012 was issued by respondent no. 1 to which the respondents 3 and 4 replied on 14/7/2012. It is stated by the petitioner that the respondent nos. 1 and 2 neither followed the procedure for the claim nor fulfilled the eligibility criteria but sent the documents to respondents 3 and 4 on 17/7/2012 which were merely forwarded to the petitioner on 19/7/2012. It is stated that the respondents 1 and 2 made several futile efforts to have the claim released; however, respondents 3 and 4 did not honour the claim which amounted to unfair trade practice and deficiency in service and caused mental agony and harassment to the respondents 1 and 2. A consumer complaint was filed by respondents 1 and 2 before the District Forum which was contested by respondents 3 and 4. It was stated, by the respondent/ Bank by way of a written statement, that the formalities of filing all documents with the claim within 10 days of date of death had not been done and only documents were filed on 17/7/2012. It was stated that the insurance cover was an additional facility by the insurance company and there was no contract between or agreement between respondent 1 and 2 and respondent 3 and 4 and that the claim was to be settled by the insurance company. Hence, deficiency in service was denied. The insurance company/petitioner herein also denied the allegations and submitted in its written statement that the said Manoj Kumar had an accident insurance cover of Rs.2,00,000.00 with it. It was denied that any transaction had been made with the debit card and as the death was within 42 days of the opening of the account, he was not entitled to any personal accident insurance coverage benefit. It was stated that though the death occurred on 18/11/2011, respondents 1 and 2 submitted the requisite papers to the petitioner insurance company after 243 days on 19/7/2012. In view of the delay, there was no liability on the petitioner to pay the claim. It is also stated that the policy of accident cover was applicable only if a successful payment transaction at any merchant outlet was made within 90 days prior to the incident which had not been proven. It was stated that the insurance cover ranged from Rs.2.00 lakhs to Rs.5.00 lakhs based on the kind of card and as no debit card had been submitted the claim could not be considered. Finally, it was stated that there was no privity of contract between respondent 1 and the petitioner and the claim having been rightfully repudiated, there was no deficiency in service as alleged.

(3.) The District Forum allowed the complaint vide order dtd. 24/9/2013 and directed the petitioner insurance company to pay the insurance amount of Rs.5.00 lakhs under the policy along with interest at 9% per annum from the due date till actual payment. Respondents 3 and 4 were directed to pay a lumpsum compensation of Rs.10,000.00 for mental harassment and litigation cost. Aggrieved by the order of the District Forum, the petitioner preferred an appeal before the State Commission through First Appeal No. 863 of 2013. This appeal was dismissed vide order dtd. 25/2/2014 on the grounds that the respondents 1 and 2 had approached the Bank in December 2011 and submitted all relevant documents such as the post mortem report, death certificate, copy of the FIR and other documents. They were advised to open a new account to transfer the balance in the account of the deceased which was done on 20/12/2011. These facts were not denied by the respondent 3/bank nor the fact that the requisite documents were submitted within the permissible time. The petitioner herein also did not deny having provided insurance coverage covering accidental death for Rs.5.00 lakhs. The State Commission held that 'Merely because some prescribed forms were not filled up, cannot be a ground to repudiate the claim, particularly when at least the initial formalities were completed by the complainants'. This order has been impugned before us by the petitioner through the present revision petition.