State Consumer Disputes Redressal Commission
Icici Bank Ltd & Ors vs Smt Anagha Ajay Mulmule & Anr on 18 March, 2011
BEFORE THE HON BEFORE THE HON'BLE STATE CONSUMER DISPUTES REDRESSAL COMMISSION, MAHARASHTRA, MUMBAI First Appeal No. A/08/1615 (Arisen out of Order Dated 06/08/2008 in Case No. 309/2006 of District Thane) 1. ICICI BANK LTD & ORS LAND MARK, ALKAPURI, RACE COURSE ROAD, WADODARA, WADODARA GUJARAT 2. The Managing Director ICICI Home Finance Co. Ltd., ICICI Bank Tower, Bandra Kurla Complex, Mumbai - 51 Mumbai Maharashtra 3. The Manager, ICICI Home Finance Co. Ltd., Woodmall Plaza, Teen Hath Naka, L.B.S. Marg, Thane (W), Thane Maharashtra ...........Appellant(s) Versus 1. SMT ANAGHA AJAY MULMULE A/303 ASHISHDEEP CHS PHULE ROAD MAHARASHTRA NAGAR DOMBIVALI (W) THANE Maharastra 2. National Insurance Company Office No. 101/102, Parekh Market, M. G. Road, Ghatkopar (E), Mumbai - 400 077. Mumbai Maharashtra ...........Respondent(s) BEFORE: Hon'ble Mr. P.N. Kashalkar PRESIDING MEMBER Hon'ble Mrs. S.P.Lale Member Hon'ble Mr. Dhanraj Khamatkar Member PRESENT: Mr.A.A.Dhumal,Advocate, Proxy for ASHISH GOGATE, Advocate for the Appellant Mrs.V.J.Kulkarni, Advocate for the Respondent Ms.Malini Rai, Advocate for the Respondent ORDER
Per Smt.S.P.Lale, Honble Member This appeal has been filed by the original O.P. against the order dated 06/08/2008 passed by the District Consumer Disputes Redressal Forum, Thane in consumer complaint no.309/06 whereby, forum directed opponent nos.1 to 3 and National Insurance company to pay the policy claim jointly and severally to the complainant. Forum further directed opponents to pay the amount of the policy with all the benefits and reliefs of the Free Personal Accident Coverage to the complainant along with interest @ 9% p.a. from 15/5/2005 to 06/08/2008. Forum further directed to pay `5000/-
as compensation to opponent nos.1 to 3 and National Insurance company and `3000/-
as cost. Being aggrieved by the said order, opponent nos.1 to 3 have filed the present appeal.
Complainant is a co-borrower of the Loan A/c no.LBMUM00000399783 of which her late husband Ajay Manohar Mulmule was a Principal borrower. They had taken home loan from ICICI Bank (opponent nos.1 to 3). It is the allegation of the complainant that the opponent had agreed to provide Free Personal Accident Insurance coverage to the Principal borrower i.e. late husband of the co-borrower. According to complainant her husband died on 27/02/2005 due to an accident i.e. while he was climbing the stairs he fell down by slip and died. Doctor issued Death certificate giving cause of death as Acute Cardiac Arrest and Heart failed. Therefore, complainant lodged her claim with opponent nos.1 to 3. In turn opponent nos.1 to 3 forwarded her claim to opponent no.4. However, opponent no.4 repudiated the claim of the complainant on 15/05/2006 on the ground that owing to cardiac arrest Mr.Ajay Mulmule collapsed from the steps of stairs of the building and as per policy condition only accidental death is covered. Hence opponent no.4 repudiated the claim of the complainant. Being aggrieved by the repudiation by opponent no.4, complainant filed consumer complaint for deficiency in service against the opponents.
Opponent nos.1 to 3 filed its written statement and pleaded that complainant and her husband had obtained Home loan from opponent no.1. While giving said loan, opponent no.1 had granted gratuitous facility of Personal insurance for the applicant no.1 of the Home loan. It further pleaded that opponent no.1 is not doing business of insurance and opponent no.4-National Insurance company had undertaken to provide Free Personal Accident Insurance cover to all who took home loan from opponent no.1. When the complainant has lodged the claim with opponent no.1, opponent no.1 had forwarded the same to National Insurance company. Ultimately, National Insurance company opponent no.4 repudiated the claim on 15/05/2006. As such, opponent nos.1 to 3 have not rendered any deficiency in service and they are not liable to pay any compensation to the complainant.
Opponent no.4 also filed written version and pleaded that they had issued Group Personal Accident policy in favour of M/s.ICICI Home Finance Co. Ltd. The group which was covered under the said policy comprised of the borrowers of ICICI Home Finance Co.Ltd. during the particular period. It further pleaded that risks covered were restricted only to the accidental death for the borrowers and the limit of insurance cover was upto the loan sanctioned and disbursed or whichever is lower.
It further pleaded that as per the claim form submitted by opponent no.1 of deceased Ajay Mulmule it was revealed that the Post Mortem was not conducted in spite of death being not natural, and on scrutiny of the papers, it was found that actual cause of death was a massive cardiac arrest. In fact the death was result of the massive cardiac arrest and not accidental death. Therefore, opponent nos.1 to 3 have repudiated the claim and, finally, pleaded for dismissal of the complaint.
On considering affidavits and documents placed before it, Ld. District Consumer Disputes Redressal Forum partly allowed the complaint as per the order referred above. It is an admitted fact that the deceased Ajay Mulmule had obtained Home finance from M/s.ICICI Home Finance Co. Ltd. i.e. from opponent nos.1 to 3 and opponent no.4 had issued Group Personal Accident policy in favour of M/s.ICICI Home Finance Co. Ltd. i.e. opponent no.1 and the group which was covered under the said policy comprised of the borrowers of M/s.ICICI Home Finance Co.Ltd. Husband of the complainant deceased Ajay Mulmule was principal borrower and the complainant was a co-borrower of the said loan. Husband of the complainant died while he was climbing stairs. Doctor certified his death as Acute Cardiac arrest and heart fail. Complainant lodged claim with opponent no.1 and opponent no.1 forwarded claim to opponent no.4. Opponent no.4 repudiated the claim on the ground that as per policy conditions only accidental death is covered. No FIR and post mortem report was filed by the complainant. Complainant had filed certificate of Dr.Prithvi of Life Line Hospital, Dombivali in which doctor has certified that death is due to Acute Cardiac Arrest and Heart fail. Therefore, death on account of heart stroke cannot be termed as accidental death. Under these circumstances, we are unable to accept the finding of the District Consumer Disputes Redressal Forum that the heart stoke is an accident. Opponent no.4/National Insurance Co. was justified in repudiating the claim and there was no deficiency in service on the part of appellant. We are therefore inclined to dismiss the complaint by allowing this appeal. Order passed by the forum is erroneous and bad in law. In the result, we pass following order:-
ORDER Appeal is allowed.
Impugned order dated 06/08/2008 passed by the District Consumer Disputes Redressal Forum, Thane in consumer complaint no.309/2006 is quashed and set aside.
Complaint stands dismissed.
Amount deposited by the appellant may be refunded to the appellant with accrued interest, if any.
Copies of the order be furnished to the parties.
Dated 18th March, 2011.
[Hon'ble Mr. P.N. Kashalkar] PRESIDING MEMBER [Hon'ble Mrs. S.P.Lale] Member [Hon'ble Mr. Dhanraj Khamatkar] Member Ms.