State Consumer Disputes Redressal Commission
Smt. Bhuri Bai Yadav vs The Oriental Insurance Co. Ltd. on 22 January, 2011
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION
PANDRI, RAIPUR
Appeal No.264/2009
Instituted on 03.06.09
Smt. Bhuri Bai Yadav, W/o Late Chinta Ram Gopal (Yadav),
R/o Qr. No. M 450 Vikas Nagar, Kusmunda,
Dist. KORBA (C.G.) ... Appellant.
Vs.
1. The Oriental Insurance Co. Ltd., Through Divisional Manager,
Divisional Office, Rama Trade Centre, Bus Stand,
BILASPUR (C.G.)
2. Oriental Bank of Commerce, Indu Chowk,
BILASPUR (C.G.) ... Respondents.
PRESENT: -
HON'BLE JUSTICE SHRI S.C. VYAS, PRESIDENT
HON'BLE SMT. VEENA MISRA, MEMBER
COUNSEL FOR THE PARTIES: -
Shri Mukesh Sharma, for appellant.
Shri Ghanshyam Patel, for respondent no.1.
Shri R.K. Gupta, for respondent no.2.
ORAL ORDER
Dated: 22/01/2011
PER: - HON'BLE JUSTICE SHRI S. C. VYAS, PRESIDENT This appeal is directed against order dated 13.05.09, passed by District Consumer Disputes Redressal Forum, Bilaspur (hereinafter called "District Forum" for short), in complaint case No.294/07, whereby the complaint of the appellant herein has been partly allowed and the respondent insurance company has been directed to pay within two months, the amount which was due against the deceased, of the housing loan obtained by him, till his date of death, deducting the amount which was already deposited by him with the Bank, either to the Bank respondent No.2 Oriental Bank of Commerce or to the // 2 // complainant. It has further been directed that if the amount is paid to the complainant then, she will provide certificate regarding her nomination by the deceased insured or succession certificate before getting that amount. Apart from it, the insurance company is also directed to pay Rs.5,000/- by way of compensation to the complainant and Rs.1,000/- as cost of litigation. This appeal has been preferred for enhancement of the awarded amount.
2. The case before District Forum was that husband of the complainant, namely Chintaram Gopal was working with SECL. During his lifetime he purchased a house from Geetanjali Constructions, Bilaspur and applied for loan of Rs.5,00,000/- to respondent No.2 for purchasing that house. For the purpose of securing that loan a policy was issued by respondent No.1 in the name of deceased Chintaram, insuring life of the deceased Chintaram against fire, explosion, self-ignition, lightning, accidental external means under Awas Rin Beema Kavach Policy. It has been averred by the complainant that later on the Chintaram died accidentally and claim was preferred before the insurance company for payment of the loan amount, but the insurance company unnecessarily delayed the matter and had not paid any amount to the Bank or to the complainant. Thereafter, the respondent No.2 Bank in terms of the agreement, between deceased Chintaram and the Bank, repossessed the house and // 3 // sold it for recovery of the loan amount. It is alleged that the insurance company as well as the Bank, both committed deficiency in service and deprived the complainant / appellant from her house and from the amount of insurance on the life of the deceased Chintaram.
3. Respondent No.1 / insurance company in reply averred that it demanded the VISARA report of the deceased vide letters dated 14.02.06, 23.02.06 and 23.03.06, but the VISARA report was not filed by the complainant and so the claim case was closed. But, later on respondent No.2 sent to it the VISARA report of the deceased, from which it was found that the deceased was driving the vehicle under influence of liquor, which was violation of terms of the policy and so the insurance company was not required to pay any amount to the complainant and it has committed no deficiency in service in not paying any amount.
4. The Bank in its separate reply has averred that it has taken action under the terms of the agreement and as per the provisions of Securitisation and Reconstruction of Financial Assets and Enforcement of Security Interest Act 2002, the complainant was required to prefer appeal before a competent tribunal constituted for that purpose, but the complainant has not followed that procedure by not filing such appeal and unnecessarily filed the complaint against the Bank. For the // 4 // purpose of filing complaint, the complainant / appellant does not come in the category of „consumer‟ of the respondent No.2 and so the complaint is not maintainable against the Bank.
5. Learned District Forum after having considered the material placed before it by all parties, allowed the complaint to the extent, as described in paragraph No.1.
6. We have heard arguments of all parties and perused the record of the District Forum.
7. Counsel for the complainant submitted that the insurance company had unnecessarily delayed payment of the sum assured on flimsy grounds and on account of this unnecessary delay, the respondent No.2 put the house on auction and sold it. Thus, she was deprived of her house on account of negligence committed by the insurance company which was a gross deficiency in service, for which compensation is liable to be paid by the insurance company. It has further been argued that the District Forum in the impugned order has not awarded any interest on the amount to be paid by the insurance company to the complainant, though the payment was unnecessarily delayed by the insurance company for years together.
// 5 //
8. It has also been argued that the complainant is wife of the deceased insured and nobody has objected that she is not entitled of the sum assured and the reliefs claimed for, but even then though there was no pleading on behalf of any party, the District Forum has unnecessarily imposed condition of producing succession certificate or nomination certificate before receiving the amount of award.
9. Per contra counsel for the insurance company submitted that as per Section II clause 4 of the insurance policy, the insurance company was required to pay only that much amount which was outstanding in the loan account of the deceased on the date of his death, in the Bank Books. He submitted that the District Forum has awarded that amount therefore, this award calls for no interference. It has also been argued that as per provisions of section 5, Excluded Perils, of the insurance policy, there was exclusion clause in respect of payment of compensation on account of death of the insured while under the influence of intoxicating liquor or drug. VISARA for chemical examination was sent, so demand of filing VISARA report was made from the complainant and which was not entertained so the claim of the complainant was delayed.
10. From the record, we find that the deceased died on account of fall of swagat dwar, which might have been put on the way for the // 6 // purpose of welcoming some personality. Thus, the death of the deceased was purely accidental and his driving had not played any role in such mode of death. If the concerning autopsy surgeon had sent some portion of VISARA for chemical examination, then looking to the nature of accident, it was not necessary for the insurance company to delay payment of sum assured for want of VISARA report. We further find that the VISARA report was not demanded from the complainant / appellant. The complainant / appellant is an illiterate lady, who simply puts her thumb impression on the papers. On the complaint before District Forum also there appears only her thumb impression, but the letters which were addressed by the insurance company for demanding VISARA report, were addressed to deceased Chintaram Gopal and were also in English. Thus, neither those letters were addressed to the complainant not were written in any local language or Hindi, and no evidence has been filed of sending those letters nor any postal receipt has been filed. These circumstances show that the demand of VISARA report was merely a delaying tactic on the part of the insurance company, which comes in the category of deficiency in service.
11. Ultimately, VISARA report was sent to the insurance company by respondent No.2 Bank. In the VISARA report it was mentioned that ethyl alcohol was found in the abdomen and intestine of the // 7 // deceased. If he had consumed some quantity of alcohol then also mere consumption, up to some extent, is not sufficient to avoid liability under the provisions of section 5.2.2 of the insurance policy, because as per the provision of the policy the person was required to be under the influence of intoxicating liquor or drug, and mere consumption of intoxicating liquor is not sufficient to show that the person was under
influence of liquor. So, we find that the insurance company has unnecessarily delayed payment of sum assured and so it is liable to pay compensation in the form of interest, on the amount awarded by the District Forum.
12. The statement of account of Oriental Bank of Commerce has been filed before us by the Bank and agreed by the complainant. From this statement of account, it appears that on 28.06.05, the outstanding amount in the loan account was Rs.4,78,628/-. This amount is liable to be paid by the insurance company along with interest @ 6% p.a. to the complainant on account of deficiency in service.
13. So far as contention regarding producing succession certificate is concerned, we find that there is no dispute between the parties that the complainant is entitled for the sum assured, being legal representative of the deceased. In the complaint, it has been stated by the complainant that she is wife of the deceased and this fact has not been challenged by any of the parties in their written version, therefore // 8 // we find that the amount was payable to the complainant as the Bank has also recovered the entire amount of loan by selling the house purchased by the deceased from the loan amount.
14. Therefore, this appeal is allowed. The insurance company is directed to pay Rs.4,78,628/- (Rupees Four Lacs Seventy Eight Thousand Six Hundred Twenty Eight) to the appellant along with interest @ 6% p.a. from the date of filing complaint i.e.26.12.07 till the date of payment. For the period during which this Commission directed the insurance company not to pay the amount, i.e. from 05.02.10 till today, no interest will be payable. The amount, so ordered, be paid within a period of two months, otherwise it will carry further interest @ 9% p.a. from the date of order of this Commission till the date of payment. Other directions of the District Forum regarding compensation of Rs.5,000/- and cost of Rs.1,000/- will remain unaltered. No further cost.
(Justice S.C. Vyas) (Smt. Veena Misra)
President Member
/01/2011 /01/2011