State Consumer Disputes Redressal Commission
Smt. Achala Nandeshwar vs Branch Manager & Anr on 10 September, 2014
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION,
PANDRI, RAIPUR (C.G.)
Complaint Case No.13/10
Instituted on : 20.05.2013
Smt. Achala Nandeshwar, W/o Late Dilip Nandeshwar,
Age 43 years, R/o : Jainarayan Singh Thakur,
Shitla Sadan, Labour Colony,
Rajnandgaon, Tehsil & Dist. Rajnandgaon (C.G.) ... Complainant.
Vs.
1. Branch Manager,
State Bank of India, Dongargarh,
Tehsil : Dongargarh, Dist. Rajnandgaon (C.G.)
2. Branch Manager,
S.B.I. Life Insurance Company Limited,
Old Bus Stand,
Rajnandgaon, Tehsil & Dist. Rajnandgaon (C.G.) ... Opposite Parties
PRESENT: -
HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT
HON'BLE MS. HEENA THAKKAR, MEMBER
HON'BLE SHRI D.K. PODDAR, MEMBER
COUNSEL FOR THE PARTIES:
Miss B.S. Kanti, for complainant.
Shri N.K. Shrivastava, for O.P.No.1.
Shri Narendra Mishra, for O.P.No.2.
ORDER
Dated : 10/09/2014 PER :- HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT. The complainant filed this consumer complaint under Section 17 of the Consumer Protection Act, 1986 against the OPs seeking relief as under :-
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(a) To direct jointly and severally to the OPs to pay the insurance amount of Rs.21,09,000/- under loan account No.31683403274 and to be adjusted in the housing loan account.
(b) To direct the OPs to refund the amount of Rs.2,83,889/-
i.e. the amount premium which was adjusted in the amount of installment of housing loan without obtaining consent of the complainant.
(c) To direct the OPs to pay a sum of Rs.5,00,000/- towards compensation for mental agony, mental harassment and physical agony.
(d) To direct the OPs to pay any other expenses and relief, which this Hon'ble Commission deems fit.
2. Brief facts of the complaint case are that the complainant with her husband jointly obtained housing loan of Rs.21,09,000/- from the O.P.No.1 (Bank) and executed relevant documents The Account No. of the said Loan was 31683403274. The O.P.No.1 (Bank) assured the complainant and her husband that detailed information would be given to them after some time and the complainant and her husband believed on the assurance given by the Bank. On being assurance given by the O.P.No.1 (Bank), the complainant and her husband Late Dilip Nandeshwar executed documents. O.P.No.1 (Bank) acted as an agent of O.P.No.2 (Insurance Company). The loan amount obtained by the // 3 // complainant was insured with the O.P.No.2 (Insurance Company) and premium of Rs.2,83,889/- was deducted from the account of the complainant on 26.03.2011 and the O.P.No.2 (Insurance Company) received the amount of premium from the O.P.No.1 (Bank), therefore, the loan obtained by the complainant and her husband was insured with the O.P.No.2 (Insurance Company). Dilip Nandeshwar, the husband of the complainant died on 23.05.2012 and the complainant sent letter to the O.P. for exonerating her from the liability of loan on the basis of terms and conditions mentioned in the insurance policy, but the OPs did not respondent her letter and simply they assured her that after completion for formalities, the complainant would be intimated after sometime. But on 21.06.2012, the, O.P.No.1 intimated the complainant that the proposal made by her for group insurance in her loan account was rejected by the O.P.No.2 (Insurance Company) The complainant sent legal notice to the OPs but the OPs did not respondent the legal notice, hence the complainant filed complaint against the OPs and prayed for granting reliefs under different heads as mentioned in the complaint.
3. The O.P.No.2 (Insurance Company) filed written statement and pleaded that in the case of group schemes, a Master Policy is issued to the Group Administrator and individual members of the group who are covered by the Group Scheme, are issued Certificate of Insurance. The O.P.No.2 (Bank) has issued Master Policy bearing No.93000001806 in // 4 // favour of State Bank of India (O.P.No.1) covering their various categories of loan borrowers, who has fulfilled the eligibility criteria and who has paid the requisite premium. Mere submission of proposal form and deposit of premium does not automatically result in the acceptance of insurance cover and issuance of insurance policy. In the instant case, the premium amount Rs.2,83,889/- was refunded vide cheque No.207660 and 207661, the month of April, 2011 i.e. during the lifetime of Shri Dilip Nandeshwar, therefore, the complaint is not maintainable. The complainant and her husband were directed to submit medical reports regarding the authorization cum good health declaration, but they did not submit the said report. The O.P.No.2 never issued any Certificate of Insurance in favour of complainant and Dilip Nandeshwar, therefore, the complainant is not entitled for getting any compensation from the O.P.No.2 (Insurance Company) and the O.P.No.2 (Insurance Company) did not commit any deficiency in service, hence the complaint is liable to be dismissed. It has been pleaded that Certificate of Insurance is the proof of contract between the insured and the insurer. As no Certificate of insurance is issued in favour of Dilip Nandeshwar, it is evident that there was no insurance contract between the insured and the insurer. Thus no claim is payable. The complaint is filed with a malafide intention to harass the O.P.No.2. There was no subsisting contract between Late Dilip Kumar Nandeshwar and the O.P.No.2, there was no locus for the complainant // 5 // to file the instant complaint. The proposer during his life time has never raised any issue about the non-acceptance of life cover nor did he complete the formalities for acceptance of the risk. The proposer had never shown any interest in the insurance cover and was well aware that there was no insurance cover on his life because the initial deposit was refunded during his life time, hence the complaint is not maintainable because the complaint is just based on conjectures and surmises which have no sanction in laws. The complainant is not a consumer within the provisions of the Consumer Protection Act, 1986 and as such has no locus to file the instant complaint and the complaint is liable to be dismissed.
4. The O.P.No.1 (Bank) also filed written statement and denied the allegations made by the complainant in the complainant and specifically pleaded that amount of premium was returned back by the O.P.No.2 (Bank) and the same was credited in the account of the complainant and her husband Dilip Nandeshwar during his life time.
5. The complainant filed documents. Document No.1 is notice dated 23.03.2013 by Shri Manoj Dubey, Advocate on behalf of the complainant to the OPs, document No.2 is postal receipts,, document No.3 is acknowledgement, document No.4 is reply dated 18.04.2013 sent by Shri M.L. Sahu, Advocate of the notice dated 23.03.2013 sent by the Shri Manoj Dubey, on behalf of the complainant, document No.5 is application dated 23.04.2013 submitted by the complainant to Public // 6 // Information Officer, State Bank of India, Branch Dongargarh, District Rajnandgaon, document No.6 is postal receipt, Annexure A is Group Master Policy, Annexure B is Life Dhanaraksha Plus LPPT Membership Form, Annexure C is letter dated 14.04.2011 sent by S.B.I. Life Insurance (O.P.No.2) to the Branch Manager, State Bank of India, Dongargarh, Annexure D is letter dated 14.04.2011 sent by S.B.I. Life Insurance (O.P.No.2) to the Branch Manager, State Bank of India, Dongargarh, Annexure - 7 is reply dated 12.08.2013 sent by Shri Manoj Dubey, Advocate to the Chief Manager/Authorized Officer, State Bank of India, Branch Dongargarh in response to registered notice sent dated 26.07.2013.
6. The O.P.No.2 (Insurance Company) has filed documents. Document No.1 is letter dated 23.05.2013 sent by State Bank of India, Bhilai, District Durg (C.G.) to the complainant along with documents, document No.2 is bank notice dated 26.07.2013, document No.3 is letter dated 31.07.2013 sent by the O.P.No.1 (Bank) to the complainant.
7. The O.P.No.1 (Bank) has also filed document. Document Annexure A-1 is letter dated 14.04.2011 sent by the O.P.No.2 (Insurance Company) to the O.P.No.1 (Bank), document A-2 is letter sent by the complainant and her husband Dilip Kumar Nandeshwar to the Branch Manager, State Bank of India, document Annexure A-3 on line proposal detail status report dated 28.03.2011 issued by O.P.No.2 (Insurance // 7 // Company), document Annexure A-4 is Statement of Account dated 24.06.2013.
8. On the basis of averments of both the parties, the points for determination are :-
1. Whether the complainant and her husband Dilip Nandeshwar were insured under SBI Life - Dhanaraksha Plus LPPT UIN :
111N035V01 Group Master Policy with the O.P.No.2 (Insurance Company) ?
2. Whether the contract was concluded between the complainant & her husband and O.P.No.2 (Insurance Company) and whether the complainant is entitled to get benefit under the insurance policy and she is entitled to be exonerate from the housing loan obtained by her & her husband Dilip Nandeshwar ?
Discussions and its conclusion:
Question No.1.
9. Firstly, we shall consider whether the complainant and her husband Dilip Nandeshwar were insured under SBI Life - Dhanaraksha Plus LPPT UIN : 111N035V01 Group Master Policy with the O.P.No.2 (Insurance Company) ?
10. Miss B.S. Kanthi, learned counsel appearing for the complainant argued that the complainant and her husband Dilip Nandeshwar had sought a housing loan of Rs.21,09,000/- from O.P.No.1 (Bank) and loan // 8 // was insured by the O.P.No.2 (Insurance Company) through the O.P.No.1 (Bank) and O.P. No.1 (Bank) deducted amount of Rs.2,83,889/- from the account of the complainant and the O.P.No.2 (Insurance Company) filed document (proposal form Annexure - A) and (Annexure - B) in which at page No.3 it is mentioned under the heading questionnaire Medical Questionnaire to be filled in according to internal underwriting rules and particulars and details were given by the complainant. The proposal form was verified by the O.P.No.2 (Insurance Company) and O.P.No.2 (Insurance Company) accepted the premium amount of Rs.2,83,889/- on 26.03.2011 and kept the premium amount with it. It appears that the O.P.No.2 (Insurance Company) accepted the proposal form and therefore, there was a contract between the complainant and the O.P.No.2 (Insurance Company). The OPs never demanded and raised any question regarding medical certificate, therefore, the housing loan obtained by the complainant and her husband Dilip Nandeshwar is completely covered under the insurance policy. Miss B.S. Kanthi, further argued that Dilip Nandeshwar died on 23.05.2012 and his death was natural death, therefore, the liability of the complainant and her husband Dilip Nandeshwar, discharged from loan liability and they are liable to be exonerated but the OPs did not adjust the loan amount and did not exonerate the complainant and the O.P. No.2 (Insurance Company) arbitrarily and willfully refunded the premium amount without intimating the complainant. The OPs did // 9 // not adjust the loan according to the terms and conditions of the insurance policy and also did not exonerate the complainant from loan liability, therefore, they committed deficiency in service as well as unfair trade practice. She further argued that the scheme was withheld and at that time the contract was concluded between the complainant and O.P.No.2 (Insurance Company), therefore, the terms and conditions of the insurance policy are binding on the O.P.No.2 (Insurance Company) and the O.P.No.2 (Insurance Company) is liable to indemnify the complainant. She placed reliance on State Bank of Hyderabad vs. Nirmala & Anr. II (2012) CPJ 10 (NC) and State Bank of India vs. Sri Easwari Vaccines & Om Vaccine Clinic & Anr. III (2014) CPJ 106 (NC).
11. Shri Narendra Mishra, learned counsel appearing for the O.P.No.2 (Insurance Company) argued that premium amount of the insurance policy was not accepted by the O.P.No.2 (Insurance Company). The O.P.No.2 (Insurance Company) asked for Medical Certificate and documents from the complainant through O.P.No.1 (Bank) but no medical certificate and documents were submitted by the complainant hence the O.P.No.2 (Insurance Company) returned back the premium amount on 11.04.2011 and the scheme was withheld w.e.f. 31.03.2011, therefore, there is no privity of contract between the complainant and the O.P.No.2 (Insurance Company). Merely acceptance of the premium amount is not sufficient to conclude that the // 10 // contract is concluded. When the proposal is accepted, and policy is issued and risk is covered on the date when the policy is issued . In the instant case the O.P.No.2 asked the complainant to fulfill medical requirements, but when the complainant utterly failed to fulfill the above medical requirements, the O.P.No.2 refunded the amount of premium and the same was credited in the housing loan account of the complainant prior to death of Dilip Nandeshwar. Dilip Nandeshwar died on 23.05.2012 and by that time the amount of premium had already been refunded to the complainant on 11.04.2011 vide cheque No.207661. It appears that during the lifetime of Dilip Nandeshwar, the amount of premium was refunded and after period of near about one year, Dilip Nandeshwar has died, therefore, there is no contract between the complainant and the O.P.No.2 (Insurance Company) as risk was not covered by the insurance policy in question, therefore, the O.P.No.2 (Insurance Company) did not commit any deficiency in service and the complaint is liable to be dismissed.
12. Shri N.K. Shrivastava, learned counsel appearing for the O.P.No.1 (Bank) also advanced above arguments and has supported the contention of learned counsel for the O.P.No.2 (Insurance Company) and specifically argued that the amount of premium was refunded by the O.P.No.2 (Insurance Company) well within time and the same was credited in the joint housing loan account of the complainant and her husband Dilip Nandeshwar and it is well within the knowledge of the // 11 // account holders. He further argued that Dilip Nandeshwar himself has written letter (Annexure A-2) to the Branch Manager, State Bank of India, Dongargarh in which it has been mentioned that he and his wife have applied for housing loan, but they wrote letter to O.P.No.1 (Bank) and wished to withdraw the earlier proposal and instead of housing loan scheme they want to cover themselves under Shield Insurance Scheme. It appears that Dilip Nandeshwar and the complainant themselves wished to left the terms and conditions of the policy, therefore, the O.P.No.1 (Bank) did not committed any deficiency in service and unfair trade practice. The complainant is not entitled for any compensation from the O.P.No.1 under the said insurance policy and the complaint is liable to be dismissed.
13. In Deokar Exports Pvt. Ltd. vs. New India Assurance Company Ltd. , I (2009) CPJ 6 (SC), Hon'ble Supreme Court has observed thus :-
"11. A policy of insurance is a contract based on an offer (proposal) and an acceptance. The appellant made a proposal. The respondent accepted the proposal with a modification. Therefore, it was a counter proposal. The appellant had three choices. The first was to refuse to accept the counter - proposal, in which event there would have been no contract. The second was to accept either expressly or impliedly, the counter proposal of the respondent (that is respondent's acceptance with modification) which would result in a concluded contract in terms of the counter proposal. The third was to make a counter proposal to the counter proposal of the respondent in which event there would have been no concluded contract unless the respondent agreed to such counter proposal. But the appellant definitely did not have the fourth choice of propounding a concluded contract with a // 12 // modification neither proposed nor agreed to by either party. If the appellant did not agree to the policy covering the period 26.8.1988 to 25.8.1989 instead of the period 12.3.1988 to 12.9.1989, the result would never create an insurance contract effective from 30.6.1989 or any other date".
14. In Life Insurance Corporation of India vs. Batthini Rama Rao, II (2009) CPJ 340 (NC), Hon'ble National Commission has observed thus :-
"5..................
"6.................. The Forums under the Consumer Protection Act, committed gross error in construing Clause 4 - B of the policy and giving the same meaning to the two expressions in the aforesaid Clause 4-B namely "the date on which the risk under the policy has commenced" and "the date of the policy is issued".
15. The complainant filed SBI Life - Dhanaraksha Plus LPPT UIN :
111N035V01 Group Insurance Policy. In the said policy under Schedule II Definitions and Rates in para No.3 the Eligibility Criteria is mentioned. It reads thus :-
"3. ELIGIILITY CRITERIA :-
The Member who, at the time of his/her admission to the Scheme.
- has a minimum outstanding loan / sanctioned loan (excluding interest) as specified in Annexure I for the relevant Loan Category.
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- has a minimum loan term of 3 years and a loan term not exceeding the Maximum Loan term specified in Annexure I, for the relevant Loan Category.
- has a minimum age* of 18 years and does not exceed a minimum age applicable for the relevant Loan Category as stated in Annexure I.
- is in good health.
- has completed and submitted a membership form along with required documents.
- Has satisfactorily completed a good health declaration in the format prescribed by the Company (for members falling within the Free Cover limit only), and
- has undergone a medical examination as per the medical underwriting process of the Company, if applicable and fulfils the underwriting criteria to the complete satisfaction of the Company; and
- is otherwise insurable.
All reference to age in this document means age as on last birthday.
** Free cover limit :
If entry age is between 18 and 60 : upto a loan amount of Rs.7.5 lakhs.
If entry age is between 61 and 65; upto a loan amount of Rs.3 lakhs."
In para No.3 the Benefits is mentioned. It reads thus :-
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5. BENEFITS : a) Death Benefit :
i) In the event of death of a Member whilst cover is in force for such Member, the Death Benefit as stated in C of Schedule I, shall become payable, provided that the provisions of this document are complied with.
ii) On payment of the Death Benefit as above, all insurance cover provided under this policy would automatically terminate and all liability of the company in respect of that Member (including rider benefits, if any) would stand automatically extinguished."
16. The SBI Life Dhanaraksha Plus LPPT Membership Form (Document Annexure A & B) are containing Medical Questionnaire Part and under this part some questions have been asked from the insured. The reply of the questions asked were given by the insured in the negative form.
17. Document Annexure C is letter dated 14.04.2011 sent by the O.P.No.2 (Insurance Company) to the Branch Manager, State Bank of India, Dongargarh. In the said letter it is mentioned thus :-
"We have to inform you that we could not provide insurance cover to the below mentioned borrower due to non receipt of the complete paper / requirement in time and product has now been withdrawn. Hence we are refunding the proposal deposit remitted.
Please find enclose the refund cheque as per details furnished below :-
// 15 // Name of Loan A/c No. Deposit Deposit Chq. dated Chq. No. borrower Paid (Rs.) Refunded (Rs).
Dilip 31683403274 203631/- 203631/ - 11.04.2011 207661 Kumar Nandeshwar Kindly note that the above mentioned borrower is no longer covered for insurance under our Group Insurance Scheme Dhanaraksha Plus LPP. You are requested to credit the Loan Account of the customer (where Loan Insurance is financed as a part of the project cost) or handover the same to the customer against his / her acknowledgment."
18. Document Annexure D is letter dated 14.04.2011 sent by the O.P.No.2 (Insurance Company) to the Branch Manager, State Bank of India, Dongargarh. In the said letter it is mentioned thus :-
"We have to inform you that we could not provide insurance cover to the below mentioned borrower due to non receipt of the complete paper / requirement in time and product has now been withdrawn. Hence we are refunding the proposal deposit remitted.
Please find enclose the refund cheque as per details furnished below :-
Name of Loan A/c No. Deposit Deposit Chq. dated Chq. No. borrower Paid (Rs.) Refunded (Rs).
Achala 31683403274 80258/- 80258 11.04.2011 207660 Nandeshwar Kindly note that the above mentioned borrower is no longer covered for insurance under our Group Insurance Scheme Dhanaraksha Plus LPP. You are requested to credit the Loan Account of the customer (where Loan Insurance is financed as a part of the project cost) or handover the same to the customer against his / her acknowledgment."
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19. Annexure A-4 which has been filed by the O.P.No.1 (Bank) is Statement of Account issued in the joint name of the complainant and Dilip Kumar Nandeshwar. In the said document, against entry dated 26.03.2011 it is mentioned that a sum of Rs.2,83,889.00 was debited and the same was credited in the account of the complainant and Dilip Nandeshwar on 24.06.2011. According to O.P.No.2 (Insurance Company) it demanded fulfillment of medical requirements from the complainant and her husband Dilip Nandeshwar through O.P.No.1 (Bank) but they utterly failed to fulfill the medical requirements demanded by the O.P.No.2 (Insurance Company) and therefore, the premium amount was refunded on 11.04.2011.
20. In Revision Petition No.211 of 2009 (Reliance Life Insurance Company Limited and another vs. Madhavacharya) decided on 02.02.2010, Hon'ble National Commission has observed that "Hon'ble Apex Court in the matter of General Assurance Society Limited vs. Chandumull Jain & Anr. reported in (1966) 3 SCR 500 in which the following observations were made by Hon'ble Apex Court :-
"In interpreting documents relating to a contract of insurance, the duty of the court is to interpret the words in which the contract is expressed by the parties, because it is not for the court to make a new contract, however reasonable, if the parties have not made it themselves. Looking at the proposal, the letter of acceptance and the cover notes, it is clear that a contract of insurance under the standard policy for fire and extended to cover flood, cyclone, etc. had come into being."
// 17 // The Hon'ble Apex Court in the matter of United India Insurance Co. Ltd. Vs. M/s. Kiran Chambers & Spinners reported in AIR (2007) SC 393, the learned counsel for the respondent tried to persuade us that where the terms of contract between the parties are unfair, the courts are well within its powers even to stretch the terms and conditions."
21. In Revision Petition No.469 of 2006 (United India Insurance Co. Ltd. Branch 35 Dhar (M.P) Through Manager United India Insurance Co. Ltd., New Delhi) decided on 19.05.2010, Hon'ble National Commission has observed that "It is now well settled that principle of insurance is fundamental to utmost good faith forbids either party from non- disclosure of the fact which the parties know and either of the parties have a duty to disclose all material facts in their knowledge."
22. In Kolla Vijaya Laxmi vs. Life Insurance Corporation of India & Anr. I (2010) CPJ 137 (NC), Hon'ble National Commission has observed thus :-
"4..............................in the case of LIC of India v. Raja Vasireddy Komalavalli Kamba & Ors., AIR 1984 SC 1014. In the said case, the Supreme Court more fully dealt with the question as to when a concluded contract of life insurance could be said to have come into existence. In the above cited case, the facts noted and law laid down are as under :
"One late Raja Vasireddi Chandra Dhara Prasad died intestate on 12th January, 1961. He had filled a proposal for insurance for Rs.50,000/ on 27th December, 1960. There was medical examination by the doctor on the life of the deceased on 27th // 18 // December, 1960. The deceased issued two cheques being the consideration towards the first premium of Rs.300 and Rs.220 respectively which were encashed by the appellant on 29th December, 1960 and 11th January, 1961. On 16th January, 1961, the widow of the deceased wrote to the appellant intimating the death of the deceased and demanded a payment of Rs.50,000. The Divisional Manager, Masulipatam Branch denied liability on behalf of the appellant on 28th January, 1961. Thereafter there was correspondence between the parties between 1st February, 1961 and 23rd December, 1963. On 10th January, 1964, the respondents filed a suit in the Court of Subordinate Judge, Masulipatam. The Trial Court dismissed the suit holding, inter alia, that there was no concluded contract, that the proposal was not accepted by the Divisional Manager for some reason or the other by time the deceased had died, that neither the encashment of the two cheques created a contract of insurance, in appeal, the High Court after ordering certain other additional documents set aside the Trial Court judgment. Hence, the appeal by the Corporation after obtaining the special leave.
"1. Having regard to the clear position in law about acceptance of insurance proposal and the evidence of record in this case, it is clear that the High Court was in error in coming to the conclusion that there was a concluded contract of insurance between the deceased and the Life Insurance Corporation.
2. Though in certain human relationship silence to a proposal might convey acceptance but the case of insurance proposal, silence does not denote consent and no binding contract arises until the person to whom an offer is made says or does something to signify his // 19 // acceptance. Mere delay in giving an answer cannot be construed as an acceptance, as , prima facie, acceptance must be communicated to the offer or the general rule is that the contract of insurance will be concluded only when the party to whom an offer has been made accepts it unconditionally and communicates his acceptance to the person making the offer. Whether the final acceptance is that of the assured or insurers, however, depend simply on the way in which negotiations for an insurance have progressed.
3. When an insurance policy becomes effective is well settled by the authorities but it is clear that the expression 'underwirte' signifies accept liability under that. The dictionary meaning also indicates that, it is true that normally expression 'underwrite' is used in Marine insurance but the expression used in Chapter III of the Financial Powers of the Standing Order in this case specifically used the expression 'underwriting and revivals' of policies in case of Life Insurance Corporation and stated that it was the Divisional Manager who was competent to underwrite policy for Rs.50,000 and above.
4. The mere receipt and retention of premium until after the death of the applicant or the mere preparation of the policy document is not acceptance. Acceptance must be signified by some acts or acts agreed on by the parties or from which the law raised a presumption of acceptance.
5. In the instant case, the High Court was in error in coming to the following conclusion; (i) that there was no concluded contract, and non-acceptance of the // 20 // proposal was not sufficient averment that the Divisional Manager was the only competent authority to accept the proposal; (ii) in its view about the powers of the different authorities under Chapter III of Standing Order 1960, dealing with the financial powers; (iii) about the view that the Assistant Divisional Manager having accepted the proposal; and (iv) about the assurance given by the Field Officers that the acceptance of the first premium would automatically create a concluded contract of insurance. The Court however, directed half the amount of the insurance amount of Rs.85,000/- paid to the respondents to be refunded to the Corporation."
23. In the instant case also the premium amount was sent to the O.P.No.2 (Insurance Company) by O.P.No.1 (Bank) and the premium amount was debited in the account of the complainant and her husband Dilip Nandeshwar, but the O.P.No.2 (Insurance Company) demanded documents relating to medical requirements from the complainant her husband Dilip Nandeshwar through O.P.No.1 but the complainant did not give any response to the said demand of the O.P.No.2 (Insurance Company). The complainant and her husband Dilip Nandeshwar could not fulfill medical requirements and thereafter the O.P.No.2 ( (Insurance Company) returned the premium amount to the O.P.No.1 (Bank) and also sent letter to that effect to the O.P.No.1 (Bank) and copy of which was also forwarded to the complainant and her husband Dilip Nandeshwar, the main borrower / loanee. Dilip Nandeshwar died on // 21 // 23.05.2012 after near about 1 years from the date of returning the premium amount by the O.P.No.2 (Insurance Company). It appears that the O.P.No.2 (Insurance Company) did not accept the proposal of the complainant and her husband Dilip Nandeshwar, therefore, there is no concluded contract between the complainant, her husband Dilip Nandeshwar and the O.P.No.2 (Insurance Company). The O.P.No.2 (Insurance Company) never issued insurance policy in favour of the complainant and her husband Dilip Nandeshwar.
24. The complainant and her husband wrote letter to the Branch Manager, State Bank of India, Dongargarh (O.P.No.1) (Bank) in which it is mentioned that : "
"izfr] 'kk[kk izc/akd] Hkkjrh; LVsV cSda Mkxas jx<+ fo"k;%& chek djus ckcrA egkns;k] mijkDsr fo"k; vraxZr fuosnu gS fd Housing Loan yrss oDr geus chek ds fy, Hkh ykus grsq vkonsu fd;k FkkA geas chek grsq yksu dh vko';drk ugha gSA vr% vkils fuonsu gS fd geas Shield chek dh ;kt s uk ds vraxZr Cover djsAa ftldk izhfe;e gekjs }kjk okf"kZd Hkqxrku fd;k tk;x s kA /kU;okn izkFkhZ ¼1½ vpyk uaUn'soj gLrk{kj // 22 // ¼2½ fnyhi dqekj uaUn'soj gLrk{kj "
25. It appears that the complainant and her husband Dilip Nandeshwar initially insured them under the Group Master Policy and they themselves made a prayer to the O.P.No.1 (Bank) to exonerate from the said Scheme and they wished to opt to cover under Shield Insurance Scheme. Looking to the above document, it appears that the complainant and her husband themselves did not accept the proposal and they withdrawn the initial proposal of the loan scheme and subsequently they sent proposal to cover them under Shield Insurance Scheme. It also indicates that there was no contract between the borrowers and the O.P.No.2 (Insurance Company). Question No.2 & 3 :
26. Now we shall consider whether the contract was concluded between the complainant and her husband Dilip Nandeshwar and O.P.No.2 (Insurance Company) and whether the complainant is entitled to get benefit under the insurance policy and she is entitled to be exonerated from the housing loan obtained by her and her husband Dilip Nandeshwar ?
27. On the basis of conclusion given in respect of Question No.1, it is established that the complainant and her husband Dilip Nandeshwar were not insured with the O.P.No.2 (Insurance Company) and the // 23 // insurance policy was not issued by the O.P.No.2 (Insurance Company) in favour of the complainant and her husband Dilip Nandeshwar. There was no contract of insurance between the complainant, her husband and the O.P.No.2 (Insurance Company) and the amount of premium was returned by the O.P.No.2 (Insurance Company) to the O.P.No.1 (Bank) and proposal was not accepted by the O.P.No.2 (Insurance Company). It appears that the loan taken by the complainant and her husband Dilip Nandeshwar was not insured with the O.P.No.2 (Insurance Company), therefore, after death of husband of the complainant, Dilip Nandeshwar, the complainant is not entitled to be exonerated from the loan liability, therefore, the complainant is not entitled to get any reliefs from the OPs and the complaint is liable to be dismissed.
28. Therefore, the complaint filed by the complainant against the OPs, is liable to be dismissed, hence the same is dismissed. Parties shall bear their own cost.
(Justice R.S. Sharma) (Ms. Heena Thakkar) (D.K. Poddar)
President Member Member
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