State Consumer Disputes Redressal Commission
The New India Assurance Co Ltd vs Yamuna Vishnu Raut on 13 December, 2023
1 A/751/2019
Date of filing :02.04.2019
Date of order :13.12.2023
MAHARASHTRA STATE CONSUMER DISPUTE
REDRESSAL COMMISSION,MUMBAI, BENCH AT
CHHATRAPATI SAMBHAJINAGAR.
FIRST APPEAL NO. : 751 OF 201
IN COMPLAINT CASE NO.: 94 OF 2018
DISTRICT CONSUMER FORUM : BEED
The New India Assurance Co.Ltd. , ...APPELLANT
D.O.142300, First Floor, N.C.L.Area, (Adv.M.R.Deshmukh)
Plot No.C-6, Bandra Kurla Complex,
Bandra(East), Mumbai 400051.
The New India Assurance Co.Ltd. ,
Through its Authorised Signatory,
Mahesh Compound, Adalat Road,
Aurangabad, Dist.Aurangabad.
VERSUS
1. Yamuna Vishnu Raut, ... RESPONDENT NO.1
R/o Antarwali, Tq.Georai, (Adv.R.V.Jadhav)
Dist.Beed.
2. Divisional Officer, ... RESPONDENT No.2.
ICICI Bank, First Floor, (Exparte)
Chatrapati Sambhajiraje Business Market,
Survey No.127/A, A.H.No.2738,
Mondha Road Georai,
Tq.Georai, Dist.Beed.
CORAM : Mr.M.S.Sonawane, Hon'ble Presiding Member.
Mrs.N.A.Chavhan, Hon'ble Member
Mr.N.C.Kumbre, Hon'ble Member
2 A/751/2019
JUDGMENT
(Delivered on 13/12/2023) Per Mr.Nagesh C.Kumbre, Hon'ble Member.
This is an appeal against the impugned judgment passed by District Consumer Commission Beed in C.C.No.94/2018 dated 07/01/2019, wherein the complaint filed by respondent No.1 is allowed by the said Commission. The appellant was the original opponent No.2, respondent No.1 was the original complainant and respondent No.2 was original opponent No.1 in the said consumer complaint before District Consumer Commission Beed.
2. Respondent No.1 had filed the above said consumer complaint before the District Consumer Commission Beed. It is the case of respondent No.1 that her husband Vishnu Manohar Raut having saving bank account with respondent No.2, ICICI Bank. The bank had also provided him ATM-Cum-Debit card which the respondent No.1 pleaded that it is Rupay Debit Card. For Rupay Card holder there is personal accident insurance claim scheme for 2016-17 with the appellant. On 09-09-2017 her husband lost his life due to electrocution. For the said incidence the accidental death (A.D.) No.24/17 was registered with concerned police station. It is further contended by respondent No.1 that she had submitted the insurance claim through her advocate to respondent No.2 and appellant. Her claim had not been considered by the appellant and kept pending. As the appellant not considered insurance claim of respondent No.1 , the respondent No.1 filed said complaint before the District 3 A/751/2019 Commission and claimed Rs.2 lacs @18% interest p.a., Rs.10,000/- for physical and mental harassment and Rs.5000/- towards cost of the complaint. The respondent No.1 submitted claim submission letter to appellant and respondent No.2, claim form, form-D, post receipt and tracking report, police papers in A.D.No.24/17, death certificate , bank statement of her husband's account and National Payment Corporation of India (in short 'NPCI') guideline along with list of documents.
3. The appellant and respondent No.2 appeared in that matter and filed their written statement before ld. District Consumer Commission.
4. The respondent No.2 in his written statement before District Commission contended that the husband of respondent No.1 was having saving account in his bank and bank provide him ATM - Debit card. The insurance of said card is with the appellant insurance company. It is further contended by respondent NO.2 that the bank provide all the necessary documents and form-D to respondent No.1 and co-operate with her for submission of insurance claim with appellant and hence they have not committed any deficiency in service towards respondent No.1.
5. The appellant in his written statement before District Commission contended that they have not received the insurance claim from the respondent No.1 and manager of respondent No.2 ICICI Bank. It is further contended by appellant that the respondent No.1 had not submitted the insurance claim through 4 A/751/2019 proper authority and therefore the complaint of respondent No.1 is not maintainable in the eye of law and as there is no cause of action appellant prayed for rejecting/dismissal of said complaint, which is the defence of appellant before District Commission. It is further contended that the death of husband of respondent No.1 and whether he was holding a ATM-cum-Debit card insured with them is not within their knowledge.
6. The ld. District Commission after considering all the record and submission held that there has been deficiency in service on the part of appellant and respondent No.2 has not committed any deficiency in service towards respondent No.1. It is held by District Commission that the husband of respondent No.1 having saving account in the bank of respondent No.2 having ATM Debit card insured with the appellant . The death of husband of respondent No.1 was accidental . Being heir, respondent No.1 submitted insurance claim with appellant and claimed insurance for Rupay platinum card holders accidental claim. But the appellant has not considered the claim of respondent No.1 and kept it pending. Hence the District Commission directed appellant to pay to respondent No.1 Rs.2 lacs within 30 days from date of order, in default pay 9% p.a. interest from the date of filing of complaint , Rs.2000/- for physical and mental harassment and Rs.2000/- for cost of complaint.
7. Being aggrieved by the said judgment and order original opponent No.2 came in appeal. Adv.M.R.Deshmukh for appellant and Adv.Shri.R.V.Jadhav for respondent No.1 were present.
5 A/751/2019 Respondent No.2, ICICI Bank duly served but not given his appearance. Hence the matter proceeded exparte against respondent No.2.
8. Adv.M.R.Deshmukh for the appellant argued in the matter. He submitted that they have not received the insurance claim from the respondent No.1 and manager of respondent No.2 ICICI Bank. It is further submitted that respondent No.1 had not submitted the insurance claim through proper authority and therefore the complaint of respondent No.1 is not maintainable in the eye of law. No debit card was placed on record by respondent No.1. It is not clear as to whether the card possessed by husband of respondent No.1 is Rupay debit card having coverage as per the scheme or not? The advocate further argued that the District Commission has not appreciated the evidence properly and passed the impugned order which needs to be quashed and set aside.
9. On the other hand , Adv.R.V.Jadhav for respondent No.1 argued in the matter. He submitted that the District Commission has rightly observed that there has been deficiency in service on the part of appellant. It is further submitted by him that the fact regarding debit card was not placed by respondent NO.1 on record has not been raised before District Commission by appellant. This fact is first time raised by the appellant before this Commission. The advocate further concluded that the District Commission has rightly adjudicated the matter and there is no necessity to interfere in the order.
6 A/751/2019
10. Against this background we perused the copy of complaint , written version given by the appellant and respondent No.2 in original proceeding before District Commission. We have also gone through the appeal compilation and impugned judgment and all documents. We have given our anxious thoughts to the argument as advanced by advocate of appellant and respondent No.1.
11. It is the argument of respondent No.1 that her husband was having bank account with respondent No.2, ICICI Bank. The bank had provided ATM-cum-Debit card and as per her contention it is Rupay card and which is insured with appellant insurance company. The Rupay card holders personal accidental insurance claim 2016-17 is with the appellant and is admitted by appellant in their written statement before ld. District Commission. The husband of respondent No.1 lost his life due to electrocution on 09/09/2017. Except accidental death of the husband of respondent NO.1 as it is not within the knowledge of respondent No.2. The other contention of respondent No.1 are admitted by respondent No.2 ICICI Bank by way of their written statement filed before District Commission. The respondent No.1 filed the police paper in AD No.24/17 including death report, PM report, inquest panchanama , death certificate etc. it shows that the death of husband of respondent No.1 is due to electrocution and which is an accidental death. These facts has been rightly considered by District Commission.
7 A/751/2019
12. It is argued by appellant that the respondent No.1 had not submitted insurance claim through proper channel. It is submitted by appellant that it is the duty of respondent No.1 to submit claim proposal to respondent No.2 ICICI Bank and bank shall forward this same to appellant insurance company. In support of this submission the appellant have not submitted any evidence on record. On perusal of scheme/NPCI guidelines which is on record, it reveals that claim for insurance benefit against policy will needed to be submitted directly with the New India Assurance Co.Ltd. i.e. appellant. As such as per the NPCI guidelines respondent No.1 can submit the claim proposal directly with the appellant. It is the submission of appellant that the appellant had not received insurance claim from respondents. Respondent No.1 had forwarded the insurance claim to respondent NO.2 on 09/11/2017 and to appellant on 21/11/2017 through registered post. Respondent No.1 had submitted the copy of both claim submitted letters alongwith postal receipt and post tracking report which shows that the appellant had received the insurance policy claim on 23/11/2017. But the appellant has not considered the claim of respondent No.1 and committed deficiency in service. This fact was rightly considered by ld. District Commission. Therefore we do not agree with the argument of appellant on this point.
13. It is further argued by appellant that the debit card was not placed on record by the respondent No.1 and raised the question that whether the debit card held by husband of respondent No.1 is Rupay card? On perusing the written statement filed by the 8 A/751/2019 appellant before ld. District Commission , it reveals that these facts were not raised by the appellant before ld. District Commission. The appellant ought to have raised these issues before the ld. District Commission because being fact finding Commission, the ld. District Commission would have examined these facts in proper prospective. On perusing NPCI guidelines Para H1 it reveals that respondent No.1 forwarded the claim along with required documents as per the checklist. The respondent No.1 submitted the bank statement on record, which shows that there are transactions made by husband of respondent No.1 before his death and the these facts were not challenged before ld. District Commission.
14. Respondent No.2 bank had provided all the necessary documents and D-form on the request of respondent No.1 and co-operate with respondent No.1 for submission of insurance claim with appellant and hence they have not committed any deficiency in service towards respondent No.1. This fact was rightly considered by ld. District Commission. The contentions of respondent No.1 in relation to bank account of her husband , holding of ATM Debit Card by her husband which is insured with appellant was supported by respondent No.2 bank by way of their written statement before District Commission . Hence we have no reason to disbelieve the contentions of respondent No.1 in this regards.
15. From above discussion we are of the view that the District Commission after giving opportunity of being heard and perusing 9 A/751/2019 entire evidence before it has rightly arrived to a finding of deficiency committed by the appellant and passed the impugned judgment and order. We do not find any infirmity and illegality in the impugned judgment and order passed by District Commission. Therefore we do not find it necessary to interference in the said order.
16. In view of above discussion and reasoning we are of the opinion that the appeal is devoid of merit and deserves to be dismissed. Hence we pass the following order.
ORDER
1. The appeal is dismissed.
2. The impugned judgment and order passed by ld.District Commission, Beed in C.C.No.94/2018 dated 07/01/2019 is hereby confirmed.
3. No order as to cost.
3. Copy of this judgment be given to the parties free of cost.
Date: 13/12/2023.
Place: Chhatrapati Sambhaji Nagar
(Aurangabad)
Sd/- Sd/- Sd/-
Mr.N.C.Kumbre Mrs.N.A.Chavhan M.S.Sonawane
Member Member Presiding Member
MBM