State Consumer Disputes Redressal Commission
The Br.Manager, Oriental Ins. Co. Ltd. vs Soumendu Chakraborty on 13 March, 2026
STATE CONSUMER DISPUTES REDRESSAL COMMISSION
WEST BENGAL
FIRST APPEAL NO. SC/19/A/282/2022
The Br.Manager, Oriental Ins. Co. Ltd.
PRESENT ADDRESS - Chinsurah Branch, Chinsurah, Hoogly, Pin- 712 101.,WEST BENGAL.
The Executive Officer, Oriental Insurance Co. Ltd. D03
PRESENT ADDRESS - 4E/14, Azad Bhawan, Jhandewalan, Extn, New Delhi- 110 055.,WEST
BENGAL.
.......Appellant(s)
Versus
Soumendu Chakraborty
PRESENT ADDRESS - S/o, Lt Shyam Sundar Chakraborty. Vill- Dasghara Purbapara,
Srikrishnapur, P.O.- Dasghara, P.S.- Dhanakhali, Dist- Hoogly, Pin- 712 402.,WEST BENGAL.
Moli Chakraborty
PRESENT ADDRESS - W/o, Lt Shyam Sundar Chakraborty. Vill- Dasghara Purbapara,
Srikrishnapur, P.O.- Dasghara, P.S.- Dhanakhali, Dist- Hoogly, Pin- 712 402.,WEST BENGAL.
Indrani Mukherjee
PRESENT ADDRESS - W/o, Kunal Mukherjee. Village- Gurap, Majherpara, P.S.- Gurap, Dist-
Hoogly. ,WEST BENGAL.
.......Respondent(s)
BEFORE:
HON'BLE MR. AJEYA MATILAL , JUDICIAL MEMBER
HON'BLE MRS. SAMIKSHA BHATTACHARYA , MEMBER
FOR THE APPELLANT:
The Br.Manager, Oriental Ins. Co. Ltd., Mr. Debasis Bhandari (Advocate)
FOR THE RESPONDENT:
Soumendu Chakraborty , Raj Sekhar Basu, Ayon Subhra Bandhopadhay (Advocate)
DATED: 13/03/2026
ORDER
Samiksha Bhattacharya, Member The instant appeal has been directed by the appellants assailing the Order dated 01/09/2022 passed by Ld. DCDRC/Hooghly in CC/167/2017.
Facts of the case in brief are that the predecessor of the Respondents/Complainants ('hereinafter' referred to as 'Complainant') Shyam Sundar Chakraborty was the policy holder of Pradhan Mantri Suraksha Bima Yojona (PMSBY) and for which the predecessor of the Complainants deposited an amount of Rs.12/- only in favour of the appellants/OPs (hereinafter referred to as "OPs") through Punjab National Bank, Dasghara Branch on 13/07/2025 and bank authority has credited the said amount in favour of the OPs. Accordingly, one bima receipt being certificate No. 064100000567 was issued and same has been transferred from the savings bank account of Shyam Sundar Chakraborty, since deceased, being account No. 0641300010008166 and the policy No. was 272200/48/2016/2017 dated 06/07/2015. During the coverage period, the predecessor of the Complainants met an accident on 24/07/2015 and admitted at Dhaniakhali Rural Hospital and subsequently the conditions of the patient has been deteriorated for which the said patient was transferred to Burdwan Medical College and hospital on 25/07/2015. Subsequently, the condition of the patient has been deteriorated more and for which the patient was referred to Medical College Hospital, Kolkata and then the patient was admitted in Nilratan Sircar Medical College and Hospital, Kolkata. The patient expired on 01/08/2015. After the death of the predecessor of the Complainants, Complainant No. 1 claimed an amount of Rs. 2 lakhs from the OPs by filing prescribed form through PNB and OPs sent a letter to the Complainant No. 1 stating that they are not entitled to get any benefit under the said scheme on 02/01/2017 and after receiving the same, the Complainants sent a letter dated 14/07/2017 through their Ld. Advocate to the office of the OPs, but the OPs did not pay in heed. Hence, the Complainants have filed the petition of complaint before the Ld. DCDRC praying for direction upon OPs 1 and 2 to pay the claimed amount or the amount of accidental benefit secured under PMSBY scheme i.e., Rs.2 lakh only with interest along with Rs.1 lakh for litigation cost and mental agony and pain suffered by the Complainants.
OPs appeared before the Ld. DCDRC and filed their written version to contest the case.
In their written version, OPs denied all material allegations inter alia stated that the predecessor of the Complainants joined the scheme on 06/07/2015, and premium was debited from his account on 13/07/2015. But, as per PMSBY scheme, the insurance coverage will start from first day of next month of premium unto debit date which means, the commencement date of said scheme was 01/08/2015 but the predecessor of the Complainants met with an accident on 24/07/2015 i.e., much before the date of coverage on insurance. Though the predecessor of the Complainants died on 01/08/2015, the cause of action occurred on 24/07/2015. The death of predecessor was a subsequent event. As per PMSBY scheme participating bank is master policy holder on behalf of participating subscribers. In the instant case, PNB is the master policy holder of Shyam Sundar Chakraborty because the premium of Shyam Sundar chakraborty was debited from PNB. Hence, the OPs have enclosed a letter dated 02/01/2017 issued to PNB. The Complainant No. 1 was also already informed by their letter dated 02/01/2017. Therefore, the OPs have prayed for dismissal of the complaint with cost.
The Ld. DCDRC allowed the complaint on contest,. The Order of the Ld. DCDRC is reproduced hereunder;
"In the result it is accordingly Ordered That the complaint case being no. 167 of 2017 be and the same is allowed on contest but in part.
It is held that the complainants are entitled to get claim amount of Rs.2,00,000/- from the opposite parties and also entitled to get interest @ 9% per annum from the date of filing this case and complainants are also get compensation for mental pain and agony and deficiency of service on the part of the opposite parties of Rs. 15,000/- and complainants are also entitled to get litigation cost of Rs. 5000/-.
Opposite parties are directed to pay the said amount within 60 days from the date of this order otherwise complainants are given liberty to execute this order as per law.
In the event of nonpayment/ noncompliance of the above noted direction the opposite parties are also directed to pay and/or deposit Rs.50,000/- in the Consumer Legal Aid Account of D.C.D.R.C., Hooghly which is to be utilized for the purpose of poor litigant public."
Being aggrieved by and dissatisfied with the above Order, the OPs have filed the instant appeal.
In course of argument, Ld. Counsel for the OPs have submitted that the Ld. DCDRC has erred in law and in fact while passing the judgment and, therefore, it is not binding upon the OP/Respondent. He has firstly argued that no cause of action arose at the jurisdiction of OP No. 1 and the OP No. 1 has been impleaded as a party to the case to bring the case within the territorial jurisdiction of this Commission.
The Ld. Counsel for the OPs has further submitted that the OPs did not receive any premium before the date of accident of the victim, i.e., 24/07/2015. Hence, the contract of insurance was not concluded. Since, the premium was not received by the Insurance Company prior to the date of accident in compliance of 64V and hence, there was no validity of contract on the date of accident of the victim. The premium was deducted by the Bank authority and the amount was lying with the bank itself and it was not transferred to the Insurance company before the date of accident of the victim. Therefore, the insurance company, i.e., the OPs are not liable to compensate the Complainants. The PMSBY policy terms and conditions has been determined by the Central Government Finance Department and according to the rules, the Insurance Company has no liability to entertain the claim of the Complainants as on the date of accident the policy has not been commenced. As per rules of the Central Government, the premium would be deducted from the account holder savings bank through auto-deduct facility in one instalment on or before 1 st June of each annual coverage but, where the auto-deduct takes place after 1st June, the coverage was commenced from the first of the month following the auto-deduct. He has cited the judgment of Hon'ble NCDRC passed in Oriental Insurance Company Ltd. Vs. Kusum chhawchharia, where the Hon'ble Commission held that the terms of conditions of the policy are sacrosanct. He has also cited the judgment by the Hon'ble Supreme Court in Suraj Mall Ram Niwas Oil Mills Pvt Ltd vs. Union of India Insurance Co-Ltd. (2010)-10-SCC-567 decided on 08/10/2010 in support of his argument. Hence, he has prayed for allowing the appeal by setting aside of the Order of the Ld. DCDRC.
Ld. Counsel for the Complainants has submitted that the Complaint case was disposed of on 1st April, 2022 holding that the Complainants are entitled to get the claimed amount of Rs.2 lakh with the consequential relief. The OPs have submitted the rules and guidelines of PMSBY before the Ld. DCDRC. From the said rules, it is clear that policy covers for a period of one year and thereafter it would be renewed for the same period. It was launched in the year 2015.
The period of joining was extended till 30th November 2015. She has argued that the Ld. DCDRC has rightly observed that since the insured died on 01/08/2015, it is the duty of the OPs to pay the insurance claimed amount. The OPs have challenged the maintainability of the case before the Ld. DCDRC. Moreover, the policy was issued by the Oriental Insurance Company Ltd and therefore, it is not necessary to add the master policy holder as a necessary party. The deceased Complainant was not provided with any iota of document indicating rules of PMSBY. The premium was deducted through auto-deduct mode under the head of PMSBY. Therefore, the OPs again denied that they did not receive the premium amount. Therefore, there is a pure nexus between the debit bank and the OPs. The insured died on 01/08/2015 and as per submission of the OPs, the policy was commenced from 01/08/2015. Therefore, the Complainants are entitled to get benefit of the PMSBY and therefore, she has prayed for dismissal of the appeal by confirming the Order of the Ld. DCDRC.
Upon hearing the parties, it is admitted fact that predecessor of the complainants paid the premium of Rs.12/-for PMSBY scheme in favour of the OPs on 13/07/2015 and from the receipt it is revealed that the policy No. was 272200/48/2016/2017 dated 06/07/2015. It is also admitted fact that the predecessor of the Complainants died on 01/08/2015. From the letter dated 02/01/2017 issued by the OPs to the manager of PNB it is revealed that the as per scheme, the insurance starts from the 1st day of the next month of the deduction of premium. The premium was debited from the account of the deceased on 06/07/2015. But the policy was effective from 01/08/2015. Therefore, the accident occurs before the date of commencement of the policy in question. It is true that the policy was issued in favour of the deceased insured, but, it is the fact that policy was effective from 01.08.2015. If the accident occurs after the date of commencement of the policy, the insured would be entitled and the legal heirs of the insured would be benefited from the insurance claim. The predecessor of the complainants joined the PMSBY on 06.07.2015 and accordingly, the effective date of commencement of the insurance was on 01.08.2015. It is very unfortunate event that the predecessor of the Complainants met with an accident on 24/07/2015, i.e., before the date of commencement of the policy in question. Therefore, we find there is irregularity, impropriety, and illegality, in the Order passed by the Ld. DCDRC. Accordingly, the Order of the Ld. DCDRC is hereby set aside.
Thus, the apple is allowed on contest and disposed of accordingly.
(Let certified copy of order be supplied to the parties, free of cost, as per Regulations).
..................
AJEYA MATILAL JUDICIAL MEMBER ..................
SAMIKSHA BHATTACHARYA MEMBER