State Consumer Disputes Redressal Commission
United India Insurance Co. Ltd. & Anr. vs Smt. Chandrima Mukhopadhyay & Ors. on 11 November, 2014
STATE CONSUMER DISPUTES
REDRESSAL COMMISSION
WEST BENGAL
11A, Mirza Ghalib Street,
Kolkata - 700087
First Appeal No.
FA/65/2013
(Arisen out of Order
Dated 27/11/2012 in Case No. CC/287/2008 of District Kolkata-I)
1.
United India Insurance Co. Ltd.
Himalaya
House, 38B, Chowringee Road, P.S. Park Street, Kolkata - 700 071.
2.
United India Insurance Co. Ltd.
Divisional
Office, Malias Bhawan, 7th Floor, 26, Kasturba Gandhi Marg, New Delhi -
110 001.
...........Appellant(s)
Versus
1.
Smt. Chandrima Mukhopadhyay
58,
R.K.M Lane, Chapdani, P.O. - Baidyabati, P.S. - Bhadreswar, Dist.
Hooghly.
2.
SBI Cards & Payment Services Pvt. Ltd.
FMC
Fortune Building, 234/3A, A.J.C. Bose Road, Kolkata - 700 020, P.S. -
Bhowanipore.
3.
SBI Cards & Payment Services Pvt. Ltd.
90,
Udyog Vihar, Sector - 18, Gurgaon, Haryana - 122 015.
4.
State Bank of India
1,
Strand Road, Kolkata - 700 001.
...........Respondent(s)
For
the Appellant: Ms Sumita Roychowdhury, Ld. Advocate
For
the Respondent: Mr. Barun Prasad, Ld. Advocate
A N D
First Appeal No.
FA/439/2013
(Arisen out of Order
Dated 27/11/2012 in Case No. CC/287/2008 of District Kolkata-I)
1.
SBI Cards and Payment Services Pvt. Ltd.
FMC
Fortuna Building, 238/3, A.J.C. Bose Road, P.S. Bhowanipore, Kolkata -
700 020.
2.
SBI Cards and Payment Services Pvt. Ltd.
P.O.
Bag No. 28, G.P.O. New Delhi - 110 001.
...........Appellant(s)
Versus
1.
Smt. Chandrima Mukhopadhyay
58,
R.K.M. Lane, Chapdani, P.O.- Baidyabati, P.S.-Bhadreswar, Dist.
Hooghly.
2.
State Bank of India
D.P.D.B.
Deptt. Sambridhhi Bhawan, 1, Strand Road, Kolkata - 1.
3.
United India Insurance Co. Ltd.
Himalaya
House, 38B, Chowringhee Road, P.S. Park Street, Kolkata-700 071.
4.
United India Insurance Co. Ltd.
Divisional
Office: Kailas Bhawan, 7th Floor, 26, Kasturba Gandhi Marg, New Delhi -
110 001.
...........Respondent(s)
For
the Appellant: Mr. Surajit Auddy, Mrs. Swapnalekha Auddy, Ld. Advocates
For
the Respondent: Mr. Barun Prasad, Mrs. S. Roy Chowdhury, Ld. Advocates
ORDER
Date: 11-11-2014 Sri Debasis Bhattacharya These appeals have been preferred against the common impugned order dated 27-11-2012 passed by the Ld. District Forum, Unit-I, Kolkata in Case No. 287/2008, by which, the case of the Complainant under Section 12 of the Consumer Protection Act, 1986 has been allowed on contest against the OPs. Being aggrieved by and dissatisfied with the same, the OPs thereof have preferred these appeals.
In brief, case of the Complainant is that her husband died in a rail accident on 02-08-2006. When she applied before the OP No. 1 for extending insurance benefit in respect of Master Policy No. 040900/46/01/267/01, the said authority informed that her husband owe a sum of Rs. 15,000/- to them and until and unless such amount is cleared, she cannot claim insurance benefit. To repay the same, she deposited a cheque of equivalent amount to the Sreerampore Branch of UBI vide cheque no. 7329203 dated 02-02-2007. The OP No. 1, on 26-03-2007, provided her with a copy of the NoC, which they forwarded to OP Nos. 4 & 5. In absence of any information from the side of the OP No. 5, the Complainant wrote a letter to them on 05-07-2007 and thereafter, again on 27-07-2007 to settle her insurance claim. On 29-08-2007, the OP No. 5 intimated her vide a letter that since her husband did not use Credit Card for consecutive 3 months prior to his death, they repudiated her claim. So, the case.
The OP Nos. 1 & 2 and 4& 5 contested the case separately by filing their respective written versions, whereby they denied all the material allegations of the Complainant. It is the case of the OPs that husband of the Complainant, Late Pranab Kumar Mukhopadhyay was a customer of the SBI Cards and Payment Services Pvt. Ltd. vide No. 4317575204021803. Said card holder failed and neglected to make payment in respect of his dues of SBI card within time. For that reason, the credit card of Late Pranab Kumar Mukhopadhyay was blocked due to non-payment. On 02-08-2006, said card holder died due to accident, after which the Complainant, in her capacity as wife of the cardholder approached the OP Nos. 1 & 2 for according insurance benefit. As per the procedure, the OP Nos. 1 & 2 requested the Complainant to make payment in respect of dues of the deceased card holder and the Complainant cleared the outstanding dues of Rs. 15,000/- and thereafter, the OP Nos. 1&2 on 27-03-2007 issued NoC to the Complainant. Thereafter, the Complainant deposited the claim form and other documents to the OP Insurer. However, the OP Insurer rejected such claim for violation of specific terms and conditions of the insurance policy. It is stated by the OP nos. 4 & 5 that the policy was issued by OP No. 5 to the OP No. 1 under certain specific terms and conditions and one of the stipulations is that the Credit Card Holder must use the card continuously. As the Complainants husband did not adhere to said terms and conditions and did not use the same for the last 3 months prior to his death, the claim was rightly repudiated by the OP No. 5 and there was no deficiency in service on their part. So, the complaint case be dismissed.
Point for consideration is whether the impugned order suffers from any kind of legal or factual infirmity or not.
Decision with reasons The Ld. Advocate for the Insurance Company has submitted that they entered into a tie-up with the SBI Cards for the purpose of extending insurance benefit to its credit cardholders. It was a master policy, not in the name of any individual cardholder, but in the name of SBI Cards. There was stipulation that such card is to be used continuously by the cardholders for 90 days, but it was not done by the Complainants husband, prior to his death. Thereby, he breached the policy condition, for which the claim of the Complainant was repudiated by them. Issue of No Due Certificate in favour of the Complainant by the SBI Cards is no ground since the policy condition is binding on all concerned in its strict sense. The death occurred to the insured instantaneously and he was not treated as such. But the Ld. District Forum made out a third case of his sickness, while in the petition of complaint it was stated that mother of the insured was ill. It was a wrong finding that bounden duty was of the OPs, specially of these OPs/Appellants. It was not the case of the Complainant that policy bond was not given and that the deceased was not aware of the policy conditions during his lifetime. Further, it is not clear as to how the Complainant suffered immense financial loss or mental harassment as said in the impugned order, as she was not at all harassed by the insurance company. On the contrary, the claim was repudiated only because of breach of policy conditions by the cardholder during his lifetime. Moreover, the quantum of compensation and cost are not at all justified, by any standard. For breach of policy condition, the Complainant is not entitled to the insurance benefit of Rs. 2,00,000/-. As such, the awards, along with interest, are not tenable as the same has got no basis whatsoever, rather it has resulted in according double benefit to the Complainant. By far, the impugned order was not a speaking order, bereft of any merit. More so, there is no privity of contract in between the insurance company and the Complainant and/or her deceased husband, but, it was in between the insurance company and the SBI Cards. He has referred to a decision of the Honble National Commission reported in I (2013) CPJ 42 (NC) in the matter.
Ld. Advocate appearing for the SBI Cards has submitted that the deceased was a clear defaulter, which has been admitted by the Complainant in paragraph 4 of her complaint. He has also mentioned that on the basis of their confirmation vide letter dated 28-11-2007 that the Cardholder did not use the card prior to 3 months of his death, the claim was repudiated by the insurer as a No Claim . In fact, the Card was blocked on 30-06-2006 due to non-payment of dues against user of the Credit Card No. 4317 5752 0402 1803. The sum assured is Rs. 2.00,000/- in the event of accidental death, other than during air travel, and it was a Master Policy, issued by the OP No. 5 i.e. Divisional Office of the Insurance Company situated in New Delhi being Policy No. 040900/46/01/267/01 in favour of the OP No. 1. After the death of the cardholder on 02-08-2006, dues amounting to Rs. 15,000/- was paid by the Complainant and accordingly, they issued NoC to the Complainant. As a contract binds all concerned in the same way, in case of any breach of policy conditions, the defaulter cannot claim any benefit out of such contract. Due to fault and/or default of the deceased cardholder, the Complainant is not entitled to get any insurance benefit. There is no speaking reason given in the order by which the complainant has been allowed, for which the order suffers from legal lacuna. He has referred to certain decisions of the Honble Apex Court reported in 2002 (1) All India Banking Law Judgments, p.36, and of the Honble National Commission as reported in 2009 (4) CPR 13 (NC) and 2011 (3) CPR 251 (NC), and of the Honble Himachal Pradesh State Commission reported in 2012 (2) CPR 1 and 2012 (1) CPR 411 and of the Honble Delhi State Commission reported in 2011 (1) CPR 131.
Ld. Advocate for the Complainant has submitted that the MoU executed in between the United India Insurance Co. Ltd. and the SBI Cards, which is a pertinent document for proper adjudication of this case, has not been filed intentionally by either of them. Admittedly, in the event of accidental death, which happened to the husband of the Complainant, a sum of Rs. 2,00,000/- is to be paid to the beneficiary. Despite fully aware about such liability on their part, the Complainant was deprived of her legitimate claim for which, she languished in sufferance and misery. Thus, there was much mental agony as well as physical harassment, being meted out to her by the OPs, with no bounds. She became widow with two minor children. Taking undue advantage of such hapless condition of her, the OPs dared to contest the case, though they have not disputed the accidental death of the cardholder i.e. her husband, giving precedence to mere technicalities. After much effort, the SBI Cards issued NoC in the matter; vide a letter dated 26-03-2007 though she made the payment of Rs. 15,000/- on 02-02-2007, while she used to commute on a regular basis from a far distance place in the District of Hooghly. Still, after issuance of such NoC, the insurance company went on to deny her claim by their letters dated 29-08-2007 and 28-11-2007. The impugned awards are just perfect in nature; 9% interest has only been imposed in case of default and the litigation cost is only one and so, there is no doubling in the matter. All these nefarious activities go to show clearly a conspiracy and collusion between the OPs in nullifying her insurance claim.
The card was blocked by the SBI Cards for non-payment on 30-06-2006 and the cardholder died accidentally on 02-08-2006, leaving him with very little time to clear his outstanding dues in respect of the card, which stood at Rs. 15,000/-, which the Complainant deposited on 02-02-2007 in order to get the insurance claim. Although the Complainant cleared the outstanding dues to the SBI Cards on 02-02-2007, the latter issued NoC to the Complainant on 26-03-2007. No plausible reason is given by the SBI Cards behind such belated issuance of NoC to the Complainant. Thereafter, the Insurance Company took much time and ultimately repudiated the claim on the basis of information from the SBI Cards about non-use of the card, namely SBI Cards by the deceased cardholder, by a letter issued by the OP No. 5 on 29-08-2007 and also by another letter of the OP No. 4 dated 28-11-2007. The reasoning is totally unfair, in the sense that there is no outward objection given by the SBI Card in the matter of claim of the Complainant, rather the SBI Cards issued a belated NoC in favour of the Complainant. Citing non-use of the Card, which was blocked by the SBI Cards, for non-payment of dues, for the stipulated period, the insurance company refused to accord any insurance benefit to the Complainant. Non-use or use of credit card does not in anyway help accumulation of wealth of the insurance company. After issuance of NoC, this kind of activity is bound to diminish the credibility of the OPs as a whole. It is indeed a sad sight that none of the OPs has got any human face. In any case, in the light of foregoing discussion, the repudiation appears to be a faulty one. The impugned order is upheld.
In the result, the appeals fail.
Hence, ORDERED that the FA Nos. 65/2013 and 439/2013 be and the same are dismissed on contest against the Respondent, without any order as to cost. The impugned order is hereby affirmed. Let a copy of this order be forwarded to the Ld. District Forum, Unit I, Kolkata along with the LCR forthwith.
The original copy of the order be kept with the earlier appeal being no. FA/65/2013 and a photocopy of the same be kept in the record of FA/439/2013.
JAGANNATH BAG DEBASIS BHATTACHARYA Member Member