State Consumer Disputes Redressal Commission
National Insurance Comapny Limited vs Smt. Nanda Dhami on 20 September, 2022
STATE CONSUMER DISPUTES REDRESSAL COMMISSION UTTARAKHAND
DEHRADUN
FIRST APPEAL NO. 41 / 2021
National Insurance Company Limited
through its Branch Manager, Branch Office Kohli Hospital Building
Haridwar Road, Rishikesh, Dehradun
through its Authorised Signatory, Regional Office, Jai Plaza
56, Rajpur Road, Dehradun
...... Appellant / Opposite Party No. 2
Versus
1. Smt. Nanda Dhami W/o late Sh. Keshar Singh
R/o Village Champani (Ranthi), Post Ranthi
Tehsil Dharchula, District Pithoragarh
...... Respondent No. 1 / Complainant
2. Branch Manager, Pithoragarh Regional Gramin Bank
Branch Dharchula, District Pithoragarh
...... Respondent No. 2 / Opposite Party No. 1
Sh. Deepak Ahluwalia, Learned Counsel for the Appellant
None for Respondents
Coram: Hon'ble Mr. Justice D.S. Tripathi, President
Mr. Udai Singh Tolia, Member-II
Dated: 20/09/2022
ORDER
(Per: Justice D.S. Tripathi, President):
This appeal under Section 41 of the Consumer Protection Act, 2019 has been preferred against the impugned judgment and order dated 15.02.2021 passed by the District Consumer Disputes Redressal Commission, Pithoragarh (in short "The District Commission") in consumer complaint No. 04 of 2015; Smt. Nanda Dhami Vs. Branch Manager, Pithoragarh Regional Gramin Bank and another, by which the consumer complaint was allowed and the appellant - opposite party No. 2 was directed to pay the insured amount of Rs. 1,00,000/- to respondent No. 1 - complainant within a period of one month, 2 failing which the above amount was directed to carry interest @7% p.a. from the date of institution of the consumer complaint till payment. The appellant was further directed to pay Rs. 5,000/- to respondent No. 1 - complainant towards mental agony as well as litigation expenses of Rs. 5,000/-.
2. Facts giving rise to this appeal, in brief, are that according to the consumer complaint, the complainant - Smt. Nanda Dhami and her deceased husband - late Sh. Keshar Singh, had a joint Savings Bank Account No. 4327076061 with Pithoragarh Regional (Kshetriya) Gramin Bank - opposite party No. 1 to the consumer complaint (respondent No. 2 herein). In the event of accidental death of the accountholder of the said account, his legal heirs were to get Rs. 1,00,000/- towards personal accident insurance cover. The husband of the complainant died in a road accident (jeep accident) on 20.11.2013. The complainant submitted the claim form with the bank and completed the requisite formalities, but the amount was not paid. The complainant sent a legal notice dated 16.09.2014 to the bank, in response whereof, the bank through letter dated 24.09.2014, intimated that they have forwarded the claim form along with documents to the appellant - insurance company. However, the claim was closed by the insurance company as No Claim, which was informed by them to the bank through letter dated 16.06.2014. Therefore, the complainant filed a consumer complaint before the District Commission.
3. The appellant - insurance company filed written statement before the District Commission, wherein it was pleaded that upon receipt of claim, investigation was carried out, which revealed that the complainant is the first accountholder of the joint account in question and her husband was a co-accountholder. As per the terms and 3 conditions of the insurance policy, the risk of first accountholder is covered, hence the claim was rightly treated as No Claim.
4. The respondent No. 2 - bank filed written statement before the District Commission, pleading therein that in respect of the account in question, the name of late Sh. Keshar Singh, the deceased husband of the complainant, was recorded as second accountholder. The amount of premium paid by the complainant, was forwarded to the insurance company. The bank has acted only as a facilitator and the consumer complaint is liable to be dismissed against the bank.
5. After giving opportunity of hearing to the parties, the consumer complaint has been decided by learned District Commission vide impugned judgment and order dated 15.02.2021, thereby allowing the consumer complaint in the above terms. Feeling aggrieved, the appellant has preferred the instant appeal.
6. We have heard arguments advanced by learned counsel for the appellant. None appeared on behalf of respondents. Service of notice upon respondents was held to be sufficient vide order dated 13.07.2022.
7. Learned counsel appearing on behalf of the appellant - insurance company argued that under the Tailormade Group Personal Accident Insurance Policy issued by the insurance company in favour of Uttarakhand Gramin Bank, the personal accident insurance cover (Death risk only) was provided to Saving and Current First Bank Accountholder to the tune of Rs. 1,00,000/- each and since the deceased husband of the complainant was the co-accountholder of the account in question and the first accountholder was the complainant, hence the deceased was not covered under the policy and no amount 4 was payable by the insurance company in the event of accidental death of the deceased.
8. We find force in the arguments advanced by learned counsel for the appellant - insurance company. The copy of the insurance policy is on record (Paper Nos. 15 to 16), the perusal thereof clearly shows that under the policy, the risk covered was group personal accident insurance (death risk only) to saving and current first bank accountholders of 705669 accounts for Rs. 1,00,000/- each Savings Bank and Current Accountholder. There is no dispute with regard to the fact that the Savings Bank Account No. 4327076061 was opened by the complainant - Smt. Nanda Dhami with Pithoragarh Kshetriya Gramin Bank and her husband - Sh. Keshar Singh was the co-accountholder (second accountholder), as would be evident from the copy of the passbook (Paper No. 18 on record). It would not be out of place to mention to here that the bank in its written statement filed before the District Commission has specifically pleaded that in the subject account, the name of the deceased - Sh. Keshar Singh was mentioned as second accountholder and the bank account was opened in the name of the complainant - Smt. Nanda Dhami. Thus, it is crystal clear that the deceased husband of the complainant being the second accountholder, was not covered under the insurance policy and the insurance company was perfectly justified in repudiating the claim as No Claim and by doing so, no deficiency in service was committed by the insurance company. The District Commission has wrongly held that since the insurance policy has been obtained in respect of the bank account, hence in the event of accidental death of any of the accountholder, the benefit of the insurance policy is to be granted to his / her legal heirs. The said observation of learned District Commission is contrary to the terms and conditions of the insurance policy, which is a contract between the parties and both the parties are 5 bound by the terms and conditions of the insurance policy. Thus, we are not in agreement with the findings recorded by learned District Commission.
9. Learned counsel for the appellant has cited judgment and order of Hon'ble Apex Court given in the case of United India Insurance Co. Ltd. Vs. Harchand Rai Chandan Lal reported in IV (2004) CPJ 15 (SC). Relevant portion of paragraph No. 5 of the said judgment is reproduced below:
"5. The question before us is whether in terms of the policy, the repudiation of the claim of the respondent by the appellant company is justified or not. We have already reproduced the terms of the policy as also the definition of burglary and / or housebreaking as defined in the policy. The definition given in the policy is binding on both the parties. The policy is a contract between the parties and both parties are bound by the terms of contract.
.......................... The terms of the policy have to be construed as it is and we cannot add or subtract something.
Howsoever liberally we may construe the policy but we cannot take liberalism to the extent of substituting the words which are not intended."
10. For the foregoing reasons, we are of the considered opinion that the impugned judgment and order passed by learned District Commission suffers from material illegality, warranting interference by this Commission. Consequently, the appeal deserves to be allowed and the impugned judgment and order passed by learned District Commission is liable to be set aside.
611. Appeal is allowed. Impugned judgment and order dated 15.02.2021 passed by the District Commission is set aside and consumer complaint No. 04 of 2015 is dismissed. No order as to costs. The amount deposited by the appellant with this Commission, be released in its favour.
12. A copy of this Order be provided to all the parties free of cost as mandated by the Consumer Protection Act, 1986 / 2019. The Order be uploaded forthwith on the website of the Commission for the perusal of the parties.
(U.S. TOLIA) (JUSTICE D.S. TRIPATHI)
Member-II President
K