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HIMACHAL PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Justice P.S. Rana (R), President, Mr. Vijay Pal Khachi, Member.
Kangra Central Cooperative Bank - Appellant
Versus
Saurabh Kumar - Respondent
First Appeal Nos. 222 and 224 of 2017
Decided On : 11-04-2018
Consumer Complaint - Consumer Protection Act 1986 - Section 12, Pradhan Mantri Suraksha Bima Yojna - [Section 12, Pradhan Mantri Suraksha Bima Yojna] - The court discussed the applicability of the Consumer Protection Act 1986 and the terms and conditions of the Pradhan Mantri Suraksha Bima Yojna. It emphasized the duty of the insurance company to explain exclusion clauses to the insured or their legal heirs and held that the insurance company could not claim the benefit of exclusion clauses if not explained. The court also considered the evidence provided by eyewitnesses and the duty of the police to record FIR, ultimately exonerating the bank and dismissing the appeal against the insurance company.
Fact of the Case:
The complainants filed a consumer complaint under section 12 of the Consumer Protection Act 1986 against the Kangra Central Cooperative Bank and National Insurance Company Limited, seeking payment of an insurance claim and alleging deficiency in service. The District Forum partly allowed the complaint, ordering the opposite parties to pay the insurance claim, interest, and costs. The opposite parties filed appeals against this order before the State Commission.
Finding of the Court:
The court analyzed the evidence provided by the complainants and the opposite parties, including affidavits and submissions. It found that the bank had fulfilled its role in deducting and transferring the premium, exonerating it from liability. The court also held that the insurance company failed to explain exclusion clauses and could not benefit from them. It considered the evidence provided by eyewitnesses and held that the duty of recording FIR lay with the police, not the complainants.
Issues: The issues involved determination of the liability of the bank and the insurance company, acceptance of the appeals, and the final order.
Ratio Decidendi: The court's decision was based on the fulfillment of the bank's role, the failure of the insurance company to explain exclusion clauses, and the duty of the police to record FIR. It emphasized the duty of the insurance company to explain exclusion clauses and the reliability of eyewitness evidence.
Final Decision: The appeal against the bank was allowed, exonerating it from liability, while the appeal against the insurance company was dismissed, affirming the District Forum's order. Each party was left to bear its own litigation costs.
ORDER
P.S. Rana (R), President. - Both appeals i.e. F.A. No. 222/2017 and F.A. No. 224/2017 filed against the same order passed by learned District Forum in consumer complaint No. 137/2016 title Saurabh Kumar & Ors. v. Kangra Central Cooperative Bank & Anr. Both appeals consolidated and dispose of vide same order in order to avoid conflicting orders.
Brief facts of Consumer Complaint:
2. Complainants filed consumer complaint under section 12 of Consumer Protection Act 1986 against opposite parties pleaded therein that predecessor in interest of complainants namely Shri Roshan Lal was agriculturist by profession who expired on dated 25.11.2015 by way of falling from the tree when deceased was cutting leaves of tree. It is pleaded that Shri Roshan Lal was insured under the accidental insurance policy scheme i.e. Pradhan Mantri Suraksha Bima Yojna with opposite party No. 2 for the year 2015-16 and premium was deducted from the account of deceased bearing account No. 20024062132 in KCC Bank Branch Jawali District Kangra H.P. It is pleaded that complainants are legal-heirs of deceased Roshan Lal and after death of Roshan Lal complainants are entitled to receive the insurance amount from opposite party No. 2. It is further pleaded that after the death of Roshan Lal complainants approached opposite parties for payment of insurance claim but opposite parties did not pay the insurance claim and committed deficiency in service. Complainants sought relief of payment of insurance claim along with interest @18% per annum. In addition complainants sought relief of payment of Rs. 50000/- (Fifty thousand) for mental agony. In addition complainants sought costs of litigation to the tune of Rs. 10000/- (Ten thousand). Prayer for acceptance of consumer complaint sought.
3. Per contra version filed on behalf of opposite party No. 1 pleaded therein that complaint is not maintainable. It is pleaded that consumer complaint has been filed just to harass opposite party No. 1. It is further pleaded that complainants have not approached District Forum with clean hands and it is further pleaded that complainants are estopped by their act, conduct and acquiescence from filing the present consumer complaint. It is admitted that deceased had obtained insurance policy under Pradhan Mantri Suraksha Bima Yojna (PMSBY) from opposite party No. 2. It is further pleaded that premium was also deducted from the account of deceased Roshan Lal bearing account No. 20024062132 in KCC Bank Branch Jawali District Kangra H.P. It is further pleaded that as per policy if any person expired due to any accident then his legal-heirs would be entitled to claim accident claim to the tune of Rs. 200000/- (Two lac). It is further pleaded that opposite party No. 1 used to collect premium from the deceased and used to transfer the premium to opposite party No. 2. It is further pleaded that no postmortem report was filed by complainants and there was delay in lodging the FIR/GD entry. It is further pleaded that opposite party No. 1 collected premium from the deceased and transferred the premium to the opposite party No. 2. It is further pleaded that opposite party No. 1 did not commit any deficiency in service. Prayer for dismissal of consumer complaint against opposite party No. 1 sought.
4. Per contra separate version filed on behalf of opposite party No. 2 pleaded therein that complainants have no cause of action against opposite party No. 2 and it is pleaded that complainants are not consumer as per Consumer Protection Act 1986. It is further pleaded that postmortem report was not filed as required under the law. It is further pleaded that no FIR was lodged and only repeat was lodged in the daily station diary on dated 26.11.2015. It is further pleaded that no MLC of deceased supplied. It is further pleaded that no treatment record of deceased supplied. It is further pleaded that complainants are not entailed to any relief. It is further pleaded that opposite party No. 2 did not c
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