Bank and insurer jointly liable for deficiency where bank as agent deducts premium from joint account for insurance scheme but fails to forward enrolment data to insurer, causing claim rejection despite insured's bona fide belief in coverage.

PRESIDENT JUDGMENT

1. The facts of the case as per the District Commission record are as under:

“1. Complainant submits that his wife namely Smt. Surinder Kaur, who was the joint account holder of SB Account No. 90462010100330 with him which was being maintained with OP No. 1 Bank at its Tilak Nagar, New Delhi branch, expired on 12.06.2017. The complainant had applied for Pradhan Mantri Jeevan Jyoti Bima Yojana Scheme (for short the 'Scheme') in the name of his wife Smt. Surinder Kaur through off-line through OP No. 1, in which complainant was her nominee. In furtherance of the above noted Scheme, the annual premium of Rs.330/- has been paid twice from the joint account of complainant and his wife and the policy document was issued by OP No. 2. The complainant had completed all the formalities including submission of death certificate of his wife for taking the claim of his deceased wife in the Scheme and also filled up the revised form as desired by OP No.1. In the said form, OP No. 1 had put its seal and its representative also signed the same.

2. Complainant submits that OP No.2 has malafidely and illegally rejected the claim of complainant due to the reason that no data is available with it for the above deceased policy holder under the Scheme. The proposal being accepted by OP No. 2 and charging of the premium for the same is clear evidence that the policy stood in the name of complainant, hence the OPs are jointly and severally liable to pay the claim of complainant, being the nominee of his deceased wife.

3. Complainant submits that in order to get his dues under the Scheme/Policy, he also sent a legal notice to both the OPs through his counsel and OP No. 2 has given reply thereto vide letter dated 30.07.2018 by stating that "We have called for the details from Syndicate Bank Corporate Office Bangalore, on hearing from them we will revert back you" but till date no response is given by OP No.2. The OPs are harassing the complainant and he is suffering due to joint acts of OPs. Hence the present complaint. The following relief are claimed by the complainant:

a. To direct the OPs to pay the claim of the complainant against policy No. 900100001.

b. To direct the OPs to pay compensation in the sum of Rs.50,000/- towards mental agony and harassment due to their deficiency and negligence in services and also to pay litigation charges amounting to Rs. 11,000/- to the complainant.

c. Any other order which this Commission deems fit and proper, in the interest of justice.

4. The following documents are attached with the complaint:

1. Acknowledgement Slip of Certificate of Insurance under PMJJBY Scheme issued by OP No.1;

2. Death certificate of Smt. Surinder Kaur

3.Consent-cum-Declaration Form under the PMJJBY Scheme dated 06.05.2016;

4. Claim Form under the PMJJBY Scheme submitted by complainant to OP No.1 on 20.07.2017 against Policy No.900100001;

5. Statement of a/c of OP No.1 showing deduction of Rs. 330/- towards premium of PMJJBY Scheme;

6. Letter dated 10.05.2018 sent by OP No.2 to OP No.1 thereby rejecting the claim under the PMJJBY Scheme;

7. Inter office Memo dated 8.6.2018 intra department of OP No.1 informing of rejection of claim in r/o late Smt. Surinder Kaur;

8. Legal notice dated 23.7.2018 sent by complainant to OPs 1 & 2

5. Upon admission of the complaint on 27.09.2018, notice was sent to OPs 1 & 2. Both the OPs filed their respective written statements.

6. In the written statement filed by OP No.1, it