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2018 DIGILAW 619 (HP)

Kangra Central Cooperative Bank v. Saurabh Kumar

2018-04-11

P.S.RANA, VIJAY PAL KHACHI

body2018
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 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 commit any deficiency in service. Prayer for dismissal of consumer complaint against opposite party No. 2 sought. 5. Learned District Forum partly allowed the complaint and ordered opposite parties No. 1 & 2 jointly and severally to pay amount of Rs. It is further pleaded that opposite party No. 2 did not commit any deficiency in service. Prayer for dismissal of consumer complaint against opposite party No. 2 sought. 5. Learned District Forum partly allowed the complaint and ordered opposite parties No. 1 & 2 jointly and severally to pay amount of Rs. 200000/- (Two lac) to the complainants along with interest @9% per annum from the date of complaint till payment. In addition learned District Forum ordered that complainants would be entitled to amount to the tune of Rs. 10000/- (Ten thousand) on account of mental harassment. In addition learned District Forum ordered that complainants would be entitled to litigation costs to the tune of Rs. 3000/- (Three thousand). 6. Feeling aggrieved against order passed by learned District Forum opposite party No. 1 i.e. Kangra Central Cooperative Bank filed F.A. No. 222 of 2017 and opposite party No. 2 i.e. National Insurance Company Limited filed F.A. No. 224 of 2017 before State Commission. 7. We have heard learned advocates appearing on behalf of opposite parties No. 1 & 2 and we have also perused entire record carefully. None appeared for complainants despite service at the time of re-arguments. 8. Following points arise for determination in present appeals. 1. Whether appeal No. 222/2017 title Kangra Central Cooperative Bank v. Saurabh Kumar & Ors. is liable to be accepted as mentioned in memorandum of grounds of appeal. 2. Whether appeal No. 224/2017 title National Insurance Company Limited v. Saurabh Kumar & Ors. is liable to be accepted as mentioned in memorandum of grounds of appeal. 3. Final order. Findings upon point No. 1 with reasons relating to appeal No. 222 of 2017 title Kangra Central Cooperative Bank v. Saurabh Kumar & Ors.: 9. Complainant Saurabh Kumar filed affidavit Ex. CW-1 in evidence. There is recital in the affidavit that father of deponent namely Roshan Lal was agriculturist by profession. There is further recital in the affidavit that father of deponent expired on dated 25.11.2015 by way of falling from the tree when deceased was cutting leaves from the tree. There is further recital in the affidavit that father of deponent had obtained insurance policy i.e. Pradhan Mantri Suraksha Bima Yojna issued by opposite party No. 2. There is further recital in the affidavit that father of deponent expired on dated 25.11.2015 by way of falling from the tree when deceased was cutting leaves from the tree. There is further recital in the affidavit that father of deponent had obtained insurance policy i.e. Pradhan Mantri Suraksha Bima Yojna issued by opposite party No. 2. There is further recital in the affidavit that premium was also deducted from the account of deceased Roshan Lal bearing account No. 20024062132 operative in KCC Bank Branch Jawali District Kangra H.P. There is further recital in the affidavit that terms and conditions of insurance policy were not explained by the opposite parties to the complainants. There is further recital in the affidavit that complainants are legal-heirs of deceased Roshan Lal and are entitled to insurance amount. There is further recital in the affidavit that opposite parties did not settle the claim and committed deficiency in service. 10. Complainants also filed affidavit of Ravi Kumar Ex-Pradhan of Gram Panchayat Jawali Ex. CW-2 in evidence. There is recital in the affidavit that deponent remained Ex-Pradhan of Jawali Panchayat w.e.f. 2010 to 2015. There is further recital in the affidavit that deceased Roshan Lal and his legal-heirs are known to the deponent and they are residing in the Panchayat of deponent. There is further recital in the affidavit that on dated 25.11.2015 Roshan Lal died by way of falling from the tree when deceased was cutting leaves of tree. 11. Complainants also filed affidavit of Pawan Kumar Ex. CW-3 in evidence. There is recital in the affidavit that deceased Roshan Lal was familiar to the deponent and there is further recital in the affidavit that family members of Roshan Lal are also personally known to the deponent. There is further recital in the affidavit that Roshan Lal died on dated 25.11.2015 when deceased was cutting leaves of tree. There is further recital in the affidavit that deponent was also working in the fields at the time of incident. There is further recital in the affidavit that deponent informed the family members of deceased about the incident. 12. Complainants also filed affidavit of Vipan Kumar Ex. CW-4 in evidence. There is recital in the affidavit that deponent remained as ward member of Gram Panchayat Jawali w.e.f. 2010 to 2015. There is further recital in the affidavit that deceased Roshan Lal was residing in his Panchayat. 12. Complainants also filed affidavit of Vipan Kumar Ex. CW-4 in evidence. There is recital in the affidavit that deponent remained as ward member of Gram Panchayat Jawali w.e.f. 2010 to 2015. There is further recital in the affidavit that deceased Roshan Lal was residing in his Panchayat. There is further recital in the affidavit that family members of deceased are also personally know to the deponent because they are also residing in his Panchayat. There is further recital in the affidavit that Roshan Lal died on dated 25.11.2015 when he was cutting leaves from the tree. State Commission also perused all annexures filed by complainants carefully. 13. Opposite party No. 1 filed affidavit of Chander Shekhar Branch Manager KCC Bank in evidence. There is recital in the affidavit that deceased was insured under the Pradhan Mantri Suraksha Bima Yojna (PMSBY) and premium to the tune of Rs. 12/- (Twelve) per annum was deducted from the account of deceased Roshan Lal bearing account No. 20024062132. There is further recital in the affidavit that as per policy if the insured dies in the accident then his legal-heirs would be entitled to amount of Rs. 200000/- (Two lac). There is further recital in the affidavit that no postmortem report filed by complainants. There is further recital in the affidavit that there was delay in lodging FIR/GD entry. There is further recital in the affidavit that deponent has transferred the premium amount to the opposite party No. 2. There is further recital in the affidavit that KCC bank is not liable. State Commission has perused all annexures filed by opposite party No. 1 carefully. 14. Opposite party No. 2 filed affidavit of Khushal Chand Branch Manager National Insurance Company Limited in evidence. There is recital in the affidavit that complainants did not file postmortem report (PMR) of deceased. There is further recital in the affidavit that due to non-filing of PMR claim of complainants could not be released. There is further recital in the affidavit that complainants did not lodge any FIR and simply filed repeat. There is further recital in the affidavit that no medical treatment record was also filed by complainants. There is further recital in the affidavit that opposite party No. 2 did not commit any deficiency in service. State Commission has perused all annexures filed by opposite party No. 2 carefully. 15. There is further recital in the affidavit that no medical treatment record was also filed by complainants. There is further recital in the affidavit that opposite party No. 2 did not commit any deficiency in service. State Commission has perused all annexures filed by opposite party No. 2 carefully. 15. Submission of learned advocate appearing on behalf of Kangra Central Cooperative Bank that role of Kangra Central Cooperative Bank was simply to deduct premium amount to the tune of Rs. 12/- (Twelve) per annum from the account of deceased and Kangra Central Cooperative Bank has performed its role in accordance with law and on this ground appeal filed by Kangra Central Cooperative Bank be allowed is decided accordingly. State Commission is of the opinion that role of Kangra Central Cooperative Bank was limited in nature to deduct the premium amount to the tune of Rs. 12/-(Twelve). There is no evidence on record in order to prove that Kangra Central Cooperative Bank did not deduct the premium and there is also no evidence on record that Kangra Central Cooperative Bank did not transfer the premium amount to the insurance company. In view of the fact that Kangra Central Cooperative Bank has performed its role State Commission is of the opinion that it is not expedient in the ends of justice and on the principle of natural justice to impose any liability upon Kangra Central Cooperative Bank. State Commission is of the opinion that learned District Forum has committed illegality by way of imposing liability upon Kangra Central Cooperative Bank. Point No. 1 is decided accordingly. Findings upon point No. 2 with reasons relating to appeal No. 224 of 2017 title National Insurance Co. Ltd. v. Saurabh Kumar & Ors.. 16. Evidence is not repeated again in order to avoid repetition. Submission of learned advocate appearing on behalf of insurance company that complainants did not file any postmortem report and on this ground appeal filed by insurance company be allowed is decided accordingly. Complainants have specifically mentioned that terms and conditions of insurance policy were not explained to deceased Roshan Lal or to his legal-heirs by insurance company. Khushal Chand Branch Manager National Insurance Co. Ltd. did not mention in the affidavit that terms and conditions of insurance policy were duly explained to deceased Roshan Lal or his legal-heirs. Complainants have specifically mentioned that terms and conditions of insurance policy were not explained to deceased Roshan Lal or to his legal-heirs by insurance company. Khushal Chand Branch Manager National Insurance Co. Ltd. did not mention in the affidavit that terms and conditions of insurance policy were duly explained to deceased Roshan Lal or his legal-heirs. It is well settled law that when exclusion clause was not explained to the beneficiary then insurance company could not claim benefit of exclusion clause. See 2000 (2) sCc 734 titled Modern Insulators Ltd. v. Oriental Insurance Company Limited. Also see 2007 (3) CPJ 34 NC National Insurance Company Limited v. D.P. Jain. Law laid down by Hon''ble Apex Court of India is binding upon all Courts, Tribunals, Commissions as per Article 141 of the Constitution of India. State Commission is of the opinion that onus was upon insurance company to explain exclusion clause to insured or legal-heirs of insured. It is well settled law that no one can be allowed to take benefit of its own wrongs and laxity. 17. It is well settled law that controversial facts could be proved by way of modes mentioned under section 13(4) of Consumer Protection Act 1986. Fact that deceased died by way of falling from the tree when deceased was cutting leaves of tree is proved by way of affidavit of Pawan Kumar. Pawan Kumar is eye-witness of incident and Pawan Kumar has specifically mentioned in affidavit that deceased had died by way of falling from tree when deceased was cutting leaves of tree. State Commission is of the opinion that affidavit filed by eye-witness Pawan Kumar is trustworthy, reliable and inspires confidence of State Commission. Affidavit of Pawan Kumar is corroborated by Ravi Kumar Ex-Pradhan by way of affidavit and also corroborated by ward Member Vipan Kumar by way of affidavit. State Commission is of the opinion that affidavits of Ravi Kumar, Pawan Kumar and Vipan Kumar are trustworthy, reliable and inspire confidence of State Commission. State Commission is of the opinion that affidavit filed by Khushal Chand Branch Manager National Insurance Company is not sufficient to rebut the affidavits filed by Ravi Kumar, Pawan Kumar and Vipan Kumar because Khushal Chand was not eyewitness of incident and Khushal Chand was not present at the place of incident when incident took place. Khushal Chand has filed affidavit on the basis of derived knowledge. Khushal Chand has filed affidavit on the basis of derived knowledge. It is held that it is not expedient in the ends of justice and on the principles of natural justice to rely upon the affidavit filed on basis of derived knowledge. Pradhan Mantri Suraksha Bima Yojna (PMSBY) is beneficial scheme and it is held that insurance company could not be allowed to take benefit of its own wrongs in order to defeat object of Pradhan Mantri Suraksha Bima Yojna (PMSBY) scheme. 18. Submission of learned advocate appearing on behalf of insurance company that no FIR was filed and simply rapat was lodged in the police station and on this ground appeal filed by insurance company be allowed is decided accordingly. State Commission is of the opinion that complainants have recorded rapat in the police station and it was the duty of police to record FIR. State Commission is of the opinion that complainants could not be penalized for the fault of police officials. Point No. 2 is decided accordingly. Point No. 3: Final Order 19. In view of findings upon points No. 1 & 2 above F.A. No. 222/2017 title Kangra Central Cooperative Bank v. Saurabh Kumar & Ors. is allowed and order of learned District Forum against Kangra Central Cooperative Bank is set aside. Kangra Central Cooperative Bank is exonerated from the liability. Appeal No. 224/2017 title National Insurance Company Limited v. Saurabh Kumar & Ors. is dismissed and order of learned District Forum passed against insurance company is affirmed. Parties are left to bear their own litigation costs before State Commission. Order of learned District Forum is modified to this extent only. Certified copy of order be placed in the original file of appeal No. 224 of 2017 forthwith. File of learned District Forum alongwith certified copy of order be sent back forthwith and files of State Commission be consigned to record room after due completion forthwith. Certified copy of order be transmitted to parties forthwith free of costs strictly as per rules. Both appeals are disposed of. Pending application(s) if any also disposed of.