SHIKHA BHATIA vs NEW INDIA ASSURANCE CO. LTD.

COMPLAINANT is widow of Mr. Deepak Bhatia who died in a car accident on 24.1.1996. He was holder of Citi Bank Diners Club Card issued by O.P. No. 3/Citi Bank. As per this Card insurance cover of Rs. 5 lacs against accident was covered. Insurance cover was issued by O.P. Nos. 1 and 2. COMPLAINANT filed a claim against insurance cover on 22.4.1996. Besides other documents, legal heirship certificate on the format provided by O.P. No. 3/Citi Bank duly notarised on Rs. 10 non-judicial stamp paper was also submitted. O.P. No. 2 raised piecemeal objections and by one of their communications dated 27th March, 1996 the O.P. No. 2 laid down unconstitutional condition that all the documents in vernacular be submitted in English signed by the translator and attested by a Notary Public. Hindi version of the FIR was also submitted. Heirship certificate from the Sub-Divisional Magistrate was also submitted to O.P. No. 2 but it rejected the same second time and directed the complainant to reproduce the same on standard format. Ultimately, the legal advisor of O.P. No. 2 Mr. S.K. Paul agreed to accept the legal heirship certificate. His opinion in this regard was as under: "I have perused document No. 1 i.e., affidait-cum-consent of certificate of legal heirship executed on a non-judicial stamp paper of Rs. 10. Please note that this affidavit should be acceptable to the New India Assurance Co. Ltd. provided the same is duly attested by a Notary Public."

HOWEVER, O.P. No. 2 passed the claim of Rs. 2,00,000 and not Rs. 5,00,000. Feeling aggrieved the complainant has filed this complaint seeking the difference of insurance amount, amounting to Rs. 3,00,000 and interest of Rs. 1,70,000 and compensation of Rs. 3,00,000 against mental torture and Rs. 10,000 against cost. As is apparent from the aforesaid facts, O.P. No. 3 took the plea that it has no role to play as the matter pertained to claim of insurance benefit and bank was not responsible for any warranty or quality, delivery of the cover or claims processing whatsoever.

Admittedly, the insurance cover was against death, disability, injury, and hospitalisation of the insured. As regards the stand of O.P. Nos. 1 and 2 the sum assured was Rs. 2 lacs and not Rs. 5 lacs and the period covered by the policy was between 1.12.1995 to 10.11.1996.

THE main controversy emerging from the aforesaid rival claim is with regard to the amount of insurance as the facts of complainant being holder of Credit Card of Citi Bank and insurance cover note, legal heirship of the complainant are not in dispute. Since the O.P. Nos. 1 and 2 have accepted the claim of the complainant to the extent of Rs. 2,00,000 every other plea raised by O.P. No. 1 as to delay in filing the claim and delay in informing O.P. Nos. 1 and 2 about the death or in filing heirship certificate etc. are rendered infrcutuous and redundant. O.P. Nos. 1 and 2 have relied upon the Diners Club Portfolio of Membership Services wherein the security for the Card member and his family under the title ''Club Protection'' was as under: "Your Diners Club International offer extra protection to your loved one. In case Diners Club Membership insured''s loss of life Rs. 30,00,000 and Rs. 2,00,000 in case of loss of life in accident. This protection cover not only in India but anywhere in the world."

AS against this the accident policy issued by O.P. No. 1 which has been produced and proved by complainant as Annexure A and is dated 29.11.1995 shows that the total amount of premium against insurance coverage received by the O.P. for the period 1.12.1995 to 30.11.1996 was Rs. 4,07,49,708. There is another document produced by the complainant which is on the letter head of Diners Club International which is dated 10.7.1997. According to this document the personal accident insurance in the form of automatic accident insurance was covered upto Rs. 15 lacs while for other accident it was Rs. 5 lacs. In this document there is different amount against loss of life in air accident than in any other accident. Third document produced and proved by the complainant is the certificate of insurance where maximum sum assured was Rs. 10,00,000 and was provided to members of Diners Club. This certifiate expired on 30.11.1994. According to this document the sum assured was Rs. 10,00,000 in case of air accident and Rs. 5,00,000 in case of other accidents.

IF we go by the certificate which expired on 30.11.1994 and also by the contention of the O.P. Nos. 1 and 2 that every year they go on changing their policy, we find in the pamphlet produced by O.P. Nos. 1 and 2 that the club member is insured against loss of life in air accident at Rs. 30 lacs and Rs. 2 lacs in any other accident. Such a differentiation is highly irrational and arbitrary and does not project that this was the policy of O.P. Nos. 1 and 2 in the year 1995-96. On the one hand, they have increased the amount of compensation in case death in air accident to three times i.e., Rs. 10 lacs in the year 1994 to Rs. 30 lacs in the year 1995-96 whereas they have reduced the amount of Rs. 5 lacs in other accident to Rs. 2 lacs. Even otherwise pamphlet produced before us shows as if it has been printed this year and does not appear to be as old as issued in 1995-96.

SINCE the O.Ps. have failed to produce any document or certificate showing that between 1995-96 the insurance amount in case of death in accident other than air was Rs. 2 lacs we do not perceive any reason by applying rule of prudence in the context of certificate which was for the period upto 30th November, 1994 that the amount of insurance cover in case of death in any other accident continued to be Rs. 5 lacs whereas the amount of insurance in case of death by air accident rose to Rs. 30 lacs i.e., three times. In the result, we allow the complaint by awarding additional compensation of Rs. 3 lacs towards insurance cover and Rs. 50,000 as compensation on account of mental agony and harassment, which shall include cost of litigation. O.P. No. 1 shall make the above payment to the complainant within one month.

Complaint is disposed of in aforesaid terms strictly in view of the agreement between the parties.

IT is not understandable as to what is the basis of difference in the amount of insurance cover in respect of death by air accident or in any other accident in spite of the fact that the club members who are holding cards pay same amount of premium. Death is a death whether it is by air accident or in any other accident. To our understanding such a distinction has been carved out to augment the business by doling out comparatively astronomically high amount to those consumers who are always on the wings. Insurance Companies and for that purpose banks know well that deaths by air are very rare while death by accidents in a metropolis like Delhi are daily tragedies. This is nothing short of an unfair trade practice and needs to be stopped forthwith. Any trade practice is unfair trade practice that materially misleades the public concerning the price at which a product or goods or services, have been or are, ordinarily sold or provided and for this purpose, a representation as to price shall be deemed to refer to the price at which the products or goods or services has or have been sold by sellers or provided by suppliers generally in the relevant market unless it is clearly specified to be the price of which the product has been sold or services have been provided by the person by whom or on whose behalf the representation is made. In the absence of any convincing evidence in case of death in accidents other than death in air accident we find it difficult to ram down the throat that the insurance cover was Rs. 2 lacs in the year 1995-96 which means that it was a reduced insurance cover than the one given in the year 1994 whereas it was increased three times in case of death by air accident.

BY this order we issue fiat to all the Banks and Insurance Companies by invoking provision of Section 14(1)(f) of the Consumer Protection Act, 1986 to the discontinuation of practice of different amount of insurance cover for death by air accidents and in any other accidents and advertise in the papers that holders of such cards shall be paid equal amount of insurance in case of death by accident irrespective of air accident or any other accident where premium amount is the same. Equals cannot be treated as unequals nor can death by accident be treated differently. A copy of this order as per the statutory requirements, be forwarded to the parties free of charge and thereafter the file be consigned to Record Room. Copy be sent to Presidents of District Forums.

COPY be sent to Citi Bank and other Banks and Insurance Companies.

COPY be sent to National dailies for the knowledge of service providers and consumers at large. Complaint allowed.