Moga District Commission Holds TATA AIG Insurance Co. Liable For Deficiency In Service, Orders Disbursement of Insurance Amount And Compensation

Brief Facts:

Mrs Baljinder Kaur's son, Prabhjot Singh (now deceased), held a savings bank account with HDFC Bank Limited (“Bank”). The account included a RuPay Debit Card, issued against a fee of Rs. 236, with an account opening date, categorized as Platinum. Her son was unmarried, making the Complainant the sole legal heir as the nominee. The deceased son was insured through Tata AIG General Insurance Policy through Tata AIG General Insurance Company Limited (“Insurance Company”), linked to his RuPay Platinum Debit Card. After his tragic death in a road accident, the Complainant filed a claim for the insurance amount, providing all necessary documents. However, the Insurance Company rejected the claim, contending that there were no POS or e-commerce transactions within 30 days before the accident. The Complainant refuted this, citing a UPI transaction made by her son, four days before his demise, for fuel payment at Monga Filling Station using the Debit Card. The Complainant made several communications with the Insurance Company but didn't receive any satisfactory reply. Feeling aggrieved, the Complainant filed a consumer complaint in the District Consumer Disputes Redressal Commission, Moga, Punjab (“District Commission”).

In response, the Insurance Company raised preliminary objections, arguing that the case involved intricate legal and factual questions requiring extensive documentation and evidence, which was unsuitable for summary proceedings under the Consumer Protection Act, 2019. It also claimed the Complainant concealed material facts, including the absence of POS or e-commerce transactions as per the insurance policy's key condition.

The bank, in its written reply, contested the complaint, labelling it an abuse of the legal process. It characterized the complaint as baseless and devoid of merit, denying all allegations made against them. It argued that the Complainant failed to prove any fault on its part, contending that there is no evidence pointing to any deficiency in service or unfair trade practice. It accused the Complainant of concealing vital facts, portraying the complaint as an attempt to harass and extort money from them without substantial evidence.

Observations by the Commission:

The central question before the District Commission was whether the transaction four days before the demise of the Complainant's son qualified as an e-commerce transaction. The District Commission referred to the 'Declaration from Member Bank' attached to the Insurance Company's records, explicitly stating the transaction as "E-Commerce" for fuel at Monga Filling Station. Therefore, the District Commission concluded that the transaction was an e-commerce transaction. It rejected the Insurance Company's contention that the deceased account holder did not make POS e-commerce transactions within the stipulated period. Additionally, the District Commission noted that the Insurance Company failed to produce evidence that the deceased was made aware of the key conditions of the policy, noting that the banks needed to inform customers about insurance cover terms. Therefore, the District Commission held the Insurance Company liable for deficiency in services. The complaint against HDFC Bank was dismissed.

The District Commission directed the Insurance Company to pay the death claim to the Complainant, along with other benefits under the policy. It directed the Insurance Company to pay a compensation of Rs. 10,000/-. It also dismissed the complaint against the bank.

Case Title: Baljinder Kaur vs Tata AIG General Insurance Company Limited and Anr.

Case No.: Complaint Case No. CC/140/2022

Advocate for the Complainant: Shri Ashok Goyal

Advocate for the Respondent: Shri Vishal Jain (For TATA AIG) and Shri Arun Tayal (For HDFC Bank Limited)

Click Here To Read/Download Order