DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MALDA, MALDA D.F.ORIGINAL CASE No.48/2007. Date of filing of the Case: 22.08.2007 Complainant | Opposite Parties | Smt. Sumitra Mandal (48 yrs) Wife of Late Madan Mandal Resident of Vill. Tipajani, P.O. Arapur, P.S. English Bazar, Dist. Malda. | 1. | The Sr. Divisional Manager, New India Assurance Company Limited, Howrah Divisional Office – 512200, Madhusudan Apartment (2nd floor), P.-18, Dobson Lane, Howrah – 711101. | 2. | Divisional Manager New India Assurance Co. Ltd., Burdwan Division G.T Road P.O. + Dist. Burdwan. | 3. | The Manager The Golden Trust Financial Services, S.B. Manson, 16, R.N. Mukherjee Road, Kol – 700 001. | 4. | The Manager The Golden Trust Financial Services (Near State Bank of India, Rathbari Branch), P.O. Rathbari, N.H. 34, P.S. E.B. District Malda. |
Present: | 1. | Shri A.K. Sinha, Member | 2. | Smt. Sumana Das, Member |
For the Petitioner : Krishnagopal Das Advocate. For the O.Ps.: For the O.P. Nos. 1 & 2 Arijit Neogi & For the O.P. Nos. 3 & 4 Tarit Ojha & Md. Ziaullaha, Advocates. Order No. 21 Dt.17.06.2008 The fact of the case, in brief is that the petitioner, Sumitra Mandal, has become a soul nominee of Group Janata Personal Accident Insurance Policy bearing No.4751220001799/E:No.47-30897 after the death of her husband due to falling down from the mango tree on 14.10.2004. On the basis of the validity period of the policy is from 237.2000 to 22.7.2015 and the sum assured is Rs.1,00,000/-. Being a rustic village woman, the petitioner informed O.P. No.4 on 08.11.2004 about the accidental death of her husband and submitted claim form along with all relevant documents to O.P. No.4 (Manager, GTFS, Rathbari branch, Malda) on 08.2.2006. O.P. No.4 thereafter sent the documents to O.P. No.3. on 03.03.2006, O.P. No.3 Contd.P/2….. P – 2 wrote a letter under No.FTFS/CLAIMS/SKB/JPA/05484 to O.P. No.1 (Sr. Divn. Manager, New India Assurance Company Ltd., Howrah Divn.) intimating that they have received all relevant documents from the petitioner and consequently O.P. No.1 received the claim form on 11.3.2006. but even after long lapse of time her claim has not yet been disbursed by the O.Ps. for which in petitioner, the wife of the deceased has filed the present case for the reliefs made out in the petition of complaint. O.P. No.1 contests the case by filing a written version denying material allegations contending inter-alia that the claim is completely based on imagination and also fabricated for unlawful gain. This O.P. is not legally bound to pay any sum insured on behalf of O.P. No.s 3 and 4 as per terms and conditions as well as ‘MOU’ executed by and between this O.P. and O.P. Nos. 3 & 4. Hence the petition will be liable to be rejected with cost. Notices have been duly served upon O.P. No.2 (Divn. Manager, New India Assurance Com. Ltd., Burdwan) but none appears. Hence the case be heard exparte as against O.P. No.2. Both O.P. Nos. 3 & 4 contest the case by filing joint written version stating therein that Madan Mandal, since deceased obtained a JPA Policy with New India Assurance Company through GTFS and the death of Madan Mandal is accidental in nature and GTFS immediately sent all the documents to appropriate authority. So there has been no negligence or deficiency in service on their part and their name be kindly expunged from the petition of complaint. On pleadings of both parties, the following points have been emerged for effective disposal – 1. Whether the petitioner is a ‘consumer’ in terms of Sec.2(1)(d)(ii) of the Consumer Protection Act? 2. Whether the service of O.Ps. suffers from any deficiency? 3. Whether the petitioner is entitled to get any relief as prayed for? Point No.1: ‘Consumer’ means any person who hires any services for consideration. ‘Service’ means service of any description which is made available to potential users and includes the provisions of facilities in connection with insurance as defined in cl(O) of Seb Sec.(i) of Sec.2 of C.P. Act. Thus, having regard to the facts and circumstances of the case there Contd.P/3….. P – 3 can be no dispute that the petitioner is a nominee of JPA Policy holder, Madan Mandal. There can also be no dispute that New India Assurance Company makes it service available in connection with insurance to potential user and as such the petitioner becomes the consumer in connection with O.Ps (1 & 2) within the meaning of the Act which disposes of the present point in the affirmative. Point No.2: We need not say that insurance contracts are ‘uberrime-fides’ and are founded upon utmost good faith. If any party fails to observe this utmost good faith, the contract may be avoided by the others. This legal position has been reiterated time and again by our Apex Court as well as by many Hon’ble High Courts. In the instant case the petitioner has been examined as P.W. – 1 and in course of her evidence she has produced some documents which have been marked as Ext.1 to 8 and in course of her cross-examination by O.P. Nos. 1, 3 & 4 the petitioner, being a nominee, has stated that all relevant documents were submitted to GTFS who in their turn has submitted all documents to New India Assurance Company Ltd. and nothing transpires on perusal of the record about any adversary against them. It appears that the petitioner has filed the claim form (Ext.2) which manifests that the same has been sent by the Superintendent, Dist. Hospital Malda dt.31.1.2006 and Madan Mandal died on 14.10.2004 at 05:55 A.M due to fall from a tree. It appears from Ext.6 that an U.D case has been started bearing No.415/04 on the date 14.10.2004 considering the intimation given by word master Hirendra Mohan Chowdhury which corroborated the documents filed by inspector-in-charge EBPS, Malda on demand of O.P. No.1. O.P. No.1 summoned Dr. Animesh Roy, Supdt. of Malda Sadar Hospital, who in his deposition submitted the attested xerox copy of the treatment sheet and admission register of the deceased Madan Mandal which are marked Ext.A to F. Ext. B and Ext.F clearly envisage that the patient Madan Mandal was admitted at the Dist. Hospital on10.10.2004 with a history of fall from tree and died on 14.10.2004 and the doctor also corroborated Ext.5 (PM report) which was also done at Sadar Hospital on 14.10.2004 by Dr. Debnath Sarkar who opined the cause of death due to the effect of antirontin injury. On further scrutiny of the record it appears that the petitioner has submitted the completed claim form, original policy certificate, original death certificate, original certified true copy of Final Report of Police, xerox copy of PM report, Original certificate issued by Prodhan of Kotwali G.P. regarding accident through G.T.F.S. (O.P. No.3) to the Sr. Divisional Contd.P/4….. P – 4 Manager (O.P. nO.1) (Ext.8) and O.P. No.1 also acknowledged and received the same claim form and other documents on 11.03.2006 by putting their seal and signature (Ext.2). as the petitioner is a rustic village women, admittedly, all the documents were submitted in a belated stage, yet there can be no definite law that all the documents must be submitted within a month. This clause is mere directory and can never be mandatory as searching of all such documents from different authorities is a time consuming matter nor such any excuse has been offered by New India Assurance Company. This policy comes within ambit of Group Janata Personal Accident Policy which necessarily means that this policy is exclusively made as and when accident takes place. In the instant case there can be denial of the fact that the husband of the present petitioner fell from the mango tree while cutting branches as has been disclosed in Ext.8, Ext.B and Ext.F and that has not been denied on behalf of either of the O.P. Nos. 1, 3 & 4. Consequently there appears reason to believe that the reason fro non-acceptance of the prayer of the petitioner instead of getting all documents cannot but be treated as a deficiency on the part of O.P. No.1. Although it is raised in the argument that they have not yet repudiated the claim but failed to gave any satisfactory answer why, they have not yet been giving the claim amount after receipt of necessary documents from O.P. No.3 on 11.3.206. such act of O.P. No.1 clearly shows deficiency in service. In view of above when O.P. No.2 kept tight in their respective office instead of taking any action from their end there appears reasonable belief that service of O.P. No.2 suffers from deficiency, which disposes of the present point in favour of petitioner. In the written objection of O.P. No.3 & 4 it manifests that there is a memorandum of understanding by and between O.P. No.1 (the New India Assurance Company) and O.P. Nos. 3 & 4 (GTFS) that GTFS only obliged to collect premium from the proper in JPA policy and to remit the same to O.P. No.1 and the New India Assurance Company will be solely and directly responsible in case of any claim contingent upon death, disability injury of the insured person. Consequently O.P. Nos. 3 & 4 does not suffer from any deficiency. Point No.3: In the result the case succeeds. Proper fees have been paid. Contd.P/5….. P – 5 Hence, ordered, that Malda D.F. Case No.48/2007 succeeds in part on contest against O.P. No.s 1 and decreed exparte as against O.P. No.2 (Divisional Manager, New India Assurance Co. Ltd., Burdwan Division G.T Road P.O. + Dist. Burdwan) and stands dismissed on contest against O.P. Nos. 3 & 4 (The Manager, The Golden Trust Financial Services, S.B. Manson, 16, R.N. Mukherjee Road, Kol – 700 001 & The Manager, The Golden Trust Financial Services [Near State Bank of India, Rathbari Branch], P.O. Rathbari, N.H. 34, P.S. E.B. District Malda). The petitioner do get award of Rs.1,00,000/- (rupees one lakh) only O.P. Nos. 1 & 2 jointly and severally do pay the aforesaid quantum of money within 30 days from date failing which the petitioner be at liberty to claim interest @9% per annum till its final realization and also at liberty to put the decree into execution. Let the copy of this order be given to both parties at free of cost. Sumana Das A. K. Sinha Member Member D.C.D.R.F., Malda D.C.D.R.F., Malda | 
