BEFORE THE PRESIDENT
DISTRICT CONSUMER DISPUTE REDRESSAL FORUM
GOMATI DISTRICT ::: UDAIPUR
CASE NO. C.C. 10 OF 2014
Petition filed U/S 12 of the Consumer Protection Act.
Date of filling the petition 23.05.2014
Smti. Shajana Marak -Complainant
Versus
1)The Regional Manager,
Bajaj Allianz General Insurance Co. Ltd.,
Kokalta-700001.
2)The Golden Trush Financial Services,
Kokata Office.
Represented by-
The Branch Manager,
Golden Trush Financial Services,
Udaipur Branch - Opposite Party
PRESENT
Shri Asish Pal,
PRESIDENT
Consumer Dispute Redressal Forum,
Gomati District, Udaipur
And
Shri Haridas Roy Barman
&
Smti. Runu Das (Roy Choudhuri)
MEMBERS
COUNSEL
For the Complainant - Mr. Mrityunjoy Debnath,
Learned Advocate.
For the Opp. Party No.1 - Mr. Shaktipada Chakraborty,
Learned Advocate.
For the Opp. Party No.2 - Mr. Pijush Kanti Sarkar,
Learned Advocate.
Date of Delivery of Judgment - 06.04.2015
J U D G M E N T
This case arises on the Complaint filed under Section 12 of the Consumers Protection Act.
2. One Smti. Shajana Marak filed this prayer claiming compensation amounting to Rs.50,000/- against the Regional Manager Bajaj Allianz General Insurance Co. Ltd.,and the Golden Trush Financial Services, represented by the Branch Manager, Golden Trush Financial Services, Udaipur Branch i.e. respondent Nos.1 & 2. It is alleged that Bishnu Marak purchased the personal accident insurance policy for a sum of Rs.50,000/- vide policy No.OG-05-2401-9960-00000039 covering the risk of accidental death/loss of limbs/permanent total disablement covering for the risk period. Petitioner Shajana Marak was made nominee of that policy. The petitioner Shajana Marak came to learn about the said policy certificate on 25th March, 2007 and then wrote a letter to the respondent No.2, Golden Trush Financial Services, claiming Rs.50,000/- along with original copy of policy certificate, certified copy of p.m. report, photo copy of FIR, ejahar and death certificate of the deceased and those were sent to the Divisional Manager, Bajaj Allianz General Insurance Co. Ltd. through the Golden Trush Financial Services. The respondent No.2, Golden Trush Financial Services, being the corporate authorized agent of Bajaj Allianz General Insurance Co. Ltd. opened branch at Udaipur. The corporate agent took the initiative for making policy in the name of deceased Bishnu Marak, who died by motor accident on 18.01.2006 at 12.30 p.m. when he was going to Gandacherra by the vehicle bearing No.TRL-1421 (Truck) along with bricks for unloading. So the petitioner Shajana Marak, being the nominee of the policy, claimed the sum assured covered by the personal accident policy along with interest @ 12%.
3. The respondent Insurance Companies appeared and filed written statement stating that limitation period for filling the complaint already gone as Bishnu Marak died on 18.01.2006. It is stated that on 27.07.2007 the O.P. Insurance Co. issued a letter addressed to Shajana Marak stating that since she is not interested in her claim and if any further response in support of her claim not received within 15 days from the date of receipt of the letter, the claim will be repudiated. It is stated in written statement that complainant filed the petition in the month of May, 2014. The complaint petition, therefore, is not maintainable as already many years gone after the accident. According to them, the policy condition is that after happening of any event which may give rise to a claim under this policy, the insured shall forthwith give notice thereof to the company. Unless reasonable cause is shown, the insured should within one calendar month after the event which may give rise to a claim under the policy, give written notice to the company with full particulars of the claim. It is also stated that proof, satisfaction to the company, shall be furnished of all matter upon which the claim is based. So, the claim of interest is unfounded and not tenable at all.
4. On the basis of assertion and denial made by the parties, following points are cropped up for determination:
(1) Whether the petition is maintainable or barred by limitation?
(2) Whether the petitioner is entitled to get the assured sum and any other amount for deficiency of service?
5. The claimant petitioner side produced certified copy of FIR and post mortem examination report which are exhibited and marked as Exbt.1 series. Petitioner side also produced statement on affidavit of one witness i.e. the complainant herself as PW-1.
Respondent’s side, on the other hand, produced copy of intimation letter and copy of notice given to Smti. Shajana Marak.
6. On the basis of evidence on record I shall, now, determine the above 2(two) points.
FINDINGS & DECISIONS AND REASONS FOR DECISION ON
POINT NOS. 1
7. Smti. Shajana Marak, complainant of the case, in her statement on affidavit stated that on 25th March, 2007 when she was searching, the policy of her brother was found. The said document was necessary foe accidental claim. Accordingly, she communicated the claim to the Golden Trust Financial Service who then supplied the prescribed claim from to her to submit the same after being filled up. Accordingly, she submitted the claim form along with all necessary documents to O.P. No.2 i.e. the Golden Trust Financial Service, Udaipur Branch.
The Golden Trust Financial Services also submitted the written statement. In the written statement they mentioned that post mortem examination of the deceased Bishnu Marak was done on 19.01.2006. it is stated that one labour inform the matter to Gandacherra police station regarding the incident. Gandacherra P.S. then registered the said complaint and it was followed by normal police procedure. Thereafter, Bajaj Allianz General Insurance co. Ltd. had advised Smati. Shajana Marak through their letters dated 28.09.2007, 30.10.2007 and on 07.12.2007 to submit final investigation report of police or charge sheet within a fortnight. They also sought clarification about the delayed intimation of death. The intimation was given to Shajana Marak by the Golden Trust Financial Services on 24.03.2007. it is stated that 11 documents were required to be produced. Again Bajaj Allianz General Insurance Co. Ltd. issued letter on 27.07.2007, 12.06.2007, 20.04.2007 to Shajane Marak as Shajane Marak, the claimant petitioner, being the nominee failed to submit the required documents i.e. the filled up claim form in original, copy of FIR, copy of final investigation report of police, prescription, certificate by the last attending doctor, admission and discharge card of hospital, disability certificate, insurance copy, income proof certificate o0f insured, voter identity card of insured and copy of ration cared. All these 11 documents were not supplied according to Bajaj Allianz General Insurance co. Ltd. So, the claim was repudiated.
8. The repudiation of the claim was not informed in right time to the petitioner. Petitioner remained under expectation to get the claim and when her expectation was not fulfilled after lapse of many years, so in the year 2014 she filed the claim before this Forum. So, the cause of action though arises in the year, 2006, it continued as the petitioner remained under reasonable expectation to get the sum assured. Admittedly, Shajana Marak was the nominee of the insured but her claim was not satisfied till date. So, it cannot be said that cause if action came to an end in the year, 2008 because the repudiation of the policy as denial of claim was not communicated to her by the respondent Nos.1 & 2. So, it cannot be said that this petition under Section 12 of the Consumer Protection Act is barred by limitation and not maintainable but it can safely be said that in a case of continuous claim, the cause of action for non- payment of the assured sum till date, this claim petition is maintainable.
Point No.1 is decided accordingly in favour of the claimant petitioner.
FINDINGS & DECISIONS AND REASONS FOR DECISION ON
POINT NOS. 2
9. It is established and admitted fact that for failure to submit the required documents by the nominee i.e. the claimant, she did not get the assured sum. Till date, she could not supply the documents as called by the Insurance co. It is also admitted fact that Bishnu Marak purchased the policy certificate and paid the premium. He died by motor accident. As per policy’s term and condition and also the memorandum of understanding, his death is covered by personal accident claim of Rs. 50,000/-. It is a personal accident claim policy. Admitted, Bishnu Marak died by motor accident. The post mortem examination report clearly established this fact. It is also supported by certified copy of FIR and the evidence of the claimant petitioner. Respondents side given no evidence. They only denied the claim of the petitioner. The contention of the respondent Insurance Co. is not supported by any single piece of evidence. Only denial without any supporting evidence cannot give any stand on the contention of the respondent side. On other hand, on the basis of evidence in record it can be said that the respondent Bajaj Allianz General Insurance Co. Ltd. only on the technical ground failed to give proper service to the petitioner who is a village rustic and not aware of pros and cons for collection of claim form timely to get the insured amount. Therefore, being nominee of the policy certificate of the deceased Bishnu Marak she is entitled to get the assured sum of Rs. 50,000/- along with other benefits, if any. However, she will get interest over the amount from the date of filing the petition i.e. from May, 2014 @ 9 %, per annum. For the deficiency of service for delay in giving this assured sum, petitioner is entitled to get additional amount of Rs. 10,000/-, as compensation. She is not entitled to get any other relief.
10. In view of our above discussion over the two points, this petition is allowed. The respondent Golden Trust Financial Services being the corporate authorized agent of Bajaj Allianz General Insurance Co. Ltd. is directed to pay the assured sum of Rs. 50,000/- to the nominee complainant. They are also directed to pay interest over this amount from the date of filing the petition i.e. 23.05.2014 @ 9%, per annum, till payment is made. There was some deficiency of service for late payment of the assured sum and for that, the complainant is entitled to get Rs. 10,000/-, as compensation.
11. The case stands disposed of accordingly.
12. Supply copy of this judgment to the parties at free of cost.
A N N O U N C E D
(Haridas Roy Barman) Smti. Runu Das (Roy Choudhuri) (Asish Pal)
Member Member President
Consumer Dispute Redressal Consumer Dispute Redressal Consumer Dispute Redressal
Forum, Gomati District Forum, Gomati District Forum, Gomati District
Udaipur Udaipur Udaipur
