F I N A L   O R D E R

This is a complaint U/S 12 of the C. P. Act, 1986 with the prayer for order directing the O.Ps. to pay compensation of Rs.4,00,000/- for financial loss and professional loss for negligence and refusal on the part of O.Ps. and also to pay the death claim amount covered by the insurance policy amounting to Rs.1,60,806/- with interest.

The complaint case in short is that he is the nominee of a policy No.0091552977 of Bajaj Allianz Life Insurance Company, O.P. No.1. That Smt. Basanti Singh, aunt of the complainant, purchased the policy on 18.03.2008 through O.P. No.4 authorized agent of O.P. No.1 and 2. Complainant has been written as nominee. The insured used to pay premium regularly. Smt. Basanti Singh expired on 11.06.2012 at N.B.M.C. and Hospital and the complainant, as a nominee, became the consumer under the policy of the deceased policy holder. He intimated the death of the insured to the O.P./ insurer and as per verbal instruction of O.P. No.2 submitted required documents to O.P. No.4 to get said insurance claim and suggested O.P. No.1, 2 and 4 to transfer the insurance claim amount towards the death claim to the savings bank A/c No.5539010010982 of Bangiya Gramin Vikash Bank, Teor Branch as only reference bank account number. O.Ps. did not comply, tried to avoid the complainant, when he visited the office of the O.Ps. at Islampur and as well as Balurghat. After a lapse of ten (10) months he came to know O.P. No.4 opened a fake savings bank account with the name of the complainant vide account No.3186794113 at Central Bank of India, Islampur Branch. Thereafter O.P. No.1 and 2 transferred the entire death claim of Rs.1,60,806/- to the said account of O.P. No.4 on 21.07.2012 behind the knowledge of the complainant. Complainant alleges that he never signed on any paper or opened any bank account nor was ever asked for to put signature and to supply documents like photograph, PAN Card, V.I. Card, etc. for that purpose. The O.Ps. 1 to 4 in spite of intimating the fact of existing account at Bangiya Gramin Vikash Bank, intentionally transferred the said death claim amount to the said account at Central Bank of India instead, which complainant alleges a fake joint account of O.P. No.4, Kanu Ranjan Roy. Accordingly he lodged FIR against O.P. No.4 over the matter and a police case was started vide Islampur PS case No.552/13, dated 30.05.2013 U/S 420/34 IPC. After completion of investigation, charge sheet was submitted. O.P. No.1, 2 and 3 did not make necessary arrangement for payment of insurance claim till date. On 11.12.2013 he informed O.P. No.1 through O.P. No. 2 & 3 in writing, but in vain. So cause of action arose from that day. Complainant faced irreparable financial loss, mental harassment for such illegal act of O.Ps. for their negligence and refusal. Therefore, he come up with this petition before this Forum with the above mentioned prayer.  

O.P. No.1 did not appear to contest the case in spite of receiving notice. Hence, the case is heard exparte against O.P. No.1. O.P. No. 2, 3 (Insurance Company) & 4 (Kanu Ranjan Roy) contested the case by filing separate written versions. O.P. No.5 (Central Bank of India, Islampur Branch), who was incorporated in this case following amendment of the complaint petition, also appeared and contested the case by filing written version.

O.P. No. 2 & 3 assailed the case on various ground including the ground that the complainant has suppressed the actual facts. That Basanti Singh applied for the said policy by filling proposal form on 25.02.2008 and on payment of insurance premium and submitted required documents and policy was issued in good faith on 18.03.2008. That, ‘Patul Laha @ Pratul Laha @Putul Laha’ was the nominee of the said policy, who applied for formal death claim following the death of Basanti Singh on 11.06.2012. The claim was processed in accordance with law in the bank account provided along with claim documents, amounting to Rs.1,60,806/- through NEFTSIN00101Q2914307 to account No.3186794113 of Pratul Laha and Kanu Ranjan Roy on 21.07.2012. O.P., Insurance Company discharged their liability and there is no negligence or deficiency in service. That O.P. No.2 and 3 never asked for any documents for any death claim from this complainant through O.P. No.4 as alleged. That O.P. No.4 is witness in the proposal Form of policy holder and was also well known to the insured and not to the company. There is no direct relation of O.P. No.4, Kanu Ranjan Roy with the company. The claimant has deposited document of bank with claim documents. On the basis of which claim was processed and payment of admitted death benefits made in the designated bank to the joint account of O.P. No.4.

O.P. No.4, Kanu Ranjan Roy in his written version stated that the complainant falsely alleges that the account was opened without following RBI Guideline and this O.P. has been falsely incorporated without any specific relief sought for and this is not the proper Forum to decide the question of fraud practice as alleged.

O.P. No.5, Central Bank of India, Islampur Branch in its written version stated that the complainant is not its customer in the Bank. That complainant falsely alleges that joint account of Kanu Ranjan Roy with another was opened without following RBI Guideline and this O.P. No.5 has been falsely incorporated in this case without any specific relief sought for.  O.P. No.5 filed some documents, Customer Information Form in the name of Kanu Ranjan Roy and ‘Patul Laha’, for KYC of Kanu Ranjan Roy Voter ID Card and Ration Card and for KYC of Patul Laha a School Transfer Certificate and Residential Certificate issued by the Chairman, Islampur Municipality.

The specific case of O.P., Insurance Company that the complainant never supplied any S/B A/c of Bangiya Gramin Vikash Bank. The O.P. No.2 and 3 further stated that O.P. No.3 never disclosed in fake account etc. opened by O.P. No.4 as alleged putting strict proof thereof to complainant. That the real facts of this case is that Basanti Singh purchased Life Insurance Policy and after her death her nephew i.e. complainant made claim and at the time of settlement of his claim he supplied the bank account No. at Central bank of India and as per rules framed by IRDA. The O.P., Insurance Company has transferred the settled amount with the bank account of the nominee of the policy holder. Under the facts and circumstances O.Ps. allege the complainant is not entitled to the relief(s) as claimed.

To establish the complaint case the complainant has relied upon an affidavit-in-chief sworn by him and his statement recorded as P.W.1. To prove his case complainant submitted a bunch of documents which are; photocopy of (i) Voter ID Card, PAN Card & Ration Card, (ii) The policy papers of Bajaj Allianz Life Insurance Company Limited,  Islampur Branch Office, The New Family Gain Policy Regular Premium Schedule against policy No.0091552977, Islampur Branch DOC dated 18.03.2008 (iii) 1st Premium Receipt, (iv) Death Certificate of Policy Holder, (v) Medical Certificate, (vi) Corresponding Letters, addressed to the O.P./ Insurance Company, (vii) Copy of FIR, dated 29.05.2013 of Islampur PS, Certificate Copy of FIR Charge Sheet of Case No. 552/2013 dated 30.05.2013 and letters issued by O.P. No.1 dated 03.06.2013. & 20.06.2013 and letters of complainant dated 11.12.2013, postal receipts etc.

DECISIONS WITH REASONS

Giving due consideration to the contents of the complaint petition, oral as well as documentary evidence on record, hearing argument advanced by the Lawyers of both sides, the Ld. Forum has come to the findings as follows: -

Complainant is examined as P.W.1 in his evidence-in-chief he deposed that he, aged about 52 years, son of Late Ramesh Chandra Laha, a farmer residing at Vill.: Jot Teor, P.S. & P.O.: Hili, Dakshin Dinajpur. He is the nominee of the policy No.0091552977, in the name of Basanti Singh. That he has no account at Central Bank of India, Islampur Branch, jointly being A/c No.3186794113 as second applicant. The said account at Central Bank in the name of “Patul Laha, son of Late Ramesh Laha as resident of Vill.: Ashrampara, Puratanpally, P.O. & P.S.: Islampur, Uttar Dinajpur” is a fake person. That “Patul Laha @ Putul Laha” is not same and identical person as Pratul Laha. That the Central Bank failed to supply any paper showing his signature as Pratul Laha in this regard. That he never signed as Pratul Laha in any document of that Bank. That O.P. No.4 has jointly opened the bank A/c with that fake name of ‘Patul Laha’. That the complainant has his bank account at Bangiya Gramin Vikash Bank, Teor Branch, which he supplied to the O.P., Insurance Company and also to O.P. No.4 in good faith knowing him as agent of O.P., Insurance Company to make claim after death of policy holder. That he only came to know about the transfer of policy money in the Central Bank from the letter of O.P. No.1 and 2 though he specifically stated his bank account at Bangiya Gramin Vikash Bank, which O.P./ Insurance Company did not comply. That the photograph at KYC Form in the name of Patul Laha is not his photograph. That the O.Ps. had conspired to grab the death claim of deceased Basanti Laha, aunt of the complainant. In cross examination P.W.1 deposed that Kanu Ranjan Roy is an agent of O.P./ Insurance Company. That a criminal case is pending at Islampur Court against O.P. No.4 over the complaint lodged by P.W.1 over the incident of fraud. That he has no account at Central Bank, Islampur Branch and he has account at Bangiya Gramin Vikash Bank at Teor Branch.

In support of his claim petitioner filed his Voter ID Card showing Pratul Laha, age 35 years on 01.01.1995 and son of Ramesh Chandra Laha of Balurghat Assembly Constituency. The PAN Card showing Pratul Laha, son of Ramesh Chandra Laha, date of birth 15.12.1958. The Ration Card in the name of Pratul Laha, son of Ramesh Chandra Laha of Vill.: Teor, P.S.: Hili, Dakshin Dinajpur. The death certificate of Basanti Singh, dated 11.06.2012 of Matigara Gram Panchayet and the medical certificate, dated 11.06.2012 of North Bengal Medical College & Hospital corresponds to each other. The letter dated 08.05.2013 of complainant to Branch Manager, Bajaj Allianz Life Insurance Company Limited stating the fact that he submitted all documents and death certificate at Islampur Branch of Insurance Company in Aug’12, but yet to receive the claim amount and that enquiry was held by the insurance company for such claim. The letter of complainant to the branch head of the company that he came to know that the claim amount has already transferred to some SBI Account, but he has no such account and he has already submitted claim documents. The letter dated 29.05.2013 to O.C., Islampur PS alleging that O.P. No.4 as authorized agent of insurance company put him as nominee of the insurance policy in the name of insured Basanti Singh. The complainant deposed that he met with O.P. No.4 after death of Basanti and handed over all the documents for the death claim but was kept in dark by O.P. No.4 for about 10 months and that O.P. No.4 opened a joint account at Central Bank, Islampur Branch along with the fake name of Patul @ Putul Laha and managed to grab the entire claim amount of Rs.1,60,806/-.

The certified copy FIR, the Charge Sheet, Final Report and copy of Order Sheets of Ld. ACJM, Islampur in G.R. 1809/13 in connection with Islampur PS Case No. 552/13 dated 30.05.2013 U/s 420 IPC supplied by the complainant in support of his petition goes to show the following facts. That the Islampur PS investigated the case over the complaint (FIR) of Pratul Laha, the complainant of this consumer complaint. That police investigated the office of the Insurance Company, also at the Central Bank of India, Islampur Branch, collected documents, examined available witnesses and find a strong prima-facie case against accused Kanu Ranjan Roy and his son Mithun Roy. The prima-facie charge is well established, the accused, Kanu Ranjan was arrested and was remanded to Judicial Custody following order of Ld. ACJM, Islampur and finally charge sheet was submitted accordingly showing Mithun Roy as absconder. A prayer was made by police to block all the transaction of said account at Central Bank in the name of Kanu Ranjan and another. O.P. No.5 in their written version admitted this fact and stated that as per instruction of Police Authority, all the transactions in the aforesaid joint account was seized by the O.P. No.5. The said G.R. Case, 1809/13 is still pending. Subsequently, O.P. No.4 made a prayer to this Forum to stay hearing of this consumer petition till disposal of the said G.R. Case, but this Forum did not entertain the prayer.

P.W.1 was examined and cross examined by the O.Ps., but O.Ps. did not adduced any evidence in their favour. O.P. No.5 only filed some documents as stated above. From the W.V. of O.P./ Insurance Company, No.2 and 3, it appears that admittedly Pratul Laha @ Patul Laha @ Putul Laha was the nominee of the said policy.  At the same time O.P., company claims O.P. No.4, Kanu Ranjan Roy is well known to the policy holder as a witness to the policy and not to the company. That there is no direct relation with O.P. No.4 with the company. So, why   the O.P., insurance company was in hurry to settle the death claim and sent the claim money to the joint account of O.P. No.4 along with one ‘Patul Laha’, without verifying, whether Patul Laha and Pratul Laha is the same and identical person and actual nominee under the said policy. The joint account opened with the Bank, O.P. No.5 and the document, KYC submitted by the O.P. No.4 & 5 goes to show that O.P. No.4 as first account holder submitted his documents, like Ration Card, Voter ID Card, Photographs, etc. in the address at Ashrampara, Islampur. Interesting to note, in the joint account opened with one ‘Patul Laha’ only a Municipality ID Proof is supplied as KYC showing ‘Patul Laha’ in the same address with O.P. No.4 at Islampur. Whereas, the complainant as Pratul Laha is well equipped with sufficient documents, like Voter ID Card, Ration Card, PAN Card showing address at P.O.: Teor, P.S.: Hili, Dakshin Dinajpur. The O.P. Insurance Company never come forward before this Forum with original documents received by the company in claim Form, policy papers showing the name, address, etc. and signature of the nominee of the said policy as ‘Pratul Laha’ @ ‘Patul Laha’ whom the O.P., Insurance Company claimed as nominee under the policy. Moreover, the documents supplied by O.P. No.5 goes to show that one ‘Patul Laha’, son of Ramesh Laha residing at the same address with O.P. No.4, Kanu Ranjan Roy at Ashrampara, Islampur, Uttar Dinajpur. No other authentic and reliable documents were supplied for ‘Patul Laha’. Comparing the documents filed by O.P. No.4 and 5 and the documents filed by the complainant, this Forum in clear eyes can easily mark the differences. The signatures of Patul Laha on the documents and the photographs and also address are not same and identical with the signatures and photographs of the complainant, Pratul Laha in his documents like Voter ID Card, PAN Card, Ration Card, etc. Even the name of father and address and the age of both ‘Patul Laha’ and complainant Pratul Laha are different. In this regard the complainant rightly questioned the involvement of O.P. No.5 alleging deliberate conspiracy with other O.Ps. in opening the joint account of Kanu Ranjan Roy, O.P. No.4 with a fake name ‘Patul Laha’ at the Islampur Branch of O.P. No.5. O.P./ Bank claimed that the complainant, Pratul Laha never signed in any document of O.P./ Bank. This Forum cannot disbelieve the evidence of complainant as P.W.1 and his identity as Pratul Laha as nominee of the policy.

From the above discussion this Forum can safely that without proper verification of the identity of the nominee with proper documents and in utmost hurry, O.P., Insurance Company settled the matter of death claim of the insured Basanti Singh and sent the total claim amount to the joint account of O.P. No.4 in the Bank of O.P. No.5. According to the O.P., Insurance Company, O.P. No.4, Kanu Ranjan Roy is a witness of the policy and not agent nor known to the company and he is the first account holder in the joint account with ‘Patul Laha’. Then, what authentic documents of ‘Patul Laha’ was relied upon by this O.P., Insurance Company for identity of the nominee under the policy and to settle the matter in favour of O.P. No.4, Kanu Ranjan Roy and another.

From the above discussion we can come to the conclusion that there is direct negligence on the part of the O.P./ Insurance Company to render service to the complainant. The complainant therefore faced irreparable loss, mental and physical harassment due to such deficiency in service on the part of O.P., Insurance Company. O.P., Insurance Company avoiding the complainant willfully and deliberately in settling the claim of the complainant as nominee. It is admitted fact that the complainant is a bonafide consumer as a nominee under the policy of O.P., Insurance. Therefore, the negligence and refusal on the part of the O.P., Insurance Company to the complainant is well established, when O.P./ Insurance Company disbursed the claim amount to the joint account of O.P. No.4 and another in the Bank of O.P. No.5 on 21.07.2012 without intimating the complainant and also without proper verification regarding the nominee under the policy. Therefore the complainant is entitled to get relief from this Forum. So, the complaint petition succeeds on contest.

Fees paid is correct.

Hence it is,

ORDERED

That the consumer complaint being No. CC-31/2014 is allowed in part on contest with cost against the O.P./ Insurance Company. At this stage this Forum is not passing any order against O.P. No.4 and 5 considering the pendency of the criminal case before Ld. ACJM, Islampur being No.1809/13 i.c.w. Islampur PS Case No. 552/13 dated 30.05.2013 U/s 420 IPC.

O.P., Insurance Company are directed to pay the death claim amount covered by the insurance policy being No.0091552977 of Bajaj Allianz Life Insurance Company Limited amounting to Rs.1,60,806/- (Rupees One Lakh Sixty Thousand Eight Hundred and Six) only with interest @9% per annum on and from 21.07.2012 till date of payment. The complainant is also entitled to get compensation of Rs.50,000/- (Rupees Fifty Thousand) only for negligence and harassment and deficiency in service on the part of the O.P., Insurance Company and also entitled to get litigation cost of Rs.5,000/- (Rupees Five Thousand) only. The entire awarded amount should be paid within one month from the date of passing of this order, failing which the complainant will be at liberty to realize the same in accordance with law.

Copy of this order be supplied to each parties free of cost.