IN THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MURSHIDABAD AT BERHAMPORE.
CASE No. CC 87/2013.
Date of Filing: 09.07.2013 Date of Final Order: 17.02.2016.
Complainant: Radha Pal, W.O. Late Shyam Sundar Pal, Vill. Ayeshbagh, P.O. Rousham Bag,
P.S.+Dist. Murshidabad. Pin 742164.
-Vs-
Opposite Party: 1. Branch Manager, New India Assurance Co. Ltd,.
New India Assurance Co. Ltd, 37A, R. N. Tagore Road, P.O.+P.S. Berhampore.
Dist. Murshidabad. Pin 742101.
2. Sr. Divisional Manager, New India Assurance Co. Ltd, Howrah D.O.512200,
P-18 Dabson Lane, Madhusudan Apartment, 2nd Floor, Howrah-711010.
3. Manager, Golden Financial Services, 158/1, R. N. Tagore Road,
P.O. & P.S. Berhampore, Dist. Murshidabad. Pin 742101.
Present: Sri Anupam Bhattacharyya ………………….President.
Sri Samaresh Kumar Mitra ……………………..Member.
Smt. Pranati Ali ……….……………….……………. Member
FINAL ORDER
Sri Anupam Bhattacharyya, Presiding Member.
The instant complaint has been filed by the complainant u/s 12 of the C. P. Act, 1986 praying for Insurance Claim of Rs.1 lac in favour of the complainant.
The complainant’s case, in brief, is that the deceased Shyam Suder Pal, husband of the complainant took a JPA Insurance Policy being No. 4751220001607/E No. A-30065 from Op No.1 & 2 Insurance Co. through the agent (OP No.3 who died on 9.5.11 at 8.20 P.M due to burn injury on 29.4.11 in New General Hospital at Berhampore during validity of the policy. The complainant nominee of said Insurance Policy and she submitted her claim being claim No. 512200471123000091 for the sum assured of Rs.1,00,000/- only under the Insurance policy under for the accidental death of her husband. On 4.9.12 the complainant came to know from the letter of Op no.2 that the complainant due to type mistake wrongly written the date of death and date of burn injury sustained by the deceased husband of the complaint on 9.5.11 and 3.5.11 instead of actual ate as 10.5.11 and 29.4.11 respectively in the claim petition. Thereafter, the complaint rectified the above mistake but no result. Then the complaint filed the instant complaint before this Forum. Hence, the instant complaint case.
The written version filed by OP No.1 & 2 , in brief, is that the complainant as well as OP No.3 is to prove by documentary as per order dt. 6.7.99 of Hon’ble High Court that the policy holder does not fall within the category of ‘friends’ which category is barred. The instant claim is barred by being filed beyond two years. The dates of death and burn injury sustained by the policy holder were incorrect. The complaint did not provide certificate copy, final policy report. The policy holder died due to Diabetic disorder and not by burn injury. There is no deficiency in service. The OP-Insurance Company is not liable to pay any claim amount. The complainant is liable to be dismissed. Hence, the instant written version filed by OP Nos. 1 & 2.
The written version filed by Op No.3, in brief, is that the order of Hon’ble High Court dt. 6.7.99 being passed before the instant policy, the question of status of policy holder will not arise to consider the question of bar of the category. The OP No.3 is not liable to pay any claim in this case. Hence, the instant written version.
Considering the pleadings of the parties the following points have been raised for the disposal of the case.
Point for decision.
- Whether the complaint is maintainable in its present form and in law?
- Whether the complainant has locus standi to file the present case?
- Whether the complaint is barred by law of limitation?
- Whether the complainant is entitled to get the relief as prayed for?
- To what other relief/reliefs the complainant is entitled to get.
Decision with Reasons.
Point Nos. 1 to 5.
All the points are taken up together for the same of convenience.
In this case the complainant has claimed Rs.1 lac towards Insurance Claim for accidental death of her husband due to burn injury.
The complainant’s case is that her husband took a JPA Insurance Policy and died due to burn injury. Initially, there were some mistakes in the claim form. The mistakes were rectified. In spite of repeated requests there is no result.
On the other hand, the OP Insurance Company took the stand that the husband of the complainant died due to Diabetic problem and not due to burn injury. For that reason the complainant is not entitled to get claim as sought for.
In order to prove the case the complainant has filed evidence-on-affidavit along with relevant documents in support of her claim.
Both the OP Nos. 1,2& 3 submitted their respective written arguments .
In this case the OP Nos. 1 & 2 have not filed any cogent evidence to establish the case that the husband of the complainant died due to Diabetic Problems and not by burn injury, whereas from the P.M. Report of the deceased it is crystal clear that death was caused due to burn injury.
Considering the submissions as above and materials on record from the side of the complainant and for absence of cogent evidence rebutting the evidence of the complainant from the side of OP Insurance , we can safely conclude that the complainant is entitled to get an award of Insurance Policy amounting to Rs.1 lac .
Admittedly, the OP No. 3 being the agent of Insurance Company and the claim for realization of Insurance Policy due to death, we are of opinion that the OP No.3 is not liable to pay any Insurance Claim to the complainant.
On the basis of above discussions as a whole all those points are disposed of in part in favour of the complainant. As such the complainant is entitled to get an award of Rs.1, 00,000/- only and there will be no order as to compensation but interest is admissible from the date of death of the Insurer.
Hence,
Ordered
that the Consumer Complaint No. 87/2013 be and the same is hereby allowed on contest in part against OP Nos. 1 & 2 who are jointly and severally liable and dismissed against Op No.3.
The complainant is entitled to get Rs.1, 00,000/- as per JPA Insurance Policy with interest as per admissible rate from the date of death of the policy holder.
The OP No.2 is directed to pay Rs.1, 00,000/- along with interest to the complainant within 60 days from the date of this order, failing which the OP No.2 is to pay Rs.100/- as fine for each day’s delay and the amount so accumulated shall be deposited in the Consumer Legal Aid Account.
Let a plain copy of this order be made available and be supplied free of cost, to each of the parties on contest in person, Ld. Advocate/Agent on record, by hand under proper acknowledgment / be sent forthwith under ordinary post to the concerned parties as per rules, for information and necessary action.
