West Bengal

Paschim Midnapore

CC/16/2013

Smt. Shila Ghosh - Complainant(s)

Versus

Branch Manager, Oriental Insurance Co.Ltd. - Opp.Party(s)

08 Jan 2014

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

PASCHIM MEDINIPUR.

 

 Complaint case No.16/2013                                                         Date of disposal: 08/01/2014.                               

 BEFORE : THE HON’BLE PRESIDENT :  Mr. Sujit Kumar Das.

                                                      MEMBER :  xxxxxxxxxxxxxxxx

                                                      MEMBER :  Mr. Kapot Chattopadhyay.

    For the Complainant/Petitioner/Plaintiff : Mr. A. K. Dutta. Advocate.

    For the Defendant/O.P.S.                           : Mr. M. K. Chowdhury, Advocate.

          

               Smt. Shila Ghosh, W/o late Subhasish Ghosh, Vill. & P.O.-Keageria, P.S.-Chandrakona,

               Dist Paschim Medinipur………………Complainant.

                                                              Vs.

   Branch Manager, Oriental Insurance Co. Ltd. Having its branch office at Midnapore, P.O.

   & P.S.-Midnapore, Dist-Paschim Medinipur.……………Op.

 

               Case of the complainant Smt. Shila Ghosh, in short, is that her husband late Subhasish Ghosh, aged 48 years, died on 15/05/2007 due to road traffic accident while driving his scooter bearing its registration no.WB 34Q/3341 at about 11 a.m. on the  Chandrakona road near Nutanhat caused by a tractor bearing its registration no.WB-33/1146.  A criminal case no.56/07 dated 15/05/2007 of Chandrakona P.S. has been started ending charge sheet.  A policy from 26/6/2006 to 25/06/2007 in favour of the deceased was validly maintained with the Op-Insurance Company.  The complainant has contended that even after observing all necessary formalities, no payment of compensation has been settled by the Op-Insurance Company.  Stating the allegation of deficiency in service against the Op, the complainant prays for necessary order for payment of compensation of 1,00,000/- (One lakh) only as per policy condition and interest thereon with harassment cost of 50,000/- (Fifty thousand) only In this connection, the complainant submitted a bunch of documents in Xerox copies. 

             

                Op-Oriental Insurance Company ltd. contested the case by filing W/O supported by affidavit challenging that the case is not maintainable and the same is barred by limitation and also for want of jurisdiction.  Apart from that, there is no deficiency in service from the end of the Op and as such the case should be dismissed with cost.

Contd………………..P/2

                                                                 

- ( 2 )-

                  Upon the case of both parties the following issues are framed for the purpose of arriving at a correct decision in the matter

 

Issues:

1. Whether the case is maintainable in its present form?
2. If the Op Oriental insurance Company Ltd. is liable for deficiency in service as alleged by the complainant?
3. Whether the complainant is entitled to get relief as prayed for?
4. What other relief or reliefs the complainant is entitled to?

 

Decisions with reasons:         

Issues no.1 to 4:-

              

                 All the issues are taken up together for discussion.  Ld. Advocate for the complainant made his argument that the complainant has already submitted all relevant documents along with the Claim Form duly furnished with documents.  Even thereafter, the Op-Oriental Insurance Company Ltd. did not take any favourable steps in order to satisfy the claim of the complainant in terms of the valid Insurance Policy.  In this connection, a Xerox copy of the letter addressing to the Op-Insurance Company written by the complainant is pointed out before us.  The letter discloses that the complainant already submitted the documents along with Claim Form, certified copy of F.I.R., Post mortem report/Death certificate and Succession certificate.  In order to support the case, some other documents in Xerox copies are also submitted.  Those are letters dated 26/11/2010 and 31/12/2010 received by the Op on 26/11/2010 and 31/12/2012 respectively.  In addition, it is also submitted by the Ld. Advocate that the complainant again and again moved before the Op but no fruitful result yielded.  Thus, the complainant, according to the Ld. Advocate, is meritted for getting favourable order from the forum.

                

                  Ld. Advocate for the Op-Insurance Company in reply submitted that the complainant did not produce sufficient documents namely Succession certificate/Marriage registration certificate, life certificate of the mother of the deceased, driving license and other documents relating to the vehicle and also did not surrender the original policy.  Unless those documents are submitted from the end of the complainant, it would, according to the submission of Ld. Advocate, not be possible to make payment of the compensation as prayed for.  So for the non-compliance of submission of necessary documents, the Op-Insurance Company cannot be said to have committed deficiency in service as to the allegation of the complainant made in her petition of complaint.

Contd………………..P/3

                                                                  

 

- ( 3 )-

                    Upon careful consideration of the entire case  together with the arguments made by the Ld. Advocate appearing for the respective parties, the evidence appearing in the Xerox copy of documents,  admitted by the  parties are carefully  gone through.  In this context, it is a very vital

issue whether the documents in Xerox copies as on record are fit for admissible in the eye of law specially when there is denial on the part of the Op-Insurance company supported by affidavit appearing in the written objection filed on 10/09/2013.  But, since there is no dispute as regards correctness of the contents of the documents, we should not form any adverse opinion on that aspect.  Now, we are to only see whether the complainant has fulfilled the conditions for availing the claim in question before the Op.

                   

                         Under the provisions of Consumer Disputes Act, there should be a lenient approach in determining the findings in the case so far as it relates to the question of deficiency in service even upon fulfilment of the conditions by the complainant.  Admittedly this is a case under Insurance Policy where the Op-Insurance Company has already accepted the claim case of the complainant and dealt with the matter in the manner as it discloses in the present case.  The delay in finalization of the claim case, the Op-Insurance Company is found to have given direction to the complainant for production of some other relevant documents.  In this aspect, there is no such prominent evidence showing that the complainant has taken appropriate step to the satisfaction of the Op-Insurance Company by submitting other related documents, mainly by surrendering original policy certificate.

    

                     Under the fact and circumstances, it is clear before us that the claim case, under the terms and conditions of validly maintained  Insurance Policy, has been initiated by the complainant on 02/07/2008 after death of the policy holder on 15/05/2007  and  from 29/05/2007 admittedly from the end of OP Insurance Company as it appears from their letter dated 21/01/2008 but there is no final decision save and except a very tedious track of prolongation created by means  of mere communication vice-versa and persuasion made  by the complainant.  It is an accepted principel that each and every case, in the nature of such claim matter, should have its definite end either in the form of repudiation of claim or favourable settlement. In this case, here, it is crystal clear to us  that the Op has not taken any decision in any form of such  conclusion whatever it may be. In absence of such decision towards the claim of the complainant, it should be proper to hold that there exists deficiency in service as alleged by the complainant against the Op-Insurance Company.   

            Contd………………..P/4

                                                                 

 

 

- ( 4 )-

                  This Forum is not supposed to pass any order in favour of giving direction to the Op for payment of compensation on the ground that the same is exclusively dependant on scheduled formalities to be observed by the parties. Here in this case  the Forum has jurisdiction to take decision in the matter of  allegation of deficiency in service as raised by the complainant. 

               

                   Under the facts and circumstances as discussed hereinabove, it is held and decided that there is sufficient ground for maintainability of the case in holding the Op-Insurance Company is liable for deficiency in service.

               

                   Thus, all the issues are held and disposed of accordingly.  Following the decision, in respect of the issues above, the complaint case should be allowed in part to the effect that the  Op-Insurance Company is liable for deficiency in service in settling the claim of the complainant.

                              Hence

                                        It is ordered

                                                            that the case be and the same is allowed on contest in part.  The Op-Insurance Company is hereby guilty of deficiency in service and thereby he is liable to pay a compensation of 30,000/- (Thirty thousand) only payable in favour of the complainant.

             

                      The Op-Insurance Company is hereby directed to make payment of compensation of 30,000/- (Thirty thousand) in favour of the complainant within 60 days from this date i.d. the complainant shall be entitled to get 9% interest till payment.  

 

  Dic. & Corrected by me                                  I agree

              

             President                                              Member                                  President

                                                                                                                      District Forum

                                                                                                                  Paschim Medinipur.