IN THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MURSHIDABAD AT BERHAMPORE.
CASE No.CC/116/2015
Date of Filing: 24/08/2015. Date of Final Order: 17.4.2017
Complainant: Sarat Bhuinmali, S/O- Late Bhujanga Bhuinmali, Vill.&P.O. - Karaya,
P.S.- Sagardighi, Dist.- Murshidabad. Pin.-742237.
-Vs-
Opposite Party: 1. Branch Manager, State Bank of India, Sagardighi Railway Station Br.
P.O.&P.S. - Sagardighi, Dist.- Murshidabad. Pin- 742226.
2. The Claims Manager, Reliance General Insurance Company Limited,
38 B, 8th Floor, Himalaya House, Jawaharlal Nehru Road,
Jeevan Deep, Park Street, Kolkata, Pin- 700016.
Present: Sri Samaresh Kumar Mitra ……………………..Member.
Smt. Pranati Ali …………………… Member.
FINAL ORDER
Sri Samaresh Kumar Mitra, Presiding Member.
This complaint has been filed by the complainant u/s 12 of C. P. Act, 1986 praying for order directing the OP to pay the insured amount of Rs.3,00,000/- and to pay further Rs.2,00,000/- towards compensation for harassment and mental agony.
The case of the complainant, in brief, is that his son namely Apurba Bhuinmali was an employee of Indian Army in the CRPF, BN 182 since deceased. Unfortunately, the son of the complainant died on 09.12.2014 at 9:45 a.m. in a motor accident while he was going to Raghunathganj from Sagardighi. The son of the complainant had a Salary Package Account being No. 30555563887 with the OP No.1 and had a Personal Accident Insurance Policy being No. 1111342914000034 with the OP No.2. Immediately, after the death of Apurba Bhuinmali, FIR was lodged with the Raghunathganj Police Station being No. 1086/2014 dt. 09.12.2014 under Sections 279, 338, 304A, 427, 34 of IPC. The complainant claimed death benefits before the OPs but without any cogent grounds the claims were repudiated and thus the OPs are practicing fraud upon the complainant by depriving him from such benefits. The acts of the OPs are deficient to service. They are liable to pay the death benefits. Hence, the instant complainant case.
The OP No.1 denied most of the allegations made by the complainant in his complaint petition and admitted that Apurba Bhuinmali, since deceased, had a Salary Package Account No. 30555563887 with is OP. It is a scheme of the Bank to pay requisite premium of an accidental insurance coverage to the Salary package Account holder under Reliance General Insurance Co. Ltd. , Op No.2 by which the account holder can get an accidental insurance policy in free of cost. Accordingly, said Apurba Bhuinmali, since deceased was also covered by an accidental insurance policy under the OP No.2. This OP has no authority to entertain the claim of the complainant. The present claim of the complainant is exclusively related with OP No.2 for settlement of Insurance Claim. As such the complainant is not at all a consumer of the OP No.1 in respect of the Insurance claim. There is no negligence or deficiency in service on the part of the OP No.1. The complaint is not maintainable against this OP.
The OP No.2 had denied almost all the allegations which are leveled against them. The admitted fact is that Apurba Bhuinmali died due to a road accident on 09.12.2014. But the complainant did not submit any claim for the death benefit of his son soon after the accident nor did he send any information regarding the said accident within the stipulated period of 90 days. Rather the complainant submitted the Claim Form after 140 days of the accident. So, the claim is repudiated by the OP No.2. They have no deficiency in service. The complaint is liable to be rejected.
The Complainant filed evidence on affidavit in which he assailed that the son of the complainant was a defence person and he was maintaining a salary package account before the OP No.1 and he had a Personal Accident Insurance before the OP No.2. After the death of his son a FIR was lodged with Raghunathganj P.S. being no 1086 of 2014 dated 09.12.2014. He was supposed to get the death benefit of his son but the OPs are practicing fraud upon him. So this complainant filed the instant complaint praying for getting a sum of Rs.3,00,000/- towards insured amount and Rs.2,00,000/- as compensation for harassment and mental agony from the opposite parties. He filed photocopy of relevant documents marked as annexure from A to N.
Argument as advanced by the agents of the parties heard in full.
From the discussion herein above, we find the following Issues/Points for consideration.
ISSUES/POINTS FOR CONSIDERATION
1. Whether the Complainant Sarat Bhuinmali is a 'Consumer' of the opposite party?
2. Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
3. Whether the O.Ps carried on unfair trade practice/rendered any deficiency in service towards the Complainant?
4. Whether the complainants proved their case against the opposite party, as alleged and whether the opposite party is liable for compensation to them?
DECISION WITH REASONS
In the light of discussions here in above we find that the issues/points should be decided based on the above perspectives.
(1).Whether the Complainant Sarat Bhuinmali is a 'Consumer' of the opposite party?
From the materials on record it is transparent that the Complainant being beneficiary is a "Consumer" as provided by the spirit of section 2(1)(d)(ii) of the Consumer Protection Act,1986. The son of the complainant was an account holder of salary package of OP No.1 and he had an accidental insurance policy of OP No.2. So the complainant herein being the consumer of the OP is entitled to get service from the OPs.
(2).Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
Both the complainant and Opposite Party No.1 & 2 are residents/carrying on business within the district of Murshidabad. The complainant prayed Rs.3,00,000/- as per accidental insurance of OP No.2 and Rs.2,00,000/- for harassment, physical injury and for mental agony ad valorem which is within Rs.20,00,000/- limit of this Forum. So, this Forum has territorial/pecuniary jurisdiction to entertain and try the case.
(3).Whether the opposite party carried on Unfair Trade Practice/rendered any deficiency in service towards the Complainant?
It appears from the case record and the documents as produced by the parties in dispute that the son of the complainant had a salary package account being no.30555563887 with the OP No.1 and he also had Personal Accident Insurance Policy being no.1111342914000034 with the Opposite Party No.2. During the period of insurance coverage the policy holder i.e. the son of the complainant met with a motor accident and died on 09.12.2014 and an FIR being No.1086/14 lodged before the Raghunathganj P.S. under sections 279/338/304A/407/34 IPC. That after the demise of his son the complainant filed Claim Form before the opposite party No.2 on 13.01.2015 and received on behalf of the OP No.2 (Annexure-E). The annexure F i.e. the letter of the OP No.1 bank dated 06.05.2015 clearly speaks that Apurba Bhuinmali & Sarat Bhuinmali is the account holder of the Salary package and Sri Apurba Bhuinmali expired on 09.12.2014 due to accident and his claim amount was Rs.3,00,000/- . The OP No.1 certified that the claim settlement will be entirely the responsibility of Insurance Company and all settlements and disputes will be between the claimant and Insurance Company and bank will not be a party to such dispute. The annexure H speaks that the complainant wrote a letter to the OP No.1 dated 08.01.2015 stating the information regarding the death of his son and prayed claim of PMSP insurance as nominee. The annexure I the requirement letter of the OP No.2 dated 6th May, 2015 depicts that he enquired to submit 7 documents in respect of claim of the complainant. Immediately after the said letter the OP No.2 by a letter dated 18th May, 2015 informed this complainant that they received the claim intimation on 28th April, 2015 i.e. delay of 140 days from the date of loss and as per terms and conditions claim intimation to be received within 90 days from the date of loss so the claim of the complainant is not payable. Then the complainant by a letter dated 29.05.2015 informed the OP No.2 to reconsider the death claim and also stated that he submitted Personal Accident Claim Form before Pallab Bera, Reliance General Manager on 13.01.2015 in Berhampore Reliance general Insurance Office. The Annexure E document of the complainant transpires that one Pallab Bera on behalf of the OP No.2 received the Claim Form in 3 copies on 13.01.2015. By a letter the OP No.1 admitted that the complainant first time informed the OP No.1 regarding the sad demise of Apurba Bhuinmali on 8th January, 2015 and the concerned bank advised the complainant to contact the Reliance General Insurance Company to lodge the claim Form under Group Personal Accident scheme. Thereafter he came to know that the claim of the complainant was turned down by the Reliance General Insurance Company owing to lodging claim in delay. He further assailed that the aggrieved customer has approached the bank for the above issue in the month of June, 2015 and several communications had been sent to Reliance General Insurance Company Limited regarding the claim. But it was turned down with indication of delay in submission of claim. However, based on document submitted by the customers, prima facie it appears that the customer has approached RGICL within stipulated time frame.
During the period of argument the agent of the OP No.1 by producing a document assailed that the OP No.1 sent several mails to the OP No.2, one them speaks that the customer has submitted his claim on 13.01.2015 i.e. within 45 days from the death to your Reliance General office at Berhampore. The name of person who has accepted the Claim Form is Pallab Bera. So there is no delay on the customer part. OP bank also prayed to reconsider the matter. Despite receiving the Claim Form in time from the part of the complainant and several requests to settle the claim from the part of the OP bank, the OP No.2 took no measure to settle the claim of the customer/policy holder. But the OP No.2 tried to escape his responsibility by repudiating the claim of the complainant on flimsy ground of delay in submission of Claim Form. Insurance Company should extend their co-operation regarding the claim of the insured person. It is not desirable to repudiate the claim of the insured person merely on technical ground by the OP No.2. So we may safely conclude regarding the entitlement of claim of insurance.
The OP No.2 being the sole authority to settle the claim of this complainant failed to settle the valid claim so he is deficient in providing service towards the claim of the complainant.
4. Whether the complainant proved his case against the opposite party, as alleged and whether the opposite party is liable for compensation to him?
The discussion made herein before, we have no hesitation to come in a conclusion that the Complainant proved his case, so the Opposite Party No.2 could not avoid his responsibility of paying the claim of the complainant including interest thereon as ascertained by this Forum.
ORDER
Hence, it is ordered that the complaint case being No.116/2015 be and the same is allowed on contest against the Opposite Party No.2 with a litigation cost of Rs.5000 payable to this complainant.
The Opposite Party No.2 is directed to pay a sum of Rs.3,00,000/- to this complainant including interest @10% since the date of filing claim Form on 13.01.2015 to this complainant within 45 days from the date of final order.
The OP No.2 is exonerated from the liability.
No other reliefs are awarded to the complainant for harassment and mental agony.
At the event of failure to comply with the order the Opposite Party No.2 shall pay fine @Rs.50/- for each day's delay, if caused, on expiry of the aforesaid 45 days by depositing the accrued amount, if any, in the Consumer Legal Aid Account.
Let a plain copy of this Order be supplied free of cost to the parties/their Ld. Advocates/Agents on record by hand under proper acknowledgement/ sent by ordinary Post for information & necessary action.
Dictated and corrected by me.
Member, Member.
