MR LAXMI NARAYAN PADHI, PRESIDENT… The factual matrix of complaint is that, Nirmal Kumar Roy, husband of the complainant had a policy bearing No.590710807 under plan/table III of the OP.s on dt.28.03.1997 with maturity date 28.03.2017 for sum assured of Rs.1,00,000/- and the nominee was the complainant. On dt.14.06.2013, the L.I was driving a Tata- 1109 bearing regd. no. OR 24 -A - 8940 dashed with one bus bearing no.OR-10-C-5371 and got injuries, and later in Koraput Hospital while on treatment succumbed to the injuries on dt.14.06.13 night. The incident was reported and recorded in Boriguma Ps vide P.s Case No.58/2013, and later recorded in the Court of SDJM, Jeypore, Dist Koraput as G.R. case no. 351/13. The complainant submitted all the relevant papers including certified copies of the GR case no. 351/13 and lodged claim with OP.1, under the policy. But despite repeated requests, through letters, legal notices, personal approaches the OP.s did not turn up for settlement of the claim. Hence the complainant praying for direction to OP.s for settlement of the claim, along with compensation of Rs.10,000/- and cost.
2. The complainant has filed policy status report, copies of FIR, witness statement recorded by policy u/s 161 CrPC, police inquest report, copy of notice to OP.s & other documents.
3. The complaint is admitted and notice along with complaint as per provisions of the Act issued to OP.s vide Memo no.265 dt.25.5.2016 seeking counter reply from OP.s. The OP.s representing through their counsel Mr S.Ch.Palo, Advocate filed their counter on dt.31.08.2016. However, he refrained from filing any other documents in support of his contentions in the counter.
4. The contentions of OP.s in the counter is that, Nirmal Kumar Roy, the D.L.A has nominated Sanjita Rani Roy, but if DLA & nominee were otherwise called Sapan Kumar Roy or Sisarani Roy is not known to them. The contention being out of context discarded.
5. The OP in his counter admitted that, the DLA had taken a policy under III-20-20 for sum assured Rs.1,00,000/- on dt.28.03.1997 with annual premium payable Rs.1319/- maturable in 20 years, policy bearing No.590710807, where in the wife Sanjita Roy is nominee.
6. In para 6 of the counter they further admitted that, on receipt of all required claim papers from the complainant, they have settled the claim for Rs.1,05,606/- on 18.11.13, as basic claim under the policy in para 07 of the same counter. They have further admitted that, the complainant has submitted court certified copies of FIR, police final report and photo copies of police inquest report & post mortem report, but the court certified copies of post mortem report and the court verdict in the case is not submitted for accidental claim settlement. The OP vide his BDO/claims dt.01.06.2016 addressed to the complainant as the complaint has not filed the same with the OP.s, they are unable to settle the claim.
7. We have observed that, the death accrued on dt.14.06.2013 and as the death claim is settled as admittedly by both parties, on dt.18.11.2013, presumably the claim papers contains accident claim is also made, and any claim could not have been made settled, on receipt of only a part of the documents, and the claim must not have been made partly for death and partly for accidental death separately. And if there were any shortage of documents the OP.s could have intimated the same to the complainant immediately within stipulated period. But after lapse of three years of the claim papers submitted, the OP.s taking the plea that certain documents were not submitted without any reasonable evidences in support of their claim is quite insusceptible to the conscious of the forum, rather an adverse inference of practicing dilatory tactics and truancy on the part of the OP is assumed.
8. Undoubtedly, circumference the claim for long three years, capriciously by the OP. is unfair trade practice, thus has inflicted injuries on the part of the bereaved widow, the nominee & the complainant. Hence we allow the complaint.
ORDER
i. The OP.s are hereby directed to pay the death claim of Rs.1,00,000/- (Rupees One Lakh) with interest of 9% p.a. calculated from the date of receipt of claim papers by the complainant till to the date of payment. Inter alia the OP.s are further directed to pay a compensation of Rs.10,000/- (Rupees Ten Thousand) including cost of litigation to the complainant.
ii. All the above directions shall be complied with in 30 days of this order, failing which, the total sum will bear 12% interest per annum till its realization. Pronounced on this the 24th day of Oct' 2016.
Sd/- Sd/-
MEMBER PRESIDENT, DCDRF,
NABARANGPUR.
