C.F. CASE No. : CC/10/57
COMPLAINANT : Jharna Shill
W/o Lt. Swapan Shill,
of Vill. 2 No. Jugpur Colony,
P.O. Jugpur, P.S. Nakashipara,
Dist. Nadia
OPPOSITE PARTIES/OPs : 1) Branch Manager
National Insurance Co. Ltd.
Krishnagar Branch
P.O. Krishnagar, P.S. Kotwali,
Dist. Nadia
2) Divisional Manager,
Division – III
National Insurance Co. Ltd.,
8, Indian Exchange Place,
Kolkata – 700001
3) The Manager,
Golden Multi Services Club
of M/S G.T.F.S. Krishnagar Branch
R.N. Tagore Road,
P.O. Krishnagar, P.S. Kotwali,
Dist. Nadia.
PRESENT : SHRI KANAILAL CHAKRABORTY PRESIDENT
: SMT SHIBANI BHATTACHARYA MEMBER
: SHRI SHYAMLAL SUKUL MEMBER
DATE OF DELIVERY
OF JUDGMENT : 24th November, 2010
: J U D G M E N T :
In brief, the case of the complainant is that her husband late Swapan Shill purchased a Janata Personal Accidental Insurance Policy of the National Insurance Co. Ltd. bearing policy No. 100300/47/2K/9601062/2K/96/00607 and the sum insured was Rs. 50,000/-. The said policy covered the period from 15.10.01 to 14.10.16 and it was purchased through Golden Multi Services Club of M/S GTFS agent. It is her further case that the policy holder, late Swapan Shill died on 12.11.07 in an accident (RTA) and on the basis of this accident, Berhampur P.S. case No. 537/07, dtd. 19.11.07, U/S 279/304(A) I.P.C. was started. The present complainant is the nominee of that policy. So she submitted the claim application along with the relevant documents to the GTFS office in proper time. On 08.01.08 the GTFS sent a letter to her, inter alia, stating that all the relevant documents along with the claim form were sent to Sr. Divisional Manager, National Insurance Co. Ltd., Division III, Kolkata for settling the claim. Thereafter she went to the office of the OP No. 2 and requested to settle her claim at an early date, but to no effect. Thereafter on 09.03.10 she again went to the office of the OP No. 2 and further requested to settle her claim at an early date, but no decision was taken by the OP No. 2 in settling her claim. So having no other alternative she has filed this case praying for the reliefs as stated in the petition of complaint.
The OP, National Insurance Co. Ltd. has contested this case by filing a written version, inter alia, stating that this case is not maintainable in its present form and nature and has denied all the allegations made in the complaint. It is his submission also that the GTFS is the insured of the policy and Swapan Shill is the insured person and actually GTFS purchased the said policy on the behalf of Swapan Shill. At the time of purchase of the said policy by the GTFS, the GTFS entered into an agreement of this OP to the extent that “All disputes between the parties, the beneficiary thereunder shall be filed within the territorial jurisdiction of courts at Kolkata.” So in view of this, this Forum has no jurisdiction to try this case. Besides this, neither the complainant nor the GTFS sent any claim form before this OP as alleged in the petition of complaint. So no question of non-settling the claim of the complainant by this OP does arise. Hence, this case is liable to be dismissed against him.
The OP No. 3, GTFS has also contested this case by filing a written version, inter alia, stating the deceased Swapan Shill purchased one Group Janata Personal Accidental Insurance Policy from the OP No. 2, National Insurance Co. Ltd., Division – III, Kolkata through GTFS which is valid from 15.10.01 to 14.10.16 and the sum insured was Rs. 50,000/-. The complainant Jharna Shill is the wife and nominee of the said policy holder. As per MOU between the National Insurance Co. Ltd. and this OP (GTFS), GTFS was empowered to extend the insurance coverage to its member under the said policy, but the exclusive right and authority to entertain, process and settlement of such claim rest upon the OP, National Insurance Co. Ltd. So this OP has no liability to make the settlement of the claim. He also submits that the complainant submitted the claim form along with the relevant documents which he duly forwarded and sent to the OP National Insurance Co. Ltd. for settlement of the claim, who did not settle the claim. So it is the duty of the Insurance Co. to settle the claim and not this OP GTFS. Hence, the case is liable to be dismissed against him.
POINTS FOR DECISION
Point No.1: Has the complainant any cause of action to file this case?
Point No.2: Is the complainant entitled to get the reliefs as prayed for?
DECISION WITH REASONS
Both the points are taken up together for discussion as they are interrelated and for the sake of convenience.
On a careful perusal of the petition of the complaint along with annexed documents filed by the complainant and the written versions filed by the OPs and after hearing the arguments advanced by the ld. lawyers of all sides it is available on record that late Swapan Shill purchased a Group Janata Personal Accidental Insurance Policy from the OP National Insurance Co. Ltd. through GTFS and the said policy covered the period from 15.10.01 to 14.010.16 and the sum insured was Rs. 50,000/- also. From other documents it is available that said Swapan Shill died in a road traffic accident on 12.11.07 regarding which Berhampur P.S. case No. 537/07 dtd. 19.11.07 U/S 279/304(A) I.P.C. was started against the driver of the offending vehicle. Death certificate of the victim also speaks that he died due to road accident. There is no denial on the side of the ld. lawyer of the OPs regarding the accidental death of the victim and being the complainant as the nominee of the policy of late Swapan Shill. The OP Insurance Co. has denied regarding the submission of the claim application and other relevant documents before him. But from the documents filed by the complainant and the OP GTFS it is available that the complainant submitted the claim form along with the other relevant documents before the OP GTFS, which the GTFS duly forwarded the OP Insurance Co. on 8th January, 08. The OP Insurance Co. duly received the claim form and the other documents by affixing its seal and signature on the documents. There is no denial on the side of the ld. lawyer of the OP Insurance Co. regarding the receipt of the claim application along with other documents by the OP Insurance Co. It is also submitted by the ld. lawyer for the OP at the time of argument that as per MOU executed by and between the National Insurance Co. Ltd. and the GTFS, it is the duty of the OP Insurance Co. to settle the claim and not the GTFS. So considering this submission and the documents filed by the complainant we hold that the National Insurance Co. Ltd. is the competent authority to settle the claim of the complainant. At the same time, it is also revealed from the documents that though this OP Insurance Co. received all the documents along with the claim application of the complainant on 08.01.08, but till the date of filing of this case he neither settled the claim of the complainant nor repudiated the same which we hold is a gross deficiency in service on the part of this OP Insurance Co.
Regarding jurisdiction point nothing is agitated by the ld. lawyer of the OP Insurance Co. at the time of argument. This point was raised earlier by this OP which was disposed of by this Forum in favour of the complainant vide order No. 10 dtd. 31.01.10.
Therefore, in view of above discussions and considering the facts of this case we have no hesitation to hold that this complainant is competent enough to get the insured amount of Rs. 50,000/- as claimed by her as she has become able to prove her case. At the same time we do also hold that the deficiency in service on the part of the OP Insurance Co. is also well established in this case. So the complainant is entitled to get compensation also. In result the case succeeds.
Hence,
Ordered,
That the case, CC/10/57 be and the same is decreed on contest against the OPs. The complainant is entitled to get Rs. 50,000/- (sum insured in the policy of her late husband Swapan Shill) along with the compensation of Rs. 5,000/- for deficiency in service caused by the OP Insurance Co. She is also entitled to get the litigation cost of Rs. 2,000/-. The OP No. 1 & 2 are jointly or severally liable to pay the decretal dues amounting to Rs. 57,000/- to the complainant within the period of one month since this date of passing this judgment, in default the decretal amount will carry interest @ 10 % per annum since this date till the date of realization of the full amount. We pass no order against the OP No. 3.
Let a copy of this judgment be delivered to the parties free of cost.
