C.F. CASE No. : CC/10/58
COMPLAINANT : Molina Bibi @ Molina Bewa,
W/o Lt. Sayed Ali Mondal
@ Md Sahid Ali Mondal,
Vill. Rawtara, P.O. Ashachia,
P.S. Kaliganj, 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 Sayed Ali Mondal @ Md Sahid Ali Mondal purchased a Janata Personal Accidental Insurance Policy of the National Insurance Co. Ltd. vide policy No. 100300/47/01/9600022/02/96/30245 and the sum insured was Rs. 1,00,000/-. The policy was valid from 23.10.2002 to 22.10.2017 and the said policy was purchased through GTFS. It is her further case that on 13.07.2008 the policy holder Sayed Ali Mondal died in an accident (RTA) regarding which Tehatta P.S. case No. 286/08 dtd. 13.07.08 U/S 279/304 (A) I.P.C. was started. The present complainant is the wife of the deceased and nominee of the policy also. After the death of her husband she submitted her claim form along with relevant documents to the GTFS Office in proper time. On 30.01.09 the GTFS sent a letter to her stating that all the documents along with the claim form were sent to Sr. Divisional Officer, National Insurance Co. Ltd., Division – III, Kolkata for proceeding the claim at an early date. But no action was taken by the OP Insurance Co. As the OP Insurance Co. did not settle her claim, so she met that office with a request to settle her claim at an early date, but to no effect. Finally on 09.03.10, she went to the office of the OP No. 2 and submitted an application to settle her claim, but to no effect. 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. He has denied all the allegations regarding sending the claim application by the complainant to him along with documents. It is his submission that the above cited policy was purchased by the GTFS who is the insured of the policy and Sayed Ali Mondal is the insured person to that policy. So GTFS is to file this case and not this complainant. Besides this, this Forum has no jurisdiction to try this case as there is an agreement between the OP No. 1 & 2 to the effect that “All disputes between the parties, the beneficiary thereunder shall be filed within the territorial jurisdiction of courts at Kolkata.” So this complainant has no cause of action to file this case and the same is liable to be dismissed against him.
GTFS has also filed written version in this case, inter alia, stating that the deceased Sayed Ali Mondal purchased a Group Janata Personal Accidental Insurance Policy from the OP No. 2 being a member of GTFS. That policy holder expired in a road accident. Thereafter, the nominee of the policy being his wife submitted a claim application along with the relevant documents before him which he duly sent to the OP No. 2 for settlement of the claim. Besides this, as per MOU executed between this OP and the OP No. 2, the authority to settle this claim is solely with the insurer (OP No. 1 & 2) who is to settle the claim of the complainant and this OP has nothing to do in this matter. So the complainant has no cause of action to file this case against him and the same is liable to be dismissed also.
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 the sides it is available on record that one Sayed Ali Mondal @ Sahid Ali Mondal purchased a Group Janata Personal Accidental Insurance Policy from the OP National Insurance Co. Ltd. being a member of GTFS and that policy was valid from 23.10.02 to 22.10.17 and the insured amount was Rs. 1,00,000/-. From the other documents filed by the complainant it is available that on 13.07.08 the policy holder expired in an accident regarding which Tehatta P.S. case No. 286/08, dtd. 13.07.08, U/S 279/304 (A) I.P.C. was started against the driver of the offending vehicle. The present complainant being the nominee of the policy submitted the claim form along with the relevant documents before the GTFS in time and thereafter GTFS sent those documents to the Sr. Divisional Manager, National Insurance Co. Ltd., Division 3, Kolkata on 30.01.09 for settling the claim of the complainant. Those documents were duly received by the OP No. 2 by affixing his seal and signature on the copy of the documents. At the time of argument ld. lawyer of the OP Insurance Co. has submitted that it is the duty of the OP Insurance Co. to settle the claim and not the GTFS. It is also evident from a letter issued by OP No. 2, dtd. 17th July, 01 to that extent “The duties of the insured person is to submit all required documents / papers through Golden Multi Services Club to National Insurance Co. Ltd., and for non-settlement of any valid claim whatsoever, the responsibility and liability is with us and none else.”
So considering this document we find that this is the duty of the OP Insurance Co. to settle the claim of the complainant. It is also evident from other documents that though all the documents were received by him in due time, but the claim of the complainant was not settled by the OP Insurance Co. till the date of filing of this case which we hold is a gross deficiency in service on the part of the OP Insurance Co. Regarding jurisdiction point nothing is agitated by the ld. lawyer of the Insurance Co. at the time of argument, as this point was already disposed of by this Forum vide its order dtd. 31.08.10.
In view of the above discussions, our considered view is that the complainant being the nominee of the policy has become able to prove her case. So she is entitled to get the reliefs as prayed for. In result the case succeeds.
Hence,
Ordered,
That the case, CC/10/58 be and the same is decreed on contest against the OPs. The complainant is entitled to get Rs. 1,00,000/- (insured amount) + Rs. 5,000/- as compensation due to deficiency in service caused by the OP No. 1 & 2 and also litigation cost of Rs. 2,000/-. The OP No. 1 & 2 are jointly or severally directed to pay the decretal amount of Rs. 1,07,000/- to the complainant within a period of one month since this date of passing this judgment, in default, the decretal amount will accrue interest @ 10% per annum since this date till the date of realization of the full amount. No order is passed against the OP No. 3.
Let a copy of this judgment be delivered to the parties free of cost.
