Shri B. Mukhopadhyay, President.   

This is an application u/s.12 of the C.P. Act, 1986.

            Complainant by filing this compliant has alleged that being the destitute widow of her husband Sanjoy Chakraborty is compelled to file this complaint for negative attitude of the OP Insurance Company for not releasing the death benefit of the insurance policy of her husband since deceased Sanjoy Chakraborty bearing policy No.411136009, 411577696 and 411902138 having sum assured of Rs.25,000/-, Rs.25,000/- and Rs.50,000/- respectively and by purchasing that policy her husband nominated his wife and during his lifetime he maintained all the three policies by paying requisite premium regularly.  But unfortunately, Sanjoy Chakraborty died on 05-04-1995 and death certificate along with claim was sent to the OP on 12-10-1995 in respect of all the three policies to the OP1 in prescribed form through the agent of the OP1 and that was received by the complainant and receipt is within the custody of the complainant but till now that claim has not yet been settled by the OP though complainant moved from pillar to the post for getting the relief from the OP but always it was reported that the matter is under process and early result would be given.  Many representations were made to the office of the OP but result is zero and for which the complainant ultimately filed this complaint for redressal.

            On the other hand the OPs by filing written version has submitted that along with the claim documents original policy documents were not submitted and at the same time no treatment papers of the complainant’s husband for last 5 years prior to death of Sanjoy Chakraborty was filed.  But complainant filed only death certificate, one premium receipt but no claim form was filed which were received by the OP on 12-10-1995 and after a long gap, the complainant lodged this complaint and, in fact, she did not comply the provision of the insurance policy for getting relief and to get the claimed amount.  Not only that it is alleged that duration of the policies of 411136009, 411577696 and 411902138 were for 2 years 7 months, 1 year 8 months and only for 7 months respectively.  In order to avoid claim enquiry, the claimant filed the claim after 14 years from the death of her husband so that after such a long period of time papers could not be located.  However, the complainant did not reply against the query letters sent by the OP as routine asking.  So, the OP could not process the claim.  Complainant deposited the claim form B and B-I with the OP.  But it is not duly filled in and deposited by the claimant.  And it is to be mentioned that claim form B was signed by Dr. Debo Prasad Ghosh but he was not treated by Dr. Debo Prasad Ghosh prior to his death and many columns were found blank and marked letter C and C-1 will prove that in view of the above situation the said claim could not be settled as it was not in order.  Thereafter, after lapse of 14 years the claim form was submitted further but in the follow up query, the complainant did not provide necessary information for processing the claim so the claim could not be processed for communication to the complainant.  A letter dated 29-07-2009 of the OPs shall prove that the entire allegation of the complainant is false and fabricated for which it should be dismissed.

Decision with Reasons

No doubt, with painful heart we have taken this case for decision on the ground that this widow of Sanjoy Chakraborty even after her husband’s death in 1995 has failed to get the fruitful result in respect of the aforesaid three policies of Latet Sanjoy Chakraborty as nominee and legally married wife of Sanjoy Chakraborty but after giving due attention of the argument as advanced by the Ld. Lawyer of the OP and also documents which were filed by the complainant before the Insurance Company, we have recovered that in claim along with claim application original policy bonds were not submitted what is fact.  At the same time date of death is not noted in any application.  Further fact is that document of medical treatment of Sanjoy Chakraborty prior to death was also not filed.  So, apparently, it is found that complainant did not file all required documents to the OP though OP requested her to file all those documents but anyhow at the time of hearing argument from the complainant’s lawyer, we have learnt that complainant lost all the three policies which was informed to the OP but it is not ventilated in the complaint.  Anyhow, OP has admitted that there was three policies in the name of late Sanjoy Chakraborty bearing No. 411136009, 411577696 and 411902138.  But it is found from death certificate of Sanjoy Chakraborty who died at his residence 27, G.G. Road, Kolkata – 46, P.S. Beniapukur at S.S.K.M. Hospital on 05-04-1995 and that is the certificate of death issued by Shanagar Burning Ghat, CMC and from the Annexure – P-4 it is found that the complainant did not file any policy along with the claim.  So, the complainant’s claim to the fact that she submitted all documents is not substantiated rather it is proved that she did not file many documents including the original policy bonds.  Anyhow, the Ld. Lawyer of the complainant submitted that policy bonds were lost and it was reported to the OP who was considering the fact and it is clear OP had no fault and in fact the complainant did not file claim form along with all documents and that was the ground for not disposing of the said three claims.  Now we have considered the situation of the present complainant what would be the fate of the complainant when she had already lost the original policy bonds then question is whether the complainant shall have to get the benefit of the Insurance Policies of late Sanjoy Chakraborty and if such a situation is faced by any widow as nominee of a policy holder in that case whether insurance company shall have to wait till the death of that nominee.  But some way shall be searched out to give relief to the said destitute policy holder because Insurance Act was enacted for the sufficient protection of the insured and on his death his or her legal heirs and invariably the insurance company ought to have adopt any simple procedure brushing aside any technicalities to give relief to the complainant and at best the deposit premium amount against three policies of Sanjoy Chakraborty ought to have been to the present complainant after satisfying themselves about the identity of the complainant as legally married wife of Sanjoy Chakraborty.  But that had not been done.  Very vital factor which was pointed out by the OP is that three policies were opened in between the period 19-08-1994 and till his death on 05-04-1995 so we have gathered after consulting the document that truth is that preceding to death of Sanjoy Chakraborty on 05-04-1995 the above policies were opened.  But might be there are some intentions of the insured but we are not in a position to decide of this matter at this stage.  But the matter ought to have been decided by the Insurance Company by showing their moral approach to give such support to the complainant so that she ought to have get the same in time.  But fact remains OPs did not take any such moral step to render service to the complainant and practically without making any communication with the complainant they have been sitting idle for 14 years but such an act of the OP is condemned by this Forum.

            Anyhow we have realized that there are some problems of the OP but acute problem is of the complainant because she has lost the original policy bonds then our expression is that the OP shall have to take such positive step and issue such second/duplicate copy of Insurance Policy and tag with the claim application after collecting all materials from S.S.K.M. Hospital about death of husband of the complainant and dispose of the matter at once and we are not in a position to hear any explanation of the OP for any sort of further delay when fact remains that Sanjoy Chakraborty died, fact remains this complainant is nominee of those policies and fact remains these policies were valid till the death of Sanjoy Chakraborty then what prevented the OP to expedite the matter extending help to the destitute wife of Sanjoy Chakraborty, the present complainant when legally she is entitled to.

            Some officials of the insurance company at the time of argument vociferously submitted that the insured was aware of the fact that his death was eminent and when he purchased three policies one after another knowing fully well that he shall not have to live longer but his death is imminent and, in fact, those officers submitted that those insurance policies were purchased by giving some false statement regarding his health.  But in this regard we are confident to say why before issuing valid insurance policy the said fellow was not examined by the doctors of the Insurance Company and for what reason the OP sold the policies relying upon the statement of the insured.  In this regard our view is that there is no necessity to mudde the past history of disease Sanjoy Chakraborty.  Let give a chance to Sanjoy Chakraborty since deceased to stay in his heavenly World by giving proper relief to the complainant at once.

            In the light of the above observation and findings, we are of view that the OPs shall have to settle the claim without any further delay and invariably within two months from the date of this order and at least give her Rs.1 lakh for three policies and accordingly settle the matter otherwise this destitute shall be thrown into the dustbin.  So save her from her starvation disposing of this claim application might be there are some fault but same may be disposed of as per direction of this Forum by the OPs and OP to handover at least Rs.1 lakh to the complainant along with some interest also when this money is in the custody of the OP for last 14 years.  In the result complaint succeeds in view of the above decision.

Hence,

Ordered

That the complaint be and the same is allowed on contest against the OPs with a cost of Rs.3,000/- (Rupees Three thousand only).

            OPs are directed to dispose the claim matter of the complainant in respect of the three policies of the insured late Sanjoy Chakraborty and to hand-over the entire amount what she is entitled to get, in favour of the complainant after adopting such necessary administrative action without begging for any further document from the complainant.  As per direction of the Forum this Claim matter shall be settled and handover whatever the final settlement amount after satisfying themselves and handover the payment to the complainant or they may submit the account payee cheque before this Forum for handing over it to the complainant but entire matter shall be complied within two months from the date of this order failing which for each days delay a sum of Rs.500/- (Rupees five hundred only) shall be assessed as punitive damages.  Even penal action may be taken against them.