This case arose out of application U/s 12 of the Consumer Protection Act, 1986.
The case of the petitioner is that during lifetime Sanjib Saha purchased two insurance policy from LICI being Policy No:456918882 & 456918517 for Rs.7,00,000/- & Rs.8,00,000/-, wherein his father/petitioner is the nominee. Suddenly on 16.05.2013 Sanjib Saha died due to murder and he was brought to Raiganj Sadar Hospital for treatment where the doctor declared already dead due to gunshot. After his death the petitioner as a nominee as well as legal heirs claimed the insured amount in respect of the policy and filed all necessary documents as required by the O.Ps.
Thereafter, the O.Ps sent a letter dated 15.01.2014 for payment of the sum assured and subsequently only sum assured has been paid by the O.Ps through NEFT to the petitioner’s bank account being No:11312081564. Being received of the letter O.P.No-2 issued a letter dated 15.01.2014 to the petitioner stating that “the net claim amount under above policy is being directly credited to your bank account of the due death of claim through NEFT mode of payment. You are requested to check your bank account after the due date of claim for confirmation of receipt of above payment” and sum assured was credited on 16.01.2014.
The petitioner sent letter to both O.Ps on 04.01.2016 & lastly on 21.11.2017 through courier service but the O.Ps did not turn up for payment of the accidental benefit and the petitioner contacted the O.Ps several times but no fruitful result comes out. After your petitioner comes to the O.P’s office the O.P concern asked the petitioner that the accidental benefit will be payable after enquire the actual facts of the incident.
Thereafter, lapsing long period the O.P keep mum and did not make any corresponding to your petitioner. Due to willful and gross negligence and deficiency in service of the O.P concern the petitioner suffers irreparable loss and injury thus he claims sum assured of Rs.8,00,000/- & Rs.7,00,000/- total Rs.15,00,000/- with @ Rs.10% pa from the date of death of Sanjib Saha, compensation of Rs.1,00,000/- for un-necessary harassment, mental pain and agony and litigation cost of Rs.5,000/-.
O.P.No-1&2 contested the case by filing written version denying case of the petitioner stating that the deceased life assured Sanjib Saha purchased LIC policy No:456918882 from Raiganj Branch on 05.01.2012 for sum assured Rs.7,00,000/- and policy No:456918517 dated 28.12.2011 for sum assured Rs.8,00,000/- . On 16.05.2013 the life assured died. Claim papers along with death certificate were submitted by the petitioner after necessary verifications the basic claim amount along with vested addition Rs.7,32,928/- & Rs.8,37,632/- were paid to the petitioner on 15.01.2014. As the death was caused due to a gunshot LICI asked the petitioner to submit police inquest report, PMR & Charge sheet to establish that the
mishap actually occurred and no criminal offence was done by the deceased. The LICI sent two letter dated 11.07.2013 & 28.09.2013 to the petitioner for submitting the same but the petitioner has not contacted since 2013 with those requirement, the period of such procrastination continued for 06 long years attracting Limitation Act. Petitioner never sent any letter on 04.01.2016 & 21.11.2017 those letters only created for filing the suit and also avoid the limitation period. Therefore, the petitioner cannot get any relief in this case and the case is liable to be dismissed.
Point for consideration is
- Whether there was willful & negligent act and deficiency in service on the part of O.P concern causing loss and injury to the petitioner?
- Is the petitioner entitled to get the relief (s) as prayed for?
D e c i s i o n w i t h r e a s o n s
Admittedly, Sanjib Saha purchased policy No:456918882 & 456918517 from LICI, Raiganj Branch on 05.01.2012 & 28.12.2011/31.12.2011 respectively for sum assured Rs.7,00,000/- & Rs.8,00,000/- respectively and present petitioner Rajendra Nath Saha, his father were nominee.
It appears that Rajendra Nath Saha (petitioner) lodged written complaint dated 16.05.2013 to the effect that he came to know over phone that Ramesh Agarwala, Bablu Agarwala, Pappu Kalyani & Ganesh Saha shot Sanjib Saha with gun at on the road of Kanchanpally near Subhash Ganj Bridge, Raiganj and fled away. It was registered as Raiganj PS F.I.R No:415 of 13 dated 16.05.2013 which has been ended with charge sheet No:689/13 dated 14.08.2013 U/s 302/379/120B of I.P.C read with Section 25/27 of Arms Act, against Raju Chowdhury @ Rajib Chowdhury, in the court of Ld. C.J.M, Raiganj, Dist-Uttar Dinajpur, vide GR-865/14.
Petitioner stated that his son was brought to Raiganj Sadar Hospital where the doctor declared him brought dead.
The case of the petitioner is that after death of his son Sanjib Saha the petitioner as a nominee as well as legal heirs claimed the insured amount in respect of the policy and filed all necessary documents as required by the O.Ps. He neither disclose date of filing claim petition nor he deposited copy of the same, but presumably after 16.05.2013 (in the year 2013).
Admittedly, the O.P.No-2 issued a letter dated 15.01.2014 stating that “the net claim amount under above policy is being directly credited to your bank account of the due death of claim through NEFT mode of payment. You are requested to check your bank account after the due date of claim for confirmation of receipt of above payment”. Thereafter, on 15.01.2014 the L.I.C.I has paid Rs.7,32,928/- & Rs.8,37,632/- i.e sum assured with return of premium excluding First year and extra premium against Policy No:456918882 & 456918517, sum assured Rs.7,00,000/- & Rs.8,00,000/- respectively, credited in petitioner’s bank A/c being No:11312081564.
Kuntal Roy the Administrative Officer, L.I.C.I, Raiganj Branch as O.P.W.1 stated that we (L.I.C.I) have/has not paid any amount against accidental benefit of those policies.
Letter dated 11.07.2013 (Exhibit-B) shows that L.I.C.I acknowledges receipt of claim papers Re:Death Claim policy No:456918517, 456925346 & 456918882 on the life of Sanjib Saha (decd) and requested the petitioner to submit documents noted therein, of which Item No:4, 6 & 7 were ticked which are as follows:-
4.(i) Post Mortem Report (ii) Police Inquest Report
(iii) Police Final report or charge sheet for consideration of Accident Benefit.
6. Claim Form A.C 7. Policy Bond
Upon receipt of the above requirements we (LICI) shall revert to the matter.
Subsequent letter dated 28.09.2013 regarding same subject (Exhibit-C) shows that L.I.C.I requested the petitioner to submit (i) Police Inquest Report (ii) Police Final Report/Charge sheet. L.I.C.I acknowledges receipt of claim forms and policy bonds. So, Item No:4(ii), 6 & 7 were waived from the list of required documents of letter dated 11.07.2013. None of the parties have any case regarding Policy No:456925346.
Though not relevant, it is mentioned that petitioner lodged complaint in respect of Policy No:455918517 which stands in the name of one Najimul (Exhibit-A), thus the petitioner amended the complaint petition by inserting policy No:456918517 instead of 455918517
The case of the petitioner is that he sent letter to both O.Ps on 04.01.2016 & lastly on 21.11.2017 through courier service but the O.Ps did not turn up for payment of the accidental benefit and the petitioner contacted the O.Ps several times but no fruitful result comes out. After your petitioner comes to the O.P’s office the O.P concern asked the petitioner that the accidental benefit will be payable after enquire the actual facts of the incident.
Xerox copy of letters dated 04.01.2016 & 21.11.2017, produced by petitioner show that those were addressed to the O.P.No-1 & 2 respectively. Xerox copy of consignment notes of M.E.C Express Courier, produced by petitioner show the name of Consignor (Receiver) were O.P.No-1 & 2 respectively.
It is categorically denied by the O.Ps that letters dated 04.01.2016 & 21.11.2017 were not sent but created only for filing the suit and also to avoid the limitation period.
In this context we are of the opinion that the burden lies on the petitioner to prove that those letters were duly served on O.P.No-1 & 2. The petitioner has failed to discharge the onus by calling for service report from the concerned Courier Agency.
From case record it reveals that Ld. Advocate of the O.Ps advanced argument mainly on two points:-
- Documents required as per letter dated 28.09.2013 being not produced claim can neither be settled nor repudiated.
- Case is barred by limitation being filed on 19.07.2019 after 6 years of said letter dated 28.09.2013.
At this juncture a petition was submitted by the petitioner for time to advance counter argument on producing required documents and the petitioner was allowed to submit certified copy of the documents, but the petitioner submits certified copy of charge sheet only on the date fixed 12.09.2022 and advanced his argument and submits further that the inquest report is not available being lying in the case diary of GR-865/14.
According to O.P concern since they did not get/receive the required documents the claim could neither be settle finally nor repudiated. We therefore, are of the opinion that the petition of complaint is not maintainable being premature.
Consequently, we are also of the opinion that the claim is not barred by limitation, rather the petitioner may be given an opportunity to produce the documents as required by O.P concern, to get the claim finally settled.
Ld. Advocate for the petitioner referred a judgment reported in II(2022) CPJ 157(Har.) of Haryana S.C.D.R.C in Re: Parvati Devi Vs ICICI Lombard G.I.C Ltd. We have perused the judgment wherein Hon’ble Court has been pleased to hold that when appellant had failed to supply required documents to opposite parties then in that situation, opposite parties cannot be said to be at fault in closing claim file of complainant. This ruling favors O.P concern.
We feel it would be just and proper to direct the petitioner to submit the required documents afresh to the opposite parties and to require opposite parties to settle the claim of the petitioner finally.
Hence, it is
O R D E R E D
that C.C-37-2019 be and the same is dismissed, being premature, on contest against the O.Ps, but without any cost.
The petitioner is given an opportunity to submit the required documents afresh to the opposite parties and the opposite parties shall consider the claim of the petitioner finally, within one month of receipt thereof.
Let a copy of this order be given to the parties free of cost.
