C.F. CASE No. : CC/09/80
COMPLAINANT : Sri Abani Das
S/o Rishipada Das
Vill. Natna
P.O. Natna Patabuka,
P.S. Karimpur,
Dist. Nadia
OPPOSITE PARTIES/OPs : 1) Manager
Golden Trust Financial Services (GTFS)
16, R.N. Mukherjee Road,
Kolkata 700 001
E-mail: gtfs@vsnl.net
- Senior Divisional Manager,
National Insurance Co. Ltd.
Division III, 8 India
Exchange Place, Kolkata – 1,
Having its Branch Office at
M.M. Ghosh St, P.O. Krishnagar
P.S. Kotwali, Dist. Nadia
PRESENT : KANAILAL CHAKRABORTY PRESIDENT
: KUMAR MUKHOPADHYAY MEMBER
: SMT SHIBANI BHATTACHARYA MEMBER
DATE OF DELIVERY
OF JUDGMENT : 30th April, 2010
: J U D G M E N T :
In brief, the case of the complainant is that he purchased a Janata Personal Accident Insurance Policy from the OP National Insurance Co. Ltd. on 31.03.05 and the said policy is valid up to 30.03.18 and the policy amount is Rs. 50,000/-. It is his further case that due to road accident he has become permanently disable. According to that policy condition he is entitled to get the insured amount due to his disablement. So he filed a claim application before the OP along with other documents requesting to make payment of the insured amount. But the OP neither repudiated his claim, nor has made any payment to him. So having no other alternative he has filed this case praying for the reliefs as stated in the petition of complaint.
OP No. 2, National Insurance Co. Ltd. has filed a written version, inter alia, stating that the case is not maintainable in its present form and nature as the policy was purchased from the National Insurance Co. Ltd., Calcutta Division and so this court has no jurisdiction to try this case. He has also stated that the petitioner lost his capacity to work due to road accident and he became permanently disable is not true at all. The petitioner did not submit any claim application before him and so no question of repudiating or settling the claim dose arise on his part. Hence, the petition is liable to be dismissed as the claimant has no cause of action to file this case.
The OP No. 1, Golden Trust Financial Services has contested this case by filing a written version, inter alia, stating that the complainant, Abani Das obtained a Janata Personal Accident insurance policy from the OP No. 2, National Insurance Co. Ltd., Division III, Calcutta under the Group Insurance Policy through GTFS on 31.03.05 and the said policy is valid up to 30.03.18 and the insured amount is Rs. 50,000/-. He also submits that the claimant fell in a road accident on 11.11.05 and after accident he was taken to District Hospital, Nadia, Saktinagar where he was treated also. Due to this accident he became permanently disable. The claimant submitted a claim application along with other documents before him, who after initial verification sent that claim application before the OP No. 2 on 29.08.07, but no positive step was taken by the Insurance Co. to settle his claim. He also submits that as per MOU executed between this OP and the National Insurance Co. Ltd. this OP has no role in settling the claim of the complainant. It exclusively rests upon the OP No. 2 to settle the claim who is liable to pay compensation to the complainant. He acted as a mere agent of the OP No. 2 and so he has no liability to pay the compensation to the complainant. Therefore, the complainant has no cause of action to file this case against him.
POINTS FOR DECISION
Point No.1: Is the case maintainable in its present form and nature?
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 and the written versions filed by the OPs and after hearing the arguments advanced by the ld. lawyers for the parties it is available on record that the complainant, Abani Das purchased a Janata Personal Accident Insurance Policy from the OP No. 2, National Insurance Co. Ltd., Kolkata, Div. III on 31.03.05 and the insured amount was Rs. 50,000/-. This policy was purchased through the OP No. 1, GTFS. The complainant’s case is that due to road accident he was injured and subsequently, he became permanently disable as a result of which he lost his working capacity. In support of his submission he has filed a document vide 'Annexure – 3’ which shows that this complainant was treated at District Hospital, Saktinagar from 11.11.05 to 14.11.05 with spinal injury from RTA (Partial collapse of L1) and the treatment was conservative. It is the claim form which was filed before the OP No. 2 duly filled in by the complainant. 'Annexure – 6’ is the document issued by Office of the Superintendent, District Hospital, Nadia which is the disability certificate and in this certificate the disablement of the complainant is assessed by the District Hospital to the extent of 50%. From the written version filed by the OP No. 1, GTFS it is available that the claim application along with other documents were forwarded by him to the OP No. 2 on 29.08.07, but till to date the OP No. 2 has neither settled the claim nor repudiated it. Copy of the injury report of the complainant is also filed from which it is available that he was injured in a road accident and accordingly a police case was started against the offending vehicle bearing case No. 0109 dtd. 11.11.05 under Sections 279, 338 and 304A IPC. OP No. 1, GTFS sent a reminder to the OP No. 2 for early disposal of the claim application vide his Memo No. 03066 dtd 25.04.09, but the claim is yet not settled by the OP Insurance Co. Ld. lawyer for the OP Insurance Co. submits that this court has no jurisdiction to try this case as the policy was issued by National Insurance Co. Ltd. Div. III, Calcutta, but in the cause title the Branch Office of the OP Insurance Co. located at Krishnagar is made a party in this case also against whom notice was also issued. So as per C.P. Act, if the OP has any Branch Office within the territorial jurisdiction of this Forum, the complainant can claim compensation before that Forum and this Forum is quite competent to try this case also.
In view of the above facts and discussions also our considered view is that the complainant became permanently disable due to a road accident and his disability is proved by the certificate issued by District Hospital, Nadia. It is also established though the complainant submitted the claim application along with the relevant documents before the OP No. 2, but the OP No. 2 has not settled his claim which is a gross deficiency in service on his part. So our considered view is that the complainant is entitled to get the insured amount as claimed by him as per policy benefits declared by the Insurance Co. In result the case succeeds.
Hence,
Ordered,
That the case, CC/09/80 be and the same is decreed on contest against the OPs. The complainant is entitled to get Rs. 50,000/- as insured sum + Rs. 5,000/- towards compensation for mental pain and harassment along with Rs. 2,000/- as litigation cost, i.e., in total Rs. 57,000/-. The OP No. 2 is directed to make payment of the decretal dues to the complainant within a period of one month since this date of passing this judgment, in default, the decretal amount will carry interest @ 9% per annum since this date till the date of realization of the full amount. We make no order against the OP No. 1, GTFS.
Let a copy of this judgment be delivered to the parties free of cost.
