West Bengal

Paschim Midnapore

CC/23/2015

Sri Pravas Nayek - Complainant(s)

Versus

National Insurance Co. Ltd. - Opp.Party(s)

04 Aug 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

PASCHIM MEDINIPUR.

                             

Bibekananda Pramanik, President, Mrs. Debi Sengupta, Member

and  Kapot Chattopadhyay, Member.

   

Complaint Case No.23/2015

                                                        

Sri Pravas Nayek……………….………Complainant

Versus

The Golden Multi Services Club………..Opp. Party.

 

For the Complainant: Mr. Ashim Kumar Dutta, Advocate.

For the O.P.               : Mr. Pradyut Ghosh, Advocate.

 

Decided on: - 04/08/2015

                                

ORDER

        Bibekananda Pramanik, President- Facts of the case, in brief, is that Sunil Nayek, since deceased, the father of the complainant had a Group Janata Personal Accident Insurance Policy with the O.P. No.2 National Insurance Company through O.P. No.1 Golden Multi Service Club valued at Rs.50,000/- and the said policy was valid from 23/07/2002 to 22/07/2017.  Complainant Sunil Nayek is the nominee of the said policy.  Unfortunately on 18/07/2010, Sunil Nayek died in a road traffic accident for which a criminal case being no.105/2010 dated 19/07/2010 was initiated and in that case charge sheet was also filed.  After the death of Sunil Nayek, the mother of the complainant Sumitra Nayek filed a complaint case being No.79/2011 against the present O.Ps and on 30/11/2011, this Forum disposed of the said case with the findings that the mother of the complainant is not the nominee of the said policy.  After disposal of that case, the complainant being the nominee of that policy, furnished  all documents along with the policy  and the O.P No.2  registered said claim under No.47/12/856 and issued claim form.  Complainant deposited the claim form on 28/11/2013 along with all documents before the OP-Insurance Company but the O.P No.2 did not settle the claim which tentamounts to deficiency in service.  Hence, the complaint, praying for an order directing the O.P to pay the insured sum of Rs.50,000/- with interest and litigation cost of  Rs.10,000/-.

Contd…………..P/2

 

-(2)-

              Both the O.Ps have contested this case by filing two separate W/O.  In their W/O, Op No.1 has stated that he is not corporate agent of O.P No.2 rather O.P No.1 such Principal Insured of the said policy.  Admitting the claim of the complainant, O.P No.1 has stated that they forwarded all documents to the O.P No.2 for settlement of the claim but for unknown reasons, the claim has not yet been settled  by the O.P No.2.

            Denying and disputing the case of the complainant, it is the specific case of the O.P No.2, as disclosed in their W/O, that two years after disposal of the complaint case filed by the mother of the complainant, the present complainant filed claim form with some papers before the O.P No.2 and he was thereafter asked to submit necessary papers including F.R.T., Charge-sheet etc. but till date the complainant did not file those same.  It is stated that there is no deficiency in service on the part of the complainant.  It is further stated that the present case is hit by section 24A of the Consumer Protection Act, in as much as, the complainant has filed the complaint after more than 4 years after the cause of action started on 18/07/2010 and hence the present complaint case is not at all maintainable and the same is liable to be dismissed summarily.      

 

Point for decision

1)Whether the complainant is a consumer within the meaning of the section 2(i) (d) (ii) of the C.P. Act, 1986?

2)Whether the Ops. are liable for deficiency in service within the meaning of section 2 (l) (g) read with section 2(1) (0) of the C.P. Act 1986 ?

3)Whether the complainant is entitled to get the reliefs, as sought for?                        

 

Decision with reasons

Point No.1

            It is not disputed that the father of the complainant namely Sunil Nayek, since deceased being a member of the O.P. No.1 G.M.S.C. took a Janata Personal Accident Insurance Policy being No.100300/47/01/9600022/01/96/30135 from the O.P. No.2-National Insurance Company for a assured sum of Rs.50,000/- and  the validity of the said policy was from 23/07/2002 to 22/07/2017.  It reveals from the copy of Insurance Policy that the present complainant Pravas Nayek is the nominee of the said policy.  It is undisputed that said Sunil Nayek, the policy holder of that Insurance Policy, died on 18/07/2010 in a road traffic accident.  The present complainant, being the nominee of the said policy, is therefore held to be a ‘Consumer’ within the meaning of the provisions of C.P. Act,1986. This point is accordingly answered in favour of the complainant.

Point Nos.2&3

            According to the complainant, he, being a nominee of the policy, submitted application 

Contd…………..P/3

 

                                                       -(3)-

along with claim form and relevant documents including the original policy on 28/11/2013 before the O.P. No.2-Insurance Company through the corporate agent namely O.P. No.1-Golden Multi Services Club. From the w/o filed by the O.P. No.1, it appears that in para 5 of the w/o, they have stated that they forwarded all documents to O.P. No.2.  In para 6 of the w/o, the O.P. No.1 has also stated that withholding of settlement and payment of the claim for such a long time by the O.P. No.2 amounts to deficiency in service and the Complainant is running from pillar to post. By filing a copy of letter dated 14/03/2013, the O.P. No.2 has stated that they asked the complainant to submit few documents namely original policy, attested photo copy of identity card or pan card, certified copy of F.I.R, Charge sheet and P.M. Report, local Panchayet/Municipal Authorities certificate regarding the status of the nominee, Bank Pas Book of the nominee and claim form in original.  From the letter dated 01/02/2013, filed by the complainant, it appears that he only sent copy of F.I.R., copy of seizure list and copy of death certificate.  Complainant failed to produce any documents to show that in compliance of the letter dated 14/03/2013 sent by the O.P. No.2, he submitted all those documents as required by their letter dated 14/03/2013.  According to the O.P. No.2 for such non-submission of all those documents they were unable to settle the claim of the complainant.  In the above circumstances, it cannot be held that there is any negligence or deficiency in service on the part of the O.P.-Insurance Company.  Since the complainant has failed to produce any documents that he submitted all those required documents before the O.P. No.2 in compliance of letter dated 14/03/2013 sent by registered post to the complainant,  so, we find that the complainant has no cause of action to file this present case and as such he is not entitled to the reliefs as prayed for.

             In the result, the complaint case stands failed.

                                              Hence, it is,

                                                Ordered,

                                                                     that the case be and the same is hereby dismissed on contest but in the circumstance without cost.          

Dictated & Corrected by me

              Sd/-                                   Sd/-                          Sd/-                                        Sd/-

         President                            Member                   Member                                 President

                                                                                                                               District Forum

                                                   Paschim Medinipur