1)           Mrs. Susoma Chatterjee,

Village: Khamarchandi,

Dist. Hooghly, Pin-712405.                                     ---------- Complainant

---Verses---

1)           National Insurance Co. Ltd.,

3, Middleton Street, Kolkata-71.

2)           Golden Trust Financial Services,

16, R.N. Mukherjee Road, Kolkata700001.            ---------- Opposite Party

Present :         Sri S. K. Majumdar, President.

                        Smt. Jhumki Saha, Member.

                        Sri T.K. Bhattachatya, Member.

Order No.   1 6   Dated  0 6 / 1 0  / 2  0 0 9.

            Complainant Ms. Susama Chatterjee by filing a petition u/s 12 of the C. P. Act on 18.02.2008 has prayed for issuing necessary direction upon the O.P.  to pay a sum of Rs. 2,00,000.00 with interest till realization of the insured amount and compensation of Rs. 5,000.00 and for any other order as the Forum may deem fit and proper.

          It is the specific case of the Complainant  that her deceased husband Kashi Nath Chatterjee was insurance policy holder covering the risk of accidental death/loss of limbs/permanent/total disablement in the name of group mediclaim insurance and Group Janata Personal Accident through O.P. 2 for a sum of Rs. 2,00,000.00 against the policy bearing No. 1003000/47/2K/9601062/2K/96/00272 expiring on 07.02.2016 in which the petitioner is the nominee. Her husband Kashi Nath died out of a road accident on 25.04.2005 at Haripal Hospital. It was informed to the local police station. After the death of her husband, the petitioner, Ms. Susoma was under the treatment of Dr. Gautam Patra from 28.04.2005 to 10.07.2005 for mental depression syndrome. After recovery she informed it to the O.P. 2 alongwith the claim for Rs. 2,00,000.00. She also submitted all other relevant papers for processing the claim of her insurance. She made a series of correspondences to settle the matter but as the O.P. no.1 has not yet taken any effective measure, she has filed this case with the aforesaid prayers

          O.P 1, National Insurance Co. by filing a WV on 31.07.2008 has contested this case alleging therein that the Petitioner has suppressed the material facts. They have no knowledge about the death of insured person, namely, Kashinath Chatterjee. They have also denied that the delay in settlement of payment of insurance was not due to their laches and negligence but the delay has been caused due to the petitioner  and they have prayed for the dismissal of the case.

DECISION WITH REASONS

          Admitted by Kashi Nath Chatterjee, the husband of the present Petitioner, the holder of the life insurance policy of Rs. 2,00,000.00 under O.P. 1 through Group Mediclaim Insurance under O.P. 2. Admittedly, he died on 25.04.2005 out of aroad accident. We have perused the insurance policy documents certifying the proposal and declaration  submitted to the insurance company by Kashi Nath Chatterjee, now dead. It is evident from his certificate of death that 25.04.2005 at the age of 65, he died at Haripal. We have also perused the FIR bearing No. 57/05 dt. 25.04.2005 lodged u/s 279/238/427/304A IPC. We have also perused the other police papers including the statement of one eye witness of the accident, which caused death of Kashi Nath Chatterjee on 25.04.2005. We have also perused the post-mortem report of deceased Kashinath. We have also perused the letter dated 21.08.2007 of GTFS, O.P. 2 on the subject of reconstruction of repudiation file of the insurance of deceased Kashinath having reference to the letter dt. 26.07.2007 addressed to Ms. Susoma Chatterjee, the wife of the deceased  Kashinath. In the impugned letter dated 21.08.2007, it has been mentioned that the claimant was under the medical treatment of Dr. Gautam Patra from 28.04.2005 to 10.07.2005 due to severe mental depression syndrome. It was also mentioned in the letter wherein GTFS had requested to reconsider the decision of O.P. 1 and proceed towards settlement of claim at an early date under advice to GTFS.

          In their WV filed on 13.08.2008 by O.P. 2 have prayed for expunging their name because the Petitioner has no claim against them. But they have suppressed the case of the Complainant. In the Affidavit  of Evidence  Shri Ashim Sengupta who had swore on 05.01.2009 had admitted that Kashinath Chatterjee was the insured person under O.P. 1 through O.P. 2. The contents of the Affidavit of Examination in-Chief of the Complainant are in tune with the averments made out in the complaint/petition.

          We have also perused the BNA filed by the parties.

          Having due regard to the facts, circumstances, evidence on record on both oral and documentary, we are of the opinion  that the Petitioner, Susoma Chatterjee is entitled to get the  relief  as prayed for. Hence ordered that the petition of complaint is allowed against the O.Ps. O.P. 1 is directed to pay a sum of Rs. 2,00.000.00 (/Two Lakh) with interest as per the then prevailing rate till full realization. The Complainant do also get an award of compensation of Rs. 3,000.00 and litigation cost of Rs. 2,000.00. The O.P. 1 is directed to pay total decreetal amount within 30 days from the date of communication to them and in default it will carry an interest @ 10% p.a. till full realization. Fees paid are correct.

Supply Certified Copies of this Order to the Complainant on payment of prescribed fees by the parties.

               Sd-                                   Sd-                                   Sd-

        ____________                    ____________                    ____________

          MEMBER                         MEMBER                       PRESIDENT