DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
MUCHIPARA, BURDWAN.
Consumer Complaint No 84 of 2015
Date of filing: 23.3.2015 Date of disposal: 08.12.2015
Complainant: Smt. Anita Agarwal, W/o. Late Manoj Kumar Agarwal, resident of 53, N. S. Road, Behind Jalan Bhaban, near C.M.C. Club, PS: Asansol (South), District: Burdwan – 713 301.
-V E R S U S-
Opposite Party: 1. Executive Worker, Asansol Sector, Sahara India Commercial Corporation Ltd., G.T.Road, Bhanga Panchal, Asansol, Burdwan – 713 301.
2. Manager, Durgapur Regional Office, Sahara India Commercial Corporation Ltd., Subhas Pally, Durgapur – 713 201.
3. In-Charge, Command Office, Sahara India Commercial Corporation Ltd., Sahara Bhaban, 1, Kapoorthala Complex, Lucknow – 226 024.
Present: Hon’ble President: Sri Asoke Kumar Mandal.
Hon’ble Member: Smt. Silpi Majumder
Hon’ble Member: Sri Pankaj Kumar Sinha.
Appeared for the Complainant: R. S. Ganguly, Autho. Representative.
Appeared for the Opposite Party No. 1: Ld. Advocate,Sk. Md. Solman Hossain.
Appeared for the Opposite Party No. 2&3: None.
J U D G E M E N T
This complaint is filed by the Complainant u/S. 12 of the Consumer Protection Act, 1986, alleging deficiency in service on the ground that the Ops have arbitrarily and illegally repudiated her legitimate death claim benefit in respect of the certificates, in which she was declared as nominee of her husband, since deceased.
The brief fact of the case of the Complainant is that her husband during his lifetime opened four accounts with the OP-1 in two separate schemes i.e. Sahara Swarna Yojna and Sahara Rajat Joyna. Rs.72, 000=00 in Swarna Yojna and Rs.7,222=00, Rs. 7,222=00 and Rs. 12,363=00 in Rajat Yojna. As per terms and conditions of these schemes the nominee of the deceased holder/applicant shall be entitled to the facility of death help and in case of accidental death the nominee of the deceased shall be entitled to insurance compensation amount. Unfortunately the account holder died on 16.03.2010 due to road traffic accident on the National Highway-33, Jharkhand. Post mortem of the deceased was done at Tata Memorial Hospital on 16.03.2010 and the injuries noted upon the dead body are anti-mortem in nature and caused by hard and blunt substance and the cause of death was due to chest injury. The death certificate was issued by the Department of Planning and Development, Jamshedpur NAC, Jharkhand on 22.03.2010. The Complainant being the nominee of the deceased account holder had submitted the death claim in the prescribed form along with necessary papers and documents i.e. copy of the FIR, Post Mortem Report, Death Certificate, Birth Certificate, Pass Books, Indemnity Bond, Affidavit, Identity Proof, Address Proof, Agent’s Report etc. to the OP-1 and the same was duly received by the OP-1 at Asansol on 14.12.2011. The sudden death of the account holder had shattered the family of the victim and to overcome such shock a reasonable time was necessary and the OPs should have appreciated the fact that a reasonable time was necessary to overcome the sudden shock arising out of the accidental death of the nearest relation and in the present case the Complainant being the wife of the deceased suffered from severe mental restlessness and could not remember anything due to sudden death of her husband. She got very much mental shock for which she had to remain under the treatment of Dr. P. Mukherjee for the period from 29.03.2010 to 30.10.2011 and she was advised for complete bed rest for total recovery. After recovery from mental disturbances she was advised to do normal work from 07.12.2011. Thereafter she became able to submit the claim form on 14.12.2011. Hence the delay in submission of the claim form cannot be treated as fatal. But the OPs neither intimated the Complainant the status of the claim nor furnished their view in the matter. The Complainant being the nominee is entitled to get the accidental death benefit as per the Clause-18 of the terms and conditions of the schemes. After issuance of several notices upon the OPs they settled part of the claim by making payment of the matured value towards three accounts vide cheques dated 25.04.2013 and 01.06.2013 respectively, but did not take any step for making payment of the death claim for Rs.11,00,000=00 as per the agreed terms and the conditions. Inspite of lapse of considerable period the OPs did not take any step, on the contrary, they always tried to avoid the claim on some false pretext. Being aggrieved with such attitude of the Ops, the Complainant furnished all the documents again to the OPs, which was received by the Ops on 02.12.2013, but to no effect. Thereafter legal notice was issued by her and ultimately by issuing letter dated 07.08.2014 the OPs have repudiated the claim of the Complainant on the plea of late submission of the claim without considering the cause of delay in submission. According to the Complainant such repudiation is unjustified, illegal, baseless and false and for this reason it is deficiency in service as well as unfair trade practice in view of the Consumer Protection Act, 1986. Thereafter finding no other alternative the Complainant had approached before this Ld. Forum by filing this complaint praying for direction upon the Ops to make payment the death help to the tune of Rs.11, 00,000=00 along with interest @12% p.a. on the said amount from 25.04.2013 till payment of the entire realization, compensation for Rs.1, 00,000=00 due to harassment, mental agony and pain and litigation cost of Rs.10, 000=00 to her.
It is evident from the record that after admission of this complaint notices were issued upon the OPs through speed post along with the copy of the complaint and other related papers on 30.03.2015 and the date was fixed for SR and appearance on 24.04.2015. On the said date the OP-1 being present by filing vokalatnama had prayed time for filing written version and accordingly allowing the prayer date was fixed on 08.05.2015 for filing written version by the OP-1 and service return of the other OPs. On the said date the OP-1 prayed further time. On 30.06.2015 it was ordered by the Ld. Forum that the complaint will run ex parte against the OP-1 as the Op-1 did not take any step to file its written version after lapse of more than one month and the Complainant was directed to take fresh steps in respect of the OP-2 and 3 for issuance of the service of notice. The orders dated 21.08.2015 and 10.09.2015 reveal that the OP-2 and 3 inspite of receipt of notices did not turn up before this Ld. Forum to contest the complaint either by filing written version or orally. So the complaint was fixed for ex parte hearing against the OPs and accordingly we have heard the complaint from the Ld. Counsel for the Complainant, who advanced argument.
We have carefully perused the record along with the papers and documents filed by the Complainant and it is seen by us that admittedly the husband of the Complainant, since deceased during his lifetime opened four accounts with the OP-1 in two separate schemes for certain amounts, the complainant was declared as nominee in those accounts, it was declared that in case of accidental death of the account holder the nominee will get insurance compensation amount, the account holder died on 16.03.2013 due to road accident, post mortem done, which confirmed the accidental death, death certificate issued on 22.03.2010, the nominee-complainant lodged the claim form along with the related documents before the OP-1 on 14.12.2011, the complainant received the matured value in respect of those accounts on 25.04.2013 and 01.06.2013 respectively through cheques, several written correspondences along with legal notice were issued to the OP-1 for making payment of the amount towards death help. The allegation of the Complainant is that till filing of this complaint she did not receive the said amount and without making payment of death help as per the terms and conditions of the policy the OPs have arbitrarily and illegally repudiated her legitimate claim stating that due to delay in submitting the claim form, the claim cannot be payable as per the policy condition. Hence this complaint is initiated praying for certain reliefs.
We have noticed from the repudiation letter issued by the OPs dated 07.08.2014 that as the claim form was lodged by the Complainant at a very belated stage, the claim cannot be payable. In the petition of complaint it is stated by the Complainant that after sad and sudden death of her husband she became very much perplexed and got severe mental shock and due to this reason she had to remain under medical treatment of the doctor and being fully cured she lodged the claim form with the OP-1 for the amount. It is evident from the document that the account holder died on 16.03.2010 and the claim was lodged on 14.12.2011 i.e. after lapse of about 18 months. During advancing argument the Ld. Counsel for the Complainant was asked as to whether any delay application along with the medical papers and certificate were send to the OPs or not. But no positive answer is received and moreover there is no iota of evidence that those papers were received by the OPs along with the claim form. Moreover, the respective clause of the terms and the conditions of the accounts showing limitation period for filing any claim by the claimant. The Complainant though has attracted our notice to the document, but we have noticed that the said page has started from the Clause no-18 only. The Clauses 1-17 of the terms and the conditions have not been filed by the Complainant. Therefore it is very difficult for us to draw a conclusion that there was delay in submitting the claim form before the OPs or there was no limitation of time for preferring the claim. There are several judgments of the upper Commissions that the terms and the conditions of any policy/account should be abide by the holder/insured strictly because the insured/holder used to accept any policy after knowing the terms and the conditions and for this reason the same are binding upon the parties and no one can travel beyond the same. As the Complainant has miserably failed to substantiate her averment by adducing cogent documentary evidence, we are not in a position to hold that there was no time limit for lodgment of any claim. In respect of the averment of the death help, the complainant has failed to show us any documentary evidence that she is entitled to get the death help. As the complainant has failed to prove her own case as well as the deficiency in service and unfair trade practice of the OPs, hence the complaint fails.
Going by the foregoing discussion hence, it is
O r d e r e d
that the complaint be dismissed ex parte against the OPs. However, considering the facts and circumstances of the case there is no order as to costs.
Let plain copies of this final order be supplied to the parties free of cost as per provisions of Consumer Protection Regulations, 2005.
(Asoke Kumar Mandal)
Dictated and corrected by me. President
DCDRF, Burdwan
(Silpi Majumder)
Member
DCDRF, Burdwan
(Pankaj Kumar Sinha) (Silpi Majumder)
Member Member
DCDRF, Burdwan DCDRF, Burdwan
