21-04-2015 - The reasons for delay in disposal of this appeal can be seen from the order sheet.

Heard the parties on limitation petition and on merits.

2.        On being satisfied with the grounds, the delay of about 29 days in filing this appeal is condoned.

3.        Mr. Jha, learned counsel appearing for the O.P. 1-2-appellants- (Insurance Company for short) assailed the impugned order and submitted that due to non-supply of required documents by the complainant, the Insurance claim could not be settled. He referred to a letter dated 25.8.2009 annexed with the memorandum of appeal. He submitted that the complaint was premature as the Insurance Company had no opportunity to settle the claim in the absence of required documents. He lastly submitted that if the required documents are supplied, the insurance claim can be settled within a reasonable time.

4.        On the other hand, Mr. Sahni, learned counsel appearing for the complainant- R-1, and Mr. Sanyal, learned counsel appearing for O.P.3-R-2-Golden Trust Finance Service (GTFS for short) supported the impugned judgment. They further submitted that nothing  was pleaded with regard to the said letter dated 25.8.2009 nor it was filed before the learned District Forum and it has been fabricated only to make out a false defence.

5.        The case of the complainant in short is that his father late Shobha Kant Thakur, who was an employee of Bokaro Steel Plant met with an accident on 9.7.2008 when a truck dashed his motorcycle, while going to attend his duty, due to which he received serious injuries and finally succumbed to the injuries on 27.7.2008 at Bokaro Zonal Hospital. A police case being Harla P.S. case No. 76/2008 was registered on 10.7.2008. After investigation chargesheet was submitted against the truck driver. According to the complainant he sent an intimation letter on 12.8.2008 regarding accidental death and on receiving the claim form, he submitted the filled up claim from on 1.10.2008 with all the requisite documents but the O.Ps. did not take any care to dispose of the insurance claim of the complainant who was the nominee of the insured. A legal notice dated 22.1.2010 was served on the O.P. which was not replied. Then the present complaint was filed on 5.5.2010.

              On the objection of Insurance Company, taken in it’s written statement, GTFS was added as O.P.3 who submitted its written statement denying its liability with regard to non-settlement of claim.

6.        Admittedly, the deceased was a policy holder under the Insurance Company, effective from 11.2.2004 to 31.1.2019 in which the complainant was nominee. The policy was for Rs. 10, 00,000/- The accident took place on 9.7.2008 due to which the insured died. An F.I.R. was lodged. Police submitted chargesheet against the offending truck driver.

7.        In paragraph 6 of the complaint petition it was specifically stated that by a letter dated 12.8.2008, the Insurance Company was informed regarding death of the policy holder and request was made for taking proper action. Copy of such letter was annexed as Annexure- E to the complaint petition. In para 7 it was stated that the said letter was received, on which the claim form was issued with instruction to the complainant to submit the claim form duly filled up with all required documents.  In paragraph 8 it was stated that on 1.10.2008, the claim Form annexing the documents were submitted which was received on the same date by the Insurance Company. The Photo copy of the said claim Form was annexed as Annexure-F.

           The Insurance Company filed a vague, general and cryptic written statement. There was no denial to the aforesaid specific statements made by the complainant in paragraphs 6, 7 and 8. It was interalia said that there was no repudiation of claim as the matter was under investigation by the Insurance Company. It was further said that all the required papers were not furnished by the complainant inspite of sending letters, though, the complainant had sent some documents through GTFS. It was, therefore pleaded that the case was premature and there was no deficiency on the part of the Insurance Company.

              In the written statement filed on behalf of the G.T.F.S.  it was interalia stated that the insured was consumer of the Insurance Company. The receipt of the intimation of death, by letter dated 12.8.2008 was admitted. It was further stated that subsequently a completed claim Form with the required documents were received on 13.10.2008 which after verification were forwarded to the Insurance Company on 24.10.2008. The complainant was asked by G.T.F.S.  to furnish certain more documents which were also received and forwarded to the Insurnace Company on 18.2.2009. Subsequently on 4.6.2009, on receipt of attested copy of some of the documents they were  forwarded to the Insurance Company after initial verification with a request to expedite the settlement/ claim. It was also stated that wihholding of settlemnet and payment of the claim for a long time without any reasonable cause amounted to deficiency on the part of the Insurnace Company .

8.        Thus, there was clear pleading by the complainant, admitted by G.T.F.S. that the claim form was furnished and the requisite documents were also furnished. The Insurance Company did not produce anything to controvert the said pleadings of the complainant  and G.T.F.S. There is no explanation by the Insurance Company for the undue delay of several years in settlement of  the claim of the complaiannt. The Insurance Company did not file copy of any letter issued by it to show that for want of which document (s) the investiagion regarding settlement  of claim was kept pending

9.        The issuance of purported letter dated 25.8.2009 relied by Mr. Jha was neither pleaded in the written statement by the Insurance Company nor it was produced before the learned lower forum and therefore the submisison made on behalf of the complainant  and  G.T.F.S. has some force that this letter has been fabricated for the purpose of this case.

10.      Thus, it  appears to be a case of gross deficiency in service on the part of the Insurance Company.We find no merit in this appeal.

11.      Mr.Jha had  lastly submitted that interest has been granted by learned District Forum from the date of filing of the claim which is not reasonable, as it can not be expected that on the same day it will be settled and moreover even as per the written statement of G.T.F.S., the documents were supplied up to June, 2009.

He also referred to the  order dated 23.3.2012 passed in F.A. No. 90/09 and order dated 1.9.2014  passed in F. A. No.  41/14  by this Commission in this regard.

12.      In the facts and circumstances of this case, we modify the operative portion of the impugned judgment only to the extent that Insurance Company-O.P-1-2 – appellants are directed to pay the sum assured i.e. Rs. 10,00,000/-  with simple interest @ 9% p.a. from the date of filing of the Complaint Case i.e. 5.5.2010 till the date of payment/ realization .

           With this modification, this appeal stands disposed off .

                      Issue free copy of this order to all concerned for information and needful.

          Ranchi,

          Dated:-21-04-2015