- Kanchan Kumar Keshri,
R/o Mohala – Shiv Ganj, Sapna
Cinema Road, Arrah, P.S. Ara Town,
Dist. Bhojpur, Bihar, Pin – 802301. _________ Complainant
____Versus____
- Senior Division Manager, representing
National Insurance Co. Ltd., Div – II,
Shakespeare Sarani,
P.S. Shakespeare Sarani, Kolkata-71. __________Opposite Party
- Golden Trust Financial Service
Through the Manager having its office at
16, R.N. Mukherjee Road, Kolkata-1.
- Branch Manager representing
National Insurance Co. Ltd.
Branch, Dharam Nagar, Triupura.
- Branch Manager, representing
Golden Trust Financial Service,
Branch, Dharam Nagar, Tripura.
- Branch Manager representing
GTFS Branch Arrah – Satya
Narayan Bhawan Mahavir Tola Arrah. __________ Proforma Opposite Parties
Present : Sri Sankar Nath Das, Hon’ble President
Dr. Subir Kumar Chaudhuri, Member.
Smt. Samiksha Bhattacharya, Member
Order No. 29 Dated 29-09-2014.
The case of the complainant in short is that the brother of complainant late Santosh Kumar Keshri was covered under Janta Personal Accident Insurance Policy, issued by the National Insurance Co. Ltd. being o.p. no.1 herein covering the risk of accidental death / loss of limbs / permanent total disablement for an overall capital sum insured of Rs.1 lakh only.
The deceased Santosh Kumar Keshri, younger brother of complainant Kanchan Kumar who was working as SIB under Home Ministry Govt. of India and was posted at Agartalla, Kanchanpur, North Tripura had taken an insurance policy of Rs.1 lakh through GTFS Dharm Nagar Tripura – o.p. no.4 and had been issued with an insurance certificate being policy no.100300 / 147 / 01 / 9600022 / 03 / 96 / 30209 issued by o.p. no.1 covering the risk period commencing from 15.9.03 to 14.9.18. The name of the complainant has been recorded as the nominee in the said policy certificate.
The insured Santosh Kumar Keshri died an accidental death on 11.8.04 at Tahsil kailasahar Tripura by drowning deep pond. Information regarding death of insured deceased late Santosh Kumar Keshri was given to local police station on 11.8.04 by local person and SIB Kailasahar. This information was recorded by officer-in-charge of police station and U.D. case No.22/2004 was lodged.
This information was given to o.p. no.1 on the basis that it is better to give notice to Principal rather than agent.
Complainant did not get any reply for o.p. no.1 against his letter dt.1.9.04 complainant again sent another letter dt.13.12.04 along with photocopy of death certificate, photocopy of postmortem report, photocopy of FIR, photocopy of nominee Identity Card and original insurance certificate to o.p. no.1 through proforma o.p. no.5.
Thereafter complainant submitted filled up claim form on 27.12.04 through proforma o.p. no.5 to the office of o.p. no.1 but no action was taken by o.p.
After two months from the submission of letter dt.13.12.04 and claim form dt.27.12.04 complainant received a letter dt.25.2.05 of o.p. no.2 demanding several documents to settle the claim. In the light of the said letter the complainant sent the required documents on 8.7.05 which was duly forwarded to the office of o.p. no.1 by o.p. no.2.
Complainant received a letter dt.10.2.06 from the office of o.p. no.1 in which the insurance claim of complainant was repudiated on the flimsy ground that the claim was not made within time.
Such action of the insurance company i.e. o.p. no.1 is clearly violation of the terms and conditions of the insurance policy and the conducxt of the insurance company reflects the most illegal, arbitrary and malafide intention on the part of the said insurance company in denying the lawful and legitimate claim of the complainant. Hence, the case was filed by the complainant with the prayers contained in the petition of complaint.
Decision with reasons:
O.ps. had entered their appearance in this case by filing w/v and denied all the material allegations labeled against them and prayed for dismissal of the case. Ld. lawyer of o.ps. in the course of argument submitted that the case has got no merit and the same is liable to be dismissed.
We have gone through the pleadings of the parties, evidence and documents in particular and we find that it is essential to submit the intimation of accident / death within 30 days from the date of accident and herein the instant case the incident took place on 11.8.04 and the claim was made on 13.12.04. On perusal of the entire materials on record we find that it is important to mention here that mere posting of document does not complete the communication and the statement made by complainant about sending alleged letter to the insurance company cannot accepted as the same was never received by insurance company.
That being the position and on perusal of the entire materials on record we are of the view that complainant has failed to substantiate and prove his case and is not entitled to relief.
Hence, ordered,
That the case is dismissed on contest without cost against the o.ps.
Supply certified copy of this order to the parties free of cost.
