Ld. Advocate(s)
For Complainant: Makbul Rahaman
For OP/OPs : Subhasis Roy
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Date of filing of the case :29.03.2019
Date of Disposal of the case : 07.07.2023
Final Order / Judgment dtd.07.07.2023
Petitioner above named filed the present complaint u/s 12 of the Consumer Protection Act, 1986 against the aforesaid opposite parties praying for direction to pay Rs.10,00,000/- as sum assured, interest at the rate of 12% per annum, over the aforesaid sum of Rs.10,00,000/-, compensation amounting to Rs.5,00,000/- for loss, damage, mental, agony etc, cost of the case amounting to Rs.3,00,000/- and other reliefs.
He alleged in the petition of complaint that her husband Late Subrata Mondal during his life time had purchased one Rural Postal Life Insurance Policy namely Gram Santosh (Endowment Assurance) proposal date 27.12.2017 and acceptance date 23.01.2018 vide no.0000001601267 sum assured Rs.10,00,000/-. At the time of purchase of said policy Late Subrata Mondal was in sound health. Said Subrata Mondal died on 01.08.2018 due to cardio respiratory failure. Said policy was in running condition. Thereafter, complainant informed the OP No.3 about the death of said Subrata Mondal . After seeing the original death certificate, OP No.3 gave a claim form and three affidavit format. Thereafter present complainant submitted the claim form, original PLI Policy, original premium policy book, original money receipt, original three affidavit, attested copy of death certificate, Xerox copy of V.I Card and Aadhaar Card, Bank account on 17.12.2018 at Bethuadahari Post Office. Complainant visited the office of the OPs on several occasions but she did not get any fruitful result from the OPs. Thereafter, complainant sent an application before the OP No.1 on 01.01.2019 and copies of the same were forwarded to OP NO.2 & 3 for getting her claim amount. She also wanted to know if any further documents are required or not but no result came from the OPs. On 14.02.2019 complainant also sent another application before the OP No.1 and copies of the same application were forwarded to OP No.2 & 3 but no result was found from the OPs. On 28.02.2019 complainant sent one Advocate’s letter to the OP No.1 and also sent copies of the said application before the OP No.2 & 3. OPs are bound to pay the sum assured of aforesaid PLI amounting to Rs.10,00,000/-. As the OPs did not pay the aforesaid sum assured amounting to Rs.10,00,000/- in favour of the complainant. Hence, the complainant filed this case.
OP No. 1-3 filed W/V and denied the entire allegations. They further contented that one certificate regarding death of insured was issued by one Homeopathy doctor who was doing his practice at Bamla, Kulgachi road
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and said death certificate was issued on 05.08.2018 but the insured died on 01.08.2018.
They further stated that as the claim arose within few months from the date of purchase of the policy having sum assured value of Rs.10,00,000/- as such there was doubt regarding the death certificate. When complainant came to the office of OPs then OPs informed her that confidential investigation would take time and for that reason complainant should have to wait till completion of investigation.
They further stated that complaint itself is not maintainable as the claim was filed after 4 months 16 days from the date of death of the insured. They prayed for dismissal of the petition.
Trial
During trial complainant filed affidavit in chief.
Documents
Complainant produced the following documents viz :
- Xerox copy of Rural Postal Life Insurance..........(One sheet)........(Annex-1)
- Copy of application of the complainant dated 17.12.2018..........(Two sheets)...........(Xerox)..........(Annex-2)
- Claim form dated 17.12.2018 with receiving endorsement dated 17.12.2019..........(Two sheets)..........(Xerox)
- Premium payment receipt dated 05.02.2018............(Two sheets).......(Xerox)........(Annex-3)
- Original Death Certificate ...........(One sheet)
- Original Certificate issued by doctor relating to Death of the insured Subrata Mondal dated 05.08.2018..........(One sheet)
- Copy of affidavit dated 10.12.2018............(Two sheets)..........(Xerox)......(Annex-6)
- Copy of affidavit dated 10.12.2018...........(One sheet)..........(Xerox)
- Copy of affidavit dated 10.12.2018.........(One sheet).........(Xerox)
10)Original Voter Identity Card ..........(One sheet)
11)Original Aadhaar Card ...........(One sheet)
12)Original Pass Book of the complainant of Punjab National Bank(Previously UBI) Dhanjoypur Branch.........(One set)
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13)Original copy of application of complainant dated 17.12.2018 along with two Postal Receipts original..............(One sheet)..........(Annex-10)
14)Copy of application dated 19.01.2019 along with three copies of Postal Receipts.........(Annex-11)
15)Copy of application of complainant dated 14.12.2019 along with three original Postal Receipts)......(Annex-12)
16)Original copy of Advocate’s notice dated 28.02.2019 along with three Postal Receipts......(Annex-13)
17)Original affidavit dated 29.11.2018...........(One sheet)........(Annex-14)
Brief Notes of Argument
Complainant filed BNA. OP No.1-3 filed BNA.
Decision with Reasons
We have carefully gone through the petition of complaint, W/V filed by the OPS, affidavit in chief filed by the complainant, documents filed by the complainant, affidavit in chief filed on behalf of OP NO.1 and BNA filed by the parties. We have carefully considered these documents.
On perusal of original Voter Identity Card and Aadhar Card filed by the complainant, we find that complainant is a resident of Dhananarayanpur , Dhananjoypur, Nadia Pin. 741126. Accordingly, we find that complainant is a resident of aforesaid addressed which is situated within the jurisdiction of this Commission. Accordingly, we are of the opinion that this Commission has the jurisdiction to entertain the complaint of the complainant.
On perusal of record, we find that complainant duly claimed the policy amount before the OP No.1-3 and she duly filed claim form and claim application before the OP NO.1-3 on 17.12.2018. OP No.1 & 3 in their W/V raised doubt that policy amount is very high but aforesaid contention bears no legal foundation. There is no provision of law that in a case of higher value of policy amount doubt may be raised.
During hearing Ld. Advocate for the OP No.1-3 argued that local doctor issued the death certificate on 05.08.2018 where is the death of the insured took place on 01.08.2018. As such doubt has been arisen in their mind. But on perusal of record we find that complainant produced original death certificate issued by the competent authority having jurisdiction over the area. Accordingly, we find that there is no doubt about death of the complainant. Moreover, in the death certificate it has
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clearly mentioned that insured died on 01.08.2018. OP No.1 in his affidavit in chief stated that Panchayet Pradhan Dhananjoypur Gram Panchayet informed him that insured was suffering from some diseases prior to his death and complainant suppressed all the material facts and therefore not entitled to get any relief.
On perusal of W/V OP NO.1 & 3 , we find that there is no such averment. Accordingly, we find that that aforesaid fact which stated in the affidavit in chief of OP NO.1 is nothing but after thought. Moreover, said fact not yet been proved before this Commission. Accordingly, we find that no value in the aforesaid contention.
On perusal of record, we find that there is no doubt about death of the insured Subrata Mondal and said death took place on 01.08.2018. As per RPLI insured is entitled to the sum assured of the policy. If he dies within the period of valid RPLI.
In the present case, we find that during the valid period of aforesaid RPLI insured Subrata Mondal died on 01.08.2018. We also find that complainant raised the claim on 17.12.2018 that is after 4 months 16 days and that cannot be said that claim application has been filed after lapse of specific period because as per RPLI scheme filing of claim after 4 months 16 days cannot be said as time barred.
Having regard to the aforesaid discussion, we are of the firmed view that complainant has established his grievance against opposite parties and she is entitled to relief as per her prayer.
In the result, present case succeeds.
Hence,
It is
Ordered
that the present case be and same is allowed on contest against OP NO.1-3 with cost of RS.5,000/- (Rupees five thousand) to be paid by OP NO.1-3 in favour of the complainant.
OP No.1-3 jointly or severally are directed to pay the sum assured of the aforesaid RPLI amounting to Rs.10,00,000/-( Rupees Ten lakh) in favour of the complainant within one month from this day failing aforesaid amount shall carry interest at the rate of 9% per annum from the date of this order to till the date of actual payment and complainant shall have liberty to put this order into execution.
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OP No.1-3 jointly or severally are directed to pay compensation amounting to Rs.20,000/- (Rupees Twenty thousand) in favour of the complainant within one month from this date failing which complainant shall have liberty to put this order into execution.
Let a copy of this final order be supplied to both the parties as free of costs.
Dictated & corrected by me
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PRESIDENT
(Shri DAMAN PROSAD BISWAS,) ..................... ..........................................
PRESIDENT
(Shri DAMAN PROSAD BISWAS,)
I concur,
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MEMBER
(NIROD BARAN ROY CHOWDHURY)
