FINAL ORDER
Samaresh Kr. Mitra, Member.
This case has been filed U/s.12 of the Consumer Protection Act, 1986 by the complainant, Lakshmi Bairagi Das.
The case of the complainant’s in short is that the brother of the complainant Probhat Chakraborty (since deceased) during his life time insured himself with a Rural Postal Life Insurance Policy from the opposite party No.3 vide RPLI Policy No.0000000796799 for a sum of Rs.3,00,000/- only on payment of first premium of Rs.735/- receipt dated 28.12.2016. The said Probhat Chakraborty nominated the complainant of the said policy. During the continuation of the policy the policy holder suddenly died on 22.01.2017 due to C.V.A. attack as it was reflected in the death certificate issued by the doctor.
After elapsing a considerable period the complainant informed the death news of her brother to the opposite party No.3. Thereafter the opposite party No.3 advised to inform the opposite party No.2. As per advice of the opposite party No.3 the complainant informed the death news of her brother to the opposite party No.2 through letter dated 23.3.2017. But opposite party did not take any steps for settlement of the said policy claim and did not issue any claim Form to the complainant. Thereafter the complainant several times visited the office of the opposite party No.2 and requested to issue claim Form and settle the claim but opposite party did not provide any satisfactory reply.
Thereafter the complainant sent a legal notice to the opposite party No.2 on 4.4.2017 and on 11.4.2017 to the opposite party No.2 & 3 through her advocate stating all the facts and requesting for claim. But unfortunately the opposite party No.2 did not communicate with the complainant. Thereafter complainant collected the claim Form from the opposite party No.3 and after filled up the same the complainant visited the office of the opposite party No.2 but opposite party No.2 refused to receive the claim Form and documents and advised to submit the same before the opposite party No.3, but opposite party No.3 also refused to receive the same.
Finding no other alternative the complainant on 25.4.2017 sent the original claim Form along with the relevant documents and letter through courier service to the opposite party No.1, 2 & 3. After receiving the said letter the opposite party No.1 sent a letter to the opposite party No.2 and also copy forwarded to the complainant directing to the opposite party No.2 to take necessary steps. Thereafter the opposite party No.2 sent all the documents along with claim Form to the opposite party No.3 and opposite party No.3 return back all the documents along with original claim Form to the complainant. The complainant immediately visited the office of the opposite party No.2 & 3 but they did not provide any satisfactory reply to the complainant.
Getting no other alternative the complainant compelled to file this case before this Forum with a prayer to direct the opposite parties jointly or severally to pay Rs.3,00,000/- towards insurance policy claim against the policy with interest @ 18% p.a. w.e.f. 23.3.2017, to pay Rs.1,00,000/- towards compensation for mental agony and anxiety of the complainant, to pay Rs.10,000/- towards litigation cost.
Opposite party No.2 & 3 contested the case by filing written version denying the allegations leveled against them in the paras of the complaint petition. The opposite party No.2 & 3 averred that the death claim application of the complainant was sent to CPC Chinsurah Head office for processing of the claim on 28.4.2017. Chinsurah Head Office, the opposite party No.3 vide its letter dated 9.5.2017 asked the complainant to re-submit the same with claim application in original after filing it properly with the list of documents. But the complainant did not submit the same and a reminder also issued by opposite party No.3 on 16.8.2017 but the complainant instead of submitting the same filed the instant case before this Forum. So the case is liable to be rejected with cost.
Complainant files evidence on affidavit in which he averred that the brother of this complainant namely Probhat Chakraborty during his life time insured his life with a Rural Postal Life Insurance Policy from the opposite party No.3, vide policy No.0000000796799 for a sum assured of Rs.3,00,000/- only on payment of first premium of Rs.735/- dated 28.12.2016. The policy holder being unmarried made nominee to this complainant out of love and affection. During the policy period the policy holder died suddenly on 22.1.2017 due to CVA. That after elapsing a considerable period the complainant intimated the death news of her brother to opposite party No.3 who on his turn advised the complainant to intimate the said news to opposite party No.2 and she informed the opposite party No.2 accordingly. After getting the information the opposite party No.2 did not take any steps for settlement of the said policy. The complainant further assailed that she several times approached the opposite party No.2 for issuing the claim Form and settled the claim but opposite party No.2 did not provide any satisfactory reply. So, the complainant served a legal notice. After waiting a long period the complainant collected one claim form from the office of opposite party No.3 and after filing up the said form she visited the office of the opposite party No.2 for submitting the said claim form along with relevant documents but the opposite party No.2 refused to receive the said claim form and documents. Similarly opposite party No.3 also refused to receive the claim form. Complainant informed everything regarding the submission of claim Form as well as refusal by the opposite party no.2&3 to the opposite party No.1. Later on 25.04.2017 the complainant sent the original claim Form along with relevant documents through courier service to the opposite party No.2 and Xerox copy of all documents and claim Form to the opposite party No.1&3 which was received by the opposite parties. That after receiving the said letter the opposite party No.1 sent a letter dated 08.05.2017 to the opposite party No.2 for taking necessary action, copy forwarded to the complainant. Then the opposite party No.2 sent all the documents alongwith the claim Form to the opposite party no.3, who on his turn returned back the documents alongwith the claim Form to the complainant. The complainant several times visited the office of the opposite party no.2&3 but they did not provide any satisfactory reply. Getting no other alternative the complainant filed the instant complaint before this Forum praying directions upon the opposite party.
The opposite party filed evidence on affidavit in which he assailed that the claim application of the complainant was sent to CPC, Chinsurah H.O. for processing of the claim on 28.4.2017. Chinsurah H.O. vide its letter dated 09.5.2017 asked the claimant/complainant to resubmit the same with claim application in original after properly filling up with a list of documents to be submitted by the claimant. Reminder letter again issued by opposite party no.3 on 16.8.2017. But till now the complainant failed to file the documents as required. In other column the opposite party denied the allegations leveled against them.
Both sides filed written notes of argument which are taken into consideration for passing final order.
ISSUES/POINTS FOR CONSIDERATION
1). Whether the Complainant Smt Lakshmi Bairagi Das is a ‘Consumer’ of the opposite party?
2).Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
3).Whether the O.Ps carried on unfair trade practice/rendered any deficiency in service towards the Complainant?
4).Whether the complainant proved her case against the opposite party, as alleged and whether the opposite party is liable for compensation to her?
DECISION WITH REASONS
In the light of discussions here in above we find that the issues/points should be decided based on the above perspectives.
(1).Whether the Complainant Smt. Lakshmi Bairagi Das is a ‘Consumer’ of the opposite party?
From the materials on record it is transparent that the Complainant is a “Consumer” as provided by the spirit of section 2(1)(d)(ii) of the Consumer Protection Act,1986. The complainant herein is the consumer of the OP, as the complainant being the nominee of deceased life assured who insured his life before the opposite party by paying premium. So she is entitled to get service from the opposite party as consumer.
(2).Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
Both the complainant and opposite parties are residents/having office address within the district of Hooghly. The complaint valued Rs.4,00,000/- for loss sustained by the complainant and as compensation for mental agony and other expenses ad valorem which is within Rs.20,00,000/- limit of this Forum. So, this Forum has territorial/pecuniary jurisdiction to entertain and try the case.
(3).Whether the opposite party carried on Unfair Trade Practice/rendered any deficiency in service towards the Complainant?
The case of the Complainant is that her brother namely Probhat Chakraborty during his life time insured his life with a Rural Postal Life Insurance Policy from the opposite party No.3, vide policy No.0000000796799 for a sum assured of Rs.3,00,000/- only on payment of first premium of Rs.735/- dated 28.12.2016. The policy holder being unmarried made nominee to this complainant out of love and affection. During the policy period the policy holder died suddenly on 22.1.2017 due to CVA. That after elapsing a considerable period the complainant intimated the death news of her brother to opposite party No.3 who on his turn advised the complainant to intimate the said news to opposite party No.2 and she informed the opposite party No.2 accordingly. After getting the information the opposite party No.2 did not take any steps for settlement of the said policy. The complainant further assailed that she several times approached the opposite party No.2 for issuing the claim Form and settled the claim but opposite party No.2 did not provide any satisfactory reply. So, the complainant served a legal notice. After waiting a long period the complainant collected one claim form from the office of opposite party No.3 and after filing up the said form she visited the office of the opposite party No.2 for submitting the said claim form along with relevant documents but the opposite party No.2 refused to receive the said claim form and documents. Similarly opposite party No.3 also refused to receive the claim form. Complainant informed everything regarding the submission of claim Form as well as refusal by the opposite party no.2&3 to the opposite party No.1. Later on 25.04.2017 the complainant sent the original claim Form along with relevant documents through courier service to the opposite party No.2 and Xerox copy of all documents and claim Form to the opposite party No.1&3 which was received by the opposite parties. That after receiving the said letter the opposite party No.1 sent a letter dated 08.05.2017 to the opposite party No.2 for taking necessary action, copy forwarded to the complainant. Then the opposite party No.2 sent all the documents alongwith the claim Form to the opposite party no.3, who on his turn returned back the documents alongwith the claim Form to the complainant. The complainant several times visited the office of the opposite party no.2&3 but they did not provide any satisfactory reply. Getting no other alternative the complainant filed the instant complaint before this Forum praying directions upon the opposite party.
Opposite party in his argument assailed that the death claim application submitted by the complainant dt.25.4.2017 was sent to CPC Chinsurah H.O. for processing of the claim on 28.04.2017 and the Chinsurah H.O., i.e. the opposite party No.3 vide letter dated 9.5.2017 marked as annexure, ‘A’ and asked the complainant to resubmit the same with claim application in original after properly filing it up with a list of documents to be submitted by the applicant vide RL No. R.W. 399474271 IN dated 11.5.2017. The same was delivered on 17.5.2017. As no reply was received from her and a reminder was again issued by the opposite party No.3 on 16.8.2017 but complainant failed to submit the claim form alongwith the documents again as stated in letter dated 09.5.2017. So the opposite party could not settle the claim of the complainant. Unless or until proper claim is furnished along with relevant documents it is not possible for the postal department to proceed the same. The postal department grew suspicious as to authenticity of the claim and in order to verify the same a letter was written to District Magistrate / District Election Officer Hooghly for verification of the Epic card of the insured on 19.3.2018 being epic card No.GFY 2779544. After search the district election officer find a report that the impugned Epic card belongs to other person. The Postal Authority also assailed that the death certificate issued by Dr. Tarak Chandra Roy, DMBS has no value as the Epic card of the insured Provat Chakraborty is not genuine. According to the opposite party the case put forth by the complainant is not a genuine as there is no existence of the policy holder in reality. To syphone the government money a fake policy has been opened. The case of the complainant should not only be dismissed but the complaint is required to be sent to I/C Chinsurah for investigation to ascertain the culpability of the person indulged in such a heinous offence.
After perusing the case record, written version, evidence on affidavit, brief notes of argument and hearing the argument it is crystal clear that the policy holder died during the continuance of the insurance policy and the complainant being the nominee tried her best to submit the claim form before the opposite party but the opposite party did not cooperate with this complainant in settling the death benefit. The complainant wrote letter to the opposite parties but her utterance became futile. She filed the claim form before the opposite party but the opposite party did not settle the claim of the complainant as such the complainant became aggrieved filed the instant complaint before this Forum praying directions upon the opposite party. The RURAL POSTAL LIFE INSURANCE, GRAM SANTOSH (ENDOWMENT ASSURANCE) policy in which it is clearly stated that the impugned policy issued in the name of deceased PRABHAT CHAKRABORTY being policy No.0000000796799, date of commencement of risk 20.12.2016, Terms- EA/60,sum assured 300000/-,date of proposal 10.12.2016, amount of premium Rs.735/- ( Monthly) & in the nomination column the name of the nominee is LAKSHMI BAIRAGI DAS, Age- 40 & relationship – Sister and the policy was issued on 02.1.2017 by the POSTMASTER ( H.S.G-1), Chinsurah, 712101. The Postal authority issued letter of proposal in the name of PRABHAT CHAKRABORTY being policy No.0000000796799 dated 28.12.2016 by the POSTMASTER (H.S.G-1), Chinsurah. It is pertinent to mention that during the continuance of policy, the policy holder died on 22.01.2017 at 4.45 P.M. due to cardiac and the death certificate issued by Dr. Tarak Chandra Roy and also the death registration certificate issued by Hooghly- Chinsurah Municipality. It is palpably clear that the policyholder died within a short span of taking the insurance before the opposite party. The opposite party nowhere in the written version as well as written notes of argument assailed the entitlement of sum assured by the complainant. In the written version it is stated that the opposite party asked the complainant to resubmit the claim Form but the complainant failed to do so as a result they could not settle the claim of the complainant. But it is transparent from the written argument of the opposite party that the complainant filed the claim Form on 25.4.2017 and it was sent to CPC Chinsurah H.O. for processing of the claim on 28.4.2017. The letter dated 08.05.2017 of Asstt. Divisional Manager (PLI) WB Circle, Kolkata-700012 speaks that Xerox copy of LI9 policy bond, acceptance letter, death certificate, first copy of premium receipt book and claimants Aadhar card received from the claimant of RPLI policy No. 0000000796799 is forwarded herewith for taking necessary action by the Superintendant of post offices, North Hooghly Division, Chinsurah- 712101. But the opposite party No.2 after getting the documents failed to take necessary action in respect of settling the claim of the complainant. So we may safely conclude that the complainant once filed the claim Form admitted by the opposite party but the opposite party failed to settle the claim of the complainant which tantamount to deficiency of service on the part of the opposite party. So the complaint petition is deserved to be allowed with cost & compensation.
Having considered the facts and circumstances of the case and the rival contentions of the Ld. Counsel for the parties, we find force in the contention raised on behalf of the complainant. From the act and conduct of the opposite parties it is fully established that there is deficiency of service on the part of the opposite parties because there is no evidence on behalf of the opposite parties to show reason for not settling the claim of the complainant.
In view of our aforesaid discussion the deficiency of service on the part of the opposite parties stands proved on record and the same is not to be overlooked keeping in view the fact that the complainant suffered from mental pain and agony at the behest of negligence on the part of the opposite parties.
4). Whether the complainant proved her case against the opposite party, as alleged and whether the opposite party is liable for compensation to her?
The discussion made herein before, we have no hesitation to come in a conclusion that the Complainant established that O.P. No.2 & 3 are jointly responsible for not settling the claim of the complainant. So the opposite party No.2 & 3 could not avoid their responsibility of paying the claim of the complainant as ascertained by this Forum.
ORDER
Hence, it is ordered that the complaint case being No.164/2017 be and the same is allowed on contest against the Opposite Party No.2&3 with a litigation cost of Rs.6000/- payable to this complainant.
The Opposite Party No.2&3 are directed to pay jointly and/or severally a sum of Rs.3,00,000/- as sum assured alongwith interest @9% since the date of filing claim Form till its realization to this complainant within 45 days from the date of this order. As interest has been allowed so there is no question to allow compensation for mental pain and agony.
The OP No.1 is exonerated from this proceeding.
At the event of failure to comply with the order the Opposite Party No. 2&3 shall pay fine @Rs.50/- for each day's delay, if caused, on expiry of the aforesaid 45 days by depositing the accrued amount, if any, in the Consumer Legal Aid Account.
Let a plain copy of this Order be supplied free of cost to the parties/their Ld. Advocates/Agents on record by hand under proper acknowledgement/ sent by ordinary Post for information & necessary action.
