West Bengal

Paschim Midnapore

CC/190/2016

Smt. Kalandi Murmu - Complainant(s)

Versus

The Divisional Manager, National Insurance Co. Ltd. - Opp.Party(s)

10 Aug 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

PASCHIM MEDINIPUR.

                             

     Bibekananda Pramanik, President,

      Pulak Kumar Singha, Member.

and

   Sagarika Sarkar, Member. 

 

Complaint Case No.190/2016

 

             Smt. Kalandi Murmu, W/o Late Kingshuk Murmu, Vill- Khgra, P.O. Tentulmuri,

            P.S. Kharagpur (L), District - Paschim Medinipur. …………..……Complainant.

                                                                              Vs.

1. The Divisional Manager, National Insurance Co. Ltd., Division-III, 8, India Exchange Place, Gr. Floor, Kolkata-700001,
2. The Divisional Manager, National Insurance Co. Ltd., Station Road, P.O. Medinipur, District Paschim Medinipur, PIN-721101,
3. The Manager, Golden Trust Financial Services, 16, R.N. Mukherjee Road, (1^st Floor), S.B. Monsion, Kolkata-700001………………………….....……….….Opp. Parties.

                                                    

               For the Complainant: Mr.  Bijoy Mookhopadhyay, Advocate.

              For the O.Ps.             : Mr. Swapan Bhattacharya, Advocate &

                                                  : Mr. Anathbandhu Ghosh, Advocate.

 

Decided on: - 10/08/2017

                               

ORDER

                          Bibekananda Pramanik, President  This consumer complaint has been filed by Smt. Kalandi Murmu against the O.Ps., named above, alleging deficiency in service on their part. 

  Facts of the case, in brief, is as follows

  O.P. nos. 1 & 2 are the General Insurance Company carrying on their

Contd…………………..P/2

 

 

 

( 2 )       

business within the jurisdiction of this Forum.  Raghunath Murmu, since deceased, the son of the complainant,  purchased a Group Janata Personal Accident Insurance Policy from the O.P. nos. 1 & 2 through their corporate agent i.e. O.P. no.3-Golden Trust Financial Services for the coverage of accidental death /loss for a sum of Rs.2,00,000/- and the O.P. no.1 issued a certificate in the name of Raghunath Murmu on 15/09/2002 vide policy no.100300/47/01/9600022/01/96/30198 and the validity of the said policy was from 15/09/2002 to 14/09/2017 and the complainant was made as nominee of the said policy of her son.  Unfortunately on 01/10/2006, Raghunath Murmu died in a road traffic accident. It is stated that Raghunath Murmu used to keep his papers and documents in a safe place and after his death, all his papers were treated as rejected papers and those were kept in a bundle of  the roof of their house.  However on 08/04/2015, the complainant found the said policy papers from those old bundles and she came to know that her son obtained the said insurance policy of Rs.2,00,000/- in his name by making the complainant as nominee.  After getting the said policy, the complainant issued a letter to the O.Ps. no.1 and 2 on 09/04/2015 through her advocate alongwith all necessary documents and after receiving the said letters alongwith documents, O.P. no.1 issued a claim form in the name of the complainant on 21/04/2015 and after filling up the said form, the complainant sent the same to the O.P. no.1 by registered post on 29/06/2015 alongwith all required documents, as per demand.  Thereafter on 28/07/2015 and 21/12/2015, the O.P. no.1 sent two letters to the complainant and the complainant gave reply of all questions of those letters to the O.P. no.1 by registered post on 22/02/2016.  In spite of that, the O.P. no.1 remained silent for which the complainant issued a letter through  her advocate on 29/06/2016 and after getting that letter, O.P. no.1 repudiated the claim of the complainant on 20/07/2016.  It is stated that such repudiation is illegal and by repudiating the claim, the O.P. no.1has caused  deficiency in service.  Hence the complaint, praying for directing the O.Ps to pay the insured sum of Rs.2,00,000/- and for compensation and litigation cost.

                  The opposite party nos. 1& 2 have contested this case by filling a joint written objection.

                    Denying and disputing the case of the complainant, it is the specific case of the opposite parties that since after 01/10/2016 when Raghunath Murmu died, there has been elapse of more than nine years for intimating the company so the complainant did not comply the terms for submitting the claim within one month from the date of death of insured and therefore the complainant has clearly violated the specific terms and conditions of the policy.  It is stated that since the complainant has filed the claim after lapse of 9 years from the date of death of her son, so the present complaint is hopelessly

Contd…………………..P/3

 

 

 

( 3 )

barred under the provisions of Consumer Protection Act.  It is also contended by the O.Ps that since the complainant has violated the terms and conditions of the policy by filing the claim after lapse of more  than nine years, so she is not entitled to get benefit of the said policy and therefore it cannot be said that there is any deficiency in service on the part of the O.Ps and the petition of complaint is therefore liable to be dismissed. 

            O.P. no.3-Golden Trust Financial Services has filed a written version.  It is stated by the O.P. no.3 that Raghunath Murmu, the deceased insured, obtained the policy coverage through facilitation of Golden Multi Services Club of O.P. no.3 and the complainant was made nominee of the said policy.  With regard to the prayer for reliefs, as claimed by the complainant, it is stated by the O.P. no.3 that it is not possible for them to make any comment.  O.P. no.3 has further stated that by impleading them as a party in this case would serve no purpose and therefore it is prayed that the name of the O.P.no.3 be expunged/struck down from the petition of complaint.

              To prove her case, the complainant has tendered a written examination-in-chief, duly supported by affidavit and she was also examined on oath as PW-1.  During her evidence, few documents were marked as exhibit 1 to 10 respectively.  On the other hand, O.Ps adduced no evidence.

 

                                                                 Points for decision

1. Is the case maintainable in it’s present form and prayer ?
2. Is the complainant a consumer of the O.Ps ?
3. Is the case barred by limitation?
4. Is there any deficiency in service on the part of the opposite party nos. 1 & 2 ?
5. Is the complainant entitled to get the reliefs, as sought for ?    

                   

Decision with reasons

For the sake of convenience and brevity, all the above points are taken up together for consideration.

Maintainability of this case has not been questioned by the O.P. at the time of final hearing of this case.  We also find nothing adverse to hold that the present case is not maintainable.

         It is not denied and disputed that Raghunath Murmu, since deceased,  the son of the

 complainant  obtained a  Group Janata Personal Accident Insurance Policy from the O.P. no.1 through O.P. no.3 of Rs.2,00,000/- vide policy no. 100300/47/01/9600022/01/96/30198 and in that policy,  the present complainant Smt. Kalandi Murmu being the mother,  was

                                                                                                                                                                  Contd………………..P/4

 

 

 

( 4 )

 made as nominee.  The complainant being the nominee of the said policy is therefore a ‘consumer’ of the O.P. nos.1 & 2.                                                                                                                                                                                  

                                                                                    

                    Regarding the question of limitation, the O.P. nos.1 & 2 in their written objection in paragraph 9 & 10 have stated that since the claim of insurance was  submitted after lapse of a 9 years from the date of death of the insured, so the present complaint is barred by limitation as per the provision of the C.P. Act.  On this score, we find from the letter dated 20/07/2016 (exhibit-10), sent by the O.P. nos. 1 & 2,  that the claim in question was repudiated on and from 20/07/2016.  So the limitation starts from that date of repudiation and not from the date of death of the deceased- insured.  The present complain has been filed on 05/12/2016 i.e. within the period of limitation of two years from 20/07/2016.  It is therefore held that the present complaint is not barred by limitation.

    Admittedly the complainant after the death of her son Raghunath Murmu, the deceased insured,  submitted claim of insurance before the O.P. nos. 1 & 2 in respect of that policy and finally the O.P. nos. 1 & 2 repudiated the said claim of insurance.  Now the question arises for consideration is as to  whether by such act of repudiation, the O.P. nos. 1 & 2 have caused deficiency in service or not?

   According to O.P. nos. 1 & 2,  as disclosed in the written objection,  that the deceased- insured died in the year 2006 but the complainant submitted claim of insurance after about 9 years from the date of death of the insured. According to them as per terms and conditions of the policy in question any claim of insurance is to be submitted within one month from the date of death but by violating the said terms and condition the present claim of insurance was filed after lapse of 9 years from the date of death and therefore they rightly repudiated the claim of insurance.  It is true that the present claim of insurance has been submitted by the complainant after lapse of about 9 years from the date of death of insured but it appears from the petition of complaint that the complainant has made out a case for such long delay in lodging the claim of insurance of the policy in question and she also informed the O.P. nos.1 & 2 through her advocate on 09/04/2015 regarding such cause of delay and after receiving the said letter, the O.P. no. 1  issued claim form to the complainant on 21/04/2015 and the complainant sent the said claim form duly filled up and signed by her along with all required documents by registered post to the O.P. no.1  as per demand and thereafter on 28/07/2015 and 21/12/2015, the opposite parties issued two letters to the complainant and the complainant also gave reply of those letters.  Said fact has not been denied by the O.P. nos. 1 & 2.

                                                                                                                                                       Contd…………………..P/5

 

 

( 5 )

 

         Since the O.P. nos. 1 & 2 at the very first instance entertained the claim of insurance along with all necessary papers, so sent by the complainant, so it is to be presumed that being satisfied with the cause of delay in lodging the claim by the complainant, O.P. nos. 1 & 2 condoned such delay and therefore they issued claim form to the complainant and made several correspondence with her.  Therefore O.P. nos. 1 & 2 are now estopped from claiming that due to such delay in lodging the claim, the complainant, as per terms and condition of  the policy,  is not entitled to get the death benefit of the policy in question and therefore it is held that by repudiating the claim of insurance in question,  the O.P. nos. 1 & 2 have caused deficiency in service and the complainant is therefore entitled to the reliefs, as prayed for.

All the points are accordingly decided in favour of the complainant.

In the result, the complaint case succeeds.

                                                  Hence, it is,

                                                          Ordered,

                                   that the complaint case no.190/2016 is allowed on contest with cost against O.P. nos. 1 & 2 and dismissed on contest  without cost against O.P. no.3.

             O.P. nos. 1 & 2 are directed to pay the sum of insured amount of policy of  Rs.2,00,000/- to the complainant with interest @ 8% p.a. from the date of filing of the complaint on 05/12/2016 till realization.  They are further directed to pay a sum of Rs.10,000/- as compensation and Rs.5000/- as litigation cost to the complainant.

                        All such payments shall be made within one month from the date of this order i.d. penal interest @ 9% p.a. shall carry over the said amount.

                     Let plain copy of this order be given to the parties free of cost.

          Dictated and Corrected by me

                  Sd/-B. Pramanik.              Sd/- P.K. Singha         Sd/- S. Sarkar                Sd/-B. Pramanik. 

                        President                          Member                     Member                          President

                                                                                                                                       District Forum

                                                                                                                                   Paschim Medinipur