West Bengal

Murshidabad

CC/28/2015

Abu Hanif Mandal - Complainant(s)

Versus

The Divisional Manager, New India Assurance Co. Ltd. - Opp.Party(s)

Mr. Siddhartha Sankar Dhar

06 Sep 2017

ORDER

IN THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MURSHIDABAD AT BERHAMPORE.

CASE No.CC/28/2015  .

 Date of Filing:            25.02.2015.                                                                                                    Date of Final Order: 06.09.2017.

 

Complainant :              Abu Hanif Mondal, S/O Late Majed Ali Mondal,Vill.&P.O. Kashipur, P.S.Rejinagar,

                                     Dist. Murshidabad.

Vs

Opposite Party: 1. Senior Divisional Manager, The New India Assurance Co. Ltd,

                              Howrah Divisional Office , Madhusudan Apartment, 2^nd Floor, P-18, Dobson Lane,

                               Howrah-711101.

                        2.  Divisional Manager, New India Assurance Co. Ltd, Berhampore Division,

                              R.N.Tagore Road, P.O& P.S. Berhampore,  Dist. Murshidabad.

                          3.  Golden Trust Financial Services,

     R. N. Tagore Road, P.O.&P.S. Berhampore, Dist. Murshidabad.

 

                       Present:    Sri Anupam Bhattacharyya            President.                              

                                                 

                                      Sri Manas Kumar Mukherjee          Member

 

FINAL ORDER

 

            Sri Anupam Bhattacharyya Presiding Member.

 

The instant complaint has been filed by the complainant U/S 12 of C. P. Act, 1986 praying for payment against policy amount of Rs.1 lakh and compensation of Rs.20,000/-.

            The complainant’s case, in brief, is that Md. Sajadur Rahaman was the son of the complainant. He had a policy being No. 4751220001607 for assured sum of Rs.01 lakh for the period from 23.11.1999 to 22.11.2014 where the complainant was nominee. He died on a motor vehicle accident on 13.3.11. The complainant had no knowledge about the said policy of his own. The complainant lodged a claim to the OP no.3 on 17.01.2012 having knowledge of that policy. Thereafter, the complainant filed all the required documents but no result. Hence, the instant complainant’s case.

            The written version filed by the OP nos. 1&2 Insurance Company , in brief, is that neither the complainant nor the GTFS provided any documentary proof regarding the status of Policy Holder. As per Hon’ble High Court’s order , GTFS is prohibited from collecting premium from category of “Friends”. Being the category is barred by the Hon’ble High court, the submission of documents is condition precedent for the due consideration of claim. The case is also barred by Law of Limitation U/s 24A of Consumer Protection Act as the case has been filed after two years from the alleged death of the complainant’s son. The cause of action arose on 13.03.2011 but in the complaint it has been stated that the claim was first lodged on 17.01.2012. So after ten month from the date of cause of action, the complainant gave the first information which is barred by the Hon’ble National Commission and as such the claim is ought to be dismissed. The Opposite party denies the Policy issued by the GTFs as a Field Worker as mentioned in the complaint. No information was received by the Opposite Party for the death of the deceased. This Opposite Party had no deficiency of service and the claim of the complainant is liable to be dismissed with cost. Hence, the instant written version by OP Nos. 1&2 Insurance Company.

            The written version filed by the Op No.3 GTFS , in brief, is that the deceased insured , the son of the complainant, was a Field Worker. As per MOU , the OP No.3-GTGFS was only to collect premium and to remit the same to Op no.1 –Insurance Company. As per judgment of Hon’ble Mr. Justice Pranab Kr. Chattopadhyay reported in 2005(3)CHN 154 : Bimal Ch. Vs. New India Assurance Co. Ltd & Ors whereby the identity of the insured person as a field worker as well as the relationship between the insured person and Golden Trust Financial Services being insured have been well elaborately dealt with and amplified giving appropriate importance to the premium forwarding list, premium forwarding letter mentioning the status of the insured person as filed worker/investor and acknowledgment by the New India Assurance Co Ltd. through an affidavit  is  sufficient . Hence, the instant written version.

            Considering the pleadings of both parties the following points have been raised for the disposal of the case.

                                                       Points for Decision.

1. Whether the complaint is maintainable in its present form and in law?
2. Whether the complaint is barred by Principle of waiver, acquiescence and estoppels.
3. Whether the complainant has any cause of action to file the present case?
4. Whether the present case is barred by Law of Limitation?
5. Whether the complainant is entitled to get relief as prayed for?
6. To what other relief/reliefs the complainant is entitled to get?

 

                                                     Decision with Reasons

            Point Nos. 1 to 6.

            All the points are taken up together for the sake of convenience.

            The instant complaint is for payment against policy amount of Rs.1 lakh and compensation of Rs.20,000/-.

            The complainant’s main case is for payment of policy amount of Rs.1 lakh for death of his son due to motor vehicle accident where the complainant was nominee but he had no knowledge about the impugned policy of his son. The complainant filed the claim application within time before the OP-Insurance Company after getting knowledge about the policy of his son.

            On the other hand, the OP-Insurance Company’s main case is that the complainant is not a consumer for the debtor-creditor relationship and the complaint was not field worker of Op No.3 and the incident being not initiated within the scheduled time the complainant is not entitled to get any relief and for that the complaint is liable to be dismissed.

            Further, the OP No.3’s case is that the complainant was their field worker. The premium forwarding letter acknowledgment of OP-Insurance Company through affidavit is sufficient.

            To prove the case the complainant has adduced evidence on affidavit along with materials on record.

            On the other hand, the OP-Insurance Co. has filed questionnaire and Op No.3 has filed duly their reply particularly regarding the status of the policy holder as Field Worker.

            The complainant has filed the relevant documents including Xerox copies of three letters of OP No.3 forwarding the claim application and original documents relating to the claim application.

            In the written version filed by the GTFS, Op no.3 and also in their reply to the questionnaire of Op nos. 1&2 Insurance Company they have categorically stated that the deceased policy holder was Field Worker of Op No.3 Company and they have also replied referring the Order dt. 27.11.15 of Hon’ble national Commission in R.P. no. 3095/10 that at this belated stage the Insurance Company cannot be permitted to take advantage of its own wrong.

            Regarding delay in intimation for about nine months and in lodging FIR for about 38 days the Ld. Lawyer for the OP-Insurance Company has referred a reported decision in I(2013) CPJ-71(NC) in the case of Virendra Kumar Vs. New India Assurance Company Ltd. where the case was for theft of vehicle and there was delay in intimation and in lodging FIR and claim was repudiated and held that repudiation was justified.

            In this case the insured was died by M.V. accident and regarding the delayed intimation the specific case of the complainant who is father of the deceased policy holder is that he had no knowledge about the policy of his deceased son. The complainant is an old aged about 65 years rural people. His specific case is that he lodged claim application when he came to know about the s aid policy of his son.  

            From the documents, death certificate and claim application

Filed by the complainant it is clear that the policy holder son of the complainant died on 13.3.11and got knowledge about the policy and filed claim to OP-Insurance Company by GTFS, Op No.3 by their letter dt. 19.01.12.

            Further, in this case there is no repudiation of the claim of the policy. Also, there is no such repudiation letter filed before this forum from either side. To reiterate, in this case the OP-Insurance Company has not filed any such repudiation letter.

            Regarding the issue as to be barred by limitation, it is clear from the letter of GTFSW –OP No.3 dt. 16.8.13 forwarding the letter of the complainant d t. 5.8.13 for settlement that sending that letter without getting any response the complainant filed the instant complaint on 25.02.15 within the statutory period of limitation for two years.

            Admittedly, the incident of death of policy holder by Motor accident took place on 13.3.11 and getting acknowledgement of the policy lodged claim application on 17.01.12 and for settlement requested the OP-Insurance Company by letter dt. 05.08.13 and thereafter lodged the instant complaint on 25.02.2015 and that being so it is clear that the instant claim is not barred by limitation.

            Admittedly, the complainant is nominee of the policy.

            Considering the materials on record as discussed above we can safely conclude that all the points are disposed of in favour of the complainant and as such the complainant is entitled to get the policy amount of Rs.1 lakh along  and    Rs.3,000/- towards compensation for mental pain and agony and litigation cost. 

            OP No.3-GTFS, being the collecting agent of the OP Nos.1&2 , is not the proper Authority to settle the claim of the complainant. So, the OP No.3 has no liability in this case.

            Hence,

                                                        Ordered

That the Consumer Complaint No. 28/2015 be and the same is hereby allowed on contest in part against the OP Nos. 1&2  and dismissed on contest against the OP No.3.

The complainant is entitled to get the policy amount of Rs.1 lakh along with   Rs.3,000/- towards compensation  for mental pain , agony and litigation cost.

            The OP Nos.1 &2 are jointly and/or severally directed to pay the policy amount of Rs.1 lakh along with Rs.3000/- towards compensation for mental pain , agony and litigation cost to the complainant  within two months from the date of this order, failing which the OP Nos.1&2 are to pay Rs.50/- as fine per day’s delay and the amount so accumulated shall be deposited by Demand Draft in the Consumer Legal Aid Account.
 

            Let a plain copy of this order be made available and be supplied free of cost, to each of the parties on contest in person, Ld. Advocate/Agent on record, by hand under proper acknowledgment / be sent forthwith under ordinary post  to the concerned parties as per rules, for information and necessary action.

 

 

 

        Member                                           Member                                                             President