DATE OF FILING : 07-09-2012.
DATE OF S/R : 04-10-2012
DATE OF FINAL ORDER : 29-01-2013.
Smt. Arati Naha,
wife of late Sanjay Naha
of 30, Madhusudan Sarani, Noth Ghoshpara,
P.O. Ghoshpara, P.S. Bally,
District –Howrah
PIN – 711227.------------------------------------------------------------------- COMPLAINANT.
Versus -
1. The Divisional Manager,
The New India Assurance Co. Ltd.
Howrah Divisional Office, 512200
Madhusudan Apartment ( 2nd floor ),
P-18, Dobson Lane,
Howrah – 711101.
2. The Manager,
Golden Trust Financial Services,
having its registered office
at 16, R.N. Mukherjee Road,
Kolkata – 700001. ---------------------------------------------OPPOSITE PARTIES.
P R E S E N T
President : Shri T.K. Bhattacharya, M.A. LL.B. WBHJS.
Member : Shri P.K. Chatterjee.
Member : Smt. Jhumki Saha.
F I N A L O R D E R
The instant case was filed by complainant U/S 12 of the C.P. Act, 1986,
as amended against the O.Ps. alleging deficiency in service U/S 2( 1 )( g ), 2( 1 )( o ) of the C.P. Act, 1986 wherein the complainant has prayed for direction upon the O.Ps. to pay the insured money to the tune of Rs. 5 lacs as per the policy certificate issued by o.p. no. 1 dated 15-03-2000 being Policy NO. 451220001799/E No. 4730712 and for Rs. 2 lacs as compensation as the o.p. no. 1 in spite of submission of all papers and claim documents has been sitting tight over the matter. Be it mentioned the husband of the complainant Sanjay Naha, the policy holder, as filed worker, died in a rail accident on 16-05-2012. Hence the case.
2. The o.p. no.1, The New India Assurance Company Ltd. in their written version contended interalia that deceased Sanjan Naha was an employee of Kolkata Port Trust and as such cannot come as a beneficiary in the category of field worker ; that during investigation by the o.p. no. 1 the complainant confirmed that her husband was not a field worker ; that there was no deficiency in service ; that the complaint should be dismissed forthwith.
4. Upon pleadings of both parties two points arose for determination :
i) Is there any deficiency in service on the part of the O.Ps. ?
Whether the complainant is entitled to get any relief as prayed for ?
DECISION WITH REASONS :
5. Both the points are taken up together for consideration. It is evident that the aforesaid certificate was issued by the o.p. no. 1 for an overall capital sum insured of Rs. 5,00,000/- for a period of coverage commencing from 15-03-2000 to 14-03-2015 after completion of all necessary formalities in that regard. It is further evident from the face of the said certificate itself with the said insurance company ( o.p. no. 1 ) issued the said certificate on the basis of proposal and declarations submitted to the company by the said insured Sanjan Naha since deceased. Naturally, it implies that the o.p. no. 1 had issued the certificate after being completely satisfied with the declaration as made in the proposal form by the deceased insured person. As per the MOU the role of the o.p. no. 2 is very limited, they are to collect the premium from the individual insured persons and to transmit the fund to the insurance company i.e., o.p. no. 1. It is immaterial if the complainant Arati Naha made any declaration before the investigating officer that her husband was not a field worker etc. In fact, a housewife cannot be expected to know all the tit bits of a policy entered by her husband. The policy in question was not cancelled by the insurance company at any point of time before the death of Sanjay. In fact, the J.P.A. Policy in question was to come in force in the event of accidental death of the policy holder. So the insurance company, o.p. no. 1 shall have no way escape from their own liabilities in terms of the policy condition.
6. Now turning to the merit of the claim we are of the view that the complainant being the nominee of the deceased policy holder produced all the relevant documents in support of her claim. But the insurance company adopted a policy of dilly-dallying and did not settle the same. It is settled principle of law that when the insurance company deliberately makes delay in settlement of claim which is recoverable by the complainant under the terms of the policy, it amounts to deficiency in service ( vide R.K. Industries Vs. N.I.A. Company 1985(2) CPJ 87 (NC).
Therefore, considering the facts and circumstances of the case and regard being had to the enclosures on record we are of the view that this is a fit case where the prayer of the complainant shall be allowed. Both the points are accordingly disposed of.
In the result, the complaint succeeds.
Hence,
O R D E R E D
That the C. C. Case No. 104 of 2012 ( HDF 104 of 2012 ) be allowed on contest with costs against the O.P. no. 1 and without cost against o.p. no. 2.
The complainant is entitled to the insured sum of Rs. 5 lacs against the policy no. 451220001799/E No. 4730712 together with the interest @ 10% per annum since 16-05-2009 ( death of her husband ) till full payment by the o.p. no. 1.
The o.p. no. 1 shall disburse the insured amount to the claimant together with the interest as directed within one month from the date of this order failing the amount shall carry interest @ 12% per annum.
The complainant is further entitled to a compensation of Rs. 50,000/- from the o.p. no. 1 for causing prolonged mental agony and harassment.
The complainant is at liberty to put the decree into execution after expiry of the appeal period.
Supply the copies of the order to the parties, as per rule.
