West Bengal

Siliguri

CC/13/131

SMT. NEELAM DEVI SINGHAL - Complainant(s)

Versus

THE DIVISIONAL MANAGER, - Opp.Party(s)

24 Jul 2015

ORDER

IN THE COURT OF THE LD. DISTRICT CONSUMER DISPUTES REDRESSAL FORUM AT S I L I G U R I.

 

CONSUMER CASE NO. : 131/S/2013.                DATED : 24.07.2015.

                

BEFORE  PRESIDENT              : SRI BISWANATH DE,

                                                              President, D.C.D.R.F., Siliguri.

 

 

                      MEMBERS              : SMT. PRATITI  BHATTACHARJEE &

                                                              SRI PABITRA MAJUMDAR.

 

COMPLAINANT                1.         : SMT. NEELAM DEVI SINGHAL

                                                              (AGARWAL),

  W/O Late Binod Agarwal,

  Residing at Agrasen Road,

  behind Agrasen Bhawan,

  Near Amit Offset Printer,

  Khalpara, Siliguri, P.O.- Siliguri Bazar,

Dist.- Darjeeling, Pin- 734 005.

 

            O.Ps.           1)       : THE DIVISIONAL MANAGER,

  Sahara India Commercial Corporation

  Limited,

  3^rd Floor, Shefali Sadan, Opp.- L.I.C. Office,

  S.F. Road, P.O.- Siliguri Bazar,

  Dist.- Darjeeling, Pin- 734 005.

                                                                                                                                                               

2)         : THE DIVISIONAL MANAGER,

              National Insurance Company Limited,     

  43, Jeevan Bhawan, Hazratganj,

  Lucknow – 226 001.

 

                                                                                                                                                                      

FOR THE COMPLAINANT         : Sri Anil Sarkar, Advocate.

FOR THE OP No.1                          : Sri Tarun Sharma, Advocate.

FOR THE OP No. 2                         : Sri Kanak Lal Kundu, Advocate.

­­­­­­­­­­­­­­­­­­­­­­­­­________________________________________________________________________________________________________________________________________________

 

J U D G E M E N T

 

 

Mr. Biswanth De, Hon’ble President

 

The complainant’s case is that she is the wife of Late Binod Agarwal.  Late Binod Agarwal opened one insurance policy from OPs by depositing 10,000/- of insurance policy under Sahara Rajat Yojna of Sahara India Commercial Corporation Limited vide its Receipt No.38581660496, Application No.333000858877, Control No.11979205080, Certificate No.11979208080, Pass Book

 

Contd…P/2

-:2:-

 

 

 

No.243000943983, dated 08.04.2004, through branch office, Siliguri.  As per terms and conditions of the said policy, the complainant being the nominee of deceased is entitled for insurance compensation amounting Rs.2,00,000/- as accidental benefit.  Her husband died on 18.09.2011.  Due to unavoidable circumstances and unfortunate death of her husband, she was so shocked that she could not make any communication with the OPs and other authority.  After passing considerable period of about six months, the complainant filed application before the OP No.1 annexing all documents for getting death benefit of the insurance policy of Rs.2,00,000/- bearing Pass Book No.243000943983.  On the basis of their assurances the complainant visited their office, but did not get any satisfactory reply.  She came to know that OPs have repudiated her claim.  Accordingly, complainant under compelling circumstances, filed this application for getting reliefs. 

OP No.1 contested the case by filing written version denying inter-alia all the material allegations as raised by the complaint.  The positive version of the OP No.1 is that as per terms and conditions of the insurance policy issued by OP No.2, the intimation of death or any incident must be given within 30 days.  In the present case information of accidental death of the investor was not submitted within time.  Consequently due to late submission of intimation National Insurance Company repudiated the claim of the complainant.  It is also stated that after receiving notice of complainant, OP No.1 became known of the death on 04.04.2012.  The death occurred on 18.09.2011.  The OP No.2 repudiated the claim vide letter dated 09.04.2012 due to late intimation.

OP No.2 contested the case by filing written version denying inter-alia all the material allegations as raised by the complaint.

OP No.2 contended that the complainant did not inform the OP No.1 and OP No.2 as per provision laid down in the Insurance Policy i.e., within 30 days.  The matter became known to the OP No.1 and OP No.2 after about six months.  Accordingly, the OP No.2 has repudiated the

 

Contd…P/3

-:3:-

 

claim as complaint has been filed in violation of the expressed law laid down in the policy schedule. 

The complainant has filed the following documents :-

1.       Photocopy of application form dated 08.04.2014;

2.       Photocopy of Pass Book in the name of the complainant;

3.       Photocopy of Money Receipt, 08.04.2014.

4.       Photocopy of Death Certificate of Binod Agarwal.

5.       Photocopy of Treatment Continuation sheet.

6.       Photocopy of Information to the Police for the death of Binod Agarwal.

7.       Photocopy of Post Mortem Report.

8.       Photocopy of F.I.R. being U/D Case No.60/11.

9.       Photocopy of Final Report.

 

OP No.1 has filed the following documents :-

1.       Xerox copy of judgment of State Consumer Disputes Redressal Commission, West Bengal.

2.       Xerox copy of policy documents of investment. 

3.       Xerox copy of intimation letter and reply letter of the Insurance Company.

4.       Xerox copy of circular I.R.D.A. 

5.       Xerox copy of terms & condition of the Insurance Company. 

 

OP No.2 has filed the following documents :-

1.       Policy schedule of Group Personal Accident Policy bearing No.451500/42/10/8200000014 issued in the name of Sahara India. 

2.       Letter dated 09.04.2012 issued by the OP No.2 to the OP No.1.

3.       Receipt No.38581660496 issued by Sahara India Commercial Corporation Ltd. 

Points for consideration

 

1.       Whether the complainant’s husband died by road accident?

2.       Whether the complainant has informed the date of death of her husband to the OPs after many days ?

 

Contd…P/4

-:4:-

 

 

Decision with reason

 

Complainant has field evidence in chief on oath.

OP No.2 has filed evidence in chief on oath. 

OP No.2 has filed evidence in chief on oath. 

 

It is argued by the ld advocate of the OP No.2 that “if the complainant had rightly lodged her claim to the proper authority within the stipulated period as mentioned in the attachment of the said policy, the OP No.2 would have paid the amount of claim to the OP No.1 (Sahara India) but not to the complainant under any circumstances.  It is also submitted that the condition No.7:- PAYMENT OF CLAIM specifically states (a) “Sahara has to submit joint discharge voucher duly signed by Sahara India & the claimant and/or legal heir for payment of claim”, (b) “All claim payment cheques will be made in favour of Sahara India.  Sahara India will be responsible for disbursement of the claim amount to the rightful claimant (or legal heir) and would inform National Insurance Co. Ltd. D.O. IV, Lucknow accordingly”. (c) “In case of non receipt of claim payment by claimant/legal heir from M/s Sahara India, only Sahara India will be responsible for the same”. 

It is admitted position that deceased i.e., husband of the complainant purchased the policy from OP No.1.  The policy was insured by the OP No.2.  It is also admitted that the policy was purchased by the complainant’s husband.  OP No.1 & OP No.2 are in unison that information of death and as well as claim would have been submitted before the OP No.1 by 30 days, but the complainant has not done these.  OP No.2 did not get any opportunity to make survey regarding reasons of death of husband of the complainant.  Ld. advocate of the OP No.1 also argued for that reason OP No.1 did not take any step for payment. 

Condition No.3 states that “As per standard terms of the policy any claim occurring under the policy has to be reported within 30 (thirty) days of occurrence of incident.  This period as a special case is extended by 15 (fifteen) days.  The claims will have to be reported in writing within

 

Contd…P/5

-:5:-

 

 

 

45 (forty five) days of occurrence of incident to National Insurance Company, D.O. IV, Lucknow.  Any claim reported after 45 (forty five( of occurrence will not be entertained”.

It is argued by ld advocate of the OP No.2 that complainant has violated the period of limitation stated expressedly in the policy.  He also argued that the complainant and the OPs are bound to act as per expressed terms in the contract.  The statement and documents of complainant show that claim has been filed after passing six months.

Ld advocate of the OP No.2 has filed some principles of law of our Apex Court as well as National Commission. These are :-

IV (2009) CPJ 38 (SC) Supreme Court of India, I (2009) CPJ 6 (SC),        IV (2004) CPJ 15 (SC) AND III (2014) CPJ 393 (NC).     

Perused those principles of law.

Ld advocate of the OP No.2 broadly submitted that in this principle of law shows that complainant ought to come by 30 days.   

In the present case in our hand, the husband of the complainant purchased the policy.  It is admitted position by OP Nos.1 & 2.  It is also admitted that husband of the complainant died by an accident due to earthquake.  There is no dispute with the death of the complainant’s husband.  To that effect documents filed by the complainant cannot be ignored that husband of the complainant died in accident due to earthquake.  It is accepted that the wife must be are of all the assets and liabilities of the deceased.  This is our common behevour and this complainant is a lady.  It is expected that she did not know regarding the limitation period of filing claim or that she was not aware regarding existence of any policy.  It is very common and conducts of uneducated house wife of our country.  It is very natural that she would have been shocked at her needless due to death of her husband.  Loss of husband cannot be substituted by any other products.  So, it is it is very common conduct that wife would be shocked and would not be known regarding existency of the policy which was purchased by her/their deceased

 

Contd…P/6

-:6:-

 

 

husband.  So, this cannot be sole ground that death of complainant’s husband must be intimated to the OP No.2 or OP No.1 within a period of 30 days only when others conditions are in existence.  The contention of the complainant in her evidence cannot be brushed aside and discarded because the complainant is the wife of the deceased. 

So, after considering the evidence on record and submissions of both sides, we are of opinion that repudiation of claim made by the OP No.2 and OP No.1 also is incorrect. 

Therefore, the complainant is entitled to get her right although the information of death of her husband has been given after 30 days. 

Accordingly, the case succeeds. 

Now we fix the quantum of compensation. 

Complainant has prayed Rs.2,00,000/- as insurance compensation for her husband’s accidental death and in default to pay interest @ 12 % per annum and Rs.1,00,000/- for deficiency in service on the part of the OPs, and Rs.50,000/- for mental pain, agony and harassment. 

Since, the husband of the complainant purchased a policy by paying Rs.10,000/- as insurance premium, and complainant’s husband died by an accident due to earthquake within the valid period of insurance policy, the complainant is entitled to get Rs.2,00,000/- as insurance compensation on account of accidental death benefit of complainant’s husband.

The complainant is also entitled to get interest @ 9% per annum from the date of appearance of the OPs before this Forum till full payment. 

The complainant is also entitled to get Rs.50,000/- due to deficiency in service on the part of the OPs. 

The complainant is also entitled to get Rs.25,000/- for mental pain, agony and harassment of the complainant.   

 

 

Contd…P/7

-:7:-

 

 

                 

Hence, it is

                   O R D E R E D

that the Consumer Case No.131/S/2013 be, and the same is hereby allowed on contest against the OPs.

The complainant is entitled to get Rs.2,00,000/- as insurance compensation on account of accidental death benefit of her husband from the OPs.

The complainant is also entitled to get interest @ 9% per annum from the date of appearance of the OPs before this Forum till full payment from the OPs. 

The complainant is also entitled to get Rs.50,000/- towards deficiency in service on the part of the OPs. 

The complainant is also entitled to get Rs.25,000/- for her mental pain, agony and harassment from the OPs. 

The OP Nos.1 & 2, who are jointly and severally liable, are directed to pay Rs.2,00,000/- by issuing an account payee cheque in the name of the complainant, towards insurance compensation on account of accidental death benefit of complainant’s husband within 45 days of this order. 

The OP Nos.1 & 2, who are jointly and severally liable, are directed to pay Rs.50,000/- by issuing an account payee cheque in the name of the complainant, for mental pain, agony and harassment of the complainant within 45 days of this order. 

Failing which the amount will carry interest @ 9 % per annum from the date of this order till realization.

In case of default of payment as ordered above, the complainant is at liberty to execute this order through this Forum as per law. 

Copies of this judgment be supplied to the parties free of cost.

 

 

 -Member-                     -Member-                         -President-