DATE OF FILING                    :           12-12-2012.

DATE OF S/R                            :         22-01-2013.

DATE OF FINAL ORDER      :           24-04-2013.

Swarna  Chatterjee,

wife of late Ajay Kumar Chatterjee,

Qtr. No. B/09/53 ( Old B Type),

Chinchuria R.N. Colony, P.O. Chinchuria,

District – Burdwan,

PIN – 713378. ------------------------------------------------------------------- COMPLAINANT.

Versus   -

The New India Assurance Company Limited,

Howrah Divisional Office – 512200,

having its office at Madhusudan Apartment (2^nd Floor ),

P-18, Dobson Lane, P.S.  Golabari,

District - Howrah ,

PIN – 711101.

The  Senior Divisional Manager,

The New India Assurance Company Limited,

Howrah Divisional Office – 512200 ,

P-18, Dobson Lane, (2^nd  floor ),

 P.S.  Golabari,

District -  Howrah,

PIN – 711101.

The Golden Trust Financial Services,

having its 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

wherein the complainant has  prayed for direction upon the o.p. nos. 1 & 2 to pay the insured sum of Rs. 2 lacs together with a compensation of Rs. 50,000/- for mental harassment and a litigation cost of Rs.20,000/- as the O.P. nos. 1 & 2 in spite of  bonafide and valid certificate repudiated the claim.

The o.p. nos. 1 & 2  in their written version contended interalia that the GTFS

is the insured in the instant case and the coverage is extended only to the group consisting of investors, field workers and their family members. So the it is the duty of the GTFS to establish the status of the certificate holder.

The O.P. no. 3, G.T.F.S. in their written version contended interalia that it is

the duty of the O.P. nos. 1 & 2 to settle the claim of the complainant in accordance with the prayer as set out in the complaint.

Upon pleadings of both parties two points arose for determination :

i)          Is there any deficiency in service on the part of the O.P. nos. 1 & 2  ?

Whether the complainant is  entitled to get any relief as prayed for ? 

DECISION  WITH   REASONS      :

Both the points are  taken up together for consideration. The husband of the

complainant Ajoy Kr. Chatterjee since deceased during his life time secured coverage under a policy namely Group Janata Personal Accident Insurance Policy from the O.P. nos. 1 & 2 to the tune of Rs. 2 lacs ( Annexure ‘A’).  Ajoy Kr. Chatterjee died in a fatal accident on 26-03-2003 (  Annexure ‘B’ ). In spite of intimation of such unfortunate accident to the O.P. nos. 1 & 2, the insurance company repudiated the claim vide letter dated 12-09-2012 with the remark that the claim has been claimed as ‘no claim’ ( Annexure ‘M’ ).

Be that as it may on scrutiny of the annexures we find that the certificate was

issued by the O.P. nos. 1 & 2 dated 23-10-2000 and the same was valid till 22-10-2015.  The O.P. no. 3  G.T.F.S. admitted that the deceased Ajoy Kumar was a field worker and as such the O.P. insurance company was not justified in repudiating the claim  irrationally. We are really distressed to learn that in spite of issuing the valid certificate the O.P. insurance company repudiated the claim raising fragile reasoning. We have no hesitation in our mind that this is a fit case where the complainant’s prayer shall be allowed. Both the points are accordingly disposed of.

                Hence,

O     R     D      E      R      E        D

                That the C. C. Case No. 167  of 2012 ( HDF 167  of 2012 )  be  and the ;same is allowed on contest with costs against the O.P. nos. 1 & 2 and dismissed against O.P. no. 3 without cost.

                The O.P.  nos. 1 & 2 be directed to pay the sum of Rs. 2 lacs as insured in the certificate  of policy to the complainant within  30 days from the date of this order failing the amount shall carry interest @ 9% per annum till full satisfaction.

                The o.p.  nos. 1 & 2 do  further pay a sum of Rs. 10,000/- to the complainant for causing prolonged mental pain and harassment.

                The complainant is further  entitled to a litigation cost of Rs. 5,000/- .

                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.