DATE OF FILING : 23.12.2015.
DATE OF S/R : 08.022.106.
DATE OF FINAL ORDER : 30.03.2017.
Smt. Malati Manna,
wife of late Mohan Manna,
viallge Kalyanpur Panjapara, P.O. Kalyanpur,
P.S. Bagnan, District Howrah,
PIN 711 303.………………………………………………………… COMPLAINANT.
1. The Sr. Divisional Manager,
New India Assurance Co. Ltd.,
CDU 511700,
4, Mango Lane,
Kolkata 700 001,
and it carries business
at Howrah Division, P. 18, Dobson Road,
Howrah 711101.
2. Golden Trust Financial Services,
16, R. N. Mukherjee Road,
Kolkata 700001. ……………………………………………OPPOSITE PARTIES.
P R E S E N T
Hon’ble President : Shri B. D. Nanda, M.A. ( double ), L.L.M., WBHJS.
Hon’ble Member : Smt. Jhumki Saha.
Hon’ble Member : Shri A.K. Pathak.
F I N A L O R D E R
- This is an application U/S 12 of the C.P. Act, 1986 filed by the petitioner, Smt. Malati Manna, wife of late Mohan Manna, praying for a direction upon the o.p., to pay the assured sum of Rs. 50,000/- and Rs. 20,000/- each for compensation and cost of proceeding.
- The case of the petitioner is that her husband Mohan Manna, was policy holder of Janata Personal Accident Policy bearing policy no. 01168097/000100/47511730090 issued by New India Assurance Company Ltd. through Golden Trust Financial Services. The policy was valid from 23.1.20101 to 22.1.2016 and the assured sum was Rs. 50,000/- and this petitioner was nomine of the policy.
- On 31.12.2013 husband of the petitioner namely Mohan Manna died of a road accident over Mankur Road near Godi Football Ground under Bagnan P.S. by lorry no. WB03/A- 9405 and Bagnan P.S. case 495 of 2013 was started under Section 279, 337, 338, 304A of I.P.C. The injured was removed to Bagnan Hospital then to Uluberia Hospital and then on the way to SSKM Hospital, Mohan Manna died. The petitioner was a rustic lady and did not know the process of law but collecting necessary documents approached for getting the assured sum of Rs. 50,000/-. The o.p. no. 1 failed and neglected to pay the assured sum compelling the petitioner to file the case as it is clear case of deficiency.
- The o.p. no. 1 contested the case by filing a written version denying the allegation made against them and submitted that the petition is not maintainable as bad in law and be dismissed in limini on the point of maintainability and jurisdiction. Though they admitted that the o.p. no. 2, Golden Trust Financial Services Ltd., was engaged in mobilizing fund on behalf of UTI and SBI Mutual Fund and to increase the same o.p. no. 2 decided to offer to its employees and investors under the benefit of insurance coverage under two heads Medi Claim and Janata Accident of the o.p. n. 1. In the year 1998, two memos of understanding were executed on 29.7.1998 for mediclaim and on 30.12.1998 for personal accident between o.p. no. 1 and o.p. no. 2. The insurer was o.p. no. 1 and Golden Trust Financial Services was o.p. no. 2 being principal insured and the insurance coverage was to cover the investors, their family members, field workers, their family members and their friends through the o.p. no. 2. The premium was collected and remitted to o.p. no. 1 by the o.p. no. 2 and a certificate used to be issued to each such person by the insurance company through G.T.F.S. Later on the MOU was cancelled by the insurance company was 7.5.1999 and Writ Petition filed by the o.p. no. 2 before the Hon’ble High Court which stayed the cancellation. The insurance company took policy decision to limit the sum assured to Rs. 1 lakh and the period of insurance to 5 years for group JPA Policy. So the o.p. no. 1 by a letter dated 01.08.2000 cancelled the JPA Policy for more than one lakh and of more than five years duration. Some certificate holder moved Hon’ble High Court filing writ petition and the Hon’ble Court stayed the operation of the said letter. Litigation went on between the o.p. no. 1 and o.p. no. 2 and the o.p. no. 1 appointed investigator to investigate the veracity of claim of the complainant and the GTFS refused to give any document issued in the name of Mohan Manna and the investigator on enquiry came to know that Mohan Manna was in fact having no nexus with the GTFS in selling their policy and product and was never a field worker and so the o.p. no. 1 is not liable to make any payment and the case is be dismissed.
- The o.p.no. 2 GTFS contested the case by filing a written version denying the allegations made against them and submitted that it is registered partnership firm having two partners and it was formed in the year 1995. In order to reach the general public certain group insurance policies were introduced by New India Assurance Company Ltd., and one such was Janata Personal Accident Insurance Policy on 30.12.1998 and the firm entered into a MOU with the o.p. no. 1 insurance company by virtue of which the o.p. no. 1 insurer agreed to extend the group insurance coverage under the Janata Personal Accident Insurance Policy to the interested / intended field workers and investors of the firm and their family members and friends. The insured person is a field worker of GTFS bearing policy no. 4751170000001 / E no. 475117 for an overall capital sum insured of Rs. 50,000/- commencing on 23.01.2001 to 22.01.2016. Here the o.p. no. 1 is insurer and the o.p. no. 2 never assumed the role of insurer. The certificate issued by o.p. no. 1 states that being satisfied with the proposal and declaration of the petitioner the o.p. no. 1 accepted the petitioner’s husband, Mohan Manna and now the o.p. no. 1 cannot deny this petitioner. The case against o.p. no. 2 be dismissed.
- Upon pleadings of parties the following points arose for determination :
- Is the case maintainable in its present form ?
- Whether the petitioner has any cause of action to file the case ?
- Whether there is any deficiency in service on the part of the O.P. ?
- Whether the complainant is entitled to get any relief as prayed for ?
DECISION WITH REASONS :
- All the issues aretaken up together for the sake of convenience and brevity for discussion and skip off reiteration. In support of her case the petitioner, Malati Manna, filed affidavit as well as documents being the death certificate of her husband Mohan Manna and the copy of the F.I.R. being Bagnan P.S. case no. 495 of 2013 dated 31.12.2013 U/S 279, 379, 338, 304I.P.C. wherefrom it is crystal clear that the accident took place on Mankur Road, Godi Football Ground Bagnan, wherein the one lorry bearing no. WB03A9405 dashed the husband of the petitioner, Mohan Manna, who was taken toBagnan Hospital and then to Uluberia Hospital and then on the way to P.G. Hospital Mohan Manna expired. The death certificate, P.M. report and voter’s I.D. card of said Mohan Manna proved the fact that he expired resulting motor accident and also the New India Assurance Company Ltd. issuing the policy no. 01168097/000100/47511730090 in his name certifying that as per the proposal and declaration submitted by the company and subject to terms and conditions exclusion definition of Janata Personal Accident Insurance Policy of the company, Mr. Mohan Manna is covered under the above policy issued in the name of Golden Trust Financial Services on 23.1.2001 and 22.1.2016 and the sum insured was Rs. 50,000/- for such accidental death and in the said policy the present petitioner Malati Manna being wife of the deceased Mohan Manna was mentioned as nominee and after such certificate once duly being issued in favour of the husband of the petitioner as per the proposal and declaration submitted to the company, the insurer cannot now deny the case of the petitioner and also be directed to settle the claim of the petitioner as mentioned in the policy.
- This Forum kept in mind the submission of the ld. Counsels of all sides and on scrutiny of the documents and also the cases of the parties and keeping in mind the decision of our National Commissionas well as our Hon’ble High wherein tjheir lordship categorically stated that it was evident from the certificate of insurance that the insurance company had given the certificate after being satisfied with the proposal and declaration sub mitted to the company. Further queries were uncalled for and once the certificate has been issued so there is no question of denial or reopening the case and the Hon’ble was pleased to direct company to settle the claim of the petitioner therein without raising any further query.
- In the instant case also the certificate issued by the insurance company proved the case of the petitioner because by issuance of such a certificate the insurance company has taken the liability to indemnify the insured for the loss or in the case death to the heirs of the insured paying compensation as in the case of accidental death here being Rs. 50,000/- since the death of date with interest. As it is clear case of deficiency on the part of the insurance company to delay the matter, so the petitioner is entitled to costs at the rate of 9% p.m. on the insured sum and no compensation is allowed but cost.
In the result, the application succeeds.
Court fee paid is correct.
Hence,
O R D E R E D
That the C. C. No. 474 of 2015 be and the same is allowed on contest with costs against the O.P. no. 1 and dismissed against the o.p. no. 2 without costs. .
The petitioner is entitled to the relief as prayed for. The O.P. no. 1 be directed to pay the insured amount of Rs. 50,000/- with @ 9% p.a. interest from the date of death of the insured i.e., husband of the petitioner, Mohan Manna, within 30 days from the date of this order.
The o.p. no. 1 do also pay a sum of Rs. 20,000/- of which Rs. 5,000/- be paid to petitioner as litigation costs and the rest amount of Rs. 15,000/- would be deposited in the Consumer Legal Aid A/c of this District Forum also within 30 days from the date of this order.
No order is awarded as to compensation as interest paid.
The complainant is at liberty to put the final order into execution after expiry of the appeal period.
Supply the copies of the order to the parties, free of costs.
DICTATED & CORRECTED
BY ME.
( B. D. Nanda )
President, C.D.R.F., Howrah.
