DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MALDA, MALDA D.F.ORIGINAL CASE No.26/2008. Date of filing of the Case: 03.04.2008 Complainant | Opposite Parties | Smt. Archana Mandal (32 years) W/O. Late Jaga Mandal @ Jagu Mandal, resident of Vill. Byaspur, P.O. Madhughat, P.S. Englishbazar, Dist. Malda. 732206. | 1. | The Senior Divisional Manager National Insurance Company Ltd., Division – III, 8 India Exchange Place, Ground floor, Kolkata – 1. | 2. | The Divisional manager, National Insurance Company Ltd., Malda Division, 93A, Rabindra Avenue, 2nd floor, P.S. Englishbazar, P.O. & Dist. Malda – 732101. | 3. | The Manager The Golden Trust Financial Services, S.B. Mansion, 16, R.N. Mukherjee Road, Kolkata – 1. | 4. | The Manager, The Golden Trust Financial Services (near S.B.I., Rathbari Branch), P.O. Rathbari, N.H. 34, P.S. Englishbazar, Dist. Malda. 732101. | | |
Present: | 1. | Shri A.K. Sinha, Member | 2. | Smt. Sumana Das, Member | | |
For the Petitioner : Indrajit Singh, Krishnagopal Das, Rabin Das & Sujoy Mitra Advocates. For the O.Ps.: For O.P. Nos.1 & 2 Arijit Neogi, Advocate. For the O.P. Nos. 3 & 4 Md. Ziaullaha, Advocate. Order No. 06 Dt. 16.06.2008 In essence, petitioner’s case is that on the death of her husband on 22.09.2006 she has become the soul nominee of Group Janata Personal Accident Policy bearing No.100300/47/01/9600022/02/96/30442 of which, period validity is from 31.03.2003 to 30.03.2018 (Midnight) and the sum assured Rs.1,00,000/- (one lakh) for which the petitioner submitted all required documents along with claim form before O.P. No.4 (Manager, G.T.F.S., Rathbari Malda). O.P. No.4 thereafter sent the relevant documents alongwith filled up claim form to O.P. No.1 on 09.08.2007. The petitioner sent reminder to O.P. No.2 on 21.2.2008 for disbursing his claim. (She also approached O.P. No.2 on 21.2.2008 for disbursing her claim). She also approached O.P. No.2 & 4 repeatedly for settlement of the claim but even after long lapse of time her claim has not been satisfied giving rise to the instant petition on the ground of negligence, deficiency in service and unfair trade practice for non payment of the claim concerned with reason for the reliefs made out in the petition of complaint. O.P. No.1 and 2 (National Insurance Co. Ltd. Division – III, & Malda Division) contested the case by filing joint written objection alleging that the case is not maintainable and denied all the material allegations. The O.Ps. also alleged that they have neither repudiated the claim nor acted any voluntary negligence for settlement of the claim and as such no cause of action has been occurred. Hence prayed that the petition of complaint is liable to be rejected. O.P. No.3 & 4 (Golden Trust Financial Services, Kolkata and Malda Branch) also contested the case by filing joint written version alleging that the petition is misconceived one as the group JPA Policy was made with National Insurance Co. Ltd, through GTFS and settlement of claim is a matter concern only with the insurance company (O.P. No.1 & 2). Heard both sides, considered, on pleadings of both parties, the following points have been emerged for effective disposal of the case. 1. Whether the Service of O.Ps. (National Insurance Company Ltd.) suffers from deficiency? 2. Whether the petitioner is entitled to get the reliefs as prayed for? DECISION WITH REASONS Point No.1 & 2: Both the points are taken up together for simultaneous disposal u/s 2(1)(o) of the C.P. Act 1986. The definition of the term ‘service’ is very comprehensive. The work ‘service’ has to be construed in the context of the definition of the word ‘consumer’, ‘service’ u/s 2 (1)(o) of the Act does not mean and include every kind of services. In the instant case it means and includes such service as is rendered against payment of money that is the facility in connection with insurance and insured; the Act has given a right to every insured consumer the benefits of cheap and speedy remedy. It is an agreement between two persons (insurer and insured) that in consideration of comparatively small payment (the premium) by the assured, the insurer will, on a certain even happening during a specified time pay to assured by the event. Insurance is a contract. When the insurer fails to abide by the undertaken given by it in present of a contract or otherwise, there is deficiency in relation to the service. In the instant case the petitioner, the wife of the insured has examined herself as P.W. – 1 and in course of her evidence she has produced some documents which have been marked Ext.1 to 12 and has claimed to be the nominee in respect of the sum insured. Admittedly, the petitioner has filed the death certificate (Ext.3) and the Post Mortem report (Ext.5). It further appears that Ext.4 discloses about lodging of FIR at Kaliachak P.S. Case No.300/06 dated 22.09.06 in connection with motor accident resulting the death of Jagu @ Jaga Mandal, the insured. On further Scrutiny of records it appears that the petitioner has submitted the claim form and other relevant documents to the National Insurance Company Ltd. through GTFS Malda Branch (Ext.11) which was received by GTFS Malda Branch on 03.08.2007. She has also filed letter to Divisional manager NIC, Malda Division through GTFS on 21.2.2008 apprising of the fact that original necessary documents of the insured were sent to him through GTFS on 03.08.2007 (Ext.12) for settlement of the claim. P.W. – 1 during cross examination by O.P. No.3 & 4 admitted that O.P. No.3 supplied claim form after receipt death intimation of her husband and they set all necessary relevant documents along with claim form so deposited to National Insurance Company. Ld. advocate for O.P. No.3 & 4 filed xerox copy of Memo No.GTFS/claim/DD/JPA-20474 dated 09.08.2007 addressed to O.P. No.1 which discloses that the submitted claim form along with original policy certificate, original death certificate, original certified true copy of FIR, original certified true copy of final report of police, photo copy of Post Mortem report and completed claim form in connection with claim of nominee of the insured in question this document has been marked as Ext.A which also reveals the receipt of the Memo by O.P. No.1 under seal & signature dated 13.08.2007. Nothing has been shown or proved on behalf of O.P. No.1 & 2 that they are not in receipt of all the exhibits referred to hereinabove nor they has satisfied the Forum that any other documents is necessary to satisfy the claim of the petitioner excepting during argument, it is raised that they have not yet repudiated the claim of the petitioner but failed to give any satisfactory reply as to why they have been sitting over the matter after receipt of necessary required documents through O.P. No.3 since August, 2007 nothing has been shown also to establish their effort to process the claim of the petitioner till date. Such act on the part of O.P. No.1 & 2 clearly shows deficiency in service. In the written objection of O.P. No.3 & 4 it manifests that tie up agreement was exceeded in between insurance Co. & GTFS wherein it was agreed that the entire responsibility relating to a policy would be borne by the insurance company and the relation between GTFS and Policy Holder is confined in respect of claim that the policy holder / nominee will submit all necessary papers pass to GTFS who in turn after getting the above documents will process the same for sanding to the insurance company for their consideration. In support of such context Ext.A has been filed by O.P. No.3 & 4. P.W. – 1 expressed her satisfaction on the service of O.P. No.3 & 4 in dealing with her claim petition. Having given our anxious consideration over the matter it can safely be said that the service of O.P. W – 3 & 4 does not suffer from deficiency. P.W. – 1 appeared in the Form with her one minor son aged 2 years named Joydeb Mandal and another son Sarat Mandal, aged about 8 years and denied to have any other dependent of her deceased husband. From the above facts and documents filed in course of proceedings it can safely be said that the petitioner has been able to prove her case. Both the points are thus disposed of in the affirmative. Hence, ordered, that Malda D.F. Case No.26/2008 is decreed on contest in part against O.P. No.1 & 2 (The Senior Divisional Manager, National Insurance Company Ltd., Division – III, 8 India Exchange Place, Ground floor, Kolkata – 1 & The Divisional manager, National Insurance Company Ltd., Malda Division, 93A, Rabindra Avenue, 2nd floor, P.S. Englishbazar, P.O. & Dist. Malda – 732101) and case against O.P. Nos. 3 & 4 (The Manager, The Golden Trust Financial, Services, S.B. Mansion,, 16, R.N. Mukherjee Road, Kolkata – 1 & The Manager, The Golden Trust Financial Services (near S.B.I., Rathbari Branch), P.O. Rathbari, N.H. 34, P.S. Englishbazar, Dist. Malda. 732101) is dismissed. The petitioner will get compensation of Rs.1,00,000/- (rupees one laks) only. Both the above named O.Ps. do pay the aforesaid amount jointly & severally within 30 days from the date. Failure to comply the order will carry interest @9% per annum till its final realization and the petitioner will have the liberty to take recourse to law. Let copy of this order be given to both parties free of cost at once. Sd/- Sd/- Sumana Das A. K. Sinha Member Member D.C.D.R.F., Malda D.C.D.R.F., Malda |
