C.F. CASE No. : CC/09/66
COMPLAINANT : Nuresa Bibi @ Nureda Sekh
W/o Late Kuddus Ali,
Vill. Gobindapur, P.O. Plassey,
P.S. Kaliganj, Dist. Nadia
OPPOSITE PARTIES/OPs : 1. The Sr. Divisional Manager,
National Insurance Co. Ltd.
Div. III, 8th India Exchange Place (Gr. Floor)
Kolkata – 700 001.
: 2. Branch Manger,
National Insurance Co. Ltd.,
Krishnagar Branch,
P.O. Krishnagar, Dist. Nadia
: 3. The Manager,
Golden Multi Services Club of G.T.F.S.,
Krishnagar Branch, 2nd Fl0or,
40 R.N. Tagore Road, P.O. Krishnagar,
P.S. Kotwali, Dist. Nadia
PRESENT : KANAILAL CHAKRABORTY PRESIDENT
: KUMAR MUKHOPADHYAY MEMBER
: SMT SHIBANI BHATTACHARYA MEMBER
DATE OF DELIVERY
OF JUDGMENT : 19th February, 2010
: J U D G M E N T :
In brief, the case of the complainant is that her husband, Late Kuddus Ali purchased a policy from the OP, National Insurance Co. Ltd. being policy No. 100300/47/2K/9601062/2K/96/00257 dtd. 01.02.01 with a sum assured of Rs.2,00,000/-. The said policy remained valid upto 31.01.11 and it was purchased through Golden Multi Services Club of GTFS agent, Nabadwip Branch. It is her further case that the policy holder, Kuddus Ali died on 26.03.06 in an accident and a case was started under Marikpur P.S. vide case No. 28/2006 dtd. 27.03.06 U/S 279/304(A) / 427 IPC. The accidental death was caused at Bongaigaon, Assam. After the death of the policy holder the petitioner being the nominee claimed the amount before the National Insurance Co. Ltd. through GTFS by submitting all necessary documents. On 11.06.09 GTFS sent a letter to National Insurance Co. Ltd. that on 27.02.08 they sent all necessary documents for the said claim, but no step was taken by the OP, Insurance Co. Again she met the OP No. 1 & 2 on 05.06.09 and 10.07.09 demanding her claim, but to no effect which she duly intimated to the OP No. 3 on 13.07.09. As the OP No. 1 & 2 have not settled her claim, so having no other alternative she has filed this case praying for the reliefs as stated in the petition of complaint.
The OP No. 1, National Insurance Co. Ltd. has contested this case by filing a written version, inter alia, stating that the case is not maintainable in its present form and nature. It is his further contention that he issued Group Janata Personal Accidental Insurance Policy in favour of Kuddus Ali subject to terms and conditions of the policy. He also submits that the complainant did not inform him regarding the accidental death of Kuddus Ali in due time. Only she filed a claim application along with same documents to settle her claim though it is the rule of the Co. that the death news is to be intimated within one calendar month since the time of death. The complainant filed some documents before GTFS on 18.10.06 as stated by her which is a belated submission of documents. The GTFS intimated the complainant to submit all the original documents, but she did not comply with that request. So the complainant has no cause of action to file this case so the same is liable to be dismissed.
OP No. 3, GTFS, Krishnagar Branch has filed a separate written version in this case, inter alia, stating that the deceased Kuddus Ali obtained a Group Janata Personal Accident Insurance Policy from the OP National Insurance Co. Ltd. and the policy was purchased through him. The policy was valued at Rs. 2,00,000/- and it was valid upto 31.01.11. The complainant being the wife of the victim was the nominee of the policy. It is his further submission that as per MOU between the National Insurance Co. Ltd. and this OP the National Insurance Co. Ltd. has the exclusive right and authority to entertain, process and settle the claim application of the petitioner and this OP has no liability to settle the claim of the complainant. After the death of Kuddus Ali on 26.03.06 the complainant submitted the claim form along with other supporting documents before the GTFS which he forwarded to National Insurance Co. Ltd. He also forwarded other letters submitted to him by the complainant before the OP Insurance Co. So it is the responsibility of the OP, National Insurance Co. Ltd. to settle the claim of the complainant. Hence, the complainant has no cause of action to file this case and the same is liable to be dismissed against him.
POINTS FOR DECISION
Point No.1: Has the complainant any cause of action to file this case?
Point No.2: Is the complainant entitled to get the reliefs as prayed for?
DECISION WITH REASONS
Both the points are taken up together for discussion as they are interrelated and for the sake of convenience.
On a careful perusal of the petition of complaint along with the annexed documents and the written versions filed by the OPs and also after hearing the arguments advanced by the ld. lawyers for the parties it is available on record that one Kuddus Ali purchased one Group Janata Personal Accidental Insurance Policy from the OP, National Insurance Co. Ltd. on 01.02.01 and the sum assured was Rs. 2,00,000/-. The policy was valid up to 31.01.2011. The petitioner being the wife of the victim was the nominee of the policy and it was purchased through GTFS. The copy of policy is marked as 'Annexure – 1’. It is the complainant’s case also that the policy holder, Kuddus Ali expired in a motor accident on 26.03.06 at Bongaigoan, Assam. From 'Annexure – 10’ it is available that the complainant intimated the death news of her husband to the OP insurance Co. on 30.03.06. She also submitted a copy of FIR, PM Report and also original policy bond along with claim application before the OP, National Insurance Co. Ltd. through GTFS on 16.09.2008. Annexure – 2, 3 & 4 show that she made correspondence with the OPs on 10.07.09 and 13.07.09, but on the side of the Insurance Co. nothing was intimated her regarding settlement of her claim. The OP No. 3, GTFS has also categorically stated that he forwarded the claim application along with the documents filed by the complainant before the insurance Co. for settlement. There is no denial by the OP, Insurance Co. regarding the purchase of the policy by the deceased and also about his accidental death. The complainant has filed a Xerox copy of PM Report which shows that the victim expired due to an accident.
It is agitated on the side of the Insurance Co. that the complainant did not intimate the death news of the victim to him within one month since the time of death. From the documents filed by the complainant it is available that she intimated the death news of the victim to the Insurance Co. after three months since the date of accident. This delay cannot be treated as a gross mistake on the part of the petitioner as she being an illiterate person is not supposed to know all the rules and regulations of the policy. So this delay is condoned. The fact is that the complainant submitted the claim application along with other documents to the OP Insurance Co. through GTFS for settlement of her claim. She time and again requested the OP to settle her claim, but the fact is till the date of filing this case the OP Insurance Co. has neither settled her claim nor repudiated it. So we find that undoubtedly there is gross deficiency in service on the part of the OP, Insurance Co. for not disposing the claim application of the petitioner.
In view of the above discussions our considered view is that the complainant has become able to prove her case. So she is entitled to get the reliefs as prayed for. We pass no order against the OP No. 3 as per MOU between the OP No. 3 and the Insurance Co. as the liability to settle the claim of the complainant rests upon the OP Insurance Co. In result the case succeeds. Hence, Ordered, That the case, CC/09/66 be and the same is decreed on contest against the OPs. The complainant is entitled to get Rs. 2,00,000/- + Rs. 5,000/- as compensation for harassment and mental agony caused to her + litigation cost of Rs. 2,000/-, i.e., in total Rs. 2,07,000/-. The OP No. 1 & 2 are jointly or severally directed to pay the decretal amount of Rs. 2,07,000/- to the complainant within a period of one month since the date of passing this order in default she is entitled to get interest @ 9% per annum upon the decretal amount since this date till the date of realization of the full amount. Let a copy of this judgment be delivered to the parties free of cost.
