DATE OF FILING: 12.09.2012.
DATE OF DISPOSAL: 13.6.2016.
Miss S.L.Pattnaik, President.
Alleging deficiency in service against the Opposite Parties, the present complaint is filed by the complainant claiming the insured amount of Rs.1,00,000/- (Rupees one lakh) with interest from the date of claim towards policy alongwith compensation of Rs.20,000/- and Rs.10,000/- respectively sustained by the complainant towards loss and litigation cost and any other relief as deemed fit in the interest of justice.
2. Brief facts of the case of the complainant is that, his son late Santosh Gouda had obtained one insurance policy under the name and style Group Janata personal Accident Insurance Policy vide policy No.100300/47/01/9600022 for a sum of Rs.1,00,000/- (Rupees one lakh) only dated 23.6.2003 from the Opposite Party No.1 namely National Insurance Company ltd through Opposite Party No.2 namely Golden Trust Financial services and the complainant was the nominee in the said policy. During subsistence of the said policy, the insured died on 4.7.2007 due to vehicular accident. So the complainant being the nominee lodged a claim against this policy with the O.P.No.1 through O.P.No.2 alongwith the original insurance policy and other relevant documents as per requirement vide claim application No.47200790000861 dated 5.11.2007, but the said claim has not been paid to him . Finding no other way out, the complainant issued a legal notice to the O.Ps on dated 15.10.2009 to which the O.P.No.1 remained silent but O.P.No.2 had given reply on dated 4.11.2009 to the complainant that he has already intimated to the O.P.No.1 to settle the claim. On dated 10.9.2010 again the O.P.No.1 after a long gap issued a letter to the complainant directing him to submit his bank details, disbursement voucher, and affidavit. Accordingly the complainant submitted all the said papers on 3.11.2011 to the O.P.No.1. Complainant further submits that inspite of receiving all the required papers, the O.P.No.1 remained silent. Again being aggrieved, the complainant on dated 20.3.2012 issued legal notice to the O.P.No.1 demanding the claim amount but in vain. So being constrained by the deficiency in service by the O.Ps the complainant filed this complaint claiming the amount under the policy and compensation etc.
The complainant in support of his case filed the following documents alongwith written arguments which are attached to the case record.
(A) Xerox copy of letter No. 0417 dated 12th June 2009 of Golden Trust Financial services to OP No.1.
(B) Xerox copy of advocate notice dt.15.10.2009.
( C ) Xerox copy of letter from O.P.No.2 to Advocate GR Tripathy, dt.4.11.2009.
(D) Xerox copy of letter of Advocate to O.P. No.2 .
(E) Xerox copy of letter from O.P.No.1 to Brundaban Gouda intimating sending of disbursement voucher in duplicate for Rs.1,00,000/- dt.10.9.2010.
(F) Xerox copy of letter Brundaban Gouda to O.P. No.1 dated 3.11.2011.
(G) Xerox of Regd. Letter from Gyanaranjan Tripathy, Advocate to the Insurance Company dt.20.3.2012 with postal receipt.
3. On perusal of the copy of letter dated 12.6.2009 from O.P.No.2 to O.P.No.1 for early disposal of the claim amount/copy of letter dated 4.11.2009 of O.P.No.2 to complainant as well as to O.P.No.1/ and copy of letter from O.P.No.1 to complainant intimating sending of disbursement voucher in duplicate for Rs.1,00,000/-. It is clear that there is no dispute with regard to the policy taken by the deceased son of complainant and also there is no denial of O.Ps regarding the claim amount of the policy and also there is no repudiation by the O.Ps at any point of time regarding the policy. On perusal of the copy of letter of Advocate to O.P.No.2 we became clear that the complainant has submitted the relevant documents before the O.Ps. It is the settled principle of law that the insurance policy between the insurer and the insured represents a contract between the parties. Since the insurer undertakes to compensate the loss suffered by the insured on account of risks covered by the insurance policy, the Insurance Company bound to pay the insured amount. Refusal or delay or neglect to make payment amounts to deficiency in service. In the instant case though notices were issued the O.Ps but they did not obey the order of the Forum and did not counter the allegation of complainant through any oral or any documentary evidence. So in the absence of the O.Ps and in the absence of any documentary evidence by them, the forum considered the contentions of the complainant including submission of original policy bond before the O.Ps. From this activities of O.Ps we became clear that if the O.Ps have not given due regards to the court proceeding how they would regards to their customer. Since the O.Ps did not pay any heed to the claim of the complainant and did not preferred to settle the claim of the complainant, they are also liable to pay the compensation for causing mental agony and harassment to the complainant. Hence ordered.
In the result, the complaint is allowed. The Opposite Parties are directed to pay the insurance amount of Rs.1,00,000/- (Rupees one lakh) only to the complainant in respect of the Policy No.100300/47/01/9600022 alongwith compensation of Rs.2000/- (Rupees two thousand) only for loss mental agony, harassment and litigation cost within two months from the date of receipt of the order failing which the awarded amount shall carry 6% interest per annum till the date of realization of amount. This case is disposed of accordingly.
Order is pronounced in the open Forum today on 13th June 2016.
Copies of the order be supplied to the parties free of cost.
