State Consumer Disputes Redressal Commission
The New India Assurance Co. Ltd. & Anr. vs Rupa Samanta & Anr. on 18 November, 2014
STATE CONSUMER DISPUTES
REDRESSAL COMMISSION
WEST BENGAL
11A, Mirza Ghalib Street,
Kolkata - 700087
First Appeal No.
FA/858/2013
(Arisen out of Order
Dated 30/05/2013 in Case No. Complaint Case No. CC/120/2012 of District
Howrah)
1.
The New India Assurance Co. Ltd.
Howrah
Branch.
2.
The Div. Manager, The New India Assurance Co. Ltd.
Unit
No.512200, Madhusudan Apartment, P-18, Dobson Lane(2nd Floor),
Howrah-711 101 & Head Office, 87, Mahatma Gandhi Road, Fort, Mumbai
- 400 001.
...........Appellant(s)
Versus
1.
Rupa Samanta
W/o
Late Amiya Kumar Samanta, Vill. & P.O. - Binogram, Dist. - Hooghly,
Pin - 712 401.
2.
M/s. Golden Trust Financial Service (P) Ltd.
16,
R.N. Mukherjee Road, Kolkata - 700 001.
...........Respondent(s)
BEFORE:
HON'BLE
MR. DEBASIS BHATTACHARYA PRESIDING MEMBER
HON'BLE
MR. JAGANNATH BAG MEMBER
For
the Appellant:
Mr.
N. R. Mukherjee, Advocate
For
the Respondent:
Mr.
Sibaji Shankar Dhar.Mr. Amar Nath Sanyal., Advocate
Mr.
Abhik Kr. Dutt., Advocate
ORDER
Date: 18-11-2014 Sri Debasis Bhattacharya This appeal is directed against the order dt. 30-05-2013 in case No. 120/2012, passed by the ld. District Forum, Howrah, whereby the complaint case has been allowed. Being aggrieved and dissatisfied with the same, the OP Nos. 1 & 2 thereof have preferred this appeal.
The factual matrix of the Complainants case is that her husband, since deceased, was covered under an insurance policy namely Group Janata Personal Accident Insurance Policy being Policy No. 4751220001799/E No. 47-30861 of the OP No. 1, obtained through the OP No. 3, for an insured sum of Rs. 50,000/-. Her husband died on a road accident on 08-11-2007. Following such death, the Complainant intimated the OP No. 1 about such accidental death of her husband by a registered letter on 14-11-2007, with copy to the OP No. 3. The Complainant further sent a letter on 29-11-2007 through the OP No. 3 providing details of the insurance policy of her husband. On receipt of such intimation, the OP No. 2 vide its letter dated 16-01-2008 asked the Complainant to provide all documents in original. Accordingly, she provided the requisite documents including the Claim Form to the OP No. 2 through the OP No. 3 under cover of a letter dated 06-08-2008. When her repeated personal visits to the office of the OP No. 1 did not yield any positive result and after waiting for one year, she sent another letter on 06-03-2009 to the OP No. 2 through the Op No. 3 with a request to expedite settlement of her claim. The OP No. 3 also sent a letter to the OP No. 2 on 12-08-2009 for settlement of her claim. Besides, the OP No. 3 forwarded the original FIR and FRT to the OP No. 2 to facilitate settlement of Complainants claim. The Complainant also sent two letters to the OP No. 2 on 04-06-2010 and on 07-10-2012, as well as a lawyers notice on 31-07-2012. Unfortunately, all such efforts went in vain. So, the case.
The case of the OP Nos. 1 & 2 is that in terms of the MoU executed by and between the OP insurance company and the OP No. 3, three categories of persons were given and/or extended insurance coverage, viz, (1) The Investors and their family members, (2) Field workers and their family members and, (3) their friends. Subsequently, the insurance company vide its letter dated 07-05-1999, cancelled the said MoU against which, GTFS moved a writ petition before the Honble High Court, Calcutta being W.P. No. 1144 of 1999. After hearing the submission made by respective parties, His Lordship inter alia directed the OP No. 3 to collect premium from the category of Field workers and Investors and their family members only but not from friend category. In view of said order, the OP insurance company asked the Claimant as well as the OP No. 3 to disclose the status of the deceased insured along with documentary evidence. However, neither of them divulged such information to the OP no. 1 to enable them to process the claim of the Complainant. After the alleged death of the said beneficiary, the Complainant issued a letter to the OP No. 1 on 14-11-2007 intimating about the accidental death of her husband. The Op No. 1, in order to facilitate settlement of her claim, issued claim form vide letter dated 16-01-2008 and requested the Complainant to submit all relevant documents in original. The Complainant, however, instead of submitting original documents and without disclosing the status of the deceased beneficiary, submitted photocopies of documents vide her letter dated 06-05-2008. The OP No. 1 appointed one investigator, Mr. Gautam Naskar to investigate the actual cause of death and also the relationship of the deceased husband with GTFS. The said investigator after completion of his investigation on 24-08-2012 submitted his investigation report dated 24-08-2012 to the OP No. 2. When the said investigator visited the house of the deceased husband, he did not find the Claimant, Rupa Samanta. When he met the father of deceased husband, Nityananda Samanta, who informed the investigator that after six months from the death of Late Amiya Kumar Samanta, his wife, Rupa Samanta got married to another person and left the place along with her daughter. Further, it appears from the said report that since no proof regarding the status of the deceased beneficiary is provided, there is no scope to ascertain the eligibility of the Complainant to get insurance benefit. Non-furnishing of documentary evidence as to the status of the insured amply proves that her deceased husband was not an agent, investor or fieldworker of GTFS. Had it been so, the OP No. 3 would have definitely provided the necessary document in this regard. As per law, after her remarriage, the Complainant has ceased to be a legal heir of the deceased ex-husband, Amiya Kumar Samanta. As such, she has no right to claim the insurance benefit. Therefore, there is no deficiency in service on their part. Hence, the case should be dismissed with exemplary cost.
It is to be considered in this appeal as to whether the impugned order is sustainable from factual and/or legal perspectives, or not.
Decision with reasons Ld. Advocate for the Appellants has submitted that the insurance company had called for certain documents from the Complainant by a letter dated 16-01-2008, with a similar request to the OP No. 3, but none of them dared to reply that. During investigation, it was unearthed by Mr. Gautam Naskar, Investigator that the Complainant got remarried after six months of death of the insured and left the erstwhile in-laws house along with her daughter, and also his search for document pertaining to the status of the deceased insured from his father as well as the GTFS drew blank. On the contrary, he was informed by the father of the deceased insured that his son was purely a cultivator by profession. Moreover, his communication dated 11-08-2012 to the OP No. 3 also did not evoke any reply. By such remarriage, the claimant-complainant-cum-nominee has become a non-entity, as her identity got changed thereby. There were also two statements of the father of the deceased insured that his said son was not a staff or fieldworker of the OP No. 3, but only a policyholder and that he was associated with cultivation having a monthly income of Rs. 600/- or Rs. 7,200/- per annum. Such documents surely belie the claim of the Claimant in the matter.
Ld. Advocate for the Respondent No. 1 has submitted that the declaration by the father of the deceased was not a correct one and he merely signed the said papers, in order to augment the claim settlement. It is only a plea to oust her legitimate claim. There cannot be any dispute regarding status of the deceased insured as an Agent/Fieldworker of the GTFS, though he used to cultivate also, and it did not create any conflict of interest. All the papers for settling her claim was forward by the OP No. 3 to the OP No. 2 by a letter dated 19-05-2008. Further, the Agency Application Form of the deceased insured was filed before the Ld. District Forum. Mr. Asim Sengupta, who deposed for the OP No. 3, also certified it in his evidence. The so-called letters, as mentioned by the insurance company dated 16-01-2008 and 11-08-2012, have not been received by her at all. It cannot be said that the identification paper of the deceased insured as a worker of the OP No. 3 is a manufactured document. Further, he has referred to Sections 8 and 24 of the Hindu Succession Act, 1956 to reinforce that the remarriage took place after the succession opened, and also Section 39 of the Insurance Act, 1938, particularly, sub-section (6). Besides, he has also referred to certain decisions of the Honble Supreme Court reported in AIR 2008 SC 1467, AIR 1984 SC 346 and of the Honble Patna High Court reported in AIR 1983 Pat. 33. The Ld. Advocate further states that the survey report was totally wrong in its findings that the Complainant got remarried after six months from the death of insured because the Certificate of Marriage goes to show that it was after about 3 years.
Ld. Advocate for the Respondent No. 1 supported the contention of the Complainant so far the status of the deceased insured is concerned and also refers to three decisions of this Commission in FA Nos. 291/2011, 598/2013 and 668/2013.
There is nothing to dispute the association of the deceased insured with the GTFS concerned. The policy also does not put any bar upon a staff of GTFS to pursue other professions. There is a valid insurance paper in favour of the insured being issued by the insurer, which cannot be nullified outright. The claimant complainant-nominee is perfectly within her right to claim the insured sum from the OP insurance company. Remarriage does not affect her status as per the law of succession. Further, the reasoning given by the Ld. District Forum in disposing of the matter is in perfect sync with the peculiar facts and circumstances of the case, that of remarriage of the mother and the condition of the girl child, who has to live in the household of her stepfather. God forbids, situation does not worsen to her, as happens in case even when there is a stepmother, but, in this case it is a case of stepfather. Considering her age and situation, such a decision is indeed praiseworthy, particularly for the welfare and security of her daughter, including her education and marriage. Accordingly, we do not find any cogent ground to disturb such an order being passed by the Ld. District Forum.
In the result, the appeal fails.
Hence ORDERED that the appeal be and the same is dismissed on contest against the Respondents, but without any cost. The impugned order is hereby affirmed.
JAGANNATH BAG DEBASIS BHATTACHARYA MEMBER MEMBER