Calcutta High Court (Appellete Side)
Monoranjan Mukherjee vs The New India Assurance Company Limited on 22 April, 2010
Author: Soumitra Pal
Bench: Soumitra Pal
1
22.04.2010. W.P. 13359 (W) of 2008
Monoranjan Mukherjee
Vs
The New India Assurance Company Limited
& Others
Mr. Arnab Chakraborty.
... For Petitioner
Mr. Anindya Lahiri.
... For Respondent No. 3
In this writ petition, the petitioner, aged about 81 years, has prayed for a direction upon the New India Assurance Company Limited and on the Senior Divisional Manager, New India Assurance Company Limited, Howrah Divisional Officers Unit No. 512200, the respondent nos. 1 and 2 respectively to settle the claim of Rs. 5 Lacs as the insured capital sum under the policy certificate being no. 4751220001607/E. No. 47-30195 on the basis of the documents submitted with the said respondents.
The matter was moved on 4th March, 2009 when after hearing the learned advocates for the parties directions were issued for filing of affidavits. The Golden Trust Financial Services, the respondent no. 3 has filed the affidavit in opposition. However, no affidavit has been filed on behalf of the respondent 2 nos. 1 and 2.
It appears from the writ petition that the son of the petitioner- Arunanshu Mukherjee- was covered under the Group Janata Personal Accident Insurance Policy (in short 'the policy') issued by the respondent no. 1 covering the risk of accidental death, loss of limbs and permanent total disablement for an overall capital sum insured of Rs. 5 Lacs. The said insurance coverage was an extension granted by the respondent no. 1 under a Group Insurance Policy issued in the name of the respondent no. 3 with a view to grant the insurance coverage to the field workers, investors and their family members and their friends also. The said insurance coverage was extended by the respondent no. 1 pursuant to the terms of Memorandum of Understanding dated 30th December, 1998 executed by and between the respondent no. 1 and the respondent no. 3. Pursuant to the proposal given by the son of the petitioner an insurance certificate was issued in favour of his son covering the risk period commencing from 23rd March, 1999, that is, the date of issuance of the certificate, which was to expire on 22nd March, 2009. Under the certificate the petitioner, being the father of the insured person, was the nominee. The said certificate was issued by the respondent no. 1 as insurer in favour of the son of the petitioner, after submission of the proposal form filled 3 up by Arunanshu Mukherjee himself. According to the petitioner, the insurance coverage was extended to Arunanshu Mukherjee on the basis of the proposal and declaration submitted to the company and after completion of all formalities. It has been stated that on 19th March, 2004 Arunanshu Mukherjee, the son of the petitioner unfortunately met with a road accident. He was immediately admitted to a hospital. However, he later succumbed to the injuries. An F.I.R. was lodged. After the death, post mortem was conducted and death certificate was issued by the hospital authorities. The petitioner by letter dated 25th March, 2004 gave claim intimation to the respondent nos. 1 and 3. The respondent no. 3 by letter dated 21st April, 2004 redirected the original intimation letter along with the photocopy of the insurance certificate to the respondent no. 2 for issuance of claim form to the petitioner. The respondent no. 2 by letter dated 26th May, 2004 acknowledged the receipt of the letter and requested to return the claim form duly completed and signed together with the documents in original which have been mentioned therein. Thereafter, the petitioner by letters dated 28th July, 2004, 14th August, 2004, 17th November, 2004, 6th January, 2005, 22nd March, 2005 and 10th May, 2005 intimated the respondent that since the final police investigation report was awaited, he could not submit the claim form along with all the required documents.
4However, after obtaining the required documents as sought for by the respondent nos. 1 and 2, by letter dated 10th September, 2005 the petitioner forwarded the claim form along with all requisite documents to the respondent no. 2. Thereafter, the respondent no. 2 by letter dated 28th November, 2005 requested the petitioner to furnish the original documents which according to the petitioner were sent for further processing of the claim. However, again by a letter dated 27th March, 2006 the respondent no. 2 requested the respondent no. 3 to furnish certain documents mentioned therein for early processing of the claim and sought for the reasons and the basis for granting the sum insured mentioned in the certificate. The respondent no.2 by a letter dated 27th March, 2006 also sought certain clarifications and documents from the petitioner. The petitioner by letter dated 5th April, 2006 replied thereto. According to the petitioner, since the respondent nos. 1 and 2 failed and/or neglected to settle his claim, repeated letters were issued to the said respondents but without any effect.
Learned advocate appearing on behalf of the respondent no. 3 relying on the affidavit in opposition submitted that all documentary evidence and declaration had been provided before issuance of the insurance certificate and upon being satisfied, the 5 certificate of insurance was issued by the insurer. It has been stated that the documents sought for in the letter dated 27th March, 2006 cannot be supplied as the same are not lying with the respondent no. 3.
The short question is whether in the facts and circumstances of the case the respondent nos. 1 and 2 were justified in withholding the claim of the petitioner in respect of the insurance policy issued in favour of his son.
It is admitted position that pursuant to the proposal and declaration submitted with the respondent nos. 1 and 2 and subject to the terms and conditions under the policy, insurance certificate was issued. The petitioner by letter dated 25th March, 2004 had intimated about the unfortunate death of his son and request was made to the respondent no. 2 for issuance of the claim form to the petitioner. The respondent nos. 1 and 2 by letter dated 26th May, 2004 requested for submission of certain documents in original which the petitioner did by letter dated 10th September, 2005. Thereafter, the respondent no. 2 by letter dated 28th November, 2005 requested for submission of original documents and sought for certain clarifications which too were submitted by the petitioner on 15th January, 2006. Thereafter, by letter dated 27th March, 2006 the respondent nos. 1 and 2 6 sought certain clarifications which was replied to by the petitioner on 5th April, 2006. So it appears that all along the petitioner had done his part of the duty as he replied to the queries of the respondent nos. 1 and
2. It is also evident from the affidavit in opposition of the respondent no. 3 that the said respondent had supplied all the documents to the respondent nos. 1 and 2. Therefore, there has been no lack of endeavour either on the part of the petitioner or on the part of the respondent no. 3 in intimating, clarifying and/or supplying the documents as were sought for by the respondent nos. 1 and 2. However, it appears that the respondent nos. 1 and 2 by letter dated 27th March, 2006 addressed to the respondent no. 3 had, amongst others, sought that "the reason and basis for granting sum insured mentioned in the certificate in which category deceased insured falls as per MOU agreement". In my view, since it is evident from the copy of the certificate, being annexure P-2 to the writ petition, that the respondent nos. 1 and 2 had given the said certificate after being satisfied with the "proposal and declarations submitted to the company," such query in the said letter issued to the respondent no. 3 is uncalled for. In my view, once certificate has been issued by the respondent nos. 1 and 2 "as per the proposal and declarations submitted to the company", it cannot be reopened. In the instant case, I find though the petitioner, an octogenarian, 7 has been knocking the doors of the respondent nos. 1 and 2 for settlement of the claim, his appeals have gone unanswered. I find there is absolute silence on the part of the respondent nos. 1 and 2 after the letter dated 27th March, 2006, though the petitioner, thereafter, had made several representations. Moreover, it has to be borne in mind that the statements in the petition have to be accepted since no affidavit in opposition has been filed on behalf of the respondent nos. 1 and 2. Therefore, considering the submissions and the facts, the respondent nos. 1 and 2 are directed to settle the claim of the petitioner as mentioned in the certificate, being annexure P-2 to the writ petition, without raising any further query within a period of eight weeks from the date of furnishing the certified copy of this order. So far as the oral prayer of the petitioner for payment of damages and interest, the petitioner is at liberty to approach the appropriate forum.
The writ petition is disposed of.
There will be no order as to costs.
Urgent photostat certified copy of this order, if applied for, be supplied to the petitioner and the respondent no. 3 on priority basis.
8(SOUMITRA PAL, J )