State Consumer Disputes Redressal Commission
Branch Manager vs Refeja Bibi on 26 September, 2014
Daily Order STATE CONSUMER DISPUTES REDRESSAL COMMISSION WEST BENGAL 11A, Mirza Ghalib Street, Kolkata - 700087 First Appeal No. FA/1162/2013 (Arisen out of Order Dated 05/09/2013 in Case No. CC/145/2010 of District Murshidabad) 1. Branch Manager, The New India Assurance Co. Ltd. Howrah Branch, Unit No.512 200, Madhusudan Apartment, P-18, Dobson Lane (2nd Floor), Howrah. 2. Branch Manager, The New India Assurance Co. Ltd. Berhampore Branch, P.O. & P.S. - Berhampore, Dist. Murshidabad. ...........Appellant(s) Versus 1. Refeja Bibi @ Afeja Bibi W/o Late Ayub Khan, Vill. Amarpur, P.O. Dodpur, P.S. Rejinagar, Dist. Murshidabad. 2. Golden Trust Financial Service Represented by its Br. Manager, Birpara Bazar, P.O. & P.S. - Birpara, Dist. Jalpaiguri. ...........Respondent(s) BEFORE: HON'BLE MR. DEBASIS BHATTACHARYA PRESIDING MEMBER HON'BLE MR. JAGANNATH BAG MEMBER For the Appellant: For the Respondent: ORDER : O R D E R : MR. J.BAG, LD. MEMBER
The present appeal is directed against the order dated 05.09.13 passed by the Ld. District Consumer Disputes Redressal Forum, Mursidabad in Case No. CC/145/10 whereby, Ld. Forum below allowed the complaint case on contest against OP No.1 and dismissed against OP No. 2& 3 without order as to costs.
Complainant's case , in brief, was as follows:
The Complainants husband Late Ayub Khan had purchased a Group Janata Personal Accident Insurance Policy of the OP Insurance Company for a sum insured of Rs. 3 lakh and the policy was valid from 31.3.2000 to 30.3.2015 . The Complainant is the nominee in respect of the policy. The insured died on 10.03.05 in a Road Traffic Accident (RTA) . The incident was registered under Berhampur P.S Case No. 98/2005 dated 10.03.05 U/S 279/338/304/(A)/427 IPC and Postmortem held at Berhampur N.G. Hospital . The Complainant reported the matter to the Insurance Company and claimed the amount filing necessary documents. No response came from OP No.1 and thereafter she again went to the OP on 05.10.2009 still there was no Respondents. The cause of action arose on and from 16.12.2009 when the Complainant last visited the office of OP No.1. The Complainant thereafter filed a complaint before the Ld. Forum below with the prayer for direction by the OP No.1 to pay the claim sum of Rs. 3 lakh with compensation of Rs. 1 lakh for harassment, physical and mental agony suffered by the Complainant.
The complaint was contested by the OP/Respondent by filing W.V. whereby the OP Insurance Company denied all materials allegation and contending that the case was barred by limitation. Further it was contended that neither the Complainant not the JTFS provided any documentary prove regarding status of the policy holder. As per Hon'ble Court ordered the JTFS was prohibited from collecting premium from category of friends and as such it was the necessary to establish the identity of the certificate holder. OP No. 3 GTFS also filed a W.V. and submitted that after observing all necessary formalities, premium was collected from the insured and after transfer of the said premium to the insurer the certificate on insurance was issued since there was not involved in any financial liability in the matter of settlement of claim. They have discharged their duties and the insurer is liable to settle the claim.
Ld. Forum below after having authorized the material on record decided that the complaint was to be allowed. Accordingly, OP No.1 New India Assurance Company was directed to pay the amount of Rs. 3 lakh within 2 months from the date of order failing which an interest @ 9% p.a will accrue upon the awarded amount from the date of filing of the case.
Being aggrieved by and dissatisfied with the order of the Ld. Forum below. The OP Appellant has come up before this Commission with the prayer for direction to set aside the impugned order. Ld. Advocate appearing for the Appellant submitted that the deceased husband of the Complainant was not an employee or agent or field worker of GTFS . He was an Government Contractor and jointly or supplies who carried on his proprietorship under the name and style of M/S Khan Construction having their office at Village Amarpur , P.O - Dadpur, P.S. Rajunagar, District- Murshidabad. The insured was not within the category of persons who were entitled to get the benefit of the subject policy. It was further emphasized that the Hon'ble Calcutta High Court excluded the persons under friends category from being covered by the Group Janta Personal Accident Policy and as such the status of the deceased was very much required before settlement of the claim. No document in support of the claim that the Complainant's husband was a field worker, accordingly the claim was not entitled and the order of the Ld. Forum below is erroneous.
Ld. Advocate appear for the Respondent No.1 submitted that the Insurance Company issued the policy in favour of deceased insured after scrutiny of all documents required for the purpose of filing a proposal and upon payment on premium, the policy was valid when the accident took place and the insured died. The plea of the Insurance Company to refuse the benefit of the policy is a deficiency in service on the part of the Insurance Company. It is not tenable , the Ld. Forum's order should be held.
Ld. Advocate appearing for the Respondent No.2 submitted that the certificate of Insurance issued by the Insurance Company was the evidence of the Insurance Contract as accepted approved and authenticated by the Appellant Insurance Company. In their judgment Hon'ble Justice Pranab Kr Chattopadhyay reported in 2005 (3) CHN 154 (Bimal Chg-vs-New India Insurance Company Ltd and Ors) whereby the identity of the insured person as a field worker as well as the relationship of the insured person and Golden Trust Financial Services being insured facilitator have been well dealed in an amplified manner giving appropriate importance to the premium to the forwarding list mentioning the status of the insured person as filed worker / investors and acknowledgement by the New India Insurance Company. We have gone through the memorandum of appeal together with copies of the impugned order , the petition of complaint , the certificate issued by the Appellant New India Assurance Company and other documents .
Decision with reasons:
There is no dispute that the insurance company certified vide their Certificate No. 0175232/990000276241 DO /BO Berhampore that the deceased Ayub Khan was covered under Group Janata Personal Accident Insurance Policy . The nominee Mrs. Refeja Bibi is the wife of the deceased and appears to be the Complainant in the present case. The policy was surely issued after full satisfaction of the Insurance Company about the status of the insured. Verification of status after the death of the insured for the purpose of settlement of insurance claim is not in conformity with the policy condition . Ld. Forum below has dealt with the complaint from all aspects and rightly adjudicated the matter . We find no reason to interfere with the impugned order . The appeal does not succeed. Hence ORDERED that the appeal be and the same is dismissed. The impugned order is confirmed. There shall be no order as to costs.
Sd/- Sd/- Sri Jagannath Bag Sri Debasis Bhattacharya (Member) (Member) [HON'BLE MR. DEBASIS BHATTACHARYA] PRESIDING MEMBER [HON'BLE MR. JAGANNATH BAG] MEMBER