State Consumer Disputes Redressal Commission
Golden Trust Financial Services vs Achchalal Sah & Another on 25 August, 2010
State Consumer Disputes Redressal Commission
State Consumer Disputes Redressal
Commission
West Bengal
BHABANI BHAVAN
(GROUND FLOOR)
31, BELVEDERE ROAD,
ALIPORE
KOLKATA 700 027
S.C. CASE NO. : FA/226/2010
DATE OF FILING :
30.04.2010 DATE OF FINAL ORDER:
25.08.2010
APPELLANT
Golden Trust Financial Services
Basudeb Complex, Kadamtala,
P.O. & Dist. Jalpaiguri
Represented by its Partner.
RESPONDENTS
1. Achchalal Sah
Silposamity Para
P.O. & District-Jalpaiguri.
2. IFFCO-TOKIO
9/1, Motor Tower
1, Hochi Minh Sarani
Kolkata-700 071.
BEFORE : MEMBER : MRS. S.MAJUMDER
MEMBER : MR. S.COARI
FOR THE PETITIONER / APPELLANT : Mr. B.Mondal, Ld. Advocate
FOR THE RESPONDENT /
O.P.S.: Mr. P.R.Sinha Sarkar, Ld.
Advocate (Res.1)
Mr. D.Nath, Ld. Advocate (Res.2)
: O R D E R :
MR. S.COARI, LD. MEMBER The present Appeal has been directed against the judgement and order dt. 31.03.2010 passed by Jalpaiguri District Consumer Disputes Redressal Forum in C.C. No. 2009/59 wherein the Ld. District Forum decreed the case in part on contest against the Ops thereby holding the Ops jointly and severally liable for the claim amount of Rs. 1,50,000/- with the direction upon the Ops to pay the same to the complainant within one month from the date of the order together with compensation of Rs. 1,000/- and litigation cost of Rs. 300/-.
The complainant/Respondents case before the Ld. District Forum, in brief, was that the complainant obtained mediclaim policy from National Insurance Co. Ltd. for an assured sum of Rs. 2,00,000/- through the agent, G.T.F., the OP No. 1. The policy was renewed by the complainant for valuable consideration, but the OP No. 1 instead of renewing the policy a fresh policy was issued with IFFCO TOKIO General Insurance Co. There was no reason assigned for the change of insurance policy and the complainant was kept in dark in this regard. During valid coverage of the insurance policy the complainants son fell ill and had to be medically attended by the doctor at Bangalore and thereafter the son of the complainant underwent surgery for Arotic Valve replacement. The complainant had to incur medical expenses to the tune of Rs. 1,55,000/- and accordingly the complainant submitted the claim for reimbursement.
But after elapse of one year the Ops refused to settle the claim of the complainant and hence, the petition of complaint was filed.
The OP No. 1 contested the case by filing written version thereby denying all the material averments of the petition of complaint and took the plea of pre-existing disease and accordingly, prayed for dismissal of the petition of complaint.
Ld. District Forum while disposing of the petition of complaint has observed that the Ops have refused to settle the claim of the complainant without basis, rhyme and reason.
The complainant was entitled to have his claim settled and the denial/repudiation of the complainants claim tantamounted to deficiency in service and accordingly, disposed of the petition of complaint in favour of the complainant as mentioned above.
Being aggrieved and dissatisfied with such finding of the Ld. District Forum the OP No. 1/Appellant has preferred the present Appeal.
The only moot question that revolves round the present Appeal is as to whether the Ld. District Forum was justified enough in disposing of the petition of complaint in the manner as discussed above.
DECISION WITH REASONS At the time of hearing the Ld. Advocate for the Appellant, Golden Trust Financial Services, has submitted before us that the Ld. District Forum has totally ignored the actual state of affairs and the real controversy between the parties and as such, has arrived at a wrong and improper decision. According to the Ld. Advocate, the role of the Appellant/OP No. 1 was nothing but that of a simple transmitter of complainants claim to the Insurance Company and nothing else. According to the Ld. Advocate, sending of the petitioners claim to the Insurance Co. never tantamounted to any pecuniary obligation upon the Appellant.
While criticizing the impugned judgement the Ld. Advocate has urged before us that the Ld. District Forum upon some misconceived ideas and notions has unnecessarily held the Appellant/OP No. 1 to be responsible and liable to compensate the complainant. According to the Ld. Advocate, there was no point on the part of the Ld. District Forum to hold the Appellant jointly and severally liable for paying the complainant to the tune of Rs. 1,50,000/- along with compensation of Rs. 1,000/- and litigation cost of Rs. 300/-. While concluding his submissions the Ld. Advocate for the Appellant has submitted that the impugned judgement suffers from material defects inasmuch as the status of the Appellant was never considered by the Ld. District Forum and on this score alone the impugned judgement is liable to be set aside.
We have duly considered the submissions so put forward on behalf of the Appellant and have gone through the materials on record, pleadings of the parties and the impugned judgement and find that in this case the complainant has put forward a case to the effect that though the complainant and his son was well within the insurance coverage, but for reasons best known to the Ops the just and bonafide claim of the complainant was not settled. The OP No. 1/Appellant has put forward a case to the effect that there was no deficiency in service at the instance of the Appellant as claimed by the complainant and that the disease being a pre-existing one the complainant is not entitled to any relief whatsoever. On perusal of the impugned judgement we find that the Ld. District Forum has really appreciated the cases of respective parties reasonably well.
The standpoint taken by the Appellant is not at all acceptable inasmuch as both the Ops are definitely jointly and severally liable to the complainant for satisfying the just and proper claim of the complainant. In this regard, we agree to the finding of the Ld. District Forum so far as it relates to holding the Appellant responsible along with the OP No. 2/Insurance Co. in settling the claim of the complainant. Thus, from the foregoing discussion we find no merit in the present Appeal and the impugned judgement stands confirmed. In the result, the Appeal fails.
Hence, it is ORDERED that the Appeal stands dismissed on contest without any order as to cost.
The impugned judgement stands confirmed.
MEMBER MEMBER