State Consumer Disputes Redressal Commission

West Bengal

BHABANI BHAVAN (GROUND FLOOR)

31, BELVEDERE ROAD, ALIPORE

KOLKATA – 700 027





S.C. CASE NO. FA/09/70



DATE OF FILING: 11.02.2009

DATE OF FINAL ORDER: 28.04.2009


APPELLANT


The Manager

The New India Assurance Co. Ltd.

Howrah Branch, Unit No.512200

Madhusudan Apartment

P-18, Dobson Lane, 2nd floor

Howrah - 1



RESPONDENTS



1) Bishnupada Manna

S/o Late Ghanashyam Manna

Vill – Kaukundu, P.O. – Dakshin Kasimnagar

P.S. – Mahisadal, Dist. – Purba Midnapur

2) The Manager

Golden Trust Financial Services

16, R.N. Mukherjee Road

Kolkata – 700 001



BEFORE : HON’BLE JUSTICE MR. A. CHAKRABARTI, PRESIDENT

MEMBER : MR. A.K. RAY

MEMBER : MRS. S. MAJUMDER



FOR THE APPELLANT : Mr. P. Banerjee, Advocate

FOR THE RESPONDENTS : Mr. N. Samanta, Advocate (No.1)

Mr. B. Mondal, Advocate (No.2)





: O R D E R :


HON’BLE JUSTICE MR. A. CHAKRABARTI, PRESIDENT





This appeal was filed by the appellant against the judgment dated 14.7.2008 passed by District Consumer Disputes Redressal Forum, Purba Medinipur in Case No.82 /2006 whereby the complaint was allowed against the Insurance Company and dismissed on contest against the OP2 and the complainant was held entitled to get Rs.50,000/- with an interest @ 9% per annum from OP1 from the date of filing of the case till payment.

The case in brief as made in the complaint is that the complainant met with an accident on 19.9.05 at about 8:30 a.m. by a lorry/truck when the complainant was operating a Rickshaw Van on NH 41 near Tajpur Bus stoppage. The complainant after being hit by the truck became unconscious with severe pain and injuries all over the body and ultimately suffered from permanent disablement. The complainant was admitted in a Nandakumar Primary Health Centre and, thereafter was referred to Medinipur District Sadar Hospital at Tamluk and again was referred to Nilratan Sarkar Medical College & Hospital in Kolkata where he was admitted on 20.9.05 and was discharged from the hospital on 04.10.05. The complainant lodged claim with the Insurance Company for the insured sum of Rs.1 lac with compound interest. As the claim was not paid the complaint was filed claiming the insured sum of Rs.1 lac with compound interest as also damages for harassment, physical injury and mental agony of Rs.40,000/-.

The Insurance Company filed its written objection stating that the OP1 never issued any single Policy in favour of the complainant but issued a Group Policy for various persons stated to be the Investors/Field Workers/Staff Members of the OP2 and Policy was issued on good faith under a memorandum of understanding between the two OPs. For good reasons the said MoU was cancelled whereupon challenging such cancellation a proceeding was initiated before the Hon’ble High Court at Kolkata in Writ Petition No.1144 of 1999 whereupon a Ld. Single Judge passed order on 07.7.99 directing OP2 not to collect any premium from the categories of friends/associates as mentioned in the MoU. After the aforesaid Interim Order the present Insurance Policy was issued and the Insurer refused to pay the claim amount on the ground that inspite of their repeated demand, no documentary evidence had been furnished to prove the insured to be investor or agent/field worker or their family members.

Heard Mr. P. Banerjee, the Ld. Advocate for the Appellant, Mr. Nemai Ch. Samanta for the Respondent No.1, Mr. Bibhas Mondal, the Ld. Advocate for the Respondent No.2.

The only contention on behalf of the Appellant Insurer is that after the Interim Order was passed in the year 1999 the present insurance policy was issued in the year 2000 by the Respondent No.2 and this was not a policy originally issued by the Insurer and, therefore, when the claim was received the Respondent 2 was enquired from as to what category the claim belong to and it is argued by Mr. Banerjee that when such intimation was not received either from the claimant or from the Respondent No.2, the claim could not be settled. On behalf of the Respondent No.2 documents have been produced including a letter dated 08.9.2000 issued by the Respondent No.2 to the present appellant being a covering letter enclosing cheques towards premium from Group Janata Personal Accident Investors, Field Workers and their family members. The contention of the Respondents is that when the policy was issued the premium was deposited with the appellant mentioning clearly therein that the insured belong to the group of field workers. Therefore, when the insurance was issued the premium was deposited with the appellant mentioning the policies issued in favour of field workers of the Respondent No.2 and their family members and, therefore, after accepting cheques from premium for long period accepting such facts, when the accident occurred and question of payment of benefit under the policy occurred, the Insurance Company is not entitled to refuse payment on the sole ground of questioning the status of the insured as to whether he belongs to friend category or not. Not disputing the category of the insured from the beginning and accepting the premium for years, the insured is not entitled to refuse the claim raising such controversy.

Accordingly, we do not find any ground to interfere with the impugned judgment and the appeal is accordingly dismissed and the impugned order is affirmed hereby. There will be no order as to costs.







(S. Majumder) (A.K. Ray) (Justice A. Chakrabarti)

MEMBER(L) MEMBER PRESIDENT