Complaint case No. 74/2009 Date of disposal: 30/12/2009

Complainant/Petitioner/Plaintiff : MANJU DOLAI.

Defendant/O.P.S. : THE PEERLESS GENERAL FINANCE &

INVESTMENT CO. LTD. & OTHERS.

BEFORE : THE HON’BLE PRESIDENT : Mr. P. K. Sarkar.

MEMBER : Mr. S. Pal.

MEMBER : ********** For the Complainant/Petitioner/Plaintiff: Mr. A. K. Dutta.

For the Defendant/O.P.S. : Mr. D. K. Bhattacharya & Mr. M. Chowdhury.

Judgement/Order.

This case of complaint was filed by Smt. Manju Dolai W/o-late Ashis Dolai residing at Vill-Kharika, P.O.-Benachapra, P.S.-Keshpur, Dist- Paschim Medinipur against the Op. no.1,. the Peerless General Finance & Investment Co. Ltd. at shahoo Bhaban Opposite Zilla Parisad Bhaban, Post office Road, P.O.-Midnapore, Dist: Paschim Medinipur and the Op. no.2. the New India Assurance Co. Ltd./ Kolkata Divisional office-511700, 4, Mangoe lane, 2nd floor, Kolkata-700001 alleging that the Ops did not pay the death claim in respect of the certificate no.6480801/222 for accidental death of the insured late Ashis Dolai

The facts of the case are that Ashis Dolai (i.e. husband of the complainant) purchased the certificate no.6480801/222 on 28/04/2001 under table & term no. 52-07 from the Op. no.1 the financial institution wherein he made investment of his money. According to a ‘tie-up policy’ in between the Op. no.1 and Op. no.2, the Op no 2.issued a ‘tie-up insurance policy’ along with all facilities of accidental death benefit in favour of said Ashis Dolai and the said certificate was in the custody of the Op. no.1 and the complainant was appointed nominee of the said certificate. Unfortunately Ashis Dolai died 08/07/05 due to a road accident. After death of Ashis Dolai the complainant submitted claim along with all relevant papers in the office of the Op. no.1 and the Op. no.1 in turn sent the papers to the office of the Op. no.2. But the Op. no.2 repudiated the claim vide their letter dated 03/06/09. Hence this case of complaint was filed praying for issuance of direction upon the Ops. (i) to effect payment of Rs.1,00,000/- together with admissible interest thereon,(ii) to pay Rs.25,000/- towards compensation for harassment; and(ii) to pay cost of litigation, to the complainant.

Contd………….P/2

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The case has been contested by the Op. no.1 and Op. no.2 by filing their written objections separately.

The Op. no.1 Peerless General Finance & Investment Co. Ltd. contended interalia, that they are not liable to pay any ‘insurance claim’ as per provisions of the tie up Insurance policy. So the claim against them should be dismissed with cost.

The Op. no.2 contended interalia, that they asked the complainant to furnish the certified copy of P.M. report, and the inquest report and as the complainant did not submit those documents, they were compelled to repudiate her claim; that as per table no. 52 of the Op. no.1, in case of any accident, the nominee of the depositor would be entitled to a benefit to the extent of 5(five) times of the annual premium subject to a maximum amount of Rs.50,000/-; that as in the instant case the annual premium was Rs.1,000/- the complainant was entitled to a benefit of Rs.5,000/- (Rupees five thousand only); and that as the claim was repudiated due to non-submission of the aforesaid documents, they are not deficient in service as alleged by the complainant and as such the case should be dismissed with cost.

Upon the pleadings of both sides the following issues are framed for our consideration :

i) whether the case is maintainable in this Forum ?

ii) whether the Ops are deficient in service as alleged by the complainant ?

iii) To what relief/relief(s) is the complainant entitled ?

Decisions with reasons:

We have very carefully perused all the papers/documents filed in this case by both parties. We have also heard and considered the submissions made by the Ld. Lawyers on behalf of both parties.

Issue No.(i)

There is no dispute that Ashis Dolai purchased the certificate no. 6480801/222 from the Op. no.1 financial institution on 28/04/01 (i.e. during his life time) and accordingly he was covered under the Group Personal Accident Policy (accidental death only) of the New India Assurance Co. Ltd. Therefore the complainant being the nominee in the policy was a consumer of the Ops. as per provisions of section 2(i)d(ii) read with section 2(i)(g) and 2(1)(o) of C.P. Act, 1986 as amended from time to time. Therefore the case is maintainable in the Forum

Issue Nos.(ii) & (iii)

There is no dispute that the life of Ashis Dolai. was covered under the policy in question under table 52 of the Op. no.1 Peerless General Finance & Investment Co. Ltd. There is also no dispute that the complainant being the nominee in the policy was entitled to get 5 (five) times of the annual premium paid by the depositor, from the Op. no.1-financial institution in case his

Contd………….P/3





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accidental death. The counsel of the Op. no.1 submitted that they had paid the amount payable to the complainant in due time and transmitted the papers/documents to the Op. no.2 for doing the needful on their part. But the Op. no.2 repudiated the claim without any basis although the Op. no.1 was said to have transmitted the relevant papers/documents to the Op. no.2 after receiving the same from the complainant. They should have settled the claim immediately on receipt of the information regarding death of the insured and related papers from the Op. no.1. The Op. no.1 too should have pursued the matter with Op. no.2 as the complainant’ husband became the insured by virtue of making deposits in their organization. So it must be held that Op. no.2 was deficient in service for repudiating the claim of the complainant. As such the Op. no.2 should compensate the complainant appropriately. Thus the issues are decided in favour of the complainant.

Hence,

Ordered,

that the complainant be allowed on contest. The Op no.2 shall pay the complainant Rs.5,000/- together with Rs.230/- being the interest thereon @9% for the period from 18/06/09 to the date of this order within 30 (thirty) days from the date of communication of this order failing which interest shall apply @12 p.a. quarterly compounded on Rs.5,230/- for the delayed period.

The Op. no.2 shall also pay the complainant Rs.1,000/- (Rupees one thousand only) towards cost of litigation within the period as stipulated hereinabove.

Thus the case is disposed of on contest.

Let the copies of the judgement be supplied to the parties free of cost.

Dic. & Corrected by me