This is a petition filed by one Smt. Thagita Das (hereinafter referred to as the petitioner) against the Golden Trust Financial Services and Two Others (hereinafter referred to as the opposite parties) U/S 12 of the consumer Protection Act, 1986 praying for recovery of money, compensation and other relief.
- The facts and circumstances for filing of the aforesaid petition as narrated by the petitioner are as follows:-
The husband of the complainant, namely, deceased Kalinath Das opened a policy with the Golden Trust Financial Services having one Branch Office at A.T. Road, Mongolunia Bhavan, Haibargaon, Nagaon, Assam, vide Group Janta Personal Accident Insurance policy No.100300/47/01/9600022/03/96/30442 covering period from 23/03/2004 to 22/03/2019 for sum assured Rs.5,00,000/- (Rupees Five Lakhs)only and the present petitioner was made a nominee holder for the said policy. Further case of the complainant is that the policyholder Kalinath Das on last 22/12/2006 met with a road accident and died on that day and thereafter, the complainant intimated the opposite parties about the death of her husband Kalinath Das and being his nominee for the abovementioned policy lodged her claim before the opposite parties along with all relevant documents to get the insurance benefit but no policy amount had ever been paid by the opposite parties after repeated request from the complainant and having no alternative, the complainant served demand notice on 08-05-2014 and advocate notice on 28-10/2016 to which the opposite parties did not response. The complainant submitted that she being the nominee of the deceased policy holder entitled to get the insurance benefit against the said policy but the opposite parties without any sufficient cause has not disposed her claim for which the complainant has to suffer irreparable loss and mental agony and such acts on the part of the opposite parties amounts to deficiency of service on their part. Hence, this claim petition is before this Commission praying for the relief.
The opposite party No.1 filed their written statement denying their liability to pay the insurance amount to the claimant. They admitted the fact that the petitioner’s husband deceased Kaliram Das opened a policy with them vide Group Janta Personal Accident Insurance policy No.100300/47/01/9600022/03/96/30442 2019 for sum assured Rs.5,00,000/- (Rupees Five Lakhs)only and submitted that according to the Memorandum of understanding existing between National Insurance Company Ltd, Division III, 8 India Exchange Place, Kolkata-700001 and this answering opposite parties, to extend the insurance coverage to the member under the said Group Janta Personal Accident Insurance policy, the National Insurance Company Ltd, Division III, 8 India Exchange Place, Kolkata-700001 have an exclusive right and authority to entertain, process and settle such claim and the answering opposite party No.1 has no role to play in this regard or has any authority. The opposite party No.1 further submits that they are never jointly and severally liable to settle the claim of the complainant and it solely with the insurer National Insurance Company Ltd. The opposite party No.1 further submitted that all the relevant documents in support of the accidental claim made by the complainant were forwarded to the Insurer National Insurance Co. Ltd and it is difficult to appreciate the reason for so much delay in taking decision by the insurer in the matter of disposing the claim of the claimant.
The opposite party No. 2 and 3 filed their written version denying all the claim of the petitioner leveled against them. By their written version, the opposite party No.2 and 3 pleaded inter- alia that there is no cause of action for the complainant to file the petition and that the petition is unsustainable in law and liable to be dismissed. The opposite party No. 2 and 3 also submitted that the complaint of the complainant is time barred as the deceased died on last 22-06-2006 and the claim petition was filed in the year 2017, i.e. after lapse of 10 years. The answering Opposite parties further submitted that they are not required to indemnify the deceased Kalinath Das as because the opposite party No.1, namely Golden Trust Financial Services committed breach of Contract with these answering opposite parties while the complainant did not take any step against the opposite party No.1 to release the amount from it and the complainant is not entitled to any relief against these answering opposite parties. Under the above premises, the opposite party No. 2 and 3 pray for dismissal of the complaint petition against them.
- Upon pleading of parties the following points are found for discussion and decision in the case.
- Whether the opposite party No.1 to 3 illegally denied to extend the benefit to the complainant for the insured policy vide Group Janta Personal Accident Insurance policy No.100300/47/01/ 9600022/03/96/30442 for sum assured Rs.5,00,000/- (Rupees Five Lakhs) only as nominee for the deceased policy holder Kalinath Das without any justified cause and such act on the part of opposite party No.1 to 3 amounts to deficiency in service?
- Whether the claimant is entitled to any relief as prayed for?
4. The complainant filed evidence in affidavit of one witness and also exhibited several documents in support of her claim. The opposite party No.2 and 3 filed written Statement and cross-examined the P.W. while the opposite party No.1 though filed written Statement but did not cross examined the P.W. The opposite parties also did not adduce any evidence of their own.
6. Decision and reasons thereof:-
7. For the sake of brevity both the Point (i) & (ii) are taken jointly for discussion and decision:-
The claim of the complainant is that her husband deceased Kalinath Das opened a policy with the Golden Trust Financial Services for sum assured Rs.5,00,000/- (Rupees Five Lakhs)only and appointed her as his nominee and on his death in a road accident, she being his wife and nominee filed her claim for getting the insurance benefit of the policy of her husband but the opposite parties without any justified cause has not settle her claim and refused to provide her with the insurance benefit. In support of her claim, she as P.W.1 adduced evidence to the effect that her husband deceased Kalinath Das opened a policy with the Golden Trust Financial Services having one Branch Office at A.T. Road, Mongolunia Bhavan, Haibargaon, Nagaon, Assam vide Group Janta Personal Accident Insurance policy No.100300/47/01/9600022 /03/96/30442 covering the period from 23/03/2004 to 22/03/2019 for sum assured Rs.5,00,000/- (Rupees Five Lakhs)only and the present petitioner was made a nominee holder for the said policy. Further evidence of the complainant is that the policy holder Kalinath Das on last 22/12/2006 met with a road accident and died on that day and thereafter, she being his nominee for the abovementioned policy lodged her claim before the opposite parties along with all relevant documents to get the insurance benefit but no policy amount had ever been paid to her by the opposite parties after repeated request from her and having no alternative, she served demand notice on last 08-05-2014 and advocate notice on last 28-10/2016 to which the opposite parties did not response. Further evidence of the P.W.1 is that she being the nominee of the deceased policy holder entitled to get the insurance benefit against the said policy but the opposite parties without any sufficient cause did not dispose her claim for which she has to suffer irreparable loss and mental agony and such acts on the part of the opposite parties amounts to deficiency of service on their part.
The opposite party No.1 while filing its written version denied their liability to pay the insurance amount to the claimant. They admitted the fact of opening the insurance policy with them vide Group Janta Personal Accident Insurance policy No.100300/47/01/9600022/03/96/30442 2019 for sum assured Rs.5,00,000/- (Rupees Five Lakhs) only by the petitioner’s late husband. They also submitted that according to the Memorandum of understanding existing between this opposite parties and the National Insurance Company Ltd, Division III, 8 India Exchange Place, Kolkata-700001, to extend the insurance coverage to the member under the said Group Janta Personal Accident Insurance policy, the National Insurance Company Ltd, Division III, 8 India Exchange Place, Kolkata-700001 have an exclusive right and authority to entertain, process and settle such claim and the answering opposite party No.1 has no role to play in this regard nor has any authority. The opposite party No.1 further submitted that they are never jointly and severally liable to settle the claim of the complainant and it solely with the insurer National Insurance Company Ltd. to settle the opposite party No.1 further submitted that all the relevant documents in support of the accidental claim made by the complainant were forwarded to the Insurer National Insurance Co. Ltd and it is difficult to appreciate the reason for so much delay in taking decision by the insurer in the matter of disposing the claim of the claimant. The opposite party No. 2 and 3 in their written version submitted that they are not required to indemnify the deceased Kalinath Das as because the opposite party No.1, committed breach of Contract with them while the complainant did not take any step against the opposite party No.1 to release the amount from it and she is not entitled to get any relief from the opposite party No. 2 & 3. However, the opposite party No.2 and 3 though cross-examined the P.W.1 but did not adduce any evidence in support of their written version that the opposite party No.1, committed breach of Contract with them. The opposite party No.1 also neither cross examined the P.W.1 nor adduce any evidence to show that they are not liable to pay the insurance amount to the claimant and according to the memorandum of understanding between it and the National Insurance Company Ltd. Division III, India Exchange place Kolkata- 700001 the National Insurance Co. has the exclusive authority to dispose the claim of the claimant. Hon’ble Apex Court in many judicial pronouncement specifically stated that mere filing of written statement is not sufficient unless supported by evidence. In the instant case, the opposite party Nos.1 to 3 have failed to adduce any evidence in support of their respective written version for reasons best known to them. In view of above observation we are of the opinion that the complainant has successfully established that there is a deficiency of service on the part of the opposite parties.
In result both the points for discussion and decision are answered in affirmative and go in favour of the complainant.
O R D E R
8. In view of the above discussion, it is found that the petitioner has succeeded to prove that there was a deficiency of service on the part of opposite parties.
Accordingly, the prayer made by the petitioner U/S 12 of the Consumer protection is allowed on contest. All the parties are held to be jointly liable to pay the insurance amount to the claimant. Issue direction to the opposite parties to pay the complainant the insurance benefit for insured policy No. Group Janta Personal Accident Insurance policy No.100300/47/01/9600022/ 03/96/30442 of deceased policy holder Kalinath Das as per terms and condition of the policy with interest @ 12 per annum from today till realization.
Inform all the parties concern.
Given under the hand and seal of this Commission, we signed and delivered this Judgment on this 4th Day of July 2022.
