SENIOR DIVISIONAL MANAGER, NEW INDIA ASSURANCE COMPANY LIMITED Vs. UMA KAR W/O AKSHAY KAR AND ORS
LAWS(WBCDRC)-2009-7-2
WEST BENGAL STATE CONSUMER DISPUTE REDRESSAL COMMISSION
Decided on July 09,2009

Senior Divisional Manager, New India Assurance Company Limited Appellant
VERSUS
Uma Kar W/O Akshay Kar And Ors Respondents

JUDGEMENT

- (1.)THE present appeal has arisen out of the judgment passed by the Ld. District Forum, Paschim Medinipur, on 17.10.2008, in its case no -52/2008, wherein the Ld. Forum below allowing the complaint on contest against the OP -2 and dismissed against the OP -1 has directed the OP - 2 to pay Rs.3,00,000/ - to the Complainant together with Rs.37,125/ - being the interest @9% p.a. for the period from 01.10.2007 to the date of the judgment within 30 days from the date of communication of the judgment, failing which interest would apply @12% with quaterly rests on the whole amount i.e. Rs.3,37,125/ - payable to the Complainant on the date date of the judgment for the delayed period. The OP -2 was also directed to pay a sum of Rs.2000/ - to the Complainant as litigation cost.
(2.)THE brief facts of the case of the Complainant before the Forum below were that her husband, since deceased obtained a Janata Personal Accident Policy during his life time on 15.12.2000 covering a period from 15.12.2000 to 14.12.2015 and the sum assured was of Rs.3,00,000/ -. The insured -husband of the Complainant died due to train accident on 15.02.2007 and the said incident was informed to the OP -1 and as per their advice the Complainant being the sole nominee of the said policy submitted the claim form along with all relevant documents to the OP -2. But till date of filing the complaint before the Forum below the OPs did not settle the claim and hence she filed the complaint against the OPs praying for direction against the OPs to pay her the assured sum along with interest, cost and compensation.
(3.)BEING aggrieved by the above -mentioned judgment the Insurance Company -Appellant has preferred the present appeal contending that the Appellant did not receive any claim from the Complainant and so they are not liable to pay the claim. It has been stated by the Appellant that as per MOU by and between the Insurance Company and the GTFS, the GTFS were under the obligation to extend the policy to the investors, their family members, field workers and their friends. The premium was collected and remitted to the Appellant by the GTFS periodically and a computerized certificate in the name of New India Assurance was issued to each policyholders. The Ld. Counsel for the Appellant has submitted that nowhere it has been stated by the GTFS that under which category the insured belonged. It has been further stated by the Appellant that after the issuance of such group policy, the same was reviewed by the GIC at the instance of the GIC and the understanding between the Insurance Company and the G.T.F.S was cancelled. Such cancellation was challenged before the Hon'ble High Court by the G.T.F.S and by an order dated 06.07.1999 the Hon'ble High Court has stayed the cancellation of MOU and directed the G.T.F.S not to collect premium from the "Friend" category. It was the incumbent upon the claimant as well as the GTFS to establish the status of the claimant by way of documentary evidence to establish that the insured does not fall under the category of 'Friends' as the Hon'ble High Court has barred this category. According to the Appellant the judgment of the Forum below is liable to be quashed and he has prayed for allowing the present appeal. Being dissatisfied with the above -mentioned judgment passed by the Ld. Forum the OP no -3 -Insurance Company has preferred the present appeal before this Commission contending that the Appellant did not receive any claims of the Complainant and so they are not liable to pay the claim. It has been stated by the Appellant that as per MOU by and between the Insurance Company and the GTFS, the GTFS were under the obligation to extend the policy to the investors, their family members, field workers and their friends. The premium was collected and remitted to the Appellant by the GTFS periodically and a computerized certificate in the name of New India Assurance was issued to each policyholders. The Ld. Counsel for the Appellant has submitted that nowhere it has been stated by the GTFS that under which category the insured belonged. It has further stated by the Appellant that after the issuance of such group policy, the same was reviewed by the GIC at the instance of the GIC and the understanding between the Insurance Company and the G.T.F.S was cancelled. Such cancellation was challenged before the Hon'ble High Court by the G.T.F.S and by an order dated 06.07.1999 the Hon'ble High Court has stayed the cancellation of MOU and directed the G.T.F.S not to collect premium from the "Friend" category. The Ld. Counsel for the Appellant has mentioned in the memorandum of appeal that the law is settled that impossibility to render service does not tantamount to deficiency in service. If the Appellant due to non -submission of appropriate documents cannot consider an insurance claim, the same cannot be termed as deficiency in service. It was the incumbent upon the claimant as well as the GTFS to establish the status of the claimant by way of documentary evidence to establish that the insured does not fall under the category of 'Friends' as the Hon'ble High Court has barred this category. According to the Appellant the judgment of the Forum below is liable to be quashed and he has prayed for allowing the present appeal.
On careful consideration of the record and document it is seen by us that there is no doubt that the deceased husband of the present Respondent -1 took a Janata Personal Accident Policy from the Appellant -Insurance Company through their agent GTFS as per Memorandum of understanding and it was settled that the nominee of the deceased insured will be entitled to get the assured money in case of accidental death of the insured. In the instant case it is an admitted fact that the insured died due to train accident and the Insurance Company did not contradict the same. As per MOU the agent -GTFS after collecting the premiums from the insured deposited the same with the Insurance Company and thereafter the Insurance Company issued the policy certificate in the name of the deceased husband of the Respondent -1 where the Respondent -1 -Complainant has been declared as legal a nominee. So, the Respondent no -1 is the real beneficiary of the Insurance Policy and there has not any reason or justification to deprive her from the legitimate claim. Due to quarrel in between the Insurance Company and its Agent the claim of the Respondent -1 cannot be affected. In course of hearing the Ld. Counsel for the Appellant has submitted that the GTFS has not declared that in which category the insured belonged as in a case the Hon'ble High Court has directed the GTFS not to collect any premium from the 'Friends' category. The Ld. Counsel for the GTFS has filed a document from which it is evident that the said insured was the 'Field Worker' of the GTFS. The deceased husband of the Respondent no -1 paid the premium in time to the G.T.F.S taking it as an agent of the Insurance Company in good faith and his nominee is not supposed to suffer in the matter of getting maturity value of the Insurance Policy due to any such conflict between G.T.F.S and the Insurance Company. In this connection the GTFS has contended that it had already paid the entire premium to the Appellant paid by the Respondent no -1 and the deceased took the policy being a filed worker not under the 'Friends' category. The Appellant has not filed any document against such contention as evidence that the insured was not within the permitted category. The GTFS is an agent of the Insurance Company and whether the agent violated any instruction of the principal or what might be the effect of such disobedience is exclusively a matter in between the two. As per the principle of vicarious liability, the principal will be responsible for all acts and omissions of the agents to a third party. At any rate, the Complainant -Respondent no -1, the real insured, cannot be compelled to suffer due to such quarrel between the two. As the Insurance Company did not settle the claim for a long period inspite of receipt of the policy and other documents in original, the Complainant moved before the District Forum.



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