NEW INDIA ASSURANCE COMPANY LIMITED Vs. CHANDANA MITRA

JUDGEMENT

(1.) -THIS appeal has arisen against the judgment passed by the learned District Forum, Howrah, on 16. 12. 2005 in its case No. HDF 102/2005, wherein the learned Forum below has allowed the complaint in part on contest against the OP Nos. 1 and 2 and dismissed on contest against the OP No. 3 and directed the OPs 1 and 2 to pay a sum of Rs. 2,00,000 to the complainant along with the interest @ 10% p. a. from the date of filing the complaint till the full payment within one month from the date of passing the judgment. The Forum has awarded cost of Rs. 500 in favour of the complainant and directed the OP Nos. 1 and 2 to pay the cost amount within one month from the date of passing the judgment.

(2.) THE brief facts of the case of the complainant before the Forum below were that the deceased husband of the complainant obtained an insurance policy namely Janata Personal Accident Policy for the period from 23. 7. 1999 to 22. 7 2014. The said husband of the complainant died on 1. 10. 2001 by a road accident at Brace Bridge on the Hide Road. The deceased was an employee under GTFS as a field worker. The GTFS is an agent of the OP Nos. 1 and 2 Insurance Company insofar as the collection of premiums of the Insurance Policy is concerned. The deceased had deposited the premium to the office of the OP No. 1 and obtained the Janata Personal Accident Insurance Policy. According to the policy the prime liability of payment of insured sum in the event of death, etc. was on the OP Nos. 1 and 2 and the GTFS being merely a service provider who has no authority to settle the claim. The total insured amount was of Rs. 2,00,000. After the death of the insured, an F. I. R. was lodged at Taratala Police Station. The complainant being the legal heir, submitted the claim form along with all necessary documents to the OP through the OP No. 3 on 11. 4. 2002. Thereafter as per the letter of the OPs the complainant again filed the copy of the FIR and other documents on 8. 5. 2003. The OP No. 3 asked the OP Nos. 1 and 2 to expedite the settlement of the claim of the complainant. Though the claim was registered, there was no response for a long period from the end of the OP Nos. 1 and 2. Thereafter the complainant made several representations regarding payment of her legitimate claim, but to no effect. Till the date of filing the complaint before the learned Forum below no positive action was taken by the OP Nos. 1 and 2 for settling the claim. The allegation of the complainant is that such inaction on behalf of the OP Nos. 1 and 2 is arbitrary and harassing and there was deliberate negligence in performing duty on the part of the OPs. Thereafter, finding no other alternative the complainant filed the complaint before the District Forum praying for direction upon the OP Nos. 1 and 2 to pay her the full policy money of Rs. 2,00,000 together with interest, litigation cost and compensation.

(3.) BEING dissatisfied with the above mentioned judgment passed by the learned Forum the Insurance Company has preferred the present appeal before this Commission contending that it is an admitted fact that the present respondent No. 1 took the Janata Personal Accident Insurance Policy, but the said policy was in the name of Golden Trust Financial Service being the insured, its field workers, agents, their family members and friends were the Group to be covered under such policy. The learned Counsel for the appellant has submitted that the deceased husband of the respondent No. 1 was an employee as a field worker and member of the GTFS Group and extended such coverage at the instance of Golden Trust, the said coverage was for fifteen years and it was a personal accident coverage for a sum of Rs. 2,00,000. It has further been stated by the appellant that after the issuance of such group policy, the same was reviewed by the GIC and at the instance of the GIC, the understanding between the Insurance Company and the GTFS was cancelled. Such cancellation was challenged before the Hon'ble High Court by the GTFS and by an order dated 6. 7. 1999 the Hon'ble High Court has stayed the cancellation of MOU and directed the GTFS not to collect premium from the "friend" category. According to the appellant the present respondent No. 1 having not entered into any contract of insurance directly with the Insurance Company, cannot be treated as the insured and it is the GTFS with which the Insurance Company entered into its agreement of insurance was the real insured and the respondent No. 1 is not entitled legally to maintain/lodge any such case before a Consumer Court under the Consumer Protection Act, as he was not the consumer under the apellant-Insurance Company and from that point of view the complaint is not maintainable and should be dismissed on that score.