Ld. Advocate(s)
For Complainant: Makbul Rahaman
For OP/OPs : Swapan Ghosh
Date of filing of the case :20.12.2021
Date of Disposal of the case : 20.07.2023
Final Order / Judgment dtd. 20.07.2023
Complainant above name filed the present complaint u/s 35 Consumer Protection Act 2019 praying for direction to the OP no. 1 and 2 to pay 1,50,000/- as accidental benefit , interest @ 12 per annum, compensation amounting to Rs. 1,00,000/-, cost of the case and other relief.
She further alleged that her husband during his life time purchased one LIC Policy and during policy tenure he died on 18.01.2020 in an accident (RTA).
Relating to the said accident Bhowanipur P.S started U.D case 76/2020 dtd 18.01.2020 and examination over the dead body of her husband took place at SSKM Hospital vide no. PM no.136/2020. As per said policy complainant was entitled to Rs. 1,50,000/- as sum assured as accidental benefit amounting to Rs.1,50,000/- in her favour but they did not paid accidental death benefit amounting to Rs.1,50,000/- in favour of the complainant. Hence the complainant filed this case.
OP no. 1 and 2 contest this case by filing W/V. They denied the entire allegation of the complaint. They further stated that they paid sum assured of Rs. 1,50,000/- in favour of the complainant. They further stated that complainant ignored rules and regulation of LIC. Letter of LIC dtd 16.10.2020 by which they requested the complainant to submit some documents.
OP no. 1 and 2 are not bound to pay accidental death benefit amounting to Rs. 1,50,000/- in favour of the complainant. They prayed for dismissal of the case.
TRIAL
During trial complainant filed affidavit-in-chief. OP no. 1 and 2 filed questionnaire and complainant gave answer.
OP no. 1 and 2 filed affidavit-in-chief. Complainant filed interrogatories and they filed answer.
DOCUMENTS
Complainant produced following documents:
1.Xerox copy of Policy. (annexure :1) one sheet.
2.Original death certificate of Pradip Banik (1 sheet original ).
3. Copy of BED HEAD TICKET duly attested by medical office . (2 sheets original ).
4.Crimation certificate . (1 sheet original ).
5. letter of Commissioner of Police, Kolkata dtd. 22.09.2020. (One sheet original)
6. FIR of UD case dtd. 18.01.2020. (Two sheets original)
7. Letter of Commissioner of police, Kolkata dtd. 29.09.2020. (One sheet original).
8. Particulars of occurrence dtd. 29.08.2020.( one sheet original).
9. Letter of LIC dtd. 16.10.2020 ( one sheet Xerox copy)
10. Claim statement. (Two sheet Xerox copy).
11. Medical Attendant’s Certificate (two sheets Xerox copy).
12. Certificate of hospital treatment (one sheet Xerox copy).
13. Certificate of identity and burial or cremation. (One sheet Xerox).
14. Disposal order dtd. 18.01.2020 (one sheet original).
15. Claim of complainant dtd. 29.09.2021 ( one sheet Xerox).
16. Xerox copy of front page of passbook of complainant.( one sheet Xerox ).
BNA
Complainant filed BNA . OP no. 1 and 2 filed BNA.
DECISION WITH REASONS
We have carefully gone through the petition of complaint filed by the complainant, W/V filed by the OP no. 1 and 2, affidavit-in-chief filed by the complainant affidavit filed by the OP no. 1 and 2, documents filed by the complainant, BNA filed by the complainant and BNA filed by the OP no. 1 and 2.
We have carefully considered these documents.
It is admitted position that complainant’s husband during his life time had purchased one LIC Police vide no. 406216169 and said policy was started on and from 29.03.2019 and due date of last premium is 18.11.2034.
Complainant’s husband paid quarterly premium amounting to Rs. 22,200/-. Said policy covered with accidental benefit rider and for the said benefit complainant’s husband used to pay Rs. 18.75 per quarters in favour of the OPs. We found that during valid period of said policy complainant’s husband Pradip Banik met with an road traffic accident.
On perusal of documents dtd. 29.08.2020 issued by O/C Bhowanipur P.S, we find that on 13.12.2019 at about 11:45 Pm said Pradip Banik met with an accident over NH34 Gandhimore, under P.S Nakashipara , Nadia and received RTA injury and he was shifted to Bethuadahari Rural Hospital, later on 26.12.2019 he was referred to SSKM Hospital, Kolkata, being referred from Shaktiganger Dist Hospital and NRS Medical College & Hospital, Kolkata , and expired on 18.01.2020 at 07:50 hours at the said Hospital having history of TRA injury.
On perusal of Bed Head ticket of SSKM Hospital we found that complainant’s husband Pradip Banik sustained head injury due to road traffic accident and on perusal of P.M report dtd. 18.01.2020 we found Autopsy Surgeon at the time of P.M examination found series of injury over the body of complainant’s husband which was caused due to accidental injury.
On perusal of report of Medical Officer SSKM Hospital which was prepared in the prescribed form of OP no. 1 and 2 we found that complainant’s husband Pradip Banik sustained injury in the road traffic accident. We also found from the another documents issued by SSKM Hospital in the prescribed form of OP no. 1 and 2, we found that Doctor of SSKM Hospital clearly considered that Pradip Banik sustained injury due to accident.
On perusal of original death certificate we found that Pradip Banik died on 18.01.2020 at SSKM Hospital. We have carefully gone though other documents.
We have carefully gone though the affidavit-in-chief filed by the complainant.
We have carefully gone though the affidavit-in-chief filed by the OP no. 1 and 2.
We found that complainant corroborated her allegation mentioned in complaint in her affidavit-in-chief and no contradiction has been found from the answer of the complainant. She submitted answer as per interrogatories of the OP no. 1 and 2. Accordingly, we do not find any reason to disbelieve the affidavit-in-chief of the complainant.
We have carefully gone though the affidavit-in-chief of the OP no. 1 and 2, but they failed to show any proper reason in support of the fact that complainant is not authorised to get the accidental benefit.
Considered the documents. We found that complainant is the consumer and OP no. 1 and 2 are the service provider.
Having regard to the aforesaid discussion and considering the evidence of the both parties, we found that complainant has able to established her grievance. Accordingly she is entitle to relief as per her prayer.
In the result present case succeeds.
Hence,
It is
Ordered
that the present case be and the same is allowed on contest against OP no. 1 and 2 with cost of Rs. 5,000/- to be paid by OP no. 1 and 2 -5 in favour of the complainant.
OP no. 1 and 2 jointly or severally are directed to pay Rs. 1,50,000/- as accidental death benefit in respect of LIC Policy vide no. 406216169 along with interest @ 9 % per annum form the date of 29.10.2020( from the date of receipt of claim application form the complainant) to till date of actual payment.
OP no. 1 and 2 jointly or severally are directed to pay Rs. 50,000/- as compensation in favour of the complainant for her harassment, mental pain and agony.
OP no. 1 and 2 are directed to comply the aforesaid order within 45 days from this date failing which complainant shall have liberty to put this order into execution.
Let a copy of this order be supplied to both the parties as free of cost.
Dictated & corrected by me
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PRESIDENT
(Shri DAMAN PROSAD BISWAS,) .................................................
PRESIDENT
(Shri DAMAN PROSAD BISWAS,)
We, concur,
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MEMBER MEMBER
(NIROD BARAN ROY CHOWDHURY) (SMT MILLIKA SAMADDAR)
