Tripura

West Tripura

CC/6/2016

Sri Babul Ch. Sen. - Complainant(s)

Versus

Divisional Manager, National Insurance Co. Ltd. & 3 others. - Opp.Party(s)

Mr.H.Deb, Mr. P.Ghosh, Mr.T.Chaudhuri.

30 Aug 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSSAL FORUM
WEST TRIPURA :  AGARTALA

CASE   NO:   CC-06 of 2016 

Sri Babul Chandra Sen,
S/O- Late Surjyangshu Bimal Sen,
Bhattapukur Par, North Badharghat,
Tahasildar Tilla, P.O. A.D. Nagar,
P.S. A.D. Nagar, West Tripura.             ..…..…...Complainant.

       VERSUS

1. National Insurance Co. Ltd.,
represented by The Divisional Manager,
Akhaura Road, P.O. Agartala,
Agartala, West Tripura.

2. Branch Manager,
National Insurance Co. Ltd.,
Akhaura Road,
Agartala, West Tripura.    

3. Sri Debu Sen, C.I.S.F.
S/O- Sri Babul Chandra Sen,
G.Mint, Q. No. 210 (New Building),
Taratala, P.O.- New Alipur,
Kolkata- 700053.

4. Smt. Nibedita Sen,(De),
D/O- Sri Babul Chandra Sen,
W/O- K.C. Dey,
C.I.S.F. Unit IGY, Airport,
New Delhi, P.O. Bijwasan CF Company,
PIN- 61.                        .........Opposite parties.

      __________PRESENT__________

 SRI A. PAL,
PRESIDENT,
  DISTRICT CONSUMER  
DISPUTES REDRESSAL FORUM,
      WEST TRIPURA, AGARTALA. 

SMT. Dr. G. DEBNATH
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

SRI U. DAS
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

 

C O U N S E L

    For the Complainant        : Sri Himangshu Deb,
                          Sri Tanmay Choudhury,
                          Sri Prasanta Ghosh,
                          Advocates.
                         
For the Opposite parties        : Sri Ashish Nandi,
                      Advocate.

        JUDGMENT  DELIVERED  ON:  30.08.2016

J U D G M E N T

        This case arose on the petition filed by one Babul Chandra Sen. Case of the petitioner in short is that his wife Gita Rani Sen purchased a 'Janata Personal Accident Policy' from the O.P. Period of coverage was from 23.12.2001 to 22.12.2016. Insured sum was Rs.1 lakh. Petitioner was the nominee of the policy. Due to sudden accident  on 23.01.13 the insured Gita Rani Sen died. So, being the nominee and legal heir along with respondents No.3 and 4 he claimed the insured amount. All required documents were submitted before the insurance company. But the O.P. insurance company did not give any response, did not pay the insured sum. Policy claim was filed on 16.01.15. and it was accepted on the same date. But no action taken. 

2.        O.P. Insurance company appeared, filed W.S. denying the claim. Main contention of the O.P. is that the cause of action arose on the death of Gita Rani Sen on 23.01.13. Her husband being the nominee did not make any claim within 2 years. After 2 years the claim is barred. So, his claim is not entertained. There was no deficiency of service by O.P.

3.        On the basis of rival contention raised by both the parties following points cropped up for determination;
        (I) Whether the claim is barred by the limitation?
        (II)Whether the petitioner is entitled to get compensation for deficiency of service and the sum assured?
    
4.        Petitioner side produced the Janata personal Accidental policy Form, letter, certificate, insurance report, FIR, Final Report, Survival Certificate, Death Certificate marked as Exhibit-1 Series. Also  the petitioner, Babul Chandra Sen examined himself as a witness. 

5.        O.P. National Insurance Co. Ltd., on the other hand produced the statement on affidavit of Snehashish Das and also produced E-mail. 
On the basis of evidence on record we shall now determine the above points.
    FINDINGS:
7.        We have gone through the policy certificate Exhibit- 1 Series. It is admitted and established fact that Gita Rani Sen was the insured and petitioner was the nominee. Accidental death, permanent disablement was covered. Original policy certificate not produced by either party. Period of coverage is from 23.12.2001 to 22.12.2016. So it is admitted fact that within the coverage period life assured Gita Rani Sen died. Death certificate is produced to support that she died on 23rd January 2013. We have gone through the postmortem report. As per report there was 3 injuries over the dead body of Gita Rani Sen. As per opinion of doctor death is due to physical assault. Injury is homicidal in nature. Therefore it is an accidental death. As per decision of National Consumer Disputes Commission in Revision Petition No- 2824 of 2007 An injury caused by the willful or even criminal act of 3rd person, provided the insured is not party or privy to it is to be regarded as accidental for the purpose of policy, since from the insured point of view it is not expected or designed. Person injured resulting from any unlooked  mishap or occurrence is accidental. The Apex Court in Rita Devi Vrs. New India Assurance Co. Ltd. - 2000 SCC 113 also viewed in the same line. The death of Gita Rani Sen was on 23.01.13, the claim was filed within 2 years by 15.01.15. 

8.        O.P. witness, Snehashish Das stated in his affidavit that the necessary documents in original not filed before the National Insurance company in time. But he did not tell what documents were required. The claim is repudiated but the repudiation letter not produced before us. The claim form submitted on 16.01.15 within the 2 years. But claim was not satisfied. Even no repudiation letter was issued. On 13.01.16 when the claim was not satisfied this petition filed. The cause of action arose not from the date of death but from the date of repudiation of the claim by the Insurance company. In this case claim was made on 16.01.15 so, within 2 years this petition for getting compensation for deficiency of service is filed so it is not time barred.
9.        From the evidence on record it is admitted and established fact that petitioner is the nominee of the 'Janata Personal Accident Policy' purchased for his wife, Gita Rani Sen. Gita Rani Sen died by accident. Her death was unnatural and it as due to homicidal injury in which she was not a party. It was accidental death. Within 2 years policy claim was made. But the O.P. Insurance company failed to meet the demand. What documents are required not disclosed. Even the cause for repudiation not sent in writing. These are all deficiency of service. Petitioner is entitled to get compensation for that deficiency of service. 
10.            We therefore, direct the National Insurance Company to pay the insured amounts and all benefits of the policy to the nominee  who is to distribute the same to all his legal heirs. We also direct the O.P. to pay compensation of Rs.15,000/- for deficiency of service, also litigation cost of Rs.5000/-, in total Rs.1,20,000/- and  pay other benefits of the policy within 2 months. If the amount is not paid it will carry interest @ 9% P.A.

                     Announced.

SRI A. PAL
PRESIDENT,
DISTRICT CONSUMER  DISPUTES 
REDRESSAL FORUM,
WEST TRIPURA,  AGARTALA.

 

 

SMT. DR. G. DEBNATH,
MEMBER,
 DISTRICT CONSUMER DISPUTES 
REDRESSAL FORUM, 
WEST TRIPURA, AGARTALA    SRI U. DAS
MEMBER,
  DISTRICT CONSUMER 
DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.