West Bengal

Birbhum

CC/53/2021

Lajina Begum - Complainant(s)

Versus

Divisional Manager, NICL, - Opp.Party(s)

Sanjit kr Achaarya

21 Aug 2024

ORDER

J U D G E M E N T

Shri Sudip Majumder  President in Charge.

            The complainant/petitioner files this case U/S 35 of Consumer Protection Act, 2019. The fact of the case in brief is that the petitioner/complainant, Lajina Begum           is the wife and beneficiary of the insured person, Late Sekh Intaj Ali as she is the nominee of the said insurance policy.

It is the case of the complainant that Sk. Intaj Ali was the good life card holder of Hero Motor Corporation. The said Sk. Intaj Ali purchased the card after paying fee of Rs. 175/. The said good life card holder was covered under personal accident insurance policy of OP being policy No. 355100/42/20/10000006, Card No. 1083520500000076 sum assured Rs. 1,00,000/- and as such Sk. Intaj Ali was the insured under the opposite party insurance company.

It is the further case of the complainant that the insured came into the contact of the electric wire which was tore down upon the body of the insured and in its’ consequence he was severely burnt/injured. Immediately after occurrence, he was taken to Sultanpur B.P.H.C wherein he was declared dead. That thereafter inquest upon the dead body of Sk. Intaj Ali was held and it was sent for postmortem before the Suri Sadar Hospital. That the postmortem was done over the dead body of the insured SK. Injaj Ali by Dr. Shankar Prasad Das on 13/09/2020 and he opined that death was due to the injuries as a result of electrocution as noted above-anti mortem in nature.

It is the next case of the complainant that as the insured died in electrocution one U.D case being No. 10/2020 dated 13/09/2020 was started by Panrui P.S. and the final report of police U/s 174 Cr.P.C was submitted to the Ld. Magistrate and those documents have been sent before the Insurance Company. That the postmortem report was also sent to the Insurance Company. That inspite of submission of all those documents, the Insurance Company claimed that further documents unnecessary.

 

Hence, after finding no other alternative the complainant is compelled to file this case before this Forum/Commission against the OP/Insurance Comapny for proper reliefs and he has prayed to the Commission, viz -

“(a) To pass an order directing the OP to pay Rs. 2,00,000/ as death claim of the insured.

            (b) To pass an order directing the OP to pay a sum of Rs. 50,000/ as compensation for harassment and mental agony.

            (c) To pass an order directing the OP to pay Rs. 10,000/ as litigation cost.

            (d) Other relief or reliefs.”

            The OP/Insurance Company stated in Page 3 of their written version as: “…… OP Insurance Company very rightly no claim due to NON SUBMISSION OF REQUISITE DOCUMENTS with is gross violation of policy conditions.”

It appears from the case record that the OP/Insurance Company filed their written version and

written notes of arguments. The OP/Insurance Company did not filed evidence in chief. The OP/Insurance Company denied all the complaints against them.

The Complainant’s side submitted evidence in chief and written notes of arguments. Some documents have also been filed by the complainant which were compared with the original ones and found to be same/identical. Thereafter, the Ld. Advocates for the both parties made oral arguments in support of their case.

Heard Ld. Advocates for the both parties.

            Considered.

            Perused all the documents.

Points for determination/Issues

1.  Whether the complainant is a consumer as per definition of the term ‘Consumer’ of the C.P Act. ?
2. Whether this Commission has jurisdiction to try this case?
3. Whether there is any deficiency in service on the part of the Op?
4. Whether the complainant is entitled to get any other relief or reliefs as prayed for?

Decision with reasons

Point No. 1:

            In this case, the deceased Sk Intaj Ali being the “Good Life Card Holder” who purchased the same on payment of proper fees and which covered personal accident insurance policy, was a consumer under the OP/National Insurance Company Ltd. and the complainant being the nominee as well as the beneficiary of the deceased, is a consumer under the OP/National Insurance Company Ltd. and the

OP/National Insurance Company Ltd. is the service provider. Hence, the complainant is a consumer as per Sec. 2(7)(ii) of the Consumer Protection Act, 2019.

 

Point No. 2:

In this case, the cause of action arose from 21/09/2020. The case has been filed on 03/08/2021 and as such it can be said that the complainant has filed this case within the statutory period of the C.P. Act, 2019 and as such the instant complaint is not barred by Section 69(1) of the C.P. Act, 2019.

Pecuniary Jurisdiction of this District Commission as per Notification No. G.S.R. 892(E). dated 20th December, 2022 by Consumer Affairs Department, Govt. of India, New Delhi i.e. Rs. 50 lakh.

The complainant is a resident of Vill.- Palashi, P.O. Talibpur, P.S. Panrui and Dist.- Birbhum, West Bengal which is under the Territorial Jurisdiction of this District Commission as per Sec. 34(2) of C.P. Act, 2019.

            Hence, this Commission has Pecuniary Jurisdiction as well as Territorial Jurisdiction on the present issue

Point No. 3:

            We have gone through the records of this case. The insured Sk Intaj Ali died in electrocution accidentally and the insurance policy had cover under personal accident claim and the opinion of the doctor of postmortem that the death was due to electrocution and as such the claim of the complainant in respect of death of Sk Intaj Ali is genuine and his wife/complainant is entitled to get the death claim of the said insured.

            It is the submission of the Ld. Advocate for the OP/Insurance Company that the OP did not repudiate the claim of the complainant but they denied and closed the claim due to non-submission of requisite documents.

            It appears from the documentary evidence as available from the case record that the complainant submitted the photocopy of the said insurance policy/certificate/Bond, Post Mortem Report.

            We have examined the Post-Mortem Report dated 13/09/2020. From this paper it is established that the victim died due to the injuries as a result of electrocution as noted above as anti-mortem in nature.

But, the OP/National Insurance Company Ltd. on several occasions harassed the complainant and did not pay Rs. 1,00,000/(One lakh only) as the personal accident insurance claim to the beneficiary/ complainant which proved beyond all reasonable doubt that there is/was deficiency in service as per    Sec. 2(11) of the C.P. Act, 2019.

Hence, from the above discussion it is proved that the complainant has able to prove her case beyond all reasonable doubt.

 

Point No. 4:

For this deficiency in service the complainant is well entitled to get the relief/relieves from the instant case.

We observed that the complainant stated in the prayer portion of her plaint as: “To pass an order directing the OP to pay Rs. 2,00,000/ as death claim of the insured.” But, the sum assured of the policy in question is/was Rs. 1,00,000/. It is an established principle in law that the insurance claim cannot beyond/above the sum assured. So, if we ordered for pay Rs. 1,00,000/ to the complainant as insurance claim it will be just and proper.

• In Chengalrayan Cooperative Sugar Mills Vs. Oriental Insurance Co. Ltd. & Anr. (2000) 10 SCC 213 it was held that “Interest ought to have been awarded from the date on which the claim was filed before the Forum.”
• In Krishna Bhagya Jala Nigam Ltd. Vs. G. Harishchandra Reddy & Anr. (2007) 2 SCC 720 it was held that “Only 9% interest be awarded on refund matter.”

            In the instant case as per view of the Hon’ble Apex Court in several cases the interest will be given @ 9% p.a. calculating from the date of filing of this case.

Hence, it is,

            O R D E R E D,

                                    that the instant C.C. Case No. CC/53/2021 be and same is allowed

on contest with cost.

The OP/National Insurance Company Limited is directed to pay Rs. 1,00,000/ (One lakh only) to the complainant as insurance claim to the complainant along with interest thereon @ 9% per annum calculating on and from 03/08/2021 (i.e. from the date of filing of this case) and pay Rs. 5,000/ (Five thousand only) to the complainant as cost of litigation.

The entire decree will be complied by the OP/Insurance Company within 45 (Forty five) days

from this date of order, in default of which, the complainant is at liberty to put this order to execution in accordance with law.

 The instant case is thus disposed of.

Let a copy of this order be given/handed over to the parties to this case free of cost.