West Bengal

Paschim Midnapore

CC/80/2015

Smt. Mamata Khetua - Complainant(s)

Versus

Life Insurance Corporation Of India - Opp.Party(s)

22 Dec 2015

ORDER

                                                             DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

PASCHIM MEDINIPUR.

                             

Bibekananda Pramanik, President,

&

Mrs. Debi Sengupta, Member

Complaint Case No.80/2015

                                                       

                                          Smt. Mamata Khetua…………………………..….……Complainant.

Versus

1)Life Insurance Corporation of India, Divisional Office;

2) Life Insurance Corporation of India, Branch Office.…..Opp. Parties.

 

              For the Complainant : Mr. Asim Kumar Dutta, Advocate.

              For the O.P.                : Mr. Swapan Bhattacharjee, Advocate.

 

Decided on: - 22/12/2015

                               

ORDER

                          Bibekananda Pramanik, President - Facts of the case, in brief, is that the husband of the complainant, Ananta Khetua obtained an Insurance Policy  in his name from the opposite party on 28/03/2009 and the sum assured of that policy was Rs.75,000/-  and the date of maturity of that policy was on 28/03/2014. The complainant was the nominee of the said policy.  Thereafter, on18/08/2009 at about 12.30 hours, while Ananta Khetua had been working in the nursary of Asish Kamilya at Purusottampur, P.S. chandrakona, Dist. Paschim Medinipur was injured by snake bite and he was brought to Chandrakona Rural Hospital where he expired after few minutes.  Medical Officer of that hospital made a primary enquiry and found that Ananta Khetua died due to snake bite and as per report of the E.M.O, Chandrakona P.S.U.D case no.52/2009 dated 18/08/2009 was started and post mortem was held by the Medical Officer at Ghatal. Chandrakona  police collected the P.M. report during  investigation.  After the death of Ananta Khetua, the complainant, being the wife and nominee of that policy, filed an application along with all relevant documents in the office of the opposite party within time and she also deposited

Contd………………..P/2

 

 

 

 

( 2 )

all relevant papers along with original policy.  After receiving those documents, opposite party no.2 again sent a letter on 05/05/2014 and requested the complainant to submit papers, F.I.R., P.S. report and Viscera report for ascertaining the cause of death. During this 5 years, the opposite party tried to avoid in various way to settle the death claim.  Chandrakona Police Station also informed the opposite party about the death of the deceased on 25/01/2011. In spite of that, the opposite party did not settle the claim and tried to withheld the claim which tantamounts to repudiation of the claim and  such type of act also tantamounts to deficiency of service on the part of the opposite party.  Hence, the complaint, praying for directing the opposite party to pay the sum  assured of Rs.75,000/- and litigation cost of Rs.25,000/-.

         Opposite parties appeared in this case and by filing a W/O, they contested this case. Denying the allegation made in the petition of complaint,  it is the specific case of the opposite parties that the husband of the complainant Ananta Khetua was a bona fide policy holder of L.I.C. having his policy no.49994871 and the date of commencement of the said policy was on 28/03/2009 but the policy holder died on 11/08/2009.  After the death of her husband,  the complainant produced some irrelevant documents from which opposite party could not come to any conclusion about the cause of death of life assured.  Opposite parties requested the complainant to submit sufficient documents regarding the cause of death of the life assured.  The complainant claimed that her husband died due to snake bite but she miserably failed to produce any document before the opposite parties to substantiate her claim.  It is stated by the opposite parties that they are always ready to settle the sum assured to the complainant within the purview of the terms and conditions of the policy and relevant document regarding the cause of death of the life assured.  It is further claimed that the complainant’s present complaint is not tenable as per law and the same is liable to be rejected. 

                                                                                     Point for decision

                                                              Is the complainant entitled to get the reliefs, as sought for ?    

                   

Decision with reasons

       In this case, neither the complainant nor the opposite party adduced any evidence, either oral or documentary, but in support of her case, the complainant has filed few documents.

   From the respective pleadings of the parties, we find that it is not denied and disputed that Ananta Khetua, since deceased, the husband of the complainant, was a bona

Contd………………..P/3

 

 

 

 

( 3 )

fide policy holder of L.I.C.I and the date of commencement of the said policy was on 28/03/2009.  Admittedly, the husband of the complainant Ananta khetua died on 11/08/2009 and after the death of Ananta Khetua, the complainant being the nominee of the said policy filed an application before the opposite party for settling the death claim of the said policy.  According of the complainant, even after lapse of 5 years, the opposite party avoided in various ways to settle the death claim intentionally.  From the written objection of the opposite party we find that although the complainant claimed that her husband died due to snake bite but she failed to produce any document regarding the cause of death of her husband and as such they are unable to settle the claim.  At the time of hearing of argument, Ld. Lawyer for the complainant draws our attention to a letter dated 25/01/2011, issued by O.C. Chandrakona P.S. informing the Branch Manager of the Op.  that the deceased Ananta Khetua was brought dead to Chandrakona Rural Hospital, Paschim Medinipur on 11/08/2009 afternoon at reported from the M.O.,  Chandrakona Rural Hospital and preliminary enquiry reveals that the deceased sustained injury by snake bite on 11/08/2009 at about 12.30 hours while he was working in the  nursary of Asish Kamilya.  Ld. Lawyer for the opposite party submitted that although post mortem was held on the dead body of Ananta Khetua but the autopsy surgeon kept his opinion pending till receipt of the report of chemical examination of viscera and therefore the cause of death of the insured was not known to them for which the opposite party is unable to settle the claim of the policy.  From the post mortem report, submitted by the complainant, we also find that the autopsy surgeon kept his opinion pending regarding the death of the deceased for want of report of chemical examination of viscera.  As against this,  Ld Lawyer for the complainant referred a ruling reported in 2015 (1) CPR 162 (NC) and submitted that in that case,  the deceased died due to snake bite and in that case no post mortem examination was not at all conducted and in spite of that, relying on the report of Village Administrative Officer and the doctor,  who treated the deceased, Hon’ble NCDRC held that there is not justifiable ground to disbelieve the Village Administrative Officer and the doctor, who treated the deceased and therefore Hon’ble NCDRC uphold the order of the District Forum regarding directing the opposite party - Insurance Company to pay the insured amount and compensation with cost.  Here in the present case also we find that the deceased Ananta Khetua was brought dead with the history of snake bite injury and the Officer-in-charge of Chandrakona P.S. also informed the opposite party - Insurance Company that on primary enquiry it was revealed that the deceased sustained injury by snake bite and he died due to such snake bite.  The said report of O.C Chandrakona P.S.

Contd………………..P/4

 

 

 

 

( 4 )

undoubtedly indicates that the death of the insured had occurred due to snake bite and therefore the claim of the petitioner should have been allowed by the opposite party -Insurance Company and the ground taken by them in delaying the settlement of the claim for want of cause of death was not justified.  In view of that and in view of the said decision of the Hon’ble NCDRC, we are of the view that there is no justifiable ground to disbelieve the report of the O.C Chandrakona P.S. The petition of complaint is therefore deserves to be allowed.

 

                                                Hence, it is,

                                                                    Ordered,

                                                                               that the complaint case no.80/2015 is allowed on contest.  The opposite parties are directed to pay the sum assured of Rs.75,000/- with interest @ 8% p.a. and to pay compensation of Rs.15,000/- and litigation cost of Rs.5000/- to the complainant - nominee of the deceased insured within a month from this date of order. 

             Dictated & Corrected by me

                                

                        President                                 Member                                         President

                                                                                                                          District Forum

                                                                                                                       Paschim Medinipur