Ld. Advocate(s)

                             For Complainant: Makbul Rahaman

                             For OP/OPs :Joydip Mitra

            Date of filing of the case                      :20.06.2022

            Date of Disposal  of the case              :25.04.2024

Final Order / Judgment dtd.25.04.2024

The dispute relating to purchase of insurance policy and failure to recovery  the policy money dragged  the complainant  to lodge the case against the OPs. The basic fact of the case of the complainant is that  the husband of the complainant no.1 Putul Dey purchased  a Motor Cycle  bearing no. WB-52AL-7419 from the  OP No.2,  Manager  Royal Auto Mobile , Krishnagar Branch which was  insured  with OP No.1 Manager, Go Digit General Insurance  Limited  having policy no. D039733208 from  07.07.2021 to 06.07.2022 for a premium of Rs. 2,634/- with P. A cover  Rs.15,00,000/-, purchased  through EMISP under OP No.2. The policy  holder Indrajit Dey  met with an accident  on 21.10.2021 and died on 21.10.2021 against which U.D case no. 585/2021 dated 22.10.2021 was registered  and P.M was held  on 22.10.2021. At that time  the policy was valid. After  the death of the said Indrajit Dey the insured  the complainant no.1 being the wife of the  insured  informed  the matter to the OP No.1. The OP no.1 then appointed   an investigator  who investigated  the matter and collected all the documents  like Insurance Policy, D.L, P.M Paper, Death Certificate final report of U.D case, Voter Identity Card, Aadhar Card, R.C Book, Bank Account, Perform  and Certificate etc. The OP No.1 sent one letter to furnish  some documents  against which  the complainant replied  on 23.05.2022 that no specific  case was  started  and as such  U/D case was  started  and all documents  were sent. Thereafter,  the complainant sent one Advocate  letter  along with all documents  as stated above but the OP NO.1 did not respond  to the same. The OP No.1 also  never repudiated  the claim of the complainant  but they are  intentionally  harassing  the complainant. So, the present case is filed.

The complainant prayed for an award for Rs.15,00,000/- towards P.A cover  for the owner  driver  together with interest  @12% for from the date of death, Rs.4,00,000/- towards  harassment  and mental pain  and agony and cost of the case.

The OP No.1 contested the case by  filing  W/V wherein  they denied  each and every allegation of the complainant.  The Op No.1 challenged  the case as not maintainable , barred by limitation and there is no cause of action. The positive defence  case of OP NO.1 is that the insurance  policy was issued in favour  of Indrajit Dey for the vehicle no.WB-52AL-7419 from 7.7.2021 to 6.7.2022 under certain terms and conditions. The complainant should be  directed to produce the purchase policy. The complainant  lodged a personal accident claim  which was duly registered  and a loss assessor  was appointed. The OP No.1 issued  one letter  to the complainant  on 22.0.4.2022  to provide certain documents  to assess the  claim.  But the complainant did not  supply  those documents. So, the OP No.1 again issued another letter on 07.05.2022. The complainant  did not submit the said documents till date. But OP No.1 never got the chance  to assess the claim.  Instead  the complainant has filed  the case which is a premature.  The OP No.1 claimed that the case is liable to be dismissed  with cost.  The name of the OP No.2 has been expunged  and as such  only  the OP No.1 contesting in this case.

Points of dispute  involved  in this case demands  for ascertainment  of the following points for proper adjudication of this case.

Points for Determination

Point No.1.

Whether the  case is maintainable  in its present form and prayer.

Point No.2.

Whether the complainant  is entitled to get the relief as prayed for.

Point No.3.

          To what other relief if any the complainant is entitled to get.

Decision with Reasons

Point No.1.

 Although the OP No.1 challenged the case  as not maintainable  yet in course of argument  Ld. Advocate for the OP No.1 could not advance  any particular  point regarding  non-maintainability  of the case. However,  after perusing the pleadings of the parties  and the evidence  in the case record  the Commission  is of the view  that the present  case is not barred by any point of law . The  complainant  resides  within the  territorial  jurisdiction  of this Commission and  the pecuniary  jurisdiction  is also within the purview  of this Commission  since the total  amounts of the relief claimed is within the  jurisdiction of this Commission.

Accordingly, point no.1 is answered in affirmative and decided on behalf of the complainant.

Point No.2&3.

It is the admitted case that the husband  of the complainant  was insured with the OP No.1. So, the policy is not disputed .

It is also the admitted  fact that the husband of the complainant  died  in an accident  for which the complainant lodged  this case for getting the insurance policy money. The OP No.1, however,  in course  of argument submitted  that there is a delay of 6 months  to inform the OP No.1. The OP NO.1 inter-alia stated  that  the insurance policy  was issued  in favour of the insured Indrajit Dey  but the defence contention  is that the complainant  did not submit  necessary documents like FIR, Accident Report, Spot Panchama, R.C, D.L inquest report, Death Certificate, PM Report, Legal heir Certificate, Viscera Report and Bank Statement.

After perusing  the case record  it transpires  that the complainant proved different documents in course of trial of this case. The complainant  proved the following documents:-

Annexure-1:- Certificate of Registration of the Vehicle bearing no.WB52AL-7419.

Annexure-2:-  is the Insurance  policy  of the said Motor Vehicle  for the period 07.07.2021 to 06.07.2022.

Annexure-3:- is the final report of un-natural death of said Indrajit Dey dated 22.10.2021.

Annexure-4:- is the Challan for P.M Report.

Annexure-5:- is the  P.M report.

Annexure-6:- is the Brought dead Intimation dated 21.10.2021 of diseased  Indrajit Dey.

Annexure-7:- is the Death Certificate  of diseased  Indrajit Dey issued by Krishnagar Municipality.

Annexure-8:- is the D.L of diseased  Indrajit Dey for the period 12.02.2014 to 08.04.2027.

Annexure-9:- is the application  for recovery  of P.A claim amounts by the complainant to the OP No.1 being dated 18.04.2022.

Annexure-10:- is the  letter issued by his OP No.1 to the complainant  acknowledging  the documents.

Annexure-11:- is the  reminder  letter by the complainant  to the OP No.1 along with  relevant  documents.

Annexure-12:- is the another  reminder  letter of the complainant to the OP No.1 along with all relevant documents dated 23.05.2022.

Annexure-13:- is the  copy of voter identity card wife of the diseased .

Annexure-14:- is the  copy of the Voter identity card of the mother of the diseased.

Annexure-15:- is the  Birth  Certificate of Arpita Dey daughter of diseased Indrajit Dey.

Annexure-16:- is the  Birth Certificate of Moumita Dey daughter of diseased Indrajit  Dey.

Annexure-17:- is the Legal notice  to the Op No.1 by Advocate  Makbul Rahaman  dated 06.06.2022.

Thus having  perused  all the documentary evidence  it is crystal clear  that the complainant  was in possession  of all the relevant documents and he submitted  it to the OP No.1.  Annexure No.9, 10, 11 and 12 are the most important correspondence of different letters  wherefrom  it is revealed that the complainant  submitted  the different letters  along with all  documents  for getting the  insurance  P.A claim  money. The OP No.1 also acknowledged the receipt of the  said documents.  But the said letters categorically  discloses  that with  each letter  the documents  were enclosed.  The Postal  receipt  further discloses that the weight of the letter  along with documents were to  such an extent  that the postal  cost was more than Rs.30/-. It means that  the documents  were certainly  sent  otherwise  one page letter could not have been so   expensive . Ld. Advocate for the complainant  also advanced  argument on the same point.

The said argument has reasonable  force as advanced  by Ld. Advocate  for the complainant.

Ld. Defence Counsel , however,  argued  that there is a considerable  delay of 6 months  to inform the  said incident.

As per the  complaint  case the insured  Indrajit Dey  died on 21.10.2021. The complainant  claimed that he informed  to the OP through  his policy  agent within due time.

The complainant  also stated the said fact by  swearing  affidavit  through  her affidavit in chief. But the OP No.1 did not cross-examine  the complainant denying the said averment.  The complainant , however, denied  the question put by the OP No.1 during interrogatories . The OP No.1 could not say  in reply to cross-examination as to in which date they received  the claim intimation.  They have  denied  the said question by stating  only that it is a matter of record.

It is further  found the case record that the OP NO.1 appointed  one investigator  to assess the claim  but the OP NO.1 categorically stated  in answer  to cross-examination  that they did not submit  any report of the investigator  regarding  the claim. When an investigator /assessor  is appointed  to assess the claim  , it is warranted  that the insurer should file the report  of the investigator/assessor.

It is the settled  position  of law that if a document  which is  in the custody of a party , if it is suppressed or not filed then presumption  shall be drawn  that the said document  will go  against the party who suppressed  it.

In the accident case the OP No.1 has not filed  the said document that is the report  of the surveyor/assessor .

It is also evident from the case record  that the OP No.1 did not repudiate the claim of the complainant. So,  there is no  sufficient  ground available  within the four-corners  of the case record to repudiate  the claim of the complainant  or deny the insured money  in the event of death of the husband  of the complainant no.1.

Ld. Defence Counsel  further argued that there is  no document  to show  that the insured  died  in course of driving  the vehicle. There is no seizure  of the vehicle .  Had there been  any accident then police would have seized  the said vehicle.

It is found  that an U/D case was started . It  is duty of the police to seize  the vehicle.  If the police does not seize the vehicle related with any accident,  the diseased  party cannot be  held responsible  for any deficiency in the  role of the police. That apart from the  report of U/D case it is found that  it is categorically  stated that  on 20.10.2021 the said Indrajit Dey  while driving  the Motor Bike  dashed with  an electric poll and thereafter,  he died. So, the complainant cannot  be held  responsible  for the alleged  non-seizure  of the  ill-fated  Motor cycle.

Ld. Advocate for the complainant rightly  argued  that lodging FIR is not mandatory  for releasing  the claim  since U/D case  has already been  started.  He also rightly  argued that in the P.M Report  it is mentioned  that it is a case of RTA.

In the backdrop  of the aforesaid  assessment  of oral and   documentary evidence vis-a-vis the observation made hereinabove  the Commission  comes to the  finding that  the  complainant  successfully  proved the case  upto the hilt.

Consequently,  point no.2&3 are answered  in affirmative  and decided  on behalf of the complainant.

In the result  the complaint case succeeds on contest with cost.

Hence,

                              It is

Ordered

that the complaint case no.CC/69/2022 be and the same is allowed on contest with cost of Rs.5,000/- (Rupees five thousand). The complainant Putul Dey  along with  other complainants  do get an award against the OP for a sum of Rs.15,00,000/- (Rupees fifteen lakhs) towards P.A cover together  with interest  @8% p.a from the date of death that is 21.10.2021 till the date of its realisation , Rs.2,00,000/- (Rupees two lakhs) towards  harassment, mental pain and agony and Rs.5,000/- (Rupees five thousand) towards  litigation cost. The OP No.1 is directed to  pay Rs. 17,05,000/-(Rupees seventeen lakhs five thousand) to the complainants within the 30 days from the date of passing the final order failing which the entire award money  shall carry an interest @8% p.a from the date of passing the final order  till the date of its realisation.

All Interim Applications  (I.A) stand disposed of  accordingly.

D.A to note in the trial register.

The case is accordingly disposed of.

Let a copy of this final order be supplied to both the parties at free of costs.                

Dictated & corrected by me

 ............................................

                PRESIDENT

(Shri   HARADHAN MUKHOPADHYAY,)                 ................ ..........................................

                                                                                                      PRESIDENT

                                                                                (Shri   HARADHAN MUKHOPADHYAY,)

I  concur,

  ........................................                                                           

            MEMBER                                                                                  

( SHRI NIROD  BARAN   ROY  CHOWDHURY)