IN THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MURSHIDABAD AT BERHAMPORE.

CASE No.  CC/214/2017.

     Date of Filing:           Date of Admission:       Date of Disposal:

      13.12.2017                           20.12.2017                       20.01.2020

Complainant:             Majina Begum, W/o late Jainuddin,

                                    Vill. Hamid Hati, P.O. Pilkhundi,

                                    P.S. Salar, Dist. Murshidabad, Pin 742401.

-Vs-

Opposite Party:         Manager,

National Insurance Company Ltd.,

26/23/1 Sahid Surya Sen Road,

P.O. and P.S. Berhampore, Dist-Murshidabad, Pin 742101.

Agent/Advocate for the Complainant: F .M. Siddique

Present:  Sri AsishKumarSenapati………………......President.

    Smt. AlokaBandyopadhyay……………………..Member.

                 Sri. Subir Sinha Ray………………………………Member.

FINAL ORDER

  Subir Sinha Ray, Member.

          Late Jainuddin, husband of the complainant obtained Life Insurance Policy being No.100300147/01/9600027/02/76/30370 for a total sum assured of Rs.500000/- for a period from 01/02/2003 to 31/01/2018 from the opposite party. He died on 13/04/2017 and claimed in terms of the insurance policy was lodged by the complainant with the opposite party and the said claim was repudiated vide letter dated 25/10/2017. Being aggrieved from the repudiation of the claim, the complainant is before the Forum seeking payment of          Rs.500000/- alongwith compensation of Rs.50000/- for mental pain and agony.

          The OP after service of notice did not turn up. So, the case proceeded ex parte against him.

          Now, the question arises whether the complainant is a ‘Consumer’ and she is entitled to get relief as prayed for.

Decision with reasons

All the points are taken up together for the sake of convenience and brevity.          The Ld. Advocate for the Complainants submits that the complainant is a ‘Consumer’ in terms of section 2 (I )(d) (ii) of the C.P.Act, 1986.

            On going through the complaint and other materials on record and on a careful consideration over the submission of the Ld Advocate of the complainant, we find that the Complainants are consumers in terms of section 2 (I )(d) (ii) of the C.P.Act, 1986.

Undoubtedly, Late Jainuddin, husband of the complainant obtained Life Insurance Policy for a total sum assured of Rs.500000/- for a period from 01/02/2003 to 31/01/2018 from the opposite party i.e. The National Insurance Co. Ltd. and the nominee was his wife.

It is a fact that the policy holder died on 13/04/2017 on a road accident.

The opposite party i.e. The National Insurance Co. Ltd. repudiated the claim vide letter dated 25/10/2017, which reads as under:-

The insured died on 13/04/2017 whilst patrolling. As per terms and conditions of J.A.P. policy Section 2(e) the company shall not be liable under this policy for payment of compensation in respect of death whilst service on duty with any Armed Force.

The insured was engaged in police force and died in RTA whilst he was performing his duty. Under the above circumstances, we have no option than to treat your claim as No Claim.

          The OP after service of notice did not turn up. So, the case proceeded ex parte.

          The Hon’ble Supreme Court in Lakshmi Chand V/s Reliance General Insuarnce (2016) 3 SCC 100:2016(3) Supreme 492 in which it has been laid down that insurer should establish that there is fundamental breach and that the subject fundamental breach had a casual relationship/ nexus with the accident.

            Considering the facts and circumstances of the case and documents filed before us, we are of the opinion that the Complainant  is entitled to get relief in this case and there is deficiency in service in service on the part of the opposite party i.e. The National Insurance Co. Ltd. by not allowing insurance claim of the complainant.

Reasons for delay

The Case was filed on 13.12.17 and admitted on 20.12.17 . This Forum tried its level best to dispose of the case as expeditiously as possible in terms of the provision under section 13(3A) of the CP Act, 1986. Delay in disposal of the case has also been explained in the day to day orders.

Fees paid are correct.

In the result, the complaint case succeeds. Hence, it is

                                    ORDERED

that the Consumer Complaint Case No. CC/214/2017 be and the same is hereby allowed on contest with litigation cost of Rs.1,000/- against the OP.

            The opposite party i.e. The National Insurance Co. Ltd. is directed to pay the sum assured of Rs.5,00,000/- to the complainant.

            The opposite party i.e. The National Insurance Co. Ltd. is further directed to pay Rs.2,000/- to the complainant for mental agony.

            The OP is directed to comply with the Order within 30 days from the date of this Order.

Let plain copy of this order  be supplied free of cost, to each of the parties / Ld. Advocate/Agent on record, by hand  /by post under proper acknowledgment  as per rules, for information and necessary action.

The Final Order will also be available in the following Website:

confonet.nic.in

          Member

Member                                   Member                                   President