C.F. CASE No. : CC/09/102
COMPLAINANT : Tapati Ghosh
W/o Late Uday Ghosh
Vill. + P.O. Mayakol
P.S. Dhubulia,
Dist. Nadia
OPPOSITE PARTIES/OPs : 1) Manager
Golden Trust Financial Services
16, R.N. Mukherjee Road,
Kolkata 700 001
- The Manager
Bajaj Allianz General Insurance Co. Ltd.
18, Rabindra Sarani,
Podder Court, 7th Floor,
Gate No. 3, Kolkata – 700 001
- The Manager
Bajaj Allianz General Insurance Co. Ltd.
Bow Bazar, D.L. Roy Rd,
P.O. Krishnagar, P.S. Kotwali, Dist. Nadia
PRESENT : KANAILAL CHAKRABORTY PRESIDENT
: KUMAR MUKHOPADHYAY MEMBER
: SMT SHIBANI BHATTACHARYA MEMBER
DATE OF DELIVERY
OF JUDGMENT : 30th April, 2010
: J U D G M E N T :
In brief, the case of the complainant is that her husband, Late Uday Ghosh purchased one Personal Accident Insurance Policy from the OP No. 2, Bajaj Allianz General Insurance Co. Ltd. on 15.06.05 which is valid up to 14.06.10. The insured amount is Rs. 1,00,000/-. It is her further case that her husband, Late Uday Ghosh expired in an accident on 04.05.09. She being the nominee of the policy, thereafter, filed an application before the OP No. 2 through the OP No. 1, GTFS intimating the death of her husband. She also requested the OP No. 2 to make payment of the insured amount to her, but to no effect. So having no other alternative she has filed this case praying for the reliefs as stated in the petition of complaint.
OP No. 1, GTFS has filed a written version in this case, inter alia, stating that Uday Ghosh purchased one Personal Accident Insurance Policy from the OP Bajaj Allianz General Insurance Co. Ltd. through GTFS on 15.06.05 and the said policy is valid up to 14.06.10 and the insured amount is Rs. 1,00,000/-. He also states that said Uday Ghosh was electrocuted on 04.05.09 at the working place and died on the spot. After his death the complainant being the nominee of the said policy submitted a claim application on 18.05.09 along with other supporting documents before the GTFS who in turn submitted the said claim application before the OP No. 2 on 26.05.09 towards settlement of the claim at an early date. From the written version it is also available that as per MOU with the OP No. 2 this OP has no liability to pay any compensation. The OP No. 2 is the sole authority to settle and make payment of the compensation. So the complainant has no cause of action to file this case against him. Hence, it is liable to be dismissed against him.
The OP No. 2, Bajaj Allianz General Insurance Co. Ltd. has contested this case by filing a written version, inter alia, stating that Late Uday Ghosh purchased one Personal Accident Insurance Policy from this OP through GTFS on 15.06.05 and the said policy is valid up to 14.06.10. He also submits that it would be evident from the documents filed by the complainant that said Uday Ghosh was an unskilled labour who was engaged against the contractual terms of allotted jobs and for that unauthorized work the concerned authority of WBSEDCL lodged one FIR against the incident by involving the names of two persons. So as per policy condition this complainant is not at all entitled to get the insured amount as claimed by her. Hence, the case is liable to be dismissed against him.
POINTS FOR DECISION
Point No.1: Has the complainant any cause of action to file this case?
Point No.2: Is the complainant entitled to get the reliefs as prayed for?
DECISION WITH REASONS
Both the points are taken up together for discussion as they are interrelated and for the sake of convenience.
On a careful perusal of the petition of the complaint along with annexed documents and the written versions filed by the OPs and after hearing the arguments advanced by the ld. lawyers for the parties it is available on record that the complainant’s husband Late Uday Ghosh purchased one Personal Accident Insurance Policy from the OP No. 1 on 15.06.05 which is valid up to 14.06.10 and the insured amount is Rs. 1,00,000/-. The present complainant is the nominee of that policy also. From the written version filed by the OP we find that the present complaint submitted claim application before the OP No. 2 through OP No. 1 on 18.05.09 and that application was duly forwarded and sent to the OP No. 2 who received the same on 26.05.09. There is no denial by the OP No. 2 on this point also. Admittedly insurer Uday Ghosh expired due to electrocution when he was working. Ld. lawyer for the OP No. 2 submits that the said Uday Ghosh was engaged in an unauthorized work by the contractor. Due to this a FIR was lodged by WBSEDCL regarding that incident involving the names of two persons and so this the OP has no liability to pay the insured amount. Ld. lawyer has stressed on point ‘2’ of the provisions which speaks that incase of death of intentional self injury suicide or attempted suicide and arising or resulting from the insured committing any breach of the law with criminal intent. Admittedly, the insurer Uday Ghosh was electrocuted and died when he was working under the contractor. So no question of attempting suicide or self implicated injury does arise on his part, nor it falls within the category of any working with criminal intention. He was engaged by a contractor to work and the contractor was allotted to complete the work by the electricity authority who lodged a FIR against the said contractor. From this FIR it does not disclose that the injury received by Uday Ghosh was self implicated.
So in view of above discussions, we hold that said Uday Ghosh admittedly was electrocuted which caused his death when he was working under a contractor engaged by WBSEDCL. So his death is actually accidental in nature and in such case the OP No. 2 is bound to pay the insured amount to the nominee of the policy, i.e., the present complainant, but he has not made any payment. So we do also hold that it is a gross deficiency in service on the part of the OP Insurance Co. Therefore, our considered view is that the complainant is entitled to get the insured amount as claimed by her. In result the case succeeds.
Hence,
Ordered,
That the case, CC/09/102 be and the same is decreed on contest against the OPs. The complainant is entitled to get Rs. 1,00,000/- i.e., the insured amount + Rs. 5,000/- as compensation for mental pain and harassment caused to her along with Rs. 1,000/- as litigation cost. The OP No. 2, Bajaj Allianz General Insurance Co. Ltd. is directed to make payment of the decretal dues amounting to Rs. 1,06,000/- to the complainant within a period of one month since this date of passing this judgment, in default, the decretal amount will accrue interest @ 9% per annum since this date till the date of realization of the full amount. We make no order against the OP No. 1, GTFS.
Let a copy of this judgment be delivered to the parties free of cost.
