West Bengal

Birbhum

CC/15/42

Robeda Khatun, W/o Lt Sakil Ahmed - Complainant(s)

Versus

Mananger, Bajaj Allianz General INS Co.ltd - Opp.Party(s)

Sanjit Kr Acharya

08 Sep 2022

ORDER

Smt. Sukla Sengupta .President.

            The instant case is filed by one Robeda Khatun (complainant) Under Section 12 of the Consumer Protection Act, 1986 as amended update.

            The fact of the case in brief is that being a resident of Suri Saddipara within the District Birbhum and also being the wife of one Md. Sakil, who was the owner of a vehicle being engine No. 4982082, chassis No. 193999 Maruti Alto 800 LXI BSIV.

            It is further stated in the petition of complaint that said Md. Sakil the husband of complainant since decease purchased an insurance policy for the aforesaid vehicle from the OP Bajaj Allianz General Insurance Company Limited on payment of proper premium after nominating the name of the complainant in respect of permanent accident claim.

            The insurance policy in question being Policy No. 0G-13-2409-1801-00005873 is/was valid on and from 09/03/2013 to 0803/2014.

            It is further stated that on 31/03/2013 the complainant was returning from Illambazar with her husband since deceased along with other family members through Panagar-Moregram Highway by that Alto 800 Car and at 3:30 p.m. when they reached at Gopalpur-more under P.S. Dubrajpur, Dist. Birbhum, W.B. an unknown truck which was proceeding towards Illambazar from Suri side dashed the Maruti-Car of the complainant. As a result the complainant, her husband and other family members (Co-passenger) received injuries on their person and her husband succumbed to such injuries on that date.

            The car was badly damaged. In respect of the incident a police case was started and that was charge sheeted U/S/279/304A/427 IPC.

           

 

 

It is further stated in the petition of complaint that immediately after the incident the matter was informed to Suri P.S. and the OP in writing.

            Thereafter on 20/04/2013 the complainant claimed compensation for damage of the vehicle and personal accident benefit but inspite of acknowledging the claim the OP insurance company did not settle the claim till date by violating the rules of IRDA.

            It is the claim of the complainant that being the beneficiary and nominee of the deceased she is entitled to get Rs. 3,00,750/- as compensation for damage of the vehicle and Rs. 2,00,000/- only for personal accident claim of her husband since deceased.

            It is alleged that the OP intentionally harassed the complainant and caused her mental pain and agony.

            Hence, this case is filed by the complainant with a prayer to pass an order directing the OP insurance company to pay a sum of Rs. 3,00,750/- to the damage of the vehicle and Rs. 2,00,000/- why for the death benefit of the owner of the vehicle as personal accident claim along with interest @ 18% p.a. on the entire amount i.e. on Rs. 5,00,750/- since 30/03/2015.

            The complainant also claimed Rs. 50,000/- as compensation for mental pain and agony along with litigation cost of Rs. 5000/- and other relief or reliefs if any.

            The OP insurance company has contested the claim application filed by the complainant by filing a written version denying all the material allegations levelled against it.

            It is the OP’s case that the case is not maintainable in the eye of law.

            That the complainant has no locus standy to file this case. That the alleged incident has not been brought in to notice to the OP immediately after the accident which is mandatory as per conditions of the policy so, the complainant cannot get the Personal Accident as the claim is premature one and is liable to be dismissed.

            It is stated by the OP that the complainant is not a consumer so question of deficiency of service on the part of the OP does not arise at all.

            It is admitted by the OP that the Maruti ALTO-800 being Registration No. - WB 54L/9784 has been registered as “Private Car” with the registering authority and the policy issued was private car policy. Though the insurance company did not repudiate her claim without any proper verification.

It is further stated by the OP that the matter is sub judice for rectification her claim and as per Section-III of Personal Accident cover for Owner-Driver the claimant only get one of the items (i) to (iv), and the claimant cannot get more than Rs. 2,00,000/- only in aggregate during any one period of insurance.

            It is alleged by the OP that there is/was no cause of action to file this case by the claimant/petitioner and she is liable to prove her case by documentary evidence.

           

 

 

The OP further stated that the OP does not admit the claim of the complainant/petitioner, and the OP is not a service provider to the petitioner so, question of deficiency of service does not arise. Thus the complainant is not entitled to get the relief as prayed for and the case is liable to be dismissed with cost.

            In view of the above stated facts and circumstances the point of considerations by this Forum are as follows:

Issues

1. Is the case maintainable as per law?
2. Has the complainant/petitioner any cause of action to file this case?
3. Is the complainant/petitioner is a consumer as per CP Act 1986?
4. Is the OP a service provider to the petitioner/complainant if so, is these any deficiency in service on the part of the OP?
5. Is the complainant entitled to get the compensation as prayed for?
6. To what other relief or reliefs is the complainant entitled to get?

   Decision with reason.

                        All these issues No. 1 to 6 are taken up together for convenience of discussions and to avoid unnecessary repetitions.

                        It is the case of the complainant/petitioner that the alleged accident took place on 31/03/2013. We have got support of this fact from the police report in C/W Dubrajpur P.S. case No. 65/13 dated 01/04/2013 started U/S. 279/337/338/427/304A I.P.C. and postmortem report of deceased Sakil Ahamed that the accident took place on 31/03/2013. From the materials on record it is proved that the case is filed on 27/03/2015. It is also proved from the materials on record that the complainant reported the matter to the OP on 30/04/2013. From which it is crystal clear that cause of action arose on 30/04/2013 so, the case is filed well within the limitation period and it is not barred by Sec. 24 (A) of Consumer Protection Act.

                        From the materials on record it is also proved that the OP runs its business within the territorial jurisdiction of this forum and the complainant also a regular resident under this Forum.

                        The valuation of this case is also within the permissible limit of this Forum.

                        Hence, the case is well maintainable in it’s present form as per law.

                        From the written argument of the OP it is revealed that the damaged vehicle has already been settled by the Op to the complainant in full and final settlement of the claim.

                        From such conduct of the OP it is proved that the complainant is a consumer under the OP as per Consumer Protection Act, which has already been admitted by the OP by his conduct, so the OP settled the claim of the complainant in respect of this damaged \vehicle in full and final.

                       

 

 

                        It is well known to us that admitted fact need not be proved.

                        Hence, in view of the above made discussions it can safely be held by me that the complainant is a Consumer under the OP and the OP is a service provider. The OP already performed his liability and responsibility to the complainant as service provider by settling the claim of the complainant in part regarding the damaged vehicle. At present the OP denying to settle the claim of the complainant in respect of the P.A. claim of deceased Sakil Ahamed the husband of the complainant.

                        The respective argument of the OP is that the complainant did not report the matter of accident to the OP in writing immediately after the accident and for that reason the claim is premature one and the OP is not liable to pay the same to the complainant.

            This Forum is surprised to hear such argument if the matter of alleged accident is accepted by the OP and the incident of death of the owner Sakil Ahamed who died by receiving injury during the alleged accident then why the OP denied the same? It is well established from the Personal Accident report of the deceased and police report that the vehicle having Policy No. 0G-13-2409-1801-00005873 met an accident on 09/03/2013 to 0803/2014 and during that accident the complainant, deceased Sakil Ahamed and other members of his family received injury on their person. The car was damaged and Sakil Ahamed succumbed to such injury. It is admitted fact that the OP got the information in writing regarding the alleged accident and the death of Sakil Ahamed the owner of the vehicle. It is also admitted fact that the OP settled the claim of the complainant regarding the damaged vehicle in full and final. Then can the OP raised the question that the complainant did not make any claim to the OP regarding Personal Accident claim for then deceased owner Sakil Ahamed as the beneficiary and nominee of the deceased?

                        If for the argument sake we hold that the complainant being a layman could not be able to place the prayer of the claim of PA of the deceased as per Sec. II of  Personal Accident coverage still then the OP cannot take the plea that the matter was not placed before it because it was informed and highlighted to the OP in time and it is the settled principle of law of the land that the legitimate claim of any person cannot be denied by the authority only for lack of technicality and procedural error. In the instant case also it is reveled from the facts and circumstances, evidence and materials on record that the OP by taking advantage of technicality is trying to derive the complainant from her legitimate claim, and did not settle her claim for Personal Accident claim of her husband Sakil Ahamed, who being the owner of the vehicle was in the car at that relevant time of the accident and deceased received severe injuries on his person during the accident which caused his death.

                        So, in view of the discussions made above I am of opinion that the complainant is entitled to get the PA coverage for the death of her husband. The OP deliberately tried to deprive the complainant

 

 

 

from his legitimate claim. So, there is/was sufficient deficiency of service on the part of the OP and the conduct of the OP caused harassment, mental pain and agony to the complainant.

            On the basis of above made discussions it is proved that the complainant is entitled to get the Personal Accident coverage for her husband Sakil Ahamed who was the owner of the car being engine No. 4982082, chassis No. 193999 Maruti Alto 800 LXI BSIV and the OP insurance company is liable to pay the PA to the complainant along with other claim as per prayer.

                        The case is sufficiently stamped.

                         Hence, all the issues i.e. issue No. 1 to 6 are decided favorably to the complainant.

                        Hence, it is,

                                    O R D E R E D,

                                                            that the instant C.C. Case No. 42/2015 be and the same is decreed in part on contest against OP. With cost.

The complainant do get the decree on prayed for.

The OP is directed to pay compensation of Rs. 2,00,000/- only to the complainant with interest @ 9% p.a. from the date of filing of this case till realization.

The OP is also directed to pay compensation of Rs. 30,000/- towards mental pain, agony and harassment and Rs. 5000/- towards litigation cost to the complainant within 45 days from this date of order.

If the OP is failed to comply the decree as per direction of this Commission within 45 days from this date of order then the complainant will get interest @6% p.a. on the entire decreetal amount from the date of default till realization.

If the OP failed to comply the decree within specified time the complainant will be at liberty to execute the same as per law.

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