In the Court of the
Consumer Disputes Redressal Forum, Unit -I, Kolkata,
8B, Nelie Sengupta Sarani, 4th Floor, Kolkata-700087.
CDF/Unit-I/Case No.70/2012
1) Sri Subhajit Mukherjee,
21O-B/1Q, Kalicharan Ghosh Road,
Kolkata-50, P.S. Sinthee . ---------- Complainant
---Versus---
1) M/s. HDFC Ergo General Insurance Co. Ltd.,
Metro Plasa, 1, Ho Chi Min Sarani, 10th Floor,
Kolkata-71, P.S. Shakespeare Sarani. ---------- Opposite Party
Present : Sri Sankar Nath Das, President.
Dr. Subir Kumar Chaudhuri, Member.
Smt. Sharmi Basu, Member
Order No. 14 Dated 11-03-2013.
The case of the complainant in short is that complainant is the holder of an accident protection plan policy no.93696038/00002 issued by o.p. in favour of complainant and the said policy was purchased by complainant from o.p. on conditions enumerated in the said policy that o.p. would pay the complainant for the complainant’s total disablement (accident) on sudden, unforeseen and unexpected happening by chance a sum of Rs.19,687.50 per week for 52 weeks, minus seven days’ amount from the date of accident and Rs.52,500/- for broken bones in addition thereto.
On 10.6.09 at about 18-30 hours while complainant was crossing B.T. Road from west to east in front of Indian Oil Petrol Pump near Dunlop Bridge, a private car which had been coming from south to north along B.T. Road, within the jurisdiction of Baranagar P.S. in a rash and negligent manner dashed against the complainant and as a result of which complainant received serious injuries on his head, upper portion and other parts of his body after he fell down on the road.
Immediately after accident complainant was rushed to the Chamber of Dr. T.N. Kundu, M.D. (Gen. Medicine) D.M. Neurology at DumDum Kolkata-30 by some unknown pedestrians and after examination of the complainant, the doctor found right side face of the complainant and other parts of the complainant’s person were grievously hurt anti advised the complainant to undergo some tests and get the affected parts of the complainant’s person x-rayed and seamed and prescribed medicines to the complainant for the petitioner’s medical treatment an further advised the complainant to take seven days’ rest and thereafter on the same day the complainant’s relatives took the complainant to his house where the complainant according to the advice of the said doctor started having prescribed medicines and apart from this other renowned doctors-visited the complainant’s house personality for his check up for providing him better treatment from day to day and the complainant underwent medical treatment according to their advice.
Complainant’s wife Smt. Swati Mukherjee lodged a G.D.E. No.938 on 11.6.09 at Baranagar P.S. regarding the aforesaid accident. She informed the aforesaid fact of the complainant’s accident to o.p. who in response to which sent a set of claim format forms to the complainant which were duly filled up by complainant’s attending Doctor Manoj Sharma, M.D. on behalf of complainant end signed by the complainant’s wife Smt. Swati Mukherjee and were sent to o.p. along with the medical prescriptions on 14.10.09. O.p. received the aforesaid forms dully filled in and signed by complainant’s wife.
O.p. asked the complainant to provide them with income proof to enable them to process the claim as per the terms and conditions of the policy. On 1.4.11 the complainant received from o.p. a letter sent by courier repudiating the claim of the complainant. Hence the case was filed by the complainant with the prayer contained in the petition of complaint.
Sole o.p. had entered their appearance in this case by filing w/v and denied all the material allegations labeled against them and prayed for dismissal of the case. Ld. Lawyer of o.p. in the course of argument submitted that the case has got no merit and the same is liable to be dismissed.
Decision with reasons:
