West Bengal

Paschim Midnapore

CC/25/2015

Smt. Shila Ghosh - Complainant(s)

Versus

Oriental Insurance Co. Ltd. - Opp.Party(s)

Mr.A.K.Dutta.

06 Aug 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

PASCHIM MEDINIPUR.

                             

Bibekananda Pramanik, President,

and  Kapot Chattopadhyay, Member.

   

Complaint Case No.25/2015

                                                       

Smt. Shila Ghosh……………….………Complainant

Versus

 Oriental Insurance Co. Ltd………………..Opp. Party.

 

 

 For the Complainant : Mr. Asim Kumar Dutta, Advocate.

 For the O.P.                : Mr. Mrinal Kanti Chowdhury, Advocate.

 

Decided on: - 06/08/2015

                                

ORDER

        Bibekananda Pramanik, President - Case of the complainant, in brief, is that Subhashis Ghosh, since deceased, the husband of the complainant, purchased a scooter being no.WB-34Q-3341 and the said scooter was covered under the Insurance Policy of the O.P. which was valid from 26/06/06 to 25/06/07.  As per the policy condition, if owner cum driver died by road traffic accident, the O.P.  Insurance Company will pay 1,00,000/- for accidental death.  On 15/05/07, Subhashis Ghosh, the husband of the complainant, died in a road traffic accident for which a criminal case being Chandrakona P.S. Case no.56/2007 dated 15/07/07 was started and the said case was ended in charge sheet.  After the death of the husband of the complainant, she filed an application along with all relevant papers before the office of the O.P. Insurance Company on 29/05/07.  Thereafter, the O.P. no.1 issued one letter dated 20/01/08 to the complainant for filing the documents namely F.I.R., Charge sheet, P.M. report, R.C. Book and Insurance Policy.  After receiving the said letter, the complainant deposited all those documents in the office of the O.P. who thereafter engaged one surveyor for investigation and the said surveyor submitted the survey report.  The complainant also deposited a driving license in the office of the O.P.  After lapse of six years, the O.P. did not settle the accident- benefit as per policy condition.  Such non-payment after demand

Contd………….P/2

 

                                                                                   - ( 2 ) -

 amounts to repudiation of the claim.  Thereafter, the complainant filed a complaint case being no.16/13 against the O.P. No.1, in this Forum and the said case was disposed of on 8/01/14 with the findings that there is sufficient ground for maintainability of the case and in holding that the O.P. is liable for deficiency in service in settling the claim of the complainant and directed the O.P. to pay compensation of Rs.30,000/- with 9% interest.  After disposal of that case, the complainant again deposited all relevant papers in the office of the O.P. No.1 and requested to settle the death benefit as per policy condition but the O.P. did not pay any heed to such request.   On 03/03/15, the complainant also sent a written representation to the O.P. No.1 and in spite of receipt of the same, the O.P. did nothing which the tentamounts to repudiation of the claim.  Hence, the complaint,  praying for directing the O.P. for payment of accidental benefit of Rs.1,00,000/- as per policy condition with interest.

            Both the O.Ps have contested this case by filing a written statement.  Denying and disputing the case of the complainant, it is the specific case of the O.Ps that after the previous complaint case no.16/13 was deposed of, the OP paid the compensation amount as directed by this Forum by cheque in favour of the complainant but even after such payment, the complainant filed an application under section 27 of C.P. Act for enforcement of the Judgement/Order dated 11/12/13 and the said execution Case was dismissed by this Forum.  It is stated that the present claim is barred by res judicata.  It is further stated that since the O.P. has complied the order passed in earlier case no.16/13 by paying awarded amount, so the present complaint is not tenable and is liable to the dismissed.    

Point for decision

                                     Is the complainant is entitled to the relief as prayed for?

Decision with reasons

It is not denied and disputed that Subhashis Ghosh, since deceased, the husband of the complainant, purchased a scooter being no. WB-34Q-3341 and the said scooter was covered under the policy with the O.P.  It is also admitted that prior to filing of this complaint case, the present complainant filed a case before this Forum which was numbered as complaint case no.16/13.  Said case was finally decided on 11/12/13.  Copy of the said order has been filed in this case wherefrom we find that this Forum held that the O.P. has not taken any decision towards the claim of the complainant which amounts to deficiency in service on the part of the O.P. Insurance Company.  This Forum, therefore, vide order dated 11/12/13, passed in that compliant case no.16/13, directed

Contd………….P/3

 

                                                                                        - ( 3 ) -

the Ops to pay compensation of Rs.30,000/- for deficiency in service.  We find that in that case, this Forum refused to pass any order for payment of compensation of the insured sum on the ground that the Forum is not supposed to pass any such order.  Be that as it may, we find that it has already been held that the O.Ps had deficiency in service for not settling the claim of the complainant in respect of that Insurance Policy.  In the present case, the complainant has again approached  before this Forum for passing an order of direction to the O.Ps for effecting payment of accidental death benefit as per the condition of that policy with interest on the ground that even after disposal of that case, the O.P. have not settled her claim in spite of her representation.  Regarding the said allegation, there is not whisper of denial on the part of the O.Ps and they have simply stated in their w/o that in compliance of the order passed in the earlier case, they have made payment of compensation of Rs. 30,000/- to the complainant.  It is very much surprising that in their w/o the O.Ps. have stated nothing as to why they refrained themselves for settling the claim of the complainant and in view of the findings of this Forum passed on 11/12/13 in earlier complaint case No.16/13, it is held that the O.Ps have deficiency in service in settling the claim and such deficiency of service should be removed by passing a speaking order directing the O.P. for settling the claim of the complainant.

            In the result, the complainant case succeeds.

 

                                                                Hence, it is,

                                                                                     ORDERED,

                                                                                                          that the complaint case and the same  is allowed on contest with cost against the O.Ps.  O.Ps are directed to settle the claim of the Policy in question within 2 month from this date of order after observing all legal formalities.  O.Ps are further directed to pay litigation cost of Rs.10,000/- to the complainant within 2 months from this date of this order.  We refrain ourselves from passing any further compensation for deficiency in service.  

Dictated & Corrected by me

                Sd/-                                                  Sd/-                                           Sd/-

           President                                            Member                                    President

                                                                                                                   District Forum

                                                                                                                Paschim Medinipur