Adv. for the complainant- Sri B.Satpathy & M.Bariha.
Adv. for the Opp.Parties -Sri P.K.Biswal.
Date of filing of the case-16.02.2017
Date of order -11.10.2017
JUDGMENT.
Sri A.K.Purohit, President.
1. The complainant has preferred this case alleging deficiency in insurance service. The case of the complainant is that he was insured with the O.P’s company under Shri life cash back term plan on dt.28.07.2015 for sum assured amounting to Rs 5,00,000/- for a period of 25 years and paid the premium amount of Rs 9,046/- on the same date vide Policy No. NN161500131128 .The said policy covers not only disability but also covers monthly income benefit. During the subsistence of the said policy the complainant met with an accident while he was traveling from Chatra to Gaya in ‘ Jaya Mangala’ bus on dt.27.1.2016. To this the complainant was treated at Shree Jagannath Hospital and Research Center at Ranchi, wherein his right hand was amputed by surgery. After recovery the complainant submitt6ed his claim before the O.Ps on dt.19.05.2016.The complainant alleges that, instead of settling his claim the O.Ps have rejected his claim vide their letter dated 20.05.2016 without proper application of mind. Hence the complaint.
2. The O.Ps have contested the case by filing their written version jointly. According to the O.Ps amputation of a hand does not come under the definition of disability as the same is not a total permanent disability and hence repudiation of the claim is in accordance with the terms and conditions of the insurance policy. In their written version the O.Ps have denied the complainant’s allegation and advised him to continue the policy by paying the renewal premium.
3. Heard both the parties. The learned advocate for the complainant submitted that on their own admission in para-2 of the written version, the policy covers the claim of the complainant and hence repudiation of the claim by the O.Ps is baseless and without proper application of mind. On the other hand the learned advocate for the O.Ps submitted that, since there is no total disability the complainant is not entitled to the claim.
4. Perused the complaint petition, written version and documentary evidence available on record. The complainant has preferred this case with the following prayer.
“(1). To pay a sum of Rs 10,00,000/- i.e amount equal to the sum assured with interest from the date of permanent disability i.e dated 11.02.2016
(2). To pay monthly income benefit of 1% of the sum assured i.e Rs 5,000/- till the end of policy term i.e for 25 ears from dated 11.02.2016.
(3). To pay compensation of Rs 4,00,000/- for loss, harassment and sufferings.
(4). To pay Rs 10,000/- towards the cost of litigation.
(5). Any other relief Hon; ble Forum deems fit and proper may pass in the interest of justice”.
5. The aggregate value of the aforesaid claim is about Rupees Twenty nine Lakhs and Ten Thousand, excluding the amount of cost and compensation. The claim of the complainant is valued at Rs 25,00,000/- (Twenty Five lakhs), therefore, considering from any angle the claim amount of the complainant is exceeding rupees Twenty Lakhs. Hence this Forum has no pecuniary jurisdiction to decide the case of the complainant. The complainant is at liberty to approach any other forum having jurisdiction to decide his case, if so advised.
6. Since this forum has no jurisdiction to decide the case it is not necessary to discuss onl the merit of the case.
Accordingly the case of the complainant is dismissed.
Order pronounced in open forum this the 11th day of October 2017.
(S.Rath.) (A.K.Purohit)
MEMBER. PRESIDENT.
