Tripura

Gomati

CC/13/2021

Smt Purnima de (Bhowmik) - Complainant(s)

Versus

The Branch Manager, ICICI Lombard General Insurance Co. Ltd. - Opp.Party(s)

Sri P.K. Sarkar, Shri B. Debnath

05 Oct 2023

ORDER

J U D G M E N T

 

                        Genesis of this case is a complaint preferred by the complainant Smt. Purnima Dey (Bhowmik) under Section 12 of the Consumer Protection Act, 2019 (Act in short hereinafter) against the opposite party praying for compensation to the tune of Rs. 15 Lac (Rupees Fifteen Lac) under the head of personal accident for owner-driver.    

2.                     The facts as pleaded in the plaint are that the husband of the complainant namely, Chandan Bhowmik (now deceased) was the registered owner of the motor cycle bearing No.TR-03-E-9621. During life time he got his vehicle insured with OP No.1 having personal accident coverage of Rs.15,00,000/- under package policy. On 16.09.2021 at around 9/9-30 p.m. when the husband of the complainant was returning home by riding his motor bike bearing No. TR-03-E-9621, it met with an accident whereby the motor cycle was dashed by a truck vehicle resulting fatal  injuries to him and subsequently, he succumbed to his injuries in the hospital. Subsequently, after death of her husband, the complainant got aware of the fact that her husband during life time purchased a policy from OP No.1 in respect of his motor cycle having the coverage of personal accident for owner-driver for a sum of Rs.15,00,000/- and then she placed her claim for compensation for the death of her husband in the accident before the OP No.1 but the OP No.1 did not settle her claim. Along with her claim she submitted all the necessary documents as per requirement of OP No.1 but inspite of that her claim remained unsettled. Finally, the complainant approached the forum for redress claiming compensation to the tune of Rs.15,00,000/-  excluding Rs.1,00,000/- as litigation cost and Rs.50,000/- for deficiency in service on the part of the Ops. 

 

3.                     On receipt of the notice, the OPs appeared and contested the case by filing join written statement denying the allegations made by the complainant. The OPs admitted the fact that the motor cycle of the husband of the complainant bearing No.TR-03-E-9621 was insured with the OPs at the material time and they issued the insurance certificate subject to terms and conditions. They denied and disputed the contention that the complainant submitted personal accident claim for the vehicle No. TR-03-E-9621, rather she submitted invalid vehicular documents. It is asserted that the deceased Chandan Bhowmik was holding a unauthorized driving licence at the time of accident. According to them, the complainant never intimated about the claim till now and the OPs are in dark about this claim and they first came know about it on receipt of the notice. According to them, the claim made by the complainant has no leg to stand upon and liable to be dismissed. 

 

 4.                    The complainant Smt. Purnima Dey (Bhowmik) examined herself as PW.1. In her examination-in-chief on affidavit she recapitulated the facts that has been stated in the complaint and as such, for the sake of brevity the same is not recapitulated. However, during re-examination, the PW.1 has exhibited the following documents:-

                         1. Claim intimation letter dt. 30.09.2021 – Ext.P1,

                        2. Certified copy of FIR & Ejahar – Ext.P2,

                        3. Certified copy of seizure list – Ext.P3,

                        4. Certified copy of Surathal Report – Ext.P4,

                        5. Certified copy of P.M. Examination Report – Ext.P5,

                        6. Certified copy of charge-sheet – Ext.P6,

                        7. Photo copy of insurance certificate – Ext.7 (compared with original),

                        8. Photo copy of registration certificate – Ext.P8 (compared with the original), and

                        9. Photo copy of driving licence – Ext.P9 (compared with the original).      

 

 

                        In cross-examination she denied the suggestions that the death of her husband was not caused by any accident involving the motor cycle or that they made no correspondence with the insurance company for payment of the personal accident insurance cover.  

 

5.                     On the other hand, the OP side examined one witness namely, Dibakar Gupta as OPW.1. The examination in chief of this OPW carries nothing important except the fact that he being the Investigator of the company went to the house of the complainant and asked for some documents but he was denied.

                        In cross-examination he admitted that he went to the house of the complainant after the present case was lodged and he voluntarily stated that he went to the complainant with the claim form. 

 

 6.                    Heard argument of the learned counsels appearing on behalf of both the parties.

7.                     The points required to be adjudicated in this case are as follows:

                                    (i) Whether the husband of the complainant (now deceased) was a consumer ;

                                    (ii)Whether there was any foul play occurred from the                                               side of OP ;

                                    (ii)Whether the complainant is entitled the amount as                                               prayed for ;

 

 DECISION AND REASONS FOR DECISION

 

8.                     All the points are taken up together for discussion.

                        There is no dispute of the fact from the side of the opposite-party that the deceased husband of the complainant was not their consumer.

9.                     According to the complainant her husband met with the accident on 16.09.2021 and on the same day he died in the hospital. In support of her contention the petitioner submitted some documents. Concerning the accident a case vide R.K.Pur P/S FIR No.144 of 2021 dated 19.07.2021 was registered under Sections 279/338/304A of IPC and Sections 177/184 of M.V.Act on the basis of FIR (Ext.P2)  lodged by the brother of the deceased. Police investigated the case and during investigation, qua Ext.P6, the charge-sheet, it was revealed that the husband of the complainant met with the accident when his motor cycle was dashed by the offending Truck vehicle bearing No.TR-01-E- 1619. The accident had occurred due to fault on the part of the truck vehicle and the husband of the petitioner sustained injuries and subsequently, died. 

 

10.                   In support of her contention the petitioner also submitted the vehicular documents including insurance policy certificate relating to the motor cycle owned by her husband. The registration certificate (Ext.P8) makes it clear that Chandan Bhowmik, the husband of the complainant, was the registered owner of the motor cycle bearing No. TR-03-E-9681. The driving licence (Ext.P9) issued in the name of Chandan Bhowmik (now deceased) shows that he was permitted to drive motor cycle.

11.                   The petitioner submitted the policy certificate (Ext.P7)  purchased by her deceased husband from his motor cycle bearing No.TR-03-E-9681 from the ICICI Lombard General Insurance Company. The motor cycle had got the coverage period from 05.03.2021 to 04.03.2022. The insured met with the accident on 16.09.2021 meaning thereby it was within the insurance coverage. The schedule of the said policy certificate shows that the insured paid the premium of Rs.330/- towards compulsory PA cover (owner driver) and the benefit coverage is Rs.15 Lac. It means in case of accidental death of the insured involving the motor cycle the insurer will pay Rs.15 Lac to the owner-driver (insured) if it happened within the period of insurance coverage.

 

12.                   As it appears that the husband of the petitioner died within the period of insurance coverage, so, as per contract between the insurance company and the insured (the deceased husband of the petitioner), the insurance company cannot escape themselves from not paying the amount as was assured by them. Accordingly, the OP ICICI Lombard General Insurance Company is liable to pay the assured amount of Rs.15 Lac to the complainant.

 

13.                   In the result and in view of the discussion made above, the claim for compensation of the complainant is allowed.

 

O  R  D  E  R.

 

14.                   In the result, it is hereby directed that the OP, Branch Manager, ICICI General Insurance Company Ltd., Agartala, West Tripura, insurer of the vehicle No.TR-03-E-9681 shall pay the amount of Rs.15,00,000/- (Rupees Fifteen Lac) only to the complainant within a period of 2(two) months from the date of this judgment failing which the amount shall carry interest @ 9% per annum from today. 

                        Apart from this, the OP is also directed to pay Rs.5,000/- towards mental agony suffered by the complainant and Rs.10,000/- towards litigation cost as despite the notice the OP did not come forward to settle the matter with the complainant. 

                        In total the OP shall pay Rs.15,15,000/- (Rupees Fifteen Lac Fifteen Thousand) to the complainant.

 15.                  The case is disposed of on contest.

16.                   Enter the result in the relevant register.

17.                   Supply copy of the judgment to the parties free of cost.                   

 

                         

A N N O U N C E D.