West Bengal

Paschim Midnapore

CC/85/2017

Madan Gopal Kubir - Complainant(s)

Versus

The Branch Manager, L.I.C. of India - Opp.Party(s)

Bijoy Mukhopadhyay

13 Dec 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

PASCHIM MEDINIPUR.

                             

Bibekananda Pramanik, President,

Pulak Kumar Singha, Member

and

Sagarika Sarkar, Member.

Complaint Case No.85/2017

 

             Madan Gopal Kubir, S/o Late Debendranath Kubir, Vill. Maniraj, P.O. Bakrabad,

             P.S. Belda, District - Paschim Medinipur.   

                                                                                            ………..……Complainant.

                                                                              Vs.

1. The Branch Manager, Life Insurance Corporation of India, Kharagpur Branch, Kusum Apartment O.T. Road, P.O. Inda, District- Paschim Medinipur,
2. The Divisional Manager, Life Insurance Corporation of India, Malancha Road, P.O. Kharagpur, P.S. Kharagpur (T), District- Paschim Medinipur .

                                                                                   .....……….….Opp. Parties.

                                                    

              For the Complainant: Mr. Bijoy Mookhopadhyay, Advocate.

              For the O.P.               : Mr. Swapan Bhattacherjee, Advocate.

 

Decided on: - 13/12/2017

                               

ORDER

                          Bibekananda Pramanik, President –This consumer complaint u/s 12 of the C.P. Act has been filed by the complainant Sri Madan Gopal Kubir against the above named O.Ps, alleging deficiency in service on their part.

                Complainant’s case, in brief, is as follows

                Complainant Madan Gopal Kubir is the father and nominee of his son Gurupada Kubir, since deceased.  During his lifetime, Gurupada Kubir obtained a Life Insurance Policy vide policy no.435714835 on 28.02.2004 and he was paying Rs.1519/- as yearly premium and the sum assured was Rs.30,000/-.

Contd…………………..P/2

 

 

( 2 )

 Gurupada Kubir met with a motor accident on 30/01/2010 and he was immediately taken to Belda B.P.H.C., but due to seriousness of the injuries he was referred to Medinipur Medical College & Hospital and there he was admitted as indoor patient on that very day.  On the next day, Gurupada Kubir was referred to S.S.K.M. Medical College & Hospital for better management and there he succumbed to his injuries on 02/02/2010.  After his death, Bhabanipur P.S. held inquest on the dead body of Gurupada Kubir on 03/02/2010 and post -mortem also was done there.  In connection with the said accident, a complaint was lodged at Dantan P.S. on 11/02/2010 and the same was registered at Dantan P.S. case no.22/2010 dated 11/02/2010 u/s 279/304(A) I.P.C. against the driver of the offending vehicle no.WB 33A/4664.  The complainant thereafter lodged claim of insurance before the O.P. along with all necessary papers and being satisfied with and on the basis of the terms and conditions of the policy, O.P. no.1 granted a part claim amount of Rs.39,529/- to the complainant with the assurance that final accidental claim will be made after all verification.  After several requests, O.P. no.1 issued a discharge voucher on 5/10/2012 and the complainant sent that discharge voucher with his signature and revenue stamp to the O.P. no.1within time but till now the O.P. did not show any interest to pay the accidental death claim amount of Rs.60,000/- to the complainant.  By sending an Advocate’s notice dated 15/01/2014, the complainant requested the O.P. to pay the death claim of Gurupada Kubir but till now O.P. did nothing. Thereafter the complainant filed a complaint case being no.86/2014 and the said case was disposed of on contest on 02/09/2015.  In the said case, this Forum was pleased to pass an order that the complain case no.86/2014 is allowed on contest against the O.Ps with cost, O.Ps are directed to settle the claim of accidental benefit under that policy as per rules within two months from this date of order on production of the copy of charge sheet/ final report afresh by the complaint.  In view of the said order, the complainant sent police final report, F.I.R. and seizure list to the O.P. no.1 by registered post through his advocate and after getting those documents, O.P. repudiated the claim on the ground that after investigation,  police submitted final report in that case.  It is stated that without any enquiry, O.P. no.1 very blindly acted upon that police final report and repudiated the claim of the complainant vide their letter dated 16/10/2015.  Hence the complaint, praying for directing the O.P. to make payment of double accident death benefit claim of Rs.60,000/-, litigation cost of Rs.30,000/-, interest and other reliefs.

Contd…………………..P/3

 

 

( 3 )

   

               Both the opposite parties have contested this case by filling a joint written objection.  

                   Denying and disputing the case of the complainant, it is the specific case of the opposite parties-Insurance Company that the complainant has filed this case with some false and fictitious allegations and therefore the complainant is not entitled to get any benefit.  It is submitted by the O.Ps that the son of the complainant Gurupada Kubir was a bona fide policy holder of LICI with sum assured of Rs.30,000/-.  He died on 02/02/2010 and the said fact was brought to the notice of O.Ps by the complainant.  After considering those documents,  O.Ps settled the basic sum assured as well as bonus total amounting to Rs.39,529/- only to the complainant and paid the said amount to the complainant vide cheque no.0729586 dated 09/08/2010.  At the time of handing over the said cheque,  the O.P. assured the complainant that the accidental benefit will be settled after going through the charge-sheet or final report.  It is stated that the O.Ps did not disbelieve the story of accident and on good faith, they handed over a discharge voucher to the complainant.  The complainant did not produce any documents regarding accidental death of Gurupada Kubir for a long time and suppressing the said fact, he filed a complaint case being no.86/2014 before this Forum.  As per  direction of this Forum, the complainant thereafter submitted the xerox certified copy of the police final report as well as other documents and from the police final report it was established that accidental death due to car accident has not been proved and the O.Ps therefore repudiated the claim of the complainant.  It is stated that the complainant has suppressed the actual state of material facts and filed this case with ill motive and the petition of complaint is therefore liable to be dismissed.

             To prove his case, the complainant Madan Gopal Kubir has examined himself as PW-1 and the documents, relied upon by the complainant, have been marked as exhibit 1 to 12 respectively.  On behalf of the complainant, another witness namely Sudipto Kumar Maity was examined as PW-2 and during his evidence, few documents were marked as exhibits 13,14 & 15 respectively.  On the other hand, O.Ps have examined one witness namely Sri Pravat Chakraborty as OPW-1 and during his evidence, one document was marked as exhibit A. 

Contd…………………..P/4

 

                                               

                                                                               ( 4 )

                                                                 Points for decision

1. Is the case maintainable in it’s present form and prayer?
2. Is there any deficiency in service on the part of the opposite parties?
3. Is the complainant entitled to get the reliefs, as sought for?    

                   

Decision with reasons

                  Point no.1

                         Maintainability of this case has not been challenged at the time of final hearing of this case.  We also do not find anything adverse regarding the maintainability of this case and   therefore we are of the view that the present case is well maintainable.

            Point no. 2

                 Regarding deficiency in service on the part of the O.P.-Insurance Company,  it is the specific case of the complainant that his son Gurupada Kubir sustained deep bleeding injury due to motor vehicle accident on 30/01/2010 and he succumbed to his such injury on 02/02/2010 at S.S.K.M. Medical College and Hospital.  Regarding such motor vehicle accident, a complaint was filed before Dantan P.S. on basis on which Dantan P.S case no.22/2010 dated 11/02/2010 u/s 279/304(A) I.P.C. was started against the driver of the offending pick- up van.  Stating all such above facts, the complainant informed the O.P.-Insurance Company thereby claiming accidental benefit of such insurance policy of his son.  He also sent the F.I.R., post mortem report, death certificate and original deed of LIC but the O.P. no.1 only granted part claim of Rs.39,529/- with the assurance that final accidental claim will be made after all verification.  According to the complainant, as per order of this Forum passed in complaint case no.86/14, he submitted copy of final report of that police case but without any enquiry or investigation, O.P.-Insurance Company blindly relied upon that police final report and repudiated the genuine claim of the complainant vide their letter dated 16/10/2015.  Said repudiation letter has been marked as Exbt. 1 in this case.  From the said repudiation letter (Exbt.1) we find that the O.P.-Insurance Company repudiated the claim of accidental benefit on the ground that from the police final report, it is established that accidental death due to car accident had not been proved and as per rules, the complainant is not eligible for getting accidental benefit in the instant case.  We have gone through the said letter of repudiation as well as the police final report in

Contd…………………..P/5

 

( 5 )

connection with Dantan P.S. case no.22/2010 dated 11/02/2010 u/s 279/304(A) of I.P.C.  It appears from the said police final report that the investigating officer visited the probable place of occurrence, examined local chance witnesses and verified the admission register of Belda  BPHC as well as M.M.C,  Medinipur and after making full investigation, the investigating officer of that case could not collect any evidence to show that any vehicle made such accident causing injury to the victim.  The investigating officer has also stated in his final report that the complainant party totally avoided police investigation and perhaps they have planned to claim insurance but out of fear of police investigation, the complainant concealed himself and did not substantiate his case through investigation.  Said police final report was duly filed by the I.O before the Ld. Court and the report of such investigation was also informed to the complainant.  There is nothing on record  to show that after submission of such FRT, the complainant filed any written objection against the FRT and it should be therefore presumed that the said FRT had been finally accepted by the Ld. Court. So relying upon the said police final report, the O.P.-Insurance Company committed no error or injustice in repudiating the claim of accidental benefit and therefore question of deficiency in service does not arise.    

     This point is accordingly decided against the complainant.

           Point no.3

                  In view of our above findings, the complainant is not entitled to get any relief, as prayed for.               

                            All the points are accordingly disposed of.

    In the result, the complaint case fails.

                                             Hence, it is,

                                         Ordered,

                   that the complaint case no.85/2017  is hereby dismissed on  contest but in the circumstances without cost.

   Let plain copy of this order be given to the parties free of cost.

   Dictated and Corrected by me

        Sd/-B. Pramanik.            Sd/-P.K. Singha           Sd/- S. Sarkar         Sd/-B. Pramanik. 

               President                        Member                       Member                  President

                                                                                                                    District Forum

                                                                                                                 Paschim Medinipur