Tripura

West Tripura

CC/14/36

Smt. Anjali Sutradhar - Complainant(s)

Versus

The Branch Manager The National Insurance - Opp.Party(s)

N. Mukharjee

16 Jun 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSSAL FORUM
WEST TRIPURA : AGARTALA

    CASE NO:  CC- 36 of 2014

Smt. Anjali Sutradhar,
W/O- Lt. Lab Chandra Sutradhar,
Khayerpur, Agartala,
West Tripura.            ............Complainant.

         ______VERSUS______

            
The Branch Manager,
        The National Insurance Company Ltd.
        Agartala Division, 
    Agartala, West Tripura.        ...........Opposite party.

 

                    __________PRESENT__________

 SRI S. C. SAHA
PRESIDENT,
  DISTRICT CONSUMER  DISPUTES REDRESSAL FORUM,
      WEST TRIPURA, AGARTALA. 

SMT. B. BHATTACHARYA,
MEMBER,
  DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

SHR. B. BHATTACHARYA,
MEMBER,
  DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, 
  WEST TRIPURA,  AGARTALA.

 

C O U N S E L

 

For the Complainant         : Mr. Niladri Mukherjee and
                  Mr. Suman Bhattacharya,
                  Advocate.
                           
For the Opposite party    : Mr. Partha Sarathi Chakraborty,
                  Advocate.
                

    

JUDGMENT  DELIVERED  ON : - 16.06.15

J U D G M E N T     
        
        This is a complaint U/S 12 of the Consumer Protection Act, 1986 (herein after referred to as 'the Act') filed by the complainant, Smt. Anjali Sutradhar, W/o- Lt. Lab Sutradhar of Khayerpur, Agartala, West Tripura against the O.P., The Branch Manager, National Insurance Company Ltd., Agartala Division, West Tripura over a consumer dispute alleging negligence and deficiency in service on the part of the O.P. 
2.        The fact of the case as gathered from the record is that the complainant's husband late Lab Sutradhar, during his life time, had taken one insurance policy on his own life for a sum assured  Rs.50,000/- under Janata Personal Accident Insurance Policy covering the period from 08.08.2003 to 07.08.2018. Having accepted the proposal, the policy issued by the National Insurance company Ltd. is no- 100300/47/01/9600022/03/96/30164. The assured was a construction labourer who in the course of engagement in construction work suddenly fell from the roof of a building and sustained grievous injury on his person. His injury was diagnosed as Traumatic Paraplegia. He underwent treatment at GBP hospital, Agartala as in-patient with effect from 16.10.09 to 03.03.2010. Subsequently the life assured died at his residence situated at Khayerpur on 29.03.2010. After the death of the life assured the complainant being the nominee U/S 39 of the Insurance Act lodged claim under the said policy with National Insurance Company Ltd. The complainant met the O.P. on a number of times for settlement of her claim but the O.P. did not respond favourably. She also submitted written representation to the O.P. but it yielded no results. Finding no other alternative, she served a demand notice upon the O.P. on 19.04.13. Despite receipt of the notice, the O.P. did not pay the sum assured under the policy. According to the complainant, the conduct of the O.P. constitutes negligence and deficiency in service. Hence, this complaint. 
3.        The O.P. Insurance company contested the case by filing written objection. The O.P., in his written objection, denied all the averments made by the complainant in her complaint. It is disputed that they were deficient in rendering service to the complainant in any manner whatsoever.

4.        In support of the case, the complainant has examined herself as P.W. 1 and has proved and exhibited the following documents:
    Exhibit 1: Copy of Policy of Insurance,
    Exhibit 2: Letter dated 06.09.10 of the ASI Ranir Bazar P.S. addressed to the O.P.,
    Exhibit 3: Original death Certificate ,
    Exhibit 4: Copy of Advocate's notice dated 19.04.13,
    Exhibit 5: Photocopy of medical certificate dated 28.10.09 issued by the M.O., GBP Hospital, Agartala.

5.        No evidence either oral or documentary has been adduced on behalf of the O.P. Insurance Company.
            
FINDINGS:
6.        The points that would arise for consideration in this case are:
        (i) Whether the O.P. Insurance company did any illegality by not settling the claim of the complainant;
        (ii) Whether the O.P. was deficient in rendering service to the complainant.
7.        We have already heard arguments advanced by the learned counsel appearing for the parties. Also perused the pleadings, documents on record, evidence adduced by the complainant and the memorandum of written argument filed on behalf of the complainant meticulously.
8.        There is no manner of dispute on the fact that the life assured during his life time became a member of Janata Personal Accident Insurance Policy floated by the National Insurance Company Ltd. for a sum assured Rs.50,000/-. The life assured while working as a construction labourer had fallen from the roof of a building and sustained grievous injury on his spinal cord. The injury of the life assured was diagnosed as 'Traumatic Paraplegia' which is caused by a lesion of the spinal cord whereby spinal cord is punctured. The life assured had undergone treatment at GBP hospital, Agartala as inpatient with effect from 16.10.09. Subsequently he died at his residence situated at Khayerpur as a result of injury sustained by him on his spinal cord. There is close nexus between the injury sustained by the life assured and his subsequent death.

9.        The O.P., in his written objection, gave evasive denial of the averments made by the complainant. The O.P. has not uttered a single word explaining the reason for non-settlement of the claim preferred by the complainant. During cross examination of the complainant on behalf of the O.P. a suggestion was put to her to the effect that the death of the life assured was natural not an accidental one. The O.P., in his written statement, never pleaded that the death of the life assured was natural not an accidental one. It is well settled that no party should be permitted to travel beyond its pleadings and that all necessary material fact should be pleaded by the party in support of the case set up by it. The object and purpose of pleading is to enable the adversary party to know the case it has to meet. It is also a settle law that no party can lead the evidence on an issue not raised in the pleadings and in case, such evidence has been adduced or the finding of fact has been recorded by the court it is just to be ignored. We have already pointed out that there is not even a whisper in the pleading of the O.P. that the life assured had suffered natural death. Learned Counsel for the O.P. has failed to satisfactorily answer query that was asked by this Forum the reason for causing undue delay in settling the claim preferred by the complainant. It is not disputed by the O.P. that the life of the assured was not covered under the Janata Personal Accident Insurance Policy with a sum assured  Rs.50,000/-. It is needless to say that non-settlement of claim for a long time without any justifiable cause amounts to negligence and deficiency in service.

10.        In the result, therefore, the complaint U/S 12 of the Act filed by the complainant is allowed on contest. The O.P. Insurance company is directed to pay to the complainant the sum assured Rs.50,000/- (Rupees fifty thousand) with 9% interest from the date of issuance of demand notice on 19.04.13 till the payment is made. The O.P. is further directed to pay Rs.5,000/-(Rupees Five thousand) to the complainant for mental agony and harassment together with 2,000/-(Rupees Two thousand) as costs of litigation.         

11.                  A N N O U N C E D

 

SRI S. C. SAHA
PRESIDENT,
DISTRICT CONSUMER  DISPUTES 
REDRESSAL FORUM,
WEST TRIPURA,  AGARTALA.

 

SHRI. B. BHATTACHARYA,
MEMBER,
  DISTRICT CONSUMER DISPUTES 
REDRESSAL FORUM, 
  AGARTALA, WEST TRIPURA.