West Bengal

Dakshin Dinajpur

CC/1/2019

Mrs. Dipali Murmu, D/O- Late Turai Murmu, C/O- Sukchand Murmu - Complainant(s)

Versus

The Deputy Vice President, Calims SBI General Insurance Co. Ltd., Grievance Redressal Officer - Opp.Party(s)

Pintu Sarkar

25 Jul 2022

ORDER

Today is fixed for passing ex-parte order. 

 The instant case has been initiated by the complainant U/S – 312of C.P. Act, 1986 against the Opposite Parties claiming an amount of Rs. 2,00,000/- + Mental harassment Rs.1,00,000/- + Litigation cost Rs.50,000/- = Total Rs.3,50,000/- from 05.10.2016.

The fact of the case, in brief, is that the father of the Complainant Turai Murmu purchased a SBI General Personal Accident Insurance  Policy vide Certificate No.8892985, Master Policy No.143820000001 on 29.10.2015 for Rs.2,00,000/- only for the period from 29.10.2015 to 28.10.2016 and the Complainant was nominee of that policy and he has paid Rs.100/- only as premium. On 04.10.2016 at about09.30.P.M.when the father of the Complainant was returning home, he suddenly fell down on the road and roll down on the road side pond and died. His dead body was recovered from the pond on 05.10.2016 and the concerned doctor opined that the death was occurred due to drowning and the EMO, Balurghat District Hospital informed the matter to the I.C. Balurghat P.S. on 05.10.2016 and on the basis of the said information the Balurghat P.S. started an U.D. case vide Balurghat P.S. U.D. case no. 374/2016 dated 05.10.2016. The Complainant is the beneficiary of the said policy of Turai Murmu as a legal heir and nominee of the said policy and as such she is a consumer U/S 2(d) of the C.P. Act, 1986.

The Complainant lodged a complaint to the Opposite Party No.1on 27.03.2017 which was duly received by the Opposite Party No.1, claiming policy money of Rs.2,00,000/- vide claim no.363304 but the Opposite Party No.1 repudiated the claim on10.08.2017. The Complainant sent a notice through her lawyer which was duly received by the Opposite Party No.1 on 02.01.2018 but he did not pay the said money to the Complainant up till now. Having no alternative, the Complainant became bound to take the shelter of this commission for getting proper redress.  

It appears from the case record that notice which were issued to the Opposite Parties, were received by them. The Opposite Party No.2 appeared before this Commission and filed written version. The Opposite Party No.1did not appear before this Commission in spite of receiving notice. So, the case is proceeded ex parte against him. After submission of evidence on affidavit by the Complainant and Opposite Party No.2, the Opposite Party No.1 appeared before this Commission and filed written version but the said written version was not accepted because the same was filed beyond the statutory period. After filing of evidence on affidavit by the Opposite Party No.2 as many as 10 (Ten) adjournments were granted to the Ld. Advocate for the Opposite Party No.2 to file written notes of argument but failed. Thereafter, the Opposite Party No.2 failed to take steps and also failed to appear on several dates, hence, this case is also heard ex parte against him.

To prove his case, the complainant has submitted

(i) Photo Copy of PA Insurance Cover

(ii) Photo copy of Death Certificate of Turai Murmu

(iii)Photo copy of Discharge Certificate of Turai Murmu of Balurghat District Hospital.

(iv) Photo copy of Investigation report U/S-174 Cr.P.C.

(v) Photo copy of Post- Mortem report of Turai Murmu.

(vi) Photo copy of Group Personal Accident Insurance Policy of SBI

(vii) Photo Copy of letter of SBI dated 10.08.2017

(viii) Photo Copy of Advocate letter.

 

                                              DECISION  WITH  REASONS

 

                  We have heard argument by Ld. Advocates for the Complainant. Perused the evidence on affidavit, written argument and other materials on record.

                 It appears from the photo copy of PA Insurance Cover issued by SBI General Insurance that the sum insured is Rs. 2,00,000/- in the name of Turai Murmu being certificate no.8892985 for the period from 29.10.2015 to 28.10.2016. The said Turai Murmu died on 04.10.2016 at about 09.30 P.M due to drowning. After the death of Turai Murmu, the Complainant put a claim before the Opposite Parties but the said claim is repudiated.

                 On perusal of the photo copy of the post-mortem report of the deceased Turai murmur, it appears from the column – stomach and its contains that the stomach contains 300 gms. of partly food and alcoholic smell . In such circumstances, it is clearly established that the decease Turai Murmu was under the influence of alcohol at the time of incidence or death. It has been mentioned in para- 4 of Part-C General exclusion of the policy that the Company will not be liable under the policy in respect of loss or damage due to – Being use/abuse of drugs, alcohol, or other intoxicants or hallucinogens unless properly prescribed by a physician and taken as prescribed .

                      In view of the above mentioned discussions, it has been established that at the time of death, the deceased was under the influence of alcohol and drowned in the pond and died. So, the Complainant is not entitled to get relief.

                      Hence, it is

                                                           Ordered

      That the instant case be and the same is dismissed ex parte but without cost.