DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION

WEST TRIPURA :  AGARTALA

 

 

CASE   NO:   CC- 49 of 2021

 

1. Sri Utpal Saha,

S/O. Sri Uttam Saha,

Of Ambagan, Bishalgarh,

P.S.-Bishalgarh, P.O.-Bishallgarh, Pin-799102,

Dist.-Sepahijala Tripura, Agartala…......................................................Complainant.

 

 

 

-VERSUS-

 

 

 

1. The Divisional Manager,

The New India Assurance Company Ltd.,

Of 6/A, Mantri Bari Road, Agartala,

P.S.-West Agartala, Dist.- West Tripura,

Insurer of the vehicle No.TR-07-D-5719(Motor cycle),

P.O.-Agartala, Pin-799001..................................................................... Opposite Party.

 

 

    __________PRESENT__________

 

 SRI RUHIDAS  PAL

PRESIDENT,

  DISTRICT CONSUMER  

DISPUTES REDRESSAL COMMISSION,

      WEST TRIPURA, AGARTALA. 

 

DR (SMT) BINDU PAL

MEMBER,

  DISTRICT CONSUMER 

DISPUTES REDRESSAL COMMISSION, 

  WEST TRIPURA,  AGARTALA.

 

 

SRI SAMIR  GUPTA

MEMBER,

  DISTRICT CONSUMER  DISPUTES  

REDRESSAL COMMISSION,

WEST TRIPURA,  AGARTALA. 

 

 

C O U N S E L

 

 

For the Complainant : Sri Suman Kumar Banik,

  Sri Arindam Roy Chowdhury,

  Advocates.

 

For the O.P.  : Sri Gitangshu Sekhar Das,

  Advocate. 

 

JUDGMENT  DELIVERED  ON : 20/06/2022.

J U D G M E N T

          The Complainant Sri Utpal Saha, set the law in motion by presenting the complaint petition U/S. 35 of the Consumer Protection Act, 2019 complaining deficiency of service by the O.P.

The Complainant's case, in brief, is that the Complainant  insured the vehicle bearing Registration No.TR-07-D-5719(Motor Cycle) with the O.P. vide Policy No.53100131191400003017 which the coverage of the said policy was from 02/10/2019 to 01/10/2024. On 25/05/2020 at about 17.00 hrs. while reached at Babul Chowmuhani market at that time one white colour Maruti vehicle which was proceeding with same direction and the said vehicle dashed behind the TR-07-D-5719(Motor Cycle) and met with an accident and got badly damaged. At the relevant point of time the injured Sri Utpal Saha was taken to TMC Hospital, Hapania but considering the injuries which are grievous in nature the attending doctor of the said hospital referred him to AGMC & GBP Hospital Agartala, from where he was taken to ILS Hospital, Agartala for his better treatment, where he was admitted as an indoor patient from 26/05/2020 to 03/06/2020. The family members of the injured spent near about Rs.7,00,000/- only for his treatment purpose. The father of the injured namely Sri Uttam Saha made a written complaint against the driver of the unknown white colour maruti vehicle to the O/C. Amtali Police Station, District-West Tripura, which was registered as Amtali P.S.Vide FIR No.069/2020 U/S 279/338 of IPC. And 184/187 of the M.V. Act. Thereafter, the father of the owner of the said motor cycle, made contact with one insurance agent of the New India Assurance Co. Ltd. namely Smt. Priyanka Biswas and as per request of the said agent, Sri Uttam Saha i.e. the father of the injured owner had given one signature in a blank paper to file / submit a insurance claim petition to the office of the New India Assurance Co. Ltd.  But the O.P. did not settle the claim of the Complainant rather delaying to settle the claim without any reason. The Complainant has served a legal demand notice dated 20/02/2021 to the O.P. for settlement of the claim. But on receipt of the legal demand notice the O.P. Insurance Company neither gave any response nor has shown any interest to settle the claim. Hence there is a clear deficiency in service on the part of O.P. Insurance Company. 

So, being aggrieved and dissatisfied by the conduct of the O.P.,  the Complainant alleging deficiency of service has filed the instant complaint before this Commission claiming the cost of treatment & compensation of Rs. Rs.9,00,000/- along with interest @12% P.A. from the date of accident till realization of the same.

2. On the other hand O.P. contested the case by filling written statement. 

        In the written statement the O.P. submitted para-wise reply to the complaint in seriatim. Mostly, O.P. denied and disputed the averments made in the complaint.  

      In the written statement it is also stated that it is not known to the O.P. that the father of the complainant put any signature in any blank paper, but the O.P. received claim settlement with an application form. Moreover, the allegations as brought against the Smt. Priyanka Biswas she is not made a party to ascertain the truthfulness of the contentions. There was no deficiency of service on the part of the O.P. but it was the Complainant for whose non cooperation the claim could not be settled. It is also stated that the Complainant is not entitled to get the treatment cost of Rs.7,00,000/- as no paper is submitted in support of the claim. Moreover, the Complainant did not make party Smt. Priyanka Biswas as O.P. for which claim is bad for non joinder of necessary party.            

EVIDENCE ADDUCED BY THE PARTIES:-

Complainant has examined himself as PW-I and he has submitted his examination-in-Chief by way of Affidavit. In this case the complainant produced 10 documents comprising 16 sheets under a Firisti dated 13/07/2021. The documents are namely xerox copy of prayer for claim settlement, xerox copy of prayer for claim withdrawal petition, Xerox copy of prayer for claim re-open petition, Xerox copy of Advocate Notice, Xerox copy of delivery report of Advocate Notice, Xerox copy of Insurance policy of vehicle, Xerox copy of registration of vehicle No.TR-07-D-5719,  Copy of F.I.R. Ejahar Scizer list, Xerox copy of Discharge summary ILS Hospital & Xerox copy of Driving License etc. which are marked as Exhibit-I series. 

          On behalf of the O.P. one witness namely Shri Suman Das, S/o. Shri Satish Ch. Das, Administrative Officer of New India Assurance Co. Ltd.,4, Mantribari Road, P.S.-West Agartala, Dist.-West Tripura was examined.  O.P. has produced 1 document comprising 06 sheets under a Firisti dated 29/09/2021 which are marked as Exhibit-A series.                 

POINTS TO BE DETERMINED:-

    On perusal of the pleadings of both parties and having regard to the evidence adduced by the parties, the following points are to be determined:

    (i). Whether there is deficiency of service on the part of the O.P. towards the Complainant?

    (ii) Whether the complainant is entitled to get any compensation/ relief as prayed for?

ARGUMENTS OF BOTH SIDES 

    Heard argument of both sides at length. 

    Learned Advocate Mr. Suman Kr. Banik appeared on behalf of the Complainant. He submits that the Complainant met with an accident with his motor cycle on 25/05/2020 and he sustained injuries as a result he was taken to TMC Hospital, Hapania but considering the injuries the attending doctor referred him to AGMC & GBP Hospital, Agartala, from where he was taken to ILS Hospital, Agartala for better treatment. He was admitted as an indoor patient from 26/05/2020 to 03/06/2020. His family members spent near about Rs.7,00,000/- only for his treatment purpose. Motor Cycle was insured the New India Assurance Co. Ltd. vide Policy No.53100131191400003017 valid w.e.f. 02/10/2019 to 01/10/2024. Father of the owner the of the said motor cycle, made contact with insurance agent namely Smt. Priyanka Biswas and as per her request Sri Uttam Saha had given one signature in a blank paper to file insurance claim petition to the office of the O.P. but O.P. did not settle the claim. He further submitted that necessary documents are produced and it is marked as Exhibit-I series. He further submits that the claimant is entitled to get his insurance benefit and O.P. is liable to settle the claim. 

  On the other hand Learned Advocate Mr. G.S. Das appeared from the side of the O.P. submitted that it is admitted fact that father of the Complainant submitted the claim settlement which is duly received by the O.P. on 13/08/2020 but in the claim settlement nothing has been clearly mentioned against which the claim has been made. Mr. Das again submitted that subsequently Complainant submitted an application for withdrawal of the claim as the claim amount is too low and for that reason the settlement proceeding was closed. He further submitted that the claim petition was not submitted properly with documents, so there is no deficiency of service on the part of the O.P. Mr. Das fairly submits that there is no dispute in respect of insurance coverage but to settle the claim. Complainant is to submit the claim petition properly with proper documentation then his claim will be re-opened.                                   

DECISION AND REASONS FOR DECISION:                                     

          Both points are taken up together for convenience. 

    We have perused the complaint as well as written statement and evidences adduced from both parties.     

    One Sri Suman Das, Administrative Officer of New India Assurance Co. Ltd. submitted his examination-in-chief on affidavit as OPW-I. In his affidavit he stated that it is admitted that FIR was lodged by the father of the Complainant that an accident took place due to rash and negligent driving of one Maruti Vehicle. He further deposed that Complainant should prove that he was admitted in the hospital and treated therein caused by motor accident and incurred Rs.7,00,000/- for the treatment purpose. At Para-7, on the examination-in-chief on affidavit OPW stated that they have received Advocate notice for claim of medical treatment cost but before that no claim had been specifically made for treatment cost or damage of motor cycle. At Para-10, OPW stated that Complainant did not submit any documents in support of  his claim and subsequently the claim was withdrawn and as such the Insurance Company did not proceed with final investigation regarding the claim of the Complainant. At Para-11, OPW further stated that there was a coverage of Personal Accident for Owner-cum-driver.    

  From the evidence adduced by the O.P. it has been made clear that actually there is no rejection of claim. It was not finally processed because of non-submission of documentation and proper claim petition. Mr. Das fairly submitted that the matter may be re-opened if the Complainant again approach before the O.P. by submitting proper documentation. 

7.    On appreciation of entire evidence we can not say that there was deficiency of service on the part of the O.P. but there was latches on the part of the claimant. Since, the matter is not settled finally, complainant is directed to approach the O.P. again by filing proper claim petition along with documentation within 1 month from the date of this judgment. At the same time O.P. is also directed to re-open the claim process and settle the claim finally within a reasonable period so, that Complainant may get justice. 

    With the above direction the complaint is disposed of and no cost.                            

Supply a certified copy of the judgment to both the parties  free of cost. 

        Announced.

 

 

SRI  RUHIDAS  PAL

PRESIDENT,

DISTRICT CONSUMER  DISPUTES 

REDRESSAL COMMISSION,

WEST TRIPURA,  AGARTALA

 

 

 

 

DR (SMT)  BINDU  PAL

MEMBER, 

DISTRICT CONSUMER DISPUTES 

REDRESSAL COMMISSION, 

WEST TRIPURA, AGARTALA

 

 

SRI SAMIR  GUPTA

MEMBER,

  DISTRICT CONSUMER  DISPUTES  

REDRESSAL COMMISSION,

WEST TRIPURA,  AGARTALA.