This case has been filed U/s.12 of the Consumer Protection Act, 1986 by the complainant that he purchased a Bajaj Pulsar Motor Cycle being Regd. No. WB 16AN 0889, engine no. JL2CFF49335, Chasis no. MD 2A55F25FCF 42451 and also he purchased an insurance policy for above mentioned motor Cycle from the opposite party which was issued on 15^th October, 2015 and was valid upto 12^th October, 2016  and he met with an accident on 12.06.2016. While riding the said Motor Vehicle on 12.6.2016 he met an accident and as a result of that accident he sustained injuries on his person and he was taken to District Hospital, Chinsurah, Hooghly and on the same day he was transferred to AMRI Hospital Kolkata and he was admitted therein on and from 12.6.2016 to 15.6.2016 and the said Bajaj Pulsar Motor Cycle being no. WB 16AN 0889 was totally damaged due to said accident and after recovery from injury he went to the showroom “Auto Aquarium” and contacted with the concerned staff/ agent of the opposite party and that said staff of the opposite party inserted the date of accident in the claim as on 5.7.2016 in place of 12.6.2016 and on 9.3.2017 the opposite party informed him that the claim is not payable and they are closing this claim without payment due to non payment of claim he suffered huge financial crisis and mental agony.

            The complainant also states that the complainant is a consumer within the meaning of the Consumer Protection Act, 1986 as he paid the entire premium amount of Rs. 2503/- to the opposite party and the opposite party willfully and intentionally has rejected the claim of the complainant and caused deficiency of service and the cause of action of this case arose on 9.3.2017.

Complainant filed the complaint petition praying direction upon the opposite party to pay a sum of Rs.1,16,612/- to the complainant as insurance claim and to pay a sum of Rs. 1,00,000/- to the complainant for harassment and mental agony and also to pay the cost of the case and to pay any other relief which complainant is entitled to get as per law.

The opposite party contested the case by filing written version denying inter-alia all the material allegations as leveled against him.  This opposite party has stated that the complainant purchased one two wheeler package policy being no. OG-16-2417-1802-00007704 effective from 13.10.2015 to 12.10.2016 from the opposite party against one Bajaj Pulsar 200 having Engine no. JL2CFF49335, Chasis no. MD 2A55F25FCF 42451 and the complainant registered a claim being no. OC-17-2401-1802-00001036 on 8.7.2016 with the opposite party on account of an alleged accident of the said vehicle being no. WB 16AN 0889 alleged to have been taken place on 5.7.2016 at about 10:15 a.m. at Bansberia and submitted claim form and one letter dt. 5.7.2016 sent by the complainant also reflected same story and on 7.12.2016 the opposite party again received a letter dt. 28.11.2016 from the complainant and complainant alleged that the said insurance claim was filed by the manager, Bajaj Showroom and the said Manager inserted the date of accident as 5.7.2016.

The opposite party also submitted that the complainant submitted one provisional estimate dt. 5.7.2016 towards the cost of spare parts replacement for the alleged accident in connection with one Bajaj Pulsar 200 being no. WB 16AN 0889 was of Rs. 1,30,403.00/- only inclusive of labour charge which suggests a major accident took place on alleged date on 12.6.2016 and the complainant was unconscious for about 30 minutes due to accident on 12.6.2016 around 1.30 p.m. and was admitted in AMRI, Salt Lake and discharged on 15.6.2016 and he was advised ice pack over right side of neck, Tab. Pyrigestic (1gm) for pain, Tab. Protera (40gm) for the treatment of gastrointestinal condition like GERD, Tab. Trinerve for nutritional deficiencies, Tab. Cetill (500 gm) used to treat a variety of conditions such as Lyme disease; infections of the ears, lungs, urinary tract, etc. caused by bacteria which is evident from the Discharge Summary of AMRI, Salt Lake and now a man of general prudence can conclude that the alleged accident that took place on 12.6.2016 was a minor one and it is highly ridiculous that the estimate prepared by the said showroom towards the cost of spare parts replacement for the alleged minor accident was of a such high value and the opposite party repudiated the said claim on the ground of misrepresentation.

The opposite party has also stated that the complainant has concealed the actual date of loss and intimated the wrong date to the opposite party in the claim form and the complainant to cover up the story of wrong intimation has stated that is was the employee of opposite party who has filled the claim form and not he himself and thus, the instant case is not maintainable as the complainant misrepresented the fact and in respect of the provisions of the law opposite party also stated that there has been no deficiency of service and hence, the instant case is liable for dismissal in limine with cost.

Issues/points for consideration

1. Whether the complainant is the consumer of the opposite party or not?
2. Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
3. Whether there is any deficiency of service on the part of the opposite party?
4. Whether the complainant is entitled to get relief, if any?

DECISIONS WITH REASONS

All the points are taken together for easiness of the discussion of this case.

1. From the materials on record, it transpires that the complainant is a “Consumer” as provided by the spirit of Section 2 (1) (d) (ii) of the Consumer Protection Act, 1986. As the complainant purchased one two wheelers package policy in respect of motor cycle in question from the opposite party insurance company.
2. It appears that complainant is a resident of District Hooghly and address of the opposite party is having within the district of Hooghly. The complaint valued within Rs. 2,00,000/- limit of this Forum. So, this Forum has territorial/pecuniary jurisdiction to entertain and try the case.
3. The main allegation of the complainant is that on 12.6.2016 he met an accident while he was riding his motor cycle in question resulting which he sustained injuries on his person and he was taken to District Hospital, Chinsurah, Hooghly on the same day and he had again been transferred to AMRI Hospital, Kolkata and he was admitted therein on or from 12.6.2016 to 15.6.2016. It is also alleged by the complainant that the motor cycle in question was totally damaged due to the said accident. Further case of the complainant is that after recovery from injuries complainant went to the showroom “AUTO AQUARIUM” and contact with the staff/ agent of the opposite party and the said staff of opposite party inserted the date of accident in the claim as 5.7.2016 in place of 12.6.2016. It is also the case of the complainant that on 9.3.2017 opposite party informed complainant that claim is not payable and it closed the claim without payment.

First of all, it is pertinent to note that the allegation against the concerned staff/ agent of opposite party made by the complainant is very serious in nature, but on that score not any convincing evidence is forthcoming before this Forum. It is the complainant who has to prove beyond doubt that the concerned staff of opposite party has inserted the date of accident as 5.7.2016 in place of 12.6.2016 in claim, but complainant did not furnish the name of concerned staff/agent of opposite party nor could able to adduce any sort of appreciable and positive evidence. It is very much clear that complainant is an adult fellow and there is no evidence that he has been suffering from any mental decease whatsoever at the relevant time. Obviously, question will arise that being a law abiding citizen of India why complainant kept his mouth shut when so called concerned staff was putting in the claim the date of accident as 5.7.2016 in place of 12.6.2016. Not only that why complainant had not drawn the attention of higher authority of opposite party regarding the alleged Illegal function of concerned staff. So, even if this part of allegation of complainant is accepted, then it clearly indicates that complainant only to have wrongful gain clubbed his hands with the hands of so called concerned staff of opposite party on that score and in that case complainant is totally out at the very inception from his making insurance claim.

In support of his case complainant filed photocopy of blue book, photocopy of the certificate of concerned prodhan of concerned gram panchayat for the purpose of proving his residence in District Hooghly. Photocopy of discharge from emergency District Hospital, Hooghly shows that complainant was discharged on 12.6.2016. Photocopy of inpatient bill cum receipt cash of AMRI Hospital has also been filed by the complainant. That apart complainant filed one photocopy of TCR of Auto Aquarium and photocopy of bill/ road challan/ quotation of Auto Aquarium

The discharge summary as appears from the photocopy of AMRI Hospital, Salt Lake filed on behalf of the opposite party clearly and emphatically indicates the discharge diagnosis, chief complaints, history of present illness and medications etc in respect of complainant and those in a body disclose that the injuries of the complainant was not very grievous and serious in nature which can very much perceive by a man of ordinary prudence just after taking a view on the discharge summary of the complainant.

Ld. Counsel appearing for the opposite party in course of his argument highlighted that the provisional estimate submitted by complainant on 5.7.2016 towards the cost of spare parts replacement for the alleged accident in connection with the motor cycle in question was of Rs, 1,30,403/- only inclusive of labour charges which clearly suggests a major accident, but from the copy of discharge summary in respect of complainant issued by the AMRI Hospital clearly reveals that the accident in question was not at all serious in nature. This Forum finds force and spirit in the argument advanced by the ld. Counsel of the opposite party. It is to be noted that on that score ld. Counsel appearing for the complainant has failed to make any convincing counter argument.

In fact, this Forum also finds no illegality in the letter of repudiation of opposite party dt. 9.3.2017.

Considering the materials on record and keeping in mind the attending facts and circumstances of this case this Forum is of the opinion that case of the complainant has no leg to stand upon and as such the instant case is liable to be dismissed.

Hence,

it is

ordered

that the instant case being no. 155 of 2017 be and the same is dismissed on contest.

There will be no order as to costs.

            Let a copy of this order be supplied free of cost to the parties/ their ld. Advocates on record by hand with proper acknowledgement/ send by ordinary course for information and necessary action.