West Bengal

Paschim Midnapore

CC/102/2015

Rohima Khatun - Complainant(s)

Versus

The Manager, I.C.I.C.I. Lombard General Insurance Co.Ltd. - Opp.Party(s)

10 Feb 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

PASCHIM MEDINIPUR.

                             

Bibekananda Pramanik, President,

Mrs. Debi Sengupta, Member

and

 Kapot Chattopadhyay, Member.

   

Complaint Case No.102/2015

                                                        

1)Rohima Khatun,

2)Nasima Khatun,

3)Rehana Khatun,

4)Rina Khatun…. …………..….……Complainants.

Versus

 

1)The Manager, I.C.I.C.I. Lombard General Insurance Co. Ltd.,

2)I.C.I.C.I. Lombard General Insurance Co. Ltd.,………Opp. Parties.

 

              For the Complainant: Mr.  Gobinda Prasad Jana, Advocate.

              For the O.P.               : Mr. Pinaki Sengupta, Advocate.

 

Decided on: - 10/02/2016

                               

ORDER

                          Bibekananda Pramanik, President – Facts of the case, in brief, is that Rowsan Ali Khan, since deceased, the husband of the complainant no.1 purchased a Maruti Swift VDI BS-IV Car from M/s Bhandari Automobiles Pvt. Ltd. and the said vehicle was covered under a  insurance policy with the opposite party and the validity of the said policy was from 27/09/2014 to 26/09/2015 and the Personal Accident Risk Covered was Rs.2,00,000/- under the said policy.  On 07/10/2014, at about 5.30 p.m., the

Contd………………P/2

 

 

( 2 )

deceased Rowsan Ali Khan was driving his aforesaid vehicle while he was coming from Krishnanagar towards Chowringhee through N.H.-6 and while his said vehicle reached near Rupnarayan village on N.H.-6 within a jurisdiction of Kharagpur (Local) Police Station, the vehicle met with an accident and the vehicle was fully damaged and Rowsan Ali Khan sustained grievous bleeding injuries all over his body.  Local people took him to Midnapur Medical College & Hospital where he was declared brought dead.  Post Mortem was held over the body of deceased Rowsan Ali Khan and a criminal case was started being Kharagpur (Local) P.S. case no.560/2014 dated 09/10/2014 u/s 279/304(A)/427 of  I.P.C.  It is stated that Rowsan Ali Khan had a valid driving license at the relevant time of accident and from the medical papers and P.S. reports  it would be evident that Rowsan Ali Khan died due to motor vehicle accident.  After the death of Rowsan Ali Khan, the complainant no.1 Rohima Khatun, the wife of the deceased, sent a letter dated 11/11/2014 by registered post with AD on 14/11/2014 to the opposite party for collection of claim form but the opposite parties did not look into the matter till now and they have been killing time for settlement of the claim and such delay of settlement of claim tantamounts to refusal of settlement of insurance claim and as such they are guilty of deficiency in service on their part.  Hence, the complaint, praying for directing the opposite parties to pay the sum assured of Rs.2,00,000/- with interest @ 12% p.a. from the date of accident along with litigation cost of Rs.30,000/-. 

                  The opposite parties have contested this case by filling a joint written statement.

                  Denying and disputing the case of the complainants, it is the specific case of the opposite parties that the complainants have no reason to file this case, that the petition of complaint is not maintainable, and that the allegations made in the petition of complaint are not correct.  It is also the case of the opposite parties that the insurance policy in question is not covered for personal accident benefit for owner-cum-driver as per insurance policy schedule and the present case is pre-mature one as because the complainant did not inform the opposite parties regarding the incident  till now.  Although the complainant no.1 sent a letter to the company but she did not make contact with the opposite party for collection of the claim form and she also did not submit necessary documents to the opposite parties for which the opposite parties are not be able to process the claim.  It is stated by the opposite parties that there is not deficiency in service on their part and the petition of complaint is therefore liable to be dismissed.  

Contd………………P/3

 

                                                         

                                                                                           ( 3 )

Point for decision

1)Is the case is maintainable in it’s present form and prayer?

2)Are the complainants consumers under the opposite parties?

3) Is there any deficiency in service on the part of the opposite parties?

4)Are the complainants entitled to the reliefs, as prayed for?   

                   

Decision with reasons

        All the above points are taken up together for consideration for the sake of convenience and brevity.

       In this case, neither the complainants nor the opposite parties have adduced any sort of evidence, either oral or documentary but they have relied upon some documents, so filed by them in this case.  It appears from the documents, filed by the complainants, that the deceased Rowsan Ali Khan was the owner of vehicle named Maruti Swift VDI BS-IV and the said vehicle was duly insured under a insurance policy being no.3001/MI-02305581/00/000 with the opposite parties-insurance company and the validity of the said policy was from 27/09/2014 to 26/09/2015.  It appears from the death certificate as well as from the police final report of Kharagpur (Local) P.S. case no.560/2014, dated 09/10/2014 that Rowsan Ali Khan, the husband of the complainant no.1, died in a motor accident while he was driving his vehicle on N.H.-6 near Rupnarayan village on 07/10/2014 at about 5.30 p.m.  According to the complainants, after the death of Rowsan Ali Khan, complainant no.1 sent a letter dated 11/11/2014 by registered post with AD on 14/11/2014 to the opposite parties requesting them for providing her with the claim form of the insurance policy and for taking necessary steps in this regard.  Further according to the complainants in spite of issuing of that notice, the opposite parties did not look into the matter and they have been killing time for settlement of the claim and according to the complainant such delay tantamounts to refusal of the settlement of the insurance claim.  As against this, according to the opposite parties, the complainants though sent a letter to them but they did not make contact with the opposite parties for collection of the claim form nor they submitted necessary papers to the insurance company for which they could not process the claim.  It appears from the said letter dated 11/11/2014 that by the said letter, the complainant no.1 requested the opposite parties for providing her with claim form.  Apart from sending the said letter, the complainant took no steps for collection of those claim form from the office of the opposite parties and the opposite parties also did not sent any claim form to the complainants.  It appears that admittedly, the complainant did not submit any claim form

                                                                                                                                                     Contd………………P/4

                                                         

                                                                                             ( 4 )

along with necessary papers.  Since no such claim form with necessary documents was submitted before the opposite parties-insurance company, so the opposite parties had no scope to settle the claim of the complainants.  In spite of that, the present case has been filed by the complainants praying for directing the opposite parties to pay the assured sum of Rs.2,00,000/- with interest @12% p.a. and that litigation cost.  Since the complainant did not submit any claim form as yet, so the opposite party cannot be held liable for deficiency in service regarding settlement of claim and the complainants are not entitled to get any such reliefs, as prayed for.  However, it appears that admittedly the complainants sent a letter dated 11/11/2014 by registered post with AD on 14/11/2014 to the opposite parties for providing them with claim form.  In spite of receipt of that letter, the opposite parties have not supplied such claim form to the complainant which tantamounts to deficiency in service on the part of the opposite parties.  The complainants are, therefore, entitled to an order for such deficiency in service and for direction upon the opposite parties for providing them with prescribed claim form.  Accordingly, the petition of complaint is deserved to be allowed in part, as aforesaid.

                                                  Hence, it is,

                                                                       Ordered,

                                                                        that the complaint case no.102/2015  is allowed in part on contest.  The opposite parties are directed to provide claim form to the petitioners in respect of the policy in question within a month from this date of order.  We make no order as to cost as the complainant took no further initiative for collection of the claim form.

               Dictated & Corrected by me

                              Sd/-                                     Sd/-                             Sd/-                        Sd/-

                         President                              Member                      Member                 President

                                                                                                                                    District Forum

                                                                                                                                Paschim Medinipur