Jharkhand

Bokaro

CC/16/13

Subhash Chandra Choudhary - Complainant(s)

Versus

The Manager, The Oriental Insurance Co. Ltd. - Opp.Party(s)

Kamlesh Kumar

23 Nov 2022

ORDER

          District Consumer Disputes Redressal Commission, Bokaro

Date of Filing-29-02-2016

Date of final hearing-23-11-2022

 Date of Order-23-11-2022

Case No. 13/2016

Subhash Chandra Choudhary S/o Jageshwar Prasad Choudhary

R/o- Qr.No. C/22, BIADA Housing Colony, P.O. & P.S.- Sector-12,

District- Bokaro, Jharkhand.

Vs.

1. The Manager, The Oriental Insurance Co. Ltd.

Swastik Centre, Near Mirch Masala Resturant,

Swastik Char Rasta, C.G. Road, Ahmedabad 380009

2. The Branch Manager, Oriental Insurance Co. Ltd.

Plot No. C-31, City Centre, B.S.City, Sector-4,

District- Bokaro, Jharkhand 827004

 

                             Present:-

                             Shri Jai Prakash Narayan Pandey, President

        Shri Bhawani Prasad Lal Das, Member

          Smt. Baby Kumari, Member

 

PER- J.P.N Pandey, President

-Judgment-

          Complainant is absent, non turned up on behalf of complainant on repeated call. Learned Counsel for O.Ps. is present.  It reveals from the record that this case is pending at the stage of argument in which complainant is absent however written argument has already been filed earlier.  Hence as per provision of Section 38 (3) (c ) Consumer Protection Act. 2019 case has been taken up for decision on merit on the basis of materials available on record as well as after argument of O.Ps.

Complainant’s case in brief is that one Mukesh Kumar obtained Insurance Policy from O.P. No.1 & 2 and maturity value of the policy was Rs. 1,00,000/- and policy was effective from 29.03.2012 to 28.03.2016 vide policy No. 141400/48/2012/2025. Further case is that complainant is nominee of said policy. Further case is that on 24.07.2014 said Mukesh Kumar met with an accident while he was going through Motorcycle with his friend Anuj Kumar at Bahu Bazar, Ranchi, who became senseless and was admitted in Prabhawati Hospital, Ranchi on 24.07.2014, from where he was discharged on 31.07.2014 thereafter, he was admitted in Orchid Medical Centre, Ranchi from where he was discharged on 25.08.2014 but his condition was not satisfactory hence he was shifted to CMC, Vellore where he was admitted on 07.12.2014 and discharged on 08.12.2014 thereafter, he remained there till 14.12.2014 but unfortunately his condition became serious hence, when he was taken to CMC Vellore hospital then he was declared brought dead. When complainant contacted for postmortem at CMC, Vellore then it was informed that it is not suspected to be a medico legal case hence P.M. cannot be held. In respect to accident Sanha was given on 24.07.2014 at Lalpur P.S.  Inspite of repeated approach to the O.Ps. they only paid Rs. 25,000/- as hospitalization charge but they have not paid Rs. 1,00,000/- as death claim hence legal notice was served having no impact, hence case has been filed with prayer to direct the O.Ps. to pay Rs. 1,00,000/- as insurance amount, to pay Rs. 20,000/- as compensation and to pay Rs. 10,000/- as litigation cost.

Both the O.Ps. appeared and have filed W.S. mentioning therein that case is barred by law of limitation and complainant has suppressed material facts and has not come before this Commission with clean hands. Further reply is that hospitalization claim of the claimant for Rs. 25,000/- has already been paid by the O.Ps. Further reply is that so far death claim is concerned, for it postmortem report showing cause of death due to accident is essential but it has not been filed hence claim has been repudiated.                           

Now, point for decision is whether complainant is entitled to get relief as claimed ?

On perusal of the papers annexed with the complaint petition it appears that Insurance policy (Annexure-1) is not in dispute. Annexure-2 is the photo copy of information given by the hospital to the Police and it is also not in dispute. Annexure- 3 & 4 are photo copy of information given to the Police. Annexure-5 & 6 are photo copy of the discharge summary of Prabhawati Hospital, Ranchi which shows that due to Road Traffic Accident Mukesh Kumar was admitted in the hospital on 24.07.2014 and discharged on 31.07.2014. Annexure-7 is photo copy of the discharge summary of Orchid Hospital, Ranchi and it shows that said Mukesh Kumar was admitted in the Orchid hospital on 31.07.2014 and discharged on 25.08.2014 while his all parameters became normal. Annexure-8 is photo copy of brought dead certificate dt. 14.12.2014 issued by CMC, Vellore hospital, annexure-9 is photo copy of death certificate issued by local municipality. Annexure-10 is the photo copy of legal notice and Annexure-11 is photo copy of reply given by the Insurance Co. on legal notice, accordingly as per legal notice patient died on 14.08.2014 but as per death certificate death was occurred on 14.12.2014.

It is important to note here that as per complaint petition said Mukesh Kumar was admitted in the CMC, Vellore Hospital on 07.12.2014 and he was discharged from that very hospital on 08.12.2014 but no any paper related to that very admission and discharge has been produced by the complainant in this case. Further Important fact is that alleged accident took place on 24.07.2014 and as per death certificate death was occurred on 14.12.2014. In this way it is not being established by the complainant that death was the result of the accident occurred on 24.07.2014 rather complainant failed to prove that there is any relation of the accident and death of said Mukesh Kumar who was discharged from the Orchid Hospital on 25.08.2014 after satisfactory condition. In this way we are of the view that repudiation of the claim by the O.Ps. is correct and there is no deficiency in service by the O.Ps.       

In light of above discussion, this case is being dismissed on merit and parties shall bear their own costs.

 

           (J.P.N. Pandey)

                                                                                      President

 

                                                                                               

    (B.P.L Das)

   Sr. Member

 

 

                                                                              (Baby Kumari)

•