Bihar

Jehanabad

CC/26/2018

Akbari Khatoon - Complainant(s)

Versus

Manager , State Bank Of India, General Insurance - Opp.Party(s)

Sushil Kumar

10 Apr 2024

ORDER

District Consumer Dispute Redressal Commission, Jehanabad

                                                                                                    Date of Filing- 11.07.2018

                                                                                                 Date of Disposal- 10.04.2024

   

                                           Before,

The District Consumer Dispute Redressal Commission,

JEHANABAD

Present: 1. Hon'ble Sri Prem Ranjan Mishra, President,

2. Syed Mohtasim Akhter, In-Charge Additional Member.

Dated, Jehanabad, the 10t Day of April, 2024.

Consumer Complaint No: 26 of 2018

Complaint Register Serial No: 08 of 2024

(Under Section 35 of Consumer Protection Act, 2019)

           Akbari Khatoon, Wife of Late Mustakeem Khan, Vill-Nagwan, PS-Kako,

           Dist- Jehanabad...........................................................................................Complainant

Versus

           1. Manager, State Bank of India, New Town, Raja Rahat, Ahirini ActionArea, Branch Code-5112, Kolkata-700056.

           2.Manager, SBI General Insurance Co. Ltd. Natraj 101, Juction ofWestern Express Highway & Andheri, Kurla Road,                                    Andheri(East), Mumbai-400069..............................................................Opposite Party.

           For the Complainant: Sri Sushil Kumar, Advocate,

           For the Opposite Party no- 1: Sri Shyam Bihari Sharma, Advocate,Opposite Party no- 2: Sri Ramdhyan, Advocate.

 

 

JUDGEMENT

As per Hon'ble Mr. Justice Prem Ranjan Mishra,

                       Present consumer Complaint under Section 35 of Consumer ProtectionAct, 2019 has been filed on 11.07. 2018 against the opposite partyalleging deficiency in service from the part of the opposite partythrough denying the benefit of accidental insurance to thecomplainant, the recorded nominee for accidental death of herhusband Md. Mustakeem Khan as per terms and conditions ofPersonnel Accident Policy of the State Bank of India General InsurancePolicy.

2.                   Case of the complainant in brief is that the complainant's husband was an Savings bank account holder of the opposite party at New TownRajarhat, Ahirini Action Area Branch (Branch Code No.5112), CIF no.87259120522 Vide Account no.20225124954 of State bank of Indiaand was accordingly insured for accidental death for a sum of Rs.2,00,000/- vide Master Policy No.143820-0000-00 for a period of oneyear from11.06.2014 (Ext.6). Unfortunately Complainant's husband on08.05.2017 at about 07.45 P.M. in the evening while working at the siteof Metro Railway Project behind Q-20, B.P. Township Kolkota-94 as anassistant on the ground started feeling unwell and thereafter fellunconscious/ senseless. Immediately, he was removed to Ruby GeneralHospital, where doctor on duty declared him as brought dead. Afterpreparation of Inquest & P.M. examination(P.M. report Ext.7) body washanded over to the deceased's son Arman Khan vide Ext.1. to which thecomplainant's son received and brought the dead body to his nativevillage within Jehanabad -District. After all above, the Complainantdeceased policy holder's wife, the recorded nominee, applied andstaked her claim for the payment of insurance Money as per the terms and the conditions of personnel Accident Policy of SBI GeneralInsurance, the same was according to the complainant was repudiatedby the Manager, State Bank of India

 

3.                    Out the two opposite parties, opposite party no. 2 only appeared on02.01. 2021 and filed his show cause cum written version .On validservice of Notice, opposite party no.1 appeared on 21.01.2022, but didnot File his show cause, Hence vide order dtd. 05.07.2023 he wasdebarred from filing of his written version cum show cause. But thelearned advocate for the Opposite party cross-examined thecomplainant.

 

4.                   Case of the appearing opposite party no. 2 is that he has notreceived any claim from the complainant nor any document to processthe claim on merits within the precincts of terms and conditions ofpolicy. The complainant has never registered any claim for the allegedaccidental death of the insured. Hence, the complainant may be directed to register the claim with him - the opposite party no.2.

5. Complainant in support of his case examined himself as C.W. 1 andproduced the following documents -

Ext.1- Inquiry report of 1.O. in reference to death of Complainant'shusband submitted to AnandPur P.S. Kolkata,

Ext. 2- Application of decd's son before the Officer in-charge, Anand purP.S. seeking permission to carry the decd's dead body,

Ext. 3- Death certificate of decd. Md. Mustakeem,

 

Ext. 4.Identity card of the decd. granted by his employer AfconsInfrastructure Limited,

Ext.5- Photo copy of first page of S/B Account of the deceased,

Ext. 6- Certificate of Insurance of Personal Accident policy of thedeceased,

Ext.7- Post Mortem Report of the deceased,

Ext. 8. Print out of continuous page of Decd.'s Pass book showingdeduction of premium for insurance on 11.06.2014,

Ext. 9 - Death certificate granted by Ruby General Hospital Ltd.

6. Now the only point to be adjudicated and determined in the case isas to whether the complainant is entitled to the relief claimed or not?

FINDING

7. As per point no.2 of the terms and conditions mentioned overleaf ofthe policy deed (Ext. 7) coverage is limited to death on account ofaccident only.

8. Here in this case, as per ext.1, while the complainant's husband, thedeceased was working at the site of Metro Railway Project, startedfeeling unwell and shortly became senseless, when carried to Hospital,he was diagnosed and reported as brought dead.

Ext.7 the post mortem report states death appears to be due to theeffects of diseased condition of heart as noted above- a Natural CauseViz. VENTRICULAR ENLARGEMENT VALVE CUSPS THICKENED.

 

9. As such, from the above referred two exhibits, it is crystal clear thatthe death was natural which do not attracts coverage of insurancevide Ext. 6 read with point no.2 of the terms and conditions mentionedoverleaf of the Accidental policy deed .

10. In view of the above said facts and circumstances of the casefollowed by the discussions made and the finding arrived atamconstrained to hold that that the complainant has miserably failed inproving his case of deficiency in service from the part of the oppositeparty,

11. Hence, it is therefore hereby,

ORDERED

That the complaint being devoid of any factual or statutory meritdismissed against the opposite no. 1 on contest but the same isdisposed of against the Opposite party no. 2 Since the opposite partyno. 2 has himself through his written version cum show causesubmitted that the complainant may be directed to register his claimwith him with all the necessary documents for processing the claim onmerits, therefore the complainant is set at liberty to register her claimwith the opposite party no. 2 afresh in which period consumed inprosecuting this complaint shall be excluded while computing theperiod of limitation under section 69 of the consumer Protection Act,2019.

Under the circumstances no any order as to costs etc. is being passed.

Parties shall bear their costs themselves.

 

Let a copy of this order be immediately served to the partiesthemselves individually in person or through their respective advocatesfree of cost.