District Consumer Forum, Bokaro
Consumer Case No.-68 /2009
Kailash Singh s/o late Sitaram Singh
R/o Sector-II/D, Road, Qr.-3- 207, Bokaro Steel City Dist.- Bokaro. (Jharkhand)
Vs.
1. Sri Sanjay Mohalkar s/o Unknown,
Claims Head Office, Poona, Bajaj Allianz General Insurance Co Ltd, G.F. Plaza, Air Port Road, Yerawada, Poona-411006
2. Secretary, Bokaro Steel Group Accident Insurance Committee, Room No.82, Old Adm. Bhawan Bokaro Steel City-827001, P.S.- B.S.City. Dist.- Bokaro( Jharkhand)
Present-
S.M. Alam, President
Sri Vijay Bahadur Singh, Member
Shabnam Praveen, Member
Date of Judgment-21/12/2009
Date of Case filing-28/08/2009
-: Judgment:-
The complainant has filed the present case against the opposite parties to pay Rs. 15000/- on account of accidental claim, besides Rs. 25000/- for mental and physical harassment and Rs. 15000/- as cost of litigation.
2 Brief fact of the case is that the complainant was appointed on the post of M.S.T. in BSL on 21.06.1973 and retired on 30.06.2008. The complainant while in service was provided Group Accident Insurance by Committee of BSL and accordingly premium was detected from the salary of the complainant to be paid to the insurance co., vide No. OG-O7-2401-9902-00000032 and claim No. OC-07-2401-9902-00000122 by the B.S.L. Bokaro having calibration with Bajaj Allianz General Insurance Co. Ltd. The complainant met with an accident on 15.07.2006 while he was going to his residence a Maruti Car dashed his Cycle from backside at Admn.Bldg. crossing and he got injured in the right leg knee and got permanent disability in that part. The complainant was also admitted in BGH from 15.07.2006 to 17.08.2006 and due to accident 6% of the body got effected and stopped functioned. The complainant informed his Department and the Group Accident Committee about the accident and claim for partial disability of the body. The complainant sent several letters to Bokaro Steel Group Accident Committee/ Bajaj Allianz General Insurance Co. as per agreement for the payment of the said claim of the complainant. The Bokaro Group Accident Committee asked the Bajaj Allianz General Insurance Co. to pay the complainant as per agreement. The Bokaro Steel Group Accidental Committee asked the Bajaj Allianz General Insurance Company Ltd to pay the applicant Rs. 15000/- as a compensation on the basis of the 6% disablement as per the medical report. The complainant also served a legal notice on 11/08/2009 upon the opposite parties but no reply was received from them. The complainant is suffering from physical and mental harassment as no compensation has been paid by the opposite parties. Thus there is apparently deficiency on the part of the opposite parties for which the complainant is entitled to get relief as sought against them.
3 Upon issuance of notices, the opposite party No.2 appeared and field its written statement, in which it has been admitted that Bokaro Steel Group Accident Committee constituted by SAIL , Bokaro Steel Plant and BSL acts as link between the insured employee of the Company and the insurer in as much as it facilitated insurance of its employee under Group Personal Accident Insurance Policy and pursues the claims with the insurer for settlement in case of accidental death or disability of the insured. The opposite party no.2 further admits that the complainant was an employee of SAIL, Bokaro Steel Plant vide Staff No. 267890, met with an accident on 15.07.2006 while he was returning back from “A” Shift duty. The necessary information of the said accident was given to the concerned Authority by the concerned department of the opposite party no.2. Accordingly on received of information from the department the opposite party no.2 sent a intimation to the opposite party no.1 on 11.08.2006. The complainant also submitted applications on 04.04.2007 and 10.03.2008 to opposite party no.2 to the effect that he would raise a formal claim with all relevant documents after assessment of the disability suffered by him due to injuries received in the said accident which was also forwarded to the opposite party No.1 on 10.09.2008. But the opposite party no.1 repudiated the claim of the complainant vide its letter dated 08.07.2009. It appears that the claim of the complainant has been repudiated on flimsy ground. The opposite party no.2 was requested to reconsider the claim in that connection also informed its attention to the understanding reached between them on 09.04.2009 that the entire pending claim relating to disability would be settled by 30.04.2009. An intimation in this regard was also given to the complainant vide its letter dated 24.07.2009. The opposite party no.1 did not reconsider the matter necessitating the filing of the present complaint by the complainant. However liability of payment of compensation to the complainant is that of opposite party no.1 and not opposite party no.2. Since the opposite party no.2 is merely work like bridge between the insured and insurer which has been done by the opposite party no.2, as such there is no deficiency on the part of the opposite party no.2 and the name of opposite party no.2 be expunged from this Consumer Complaint.
4 However the opposite party no.1 neither appeared nor file any written statement in this case, hence proceeding against the opposite party no.2 proceeded Ex-parte.
5 We heard the complainant and the opposite party no.2. The opposite Party No.1 has failed to argue the case. On perusal of the entire case records and documents filed by the parties it is observed that the complainant was declared 6% disabled by the proper authority due to his accident on 15.07.2006 while he was returning from his Duty of “A” Shift. The medical certificate issued by the concerned doctor and proper authority declared the complainant as 6% permanent disabled. But the opposite party no.1 repudiated the claimant’s claim on the ground of temporary disablement of the complainant.
6 In view of the above the repudiation of the claimants claim by the opposite party no.1 is held to be an act of negligence and deficiency in service. We, therefore, hold the opposite party no.1 liable to pay 6% of the insured amount of Rs. 250000/-(Rs. 15000/-) to the complainant besides other reliefs.
7 Under the facts and circumstances of the case, the opposite party No.1 Sri Sanjay Mohalkar s/o Unknown, Claims Head India Office, Poona, Bajaj Allianz General Insurance Co Ltd, G.F. Plaza, Air Port Road, Yerawada, Poona-411006 is directed to pay Rs. 15000/- (Rs. Fifteen thousand) only to the complainant within 30 days from the date of this order. The above opposite party is further directed to pay compensation of Rs. 500/- (five hundred) only to the complainant within 30 days from the date of this order.
Member (lady) Member President