Orissa

Kendujhar

CC/48/2015

Binapani Mohapatra - Complainant(s)

Versus

1. Ambuja Das - Opp.Party(s)

Sri H.S. Mohanty & Sri G.N. Jena

08 Mar 2017

ORDER

IN THE COURT OF THE PRESIDENT DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, KENDUJHAR

CONSUMER COMPLAINT CASE NO. 48 OF 2015

    Binapani Mohapatra, aged 63 years,

    W/o- Late Jadabananda Mohapatra,

    At/P.O- Dhurpada, P.S- Sadar,

    Dist- Keonjhar…………………………………………………………Complainant

                     Vrs.

1. Ambuja Das,

     S/o- Rabinarayan Das,

     At- Bhatasahi, P.O- Old Town,

     P.S- Town, Pin- 758002,

     Dist- Keonjhar

2. Claim Manager,

     SBI General Insurance Co. Ltd.

     1^st Floor, ATM ARCADE,

     Plot No.191, Unit-iii,

     Bhubaneswar-751001………………….……………………….Op. Parties

PRESENT:

Shri Purushottam Samantara, President

Smt. B. Giri, Member (W)

Adv. for the Complainant - Sri H.S. Mohanty & G.N. Jena

Advocate for OP1 - Exparte

Advocate for OP2 - Sri N.G. Das

__________________________________________________________________________________________

Date of Filing - 05.10.2015                                                                                          Date of Order - 08.03.2017

SHRI PURUSHOTTAM SAMANTARA, PRESIDENT

1.  In brief, that one vehicle bearing Regd.No.OR-09H-0163, Model No.LPT 2515, retained in the name Binapani Mohapatra. By virtue of same became the complainant and ensured Insurance of comprehensive nature under SBI General Insurance, being the Policy No.00000000033113501  valid from dt.30.05.2013 to 29.05.2014.   

2. The complainant stated, the vehicle sustained heavy damage while going to Paradeep on the date 13.10.2013. The occurance has intimated under station diary so also to the Insurer.

3. The complainant also stated, post intimation surveyor deputed loss assessed and claim No. did not get settled although repaired by authorized service centre of the vehicle and giving the necessary documents, papers and information sought by the Insurer and loss assessor. The Non-Settlement compelled him to institutes the case as the OP advanced under various pretext. Make reliance on Insurance paper, D/L, R/C of vehicle and F.I.R in photocopies and affidavit.

4. Upon notice, the OP appeared and filed the version in too belated stage, beyond the statutory time limit. Admitting the issuance of policy and tenure but contested in contending. There is no cause of action, grossly barred of limitation and not maintainable inter alia pleading that the complainant failed to produce the necessary document in processing of the claim and the case is premature, which is not repudiated rather pending for want of documents. No deficiency to lie as claim is excessive and the complaint is nature of frivolous, illegal and false, therefore not tenable and liable to be dismissed.

5. Heard the learned submissions at both end and perused the materials on record.

6. On the outset, we found that no dispute prevails on the nature of policy extended and validity, so claim as lodged with the Insurer needs to assessed as per the law. Even it is not in dispute the nature of accident and consequential loss arising out of same.

7. The only dispute persists on the documents sought and received at insurers end. It is settled principle, short of document may not fail a settlement rather it urgent to be settled possibly under Non-standard basis, which grossly violated and not abided with as per IRDA Norms.

8. The OP vehemently contended, the issue of letter dated 02.10.14 and 25.09.14 amply shows, the necessary documents has not received in finalization claim, whereas the complainant adduced same requirement has been fulfilled as to advise of the surveyor and same may be proved by the call of this forum.

9. The learned OP filed the report on dt.15.02.2016 and the observation & verification noticed that the required papers and documents have been submitted to the surveyor at petitioner end.

10. The experts from the report as expressed for corroboration to the OPs denouncement and countenance.  

Report No. MKS/ SFR/ ILG/CL/ MOT/ 19253/ 13-14 DT.30.03.2014.

Surveyor & Loss Assessor - M.K. Singh.

II. REMARKS (i)   x     x

                       (ii)  x     x

                       (iii) After several reminder the Insured produced the documents of the vehicle for my

                             verification on last week but could not produce all pages of Policy copy & Load challan.

The above noted “remarks” by the surveyor & loss assessor explicitly speaks, the documents has been received at surveyors end, the letter issued by OP in submission of documents to the Insured has no bearing as the assessment report has already produced before the Insurer. So writing letters are deemed appear to have deferred the settlement to an un-time end, which against the settled principle and IRDA standing regulations. Our same view is fortified by the decision as given and relied by the complainant’s counsel - that we also prefer to rely, “M/s. Uttam Con. Infra Structure (P) Ltd. Versus Oriental Insurance Co. Ltd. - Held - “When there are specific latches by Respondent/ Insurance Company in not only delaying submission of survey report but also delaying repudiation by 18 months contrary to rules stipulated by IRDA…………………Which does not speak well of the Insurance Company”. - 2016(3) CPR 26 (NC).

(ii) Insurance Company was not justified in repudiating the claim on ground that Insured failed to submit relevant records demanded by surveyor - Sri Priyaluckmi Garments  Versus  The Oriental Insurance Co. Ltd.- 2014 (3) CPR 278 (NC).        

11. Although in the present case, the OP is contending that the claim is not repudiated, in our opinion, the non-action in settlement of the claim does not speak well of the company, which needs to be repudiated or settled on the settled principle as laid down.

12. Again, the survey & loss assessor submitted the report on dt.30.03.2014 and nothing well suffice is available on the record that the delay is not willful default and non-intentional one, which is no way believable to us. On the other hand the advancement of petitioner to have submitted the document is well corroborated under surveyor report that placed before the insurer on dt.30.3.2014. In which no specific issue is urged against the petitioner to take into account. Such non-specific and non-solid rebuttal by the OP is no more tenable under the law. 

13. So we found a bonafide and genuine Insurance claim has been unnecessary delayed and for no reason the petitioner suffered loss and sustained harassment & mental agony, which laid ample proof on its favour so under foregoing discussion, it is established the claim is allowed under the Provision of the Act to the extent survey report. As we believe - “Surveyor report performs a statutory function and report submitted by him carries great evidentiary value unless proved otherwise - 2014 (4) CPR 47 (Goa).

(ii) Survey report is an important document and its non-consideration would result in mis-carriage of justice - 2011 (3) CPR 230.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           

      On the backdrop of above noted piece of authority, we consider the Insured cannot be made suffered for lapses of the Insurer/ the company, thus liable to pay.

O  R  D  E  R

The case is allowed on contest. The OP2 is hereby directed to pay justifiably a sum of Rs.2,78,000/- (Two lakh seventy eight  thousand ) to the petitioner along with a sum of Rs.4,000/- (Four thousand) towards compensation and harassment & mental agony sustained inclusive of cost, within 4 weeks of this order, failing @6% per annum interest will accrue on the entire amount till realization.

Copy of the Order be made available to the parties as per rule.

File be consigned to record room.

Pronounced, 8^th March 2017.      

 

                                                                                                                                                                 

                  I agree                                                                        

             (Smt. B. Giri)                                                                                      (Shri Purushottam Samantara)

            Member (W)                                                                                                         President                     

         DCDRF, Keonjhar                                                                                             DCDRF, Keonjhar                                                   

          

                                                                                 Dictated & Corrected by me

                                                                               (Shri Purushottam Samantara)

                                                                                          (President)

                                                                                     DCDRF, Keonjhar