BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
KADAPA Y.S.R DISTRICT
PRESENT SMT. K. SIREESHA, B.L., PRESIDENT FAC
SRI M.V.R. SHARMA, MEMBER.
Friday, 07th March 2014
CONSUMER COMPLAINT No. 28/ 2013
Ontigari Vijayalaxmi, W/o Srinivasulu,
aged 30 years, Hindu, R/at D.No. 70/97,
Alankanpalli, Kadapa, YSR District. ….. Complainant.
Vs.
1. Bharath Petroleum Corporation Ltd., Rep. by its
General Manager, 4 & 6 Currimbhoy Road, P.B. No. 688,
Ballard Estate, Mumbai – 400 001.
2. Sujatha Gas Agencies, Rep. by its Proprietor, D.No. 12/170,
State Bank Colony, Chennur – 516 162, YSR District.
3. National Insurance Company Ltd., Rep by its
Regional Manager Corporate Regional Office,
Royal Insurance Building, 2nd floor 14, Jamshedji TATA Road,
Church Gate, Mumbai – 400 020.
4. National Insurance Company Ltd., Rep by its
Branch Manager, Opp. RTC Bus stand Out Gate,
Kadapa city, YSR District. ….. Opposite parties.
This complaint is coming before us for final hearing on 5-3-2014 and perusing complaint and other material papers on record and on hearing the arguments of Sri G. Trivikram Singh, Advocate for complainant and Sri P. Goutham Kumar, Advocate for O.P. No. 4 and O.P.2 appeared as in person and O.P.1 & O.P. 3 are called absent and set exparte and the matter having stood over for consideration this day, the Forum made the following:-
O R D E R
(Per Sri M.V.R. Sharma, Member),
1. This Complaint is filed under section 12 of the C.P. Act 1986 by the complainant to direct the opposite parties to pay an amount of Rs. 86,210/- with 24% interest p.a. from the date of accident till the date of realization, to pay an amount of Rs. 30,000/- towards compensation and an amount of Rs. 3,000/- towards cost of the complaint.
2. The complainant took LPG connection under customer No. 5733 pertaining to O.P. No. 1, distributor of LPG Connection through O.P. 2, who is the dealer. The O.P.1 & O.P.2’s have taken comprehensive insurance policy for the benefit of customer to compensate them in the event of accident. The said policy bearing No. 251100/46/12/9500000206. The policy period commenced from 2-5-2012 till midnight of 1-5-2013. The said policy covers any untoward accident occurred within the premises of the customer who avails LPG connection. Complainant further stated that she sustained burn injuries in the fire accident on 2-7-2012 at about 6.30 a.m while she was preparing lunch and there was leakage of gas and suddenly flames broken out and sustained burning injuries to her face, neck, posterior chest, anterior and posterior abdomen, both upper and lower limbs and she was admitted in Govt. Hospital, Kadapa. The complainant has incurred Rs. 1,00,000/- towards her treatment for medical bills and for transportation and also stated that she was operated by Doctors at Kadapa and she has suffering from hearing problem and she has been taking treatment from skin specialist till date. Apart from that kitchen room of the complainant was burnt and kitchen utensils were also burnt and thereby it caused financial loss of Rs. 30,000/-.
3. The complainant further stated that the insurance coverage is with O.P. No. 3 and she made claim by submitting all reports showing the accident. But the O.P. 3 did not settle the claim of the complainant. After several requests the O.P. 3 & 4 send a cheque for Rs. 13,790/- to the complainant by post and termed as full and final settlement amount. The complainant received the said amount and also stated that as per the terms and conditions of the policy in the first instance itself, the O.P.3 & 4 has to pay Rs. 25,000/- to the customer. O.P.1 & 2 under 3rd party coverage and liable to pay upto Rs. 1,00,000/- towards damage. The opposite parties without any proper calculation tried to settle the claim of the complainant with lesser amount. The opposite parties are deficient in nature and unfair trade practice. Hence, this complaint filed.
4. After numbering the case notices were issued to the O.P. 1 to O.P. 4 and the same is served. O.P.2 & 4 filed their counter and O.P.1 & 3 did not appear before the forum and they said exparte on 24-7-2013. The O.P.2 filed a counter and admitted that the complainant took LPG connection under consumer No. 5733 and regularly using Bharath Gas. O.P. 2 further stated that the complainant LPG connection refills on 19-6-2012 using regularly up to 01-7-2012. On the next day i.e. 2-7-2012 morning 6.30 a.m fire accident acquired at the resident of complainants house and the same was received afternoon and also stated that after receiving information that O.P. 2 went to the complainant house with staff and enquired about the accident acquired is true. But he did not know the reason to accrued fire accident.
5. It is further stated that as per the terms and conditions of Bharath Petroleum Company Ltd., for the welfare of the customers in Oriental Insurance Co. Ltd., Proddatur vide policy No. 433103/48/2013/65 valid from 28-4-2012 to 27-4-2012 mid night and O.P. 2 informed insurance company on 2-7-2012 at the time of insurance policy is in force. Hence, the insurance company is liable to pay compensation to the complainant and O.P.2 is not liable to pay any compensation. Hence, O.P 2 prayed this Hon’ble forum to dismiss the complaint.
6. The O.P. 4 filed counter denying all the allegations made in the complaint.
7. It is admitted by the O.P.4 that the O.P.3 issued a policy bearing No. 251100/46/12/9500000206 valid from 2-5-2012 till mid night of 1-5-2013. It is stated that the O.P. 1 has failed to give immediate notice thereof in writing to the nearest office of O.P.4 with a cop of policy to the insurance office, insurance office of O.P.4 and the O.P.1 shall within 14 days of the date should submit in detailed statement in writing of the loss of damage with an estimate of the intrinsic value of the property lost and the amount of damage sustained as per the conditions of the policy. Hence, O.P.4 is not liable to indemnify the O.P. No. 1 and the O.P. 1 alone is liable to pay compensation if any and also stated that, the O.P. 4 is appointed a surveyor by name Venkateswara Babu for assessing the damages and loss of the property and also burns received by her in the said accident. The surveyor conducted survey and reported to O.P. 3 on 28-9-2012.
8. It is further stated that the surveyor report is clearly shows that the complainant has not shown any damage items during the survey and as per observation of the surveyor the complainant has received burn injuries and damages to the gas stove, regulator, regulator pipe, gas cylinder, mixy, cooker and building repairs. Though she failed to show any damaged items the surveyor has assessed the damages and submitted his detailed report stating that she sustained damages to her untensils and other things to a tune of Rs. 13,510/-. But no bills or proof were shown by the consumer as well as the surveyor for assessing property damage of Rs. 13,510/-. The O.P. 4 further stated that the complainant has claimed Rs. 1,00,000/- towards her medical treatment and transportation. The complainant submitted only prescription, even though the O.P.4 has considered which are amounting to Rs. 23,790/- and therefore, paid an amount of Rs. 13,790/- after deducing policy excess from the gross assessed i.e. (Rs. 23,790/- - 10,000/- = Rs. 13,790/-) as per schedule of the policy the insured i.e. O.P. 1 shall bear the compulsory excess of Rs. 10,000/- for any one accident and this excess shall be applicable to both death or bodily injury and the property damage and that finally O.P. 4 sent an amount of Rs. 13,790/- through a cheque to the complainant as full and final settlement and also stated that the complainant taken medical treatment at free of cost under Rajiv Arogyasree Health Insurance Scheme medicines prescribed by the Hospital after her discharge were indemnified after deducting policy excess. The O.P 4 also stated that the complainant is not eligible to claim compensation as per section 2 of the policy, the complainant has took consumer connection from O.P.1 company through O.P.2 in the premises bearing D.No. 3/37, Alankanpalli. But as per FIR and the statement of the complainant the accident took place in the house No. 70/99, Alankanpalli. Hence, heavy burden lies on the complainant to prove that D.No. 3/37-2 and 70/99 are one and same, otherwise the complainant is not entitled for compensation and also stated that there is clause in general condition of policy that if any dispute or difference arise to the quantum to pay under the policy shall independently of all other questions to be differ to the decision in arbitrator. Hence, the forum is not jurisdiction to entertain the complaint. Therefore, in view of the facts and circumstances there is no deficiency of service on the part of O.P.4. Hence, O.P. 4 prayed to the Hon’ble forum to dismiss the complaint.
9. To prove her case the complainant filed affidavit along with documents and marked Ex. A1 to A6. To disprove the case of O.P.4 filed documents and got marked Ex. B1 to B5. O.P.2 filed two documents i.e. policy and intimation letter but not marked.
10. On the basis of the above pleadings the following points are settled for determination.
- Whether the complainant is eligible for compensation as prayed by her?
- Whether there is negligence or deficiency of service on the part of their opposite parties?
- To what relief?
11. Point No. 1. According to the complaint the complainant having LPG connection under the consumer No. 5733 pertaining to O.P.1 through O.P.2, who is dealer. The O.P. 1 & 2 have taken comprehensive insurance policy for the benefit of LPG connection customers to compensate them in the event of accident. The said policy bearing No. 251100/46/12/9500000206 and the policy period commenced from 2-5-2012 till midnight of 1-5-2013. The said policy covers any untoward accident occurred within the premises of the customer who avails LPG connection and on 2-7-2012 at about 6.30 a.m the complainant preparing lunch at her house at Alankanpalli, Kadapa city there was leakage and suddenly flames broken out and sustained burning injuries to her face, neck, posterior chest, anterior and posterior abdomen, both upper and lower limbs and she was admitted in Govt. Hospital, Kadapa. The complainant has incurred Rs. 1,00,000/- towards her treatment for medical bills and for transportation. She has been taking treatment with skin specialist till date now. Though she has been suffering hearing problem apart from kitchen room of the complainant was burnt and utensils were also burnt and thereby caused financial loss of Rs. 30,000/- to her. After that the complainant made a claim by submitting all reports showing the accident. But the O.P. did not settle the claim of the complainant. After several requests the O.P. 3 & 4 send a cheque for Rs. 13,790/- to the complainant by post and termed as full and final settlement amount. Under the protest the complainant received the said amount as per the terms and conditions of the policy in the first instance itself. The Insurance Company i.e. O.P.3 & 4 has to pay Rs. 25,000/- to the customer of O.P.1 & 2 under 3rd party coverage and liable to pay upto Rs. 1,00,000/- towards damage to the 3rd parties, without any proper calculation. The O.P’s. tried to settle the claim of the complainant with lesser amount. The O.P.2 admitted that the complainant is a customer and she is using Bharath Gas under Gas connection No. 5733 and also O.P.2 admitted that on 2-7-2012 morning 6.30 a.m fire accident acquired at the resident of complainant’s house while preparing lunch and the same was received afternoon and he went along with his staff and enquired about the accident is true. After that O.P.2 intimated to the insurance company on 4-7-2012. The contention of O.P.4 is that as per the conditions of the policy that and also contended that O.P. 1 failed to give immediate notice thereof in writing to the nearest office of O.P.4 about incident and O.P.No. 1 submit detailed written statement of loss damaged with an estimate of the intrinsic value of the property lost and the amount of damage sustained within 14 days as per conditions of the policy. Even though the O.P. 4 appointed surveyor by name Venkateswara Babu for assessing the damages and loss of the property and also burns received by her in the said accident and the surveyor conducted survey and reported to O.P. 3 on 28-9-2012. As per survey report she sustained damages to her utensils and other things to a tune of Rs. 13,510/-. But no bills or proof were shown by the consumer as well as the surveyor for assessing property damage of Rs. 13,510/-. The complainant claimed Rs. 1,00,000/- towards her medical treatment and transportation. As per section 2 of the policy, the complainant has to prove that sustained bodily injuries damage. The complainant has took connection from O.P.1 company to the O.P.2 bearing D.No. 3/37, Alankanpalli. But as per FIR and the statement of the complainant the accident took place in the house No. 70/99, Alankanpalli. Hence, heavy burden lies on the complainant to prove that D.No. 3/37-2 and 70/99 are one and same, otherwise the complainant is not entitled for compensation. But the complainant submitted only prescription even though the O.P. 4 has considered cheque amounting Rs. 23,790/-, after deducting policy excess from grass assessed i.e. (Rs. 23,790/- - Rs. 10,000/- = Rs. 13,790/-) as per schedule of the policy insured i.e. O.P. 1 shall bear the compulsory excess of Rs. 10,000/- for any one accident and this excess shall be applicable to both death or bodily injury and the property damage and that finally O.P. 4 sent an amount of Rs. 13,790/- through a cheque to the complainant as full and final settlement. Hence, the point is answered accordingly.
12. Point No. 2 As seen from Ex. A1 the complainant having LPG connection under the customer No. 5733 with O.P.2. Ex. A2 subscription voucher issued by O.P. 2. Ex. A3 cash receipt issued by O.P. 1 & 2. Ex. A4 is the FIR. Ex. A5 is the discharge summary issued by Rajivegandhi Institute of Medical Science General Hospital, Kadapa. Ex. A5 shows that the complainant admitted in RIMS Hospital at Kadapa on 11-7-2012 she is operated by Dr. Giridar and discharged on 18-7-2012 and also same in the discharge summary it is clearly shows that burns involving face and neck, posterior chest, anterior and posterior abdomen, both upper and lower limbs. Final diagnosis mixed burns 35%. Ex. A6 policy issued by O.P. 4.
13. The contention of the O.P.2 that the fire accident at the register residence of the complainant house on 2-7-2012 at 6.30 a.m and the same was received after noon and he went and enquired about the accident and found about the accident it true. As per terms of the condition Bharat Petroleum Corporation Ltd., informed the accident of fire to the insurance company on 4-7-2012. In this regard we observed the documents are filed by O.P. 2 are not marked as seen in the documents we noticed that O.P. 2 informed on 4-2-2012 to the Branch Manager, the Oriental Insurance Co. Ltd., Proddatur branch. Instead of National Insurance Company Ltd,. Kadapa i.e. O.P. 4. It clearly shows that grass negligence and irresponsibility of O.P.2. The attitude of O.P. 2 is not correct and the O.P.1 has to observe the attitude of the dealers. The main contention of the opposite parties is that the complainant has claimed Rs. 1,00,000/- towards her medical treatment and transportation but did not filed any medical bills. She submitted prescription only as Ex. A6 i.e. policy terms and conditions. It is clearly shows that the medical expenses per person Rs. 1,00,000/- and immediate relief up to Rs. 25,000/-, property damages, Rs. 1,00,000/- for event authorized customers at registered premises. The complainant did not filed prescription and medical bills to prove. The complainant has incurred Rs. 1,00,000/- towards her treatment. Even though the O.P. 4 appointed surveyor namely Venkateswara Babu, conducted survey and submitted his report to O.P.3 on 28-9-2012. It is Ex. B1. The survey report shows that the surveyor assessed the damages utensils and other things to a tune of Rs. 13,510/-. The O.P. 4 considered assessed loss of Rs. 23,790/- - Rs. 10,000/- as per schedule of the policy the insured i.e. O.P. 1 shall bear compulsory Rs. 10,000/- for any accident and this excess shall be applicable to both death or bodily injury and the property damage and that finally O.P. 4 sent an amount of Rs. 13,790/- through a cheque to the complainant as full and final settlement as per Ex. B4. Ex. B2 LPG accident fire form on 7-7-2012 issued by National Insurance Co. Ltd., Anantapur. Ex. B3 accident for – B, dt. 7-7-2012 issued National Insurance Co. Ltd., Ex. B5 survey in respect of compliance. Ex. A5 discharge summary RIMS Hospital, Kadapa. It clearly shows that on examination the burns involving face, neck, posterior chest, anterior and posterior abdomen, both upper and lower limbs and mixed burns 35%. O.P. No. 4 also raised that if any dispute or difference arose to the quantum to be paid under the policy such difference shall be independently of all other questions to be referred to the decision of arbitrator. In this regard as per the Arbitration Act section 8 (1) of 1996 says that Arbitration clause under agreement is no bar to approach one among the parties to Consumer Forum for redressal of their grievances, unless there is proceedings initiated by any of the parties to the agreement. O.P. No. 4 also stated that the O.P. 2 has failed to give immediate notice thereof in writing in nearest office of the O.P.1 with a copy of policy to the issuance of this O.P.4 and also the O.P.1 shall within 14 days of the date should submit in detailed statement in writing of loss of damage. In view of our opinion delay in intimation and submitting the claim to the insurance company is not so fatal and not a fundamental breach where there is an FIR and investigation report in support of the accident. The O.P.4 considered Rs. 13,790/- as itself admitted the damage, burns of the complainant. O.P.4 stated that the complainant did not filed any medical bills. The contention of O.P. 4 is not tenable. But as seen Ex. A5 it is clearly shows that the complainant mixed burns 35% as has discussed above and the circumstances of the case we are opined that the complainant eligible for Rs. 50,000/- insurance policy amount for burnings and utensils of the complainant.
13. Point No. 3 In the result, the complaint is allowed, directing to the respondents 3 & 4 jointly and severally liable to pay Rs. 50,000/- (Rupees fifty thousand only) towards insurance amount, to pay Rs. 3,000/- for mental agony and to pay Rs. 3,000/- for cost of the complaint, within 45 days date of receipt of the order. Case against R1 and R2 dismissed. No cost.
Dictated to the Stenographer, transcribed by him, corrected and pronounced by us in the open Forum, this the 7th March 014
MEMBER PRESIDENT FAC
APPENDIX OF EVIDENCE
Witnesses examined.
For Complainant NIL For Respondents : NIL
Exhibits marked for Complainant : -
Ex. A1 P/c of pass book of complainant for LPG connection under customer No. 5733 issued by the 2nd respondent in favour of the complainant.
Ex. A2 P/c of subscription voucher issued by 1st respondent in favour of complainant.
Ex. A3 Original cash memos (three in numbers) issued by R1 and R2 in favour of the complainant.
Ex. A4 P/c of FIR No. 103/2012 of Kadapa Taluq police station.
Ex. A5 P/c of Discharge certificate issued by the RIMS General Hospital, Kadapa.
Ex. A6 P/c of Public Liability policy for oil industris, policy bearing No. 251100/46/12/9500000206.
Exhibits marked for Opposite party No. 4: -
Ex. B1 Surveyor report dt. 28-9-2012 submitted to the R3.
Ex. B2 LPG Accident form – A cum Accident report dt. 7-7-2012 issued by the National Insurance Co. Ltd., Anantapur.
Ex. B3 LPG Accident form –B, dt. 7-7-2012 issued by the National Insurance Co. Ltd., Anantapur.
Ex. B4 Letter to Manager, dt. 19-11-2012.
Ex. B5 P/c of certificate in respect of compliance of section 64 VB of Insurance Act 1938 policy No. 251100/46/12/9500000206, dt. 2-5-2012.
MEMBER PRESIDENT FAC
Copy to :-
- Sri G. Trivikram Singh, Advocate for complainant.
- Sri P. Goutham Kumar, Advocate for O.P No. 4.
- Bharath Petroleum Corporation Ltd., Rep. by its
General Manager, 4 & 6 Currimbhoy Road, P.B. No. 688,
Ballard Estate, Mumbai – 400 001.
- Sujatha Gas Agencies, Rep. by its Proprietor, D.No. 12/170, State Bank Colony, Chennur – 516 162, YSR District.
- National Insurance Company Ltd., Rep by its Regional Manager Corporate Regional Office, Royal Insurance Building, 2nd floor 14, Jamshedji TATA Road,
Church Gate, Mumbai – 400 020
B.V.P. - - -
