PRESIDENT, DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR

CONSUMER COMPLAINT NO.- 55/2021

Present-Dr. Ramakanta Satapathy, President,

  Sri. Sadananda Tripathy, Member,

1. Sri. Bapun Bhai Pradhan,

         S/o- Late Jaminikanta Pradhan,

2. Mst. Kanaka Pradhan

         W/O- Late Jaminikanta Pradhan,

Both 1 & 2 R/O-Samara, Ps-Tusura, Dist-Balangir, Odisha-767030.

3. Mrs. Punamayee Padhan,

W/O- Deepak Kumar Padhan, D/O- Late Jaminikanta Pradhan,

At/Po-Dahigaon, Via-Rajborasambar

PS-Buden, Dist-Bargarh.                                               ...………..Complainant

                                                Versus

1. ICICI Lombard General Insurance Company Ltd.

ICICI Lombard House, 414 Veer Savarkar Marg,

Near Siddhi Vinayak Temple, Pravadevi,

Mumbai-400025.

2. ICICI Lombard General Insurance Company Ltd. Sambalpur Branch Office.

At-2^nd Floor, Balaji Towers, Plot No. 204/3644, G.M. College Road,

Sambalpur-768001, Odisha.                                …………...Opp.Parties

Counsels:-

1. For the Complainant         :-       Sri. S.S. Sarangi, Adv. & Associates
2. For the O.P.                        :-       Sri. B.K. Purohit, Advocate

Date of Filing:25.10.2021,  Date of Hearing :04.07.2023  Date of Judgement : 07.08.2023

Presented by Sri Sadananda Tripathy, Member.

1. The case of the Complainant is that the deceased namely Jaminikanta Pradhan, policy holder was a teacher who met his untimely death on dt. 19.10.202. He has purchased a Hyundi Moter Car for his personal use by incurring loan and insured the car with the OPs under comprehensive Policy on payment of premium of Rs. 7,885.00 for the period from 12.03.2019 to 11.03.2021. The Complainants are the legal heirs of the said Jaminikanta Pradhan and the Complainant No. 1 is the nominee.The said Jaminikanta Pradhan knew driving and he had holding a valid driving license which was issued by the RTO Balangir. On the ill-fated date of accident on dt. 03.11.2019, he along with his Samudi were proceeding to Paikmal for family work. In the morning while they were going on the Padampur Nuapada State Highway, near Bijadihi Chowk at about 9 A.M suddenly a motor cyclist with Pillion ridder came in front of the car as a result of which the driving balance of deceased Jaminikanta Pradhan was became imbalance and the car dashed against the motor cycle, then with a road side big tree. After the accident deceased Jaminikanta Pradhan had intimated the fact of the accident to the OPs over telephone and thereafter on the next date on dt. 04.11.2019, one of his relation submitted claim form before them and the OPs have registered the same as insurance claim No. MOT009338108. After receiving the claim form the OP No. 1 deputed a surveyor, on the same date, to the spot of the accident, to see the damaged vehicle and assess the preliminary loss. Thereafter, the Complainant shifted the damaged vehicle to the authorized service center i.e Sonu Motors, Sambalpur as per the direction of the surveyor. The authorised service center issued a preliminary assessment bill amounting to Rs. 1,08,942/- and after seeing the preliminary assessment the surveyor of the OP No. 1 directed the Complainant to submit necessary papers before him and after submission of papers directed the Complainant to start the repairing work of the damaged vehicle. After completion of the repairing, the deceased policy holder intimated the surveyor and accordingly, the surveyor came and visited the repairing vehicle. Thereafte the deceased himself submitted the repairing bill amounting to Rs. 1,08,000/- to the surveyor, issued by the service center for settlement of claim. But in the meantime the policy holder expired and the OPs have not settled the claim and paid to the legal heirs of the deceased. After his death his legal heirs have collected all papers and filed the present case for settlement of the claim.
2. The Written Version of the  O.Ps is that the Policy was issued by the OPs in favour of Jaminikanta Pradhan. After intimation to Insurance Company, letter was sent by this OP to the insured on dtd. 22/11/2019 requesting him to place his vehicle in garage within 7 days from the date of receipt of the letter and to provide the name and address of garage to OP so that OP could be able to inspect the vehicle and assess the loss through surveyor which the Complainant failed to do so. The Claim was intimated on dt. 03.11.19 and again vide letter dt. 22.11.2019, the Complainant had been intimated about the fact since the vehicle was not made available for surveyor’s inspection despite best effort of OP and therefore this OP was unable to process the claim on the ground of “Vehicle not reported”. Hence the OPs have got no liability in this case, which has been communicated to Complainant and there is no deficiency of rendering service.  
3. From the Written Statements of the both the parties, it is observed that both of their Statements are contradictory. The Complainants have mentioned in their petition that after the accident deceased Jaminikanta Pradhan had intimated the fact of the accident to the OPs over telephone and thereafter on the next date on dt. 04.11.2019, one of his relation submitted claim form before them and the OPs have registered the same as insurance claim No. MOT009338108. After receiving the claim form the OP No. 1 deputed a surveyor, on the same date, to the spot of the accident, to see the damaged vehicle and assess the preliminary loss. After receiving the claim form the OP No. 1 deputed a surveyor, on the same date, to the spot of the accident, to see the damaged vehicle and assess the preliminary loss. Thereafter, the Complainant shifted the damaged vehicle to the authorized service center i.e Sonu Motors, Sambalpur as per the direction of the surveyor. The authorised service center issued a preliminary assessment bill amounting to Rs. 1,08,942/- and after seeing the preliminary assessment the surveyor of the OP No. 1 directed the Complainant to submit necessary papers before him and after submission of papers directed the Complainant to start the repairing work of the damaged vehicle. After completion of the repairing, the deceased policy holder intimated the surveyor and accordingly, the surveyor came and visited the repairing vehicle. Thereafter the deceased himself submitted the repairing bill amounting to Rs. 1, 08,000/- to the surveyor, issued by the service center for settlement of claim. Whereas the OPs, in his Version mentioned that after intimation to Insurance Company, letter was sent by this OP to the insured on dtd. 22/11/2019 requesting him to place his vehicle in garage within 7 days from the date of receipt of the letter and to provide the name and address of garage to OP so that OP could be able to inspect the vehicle and assess the loss through surveyor which the Complainant failed to do so.
4. The Complainants have not submitted any documents of claims or evidences regarding the surveyor who came and visited the repairing vehicle and submitted his survey report. In the other hand the OPs have also not produced any postal receipt from which it can reveal that letter given by the OPs to the Complainant has properly been communicated to the Complainants. However the Policy was a valid Policy and also the OPs in its version admitted the same. So the OPs are liable to pay the claim amount to the Complainant after receiving proper documents from the Complainants or receiving evidences that the Complainants have submitted the same before the OPs in proper format earlier.

ORDER

The case is disposed of on contest. The O.Ps are directed to pay a sum of Rs. 1, 08,000/- towards the total repairing expenditure of damaged car to the Complainants with 6% interest from the date of accident till realisation after receiving proper documents from the Complainants or receivingevidences that the Complainant have submitted the same before the OPs in proper format earlier and Rs. 5,000/- towards cost & litigation expenses of the petition to the Complainant within 30 days from the date of order, failing which the amount will further carry 9% interest per annum till realization.

Order pronounced in the open Court today on 7^th day of Aug, 2023.

Free copies of this order to the parties are supplied.