Date of filing:- 11/10/2022.

Date of Order:-30/07/2024.

DISTRICT CONSUMER DISPUTE REDRESSAL COMMISSION

B A R G A R H (ODISHA).

Consumer Complaint No. 35 of  2022.

            Gunabanti Suna, Wife of Ananga Suna, Permanent Resident of At/Po. Baladi, Ps. Tarbha, Dist. Subarnpur, Pin-767016, At present residing at Ghulipali Chowk, new NH, in front of BJP Party Office, care of Ratnakar Mahapatra, Ward No..09(nine), Po/Ps/Dist. Bargarh, Pin-768028.                                         .....       .....     .....                        Complainant.

-: V e r s u s :-

1. Tata AIG General Insurance Co. Ltd, 2^nd Floor, Kailash Plaza, At- Link Road, Po/Dist. Cuttack (Odisha), Pin-753012.
2. Hero Finance Corporation Ltd., No.1(one), Puri-Cuttack Road, Budheswari Colony, Laxisagar, Bhubaneswar, Odisha-751006.           .....       .....   Opposite Parties.

Counsel for the Parties:-

For the Complainant :-            Sri Jagannath Sarangi, Advocate.

For the Opposite Party No.1(one):-     Sri A.K.Dash, Advocate with associates.

For the Opposite Party No.2(two):-     Ex-parte.

                                                            -: P  R  E  S  E  N  T :-

Smt. Jigeesha Mishra               .....       .....       .....       .....       .....       P r e s i d e n t.

Smt. Anju Agrawal             .....            .....       .....       .....       .....       M e m b e r (W).

Dt.30/07/2024.                                 -: J   U  D   G  E  M  E  N  T:-

Presented by Smt. Jigeesha Mishra, President:-   

1)         The case of the Complainant is that the husband of the Complainant Ananga Suna had insured his new Maestro Edge 125 Drum Case Scooty bearing Regd No. OD-31H-6007 having Engine No. JF17ELLGK08428 and Chassis No. MBLJFW204LGK02502 comprehensively with the Opposite Party No.1(one) vide Policy No. 3193028983/ 000000/00 valid from 26-12-2020 to 25-12-2025 on payment of premium ₹ 5,873/-(Rupees five thousand eight hundred seventy three)only and the premium was included ₹ 330/-(Rupees three hundred thirty)only for coverage of his own life risk under the head compulsory PA cover for owner driver of ₹ 15 lakh. Likewise a premium of ₹ 1,362/-(Rupees one thousand three hundred sixty two)only was also included for coverage of own damage of the vehicle under IDV of ₹ 68,923/-(Rupees sixty eight thousand nine hundred twenty three)only. The vehicle was financed by Opposite Party No.2(two). The wife of the Complainant is the nominee in the policy. During the currency of the policy on 29-01-2021 while the deceased was proceeding from his village Baladi towards Bolangir faced with an accident near Tirekela Chawk (Khari) under Tarbha Police Station due to dash with an unknown vehicle. Subsequently he died on 03-03-2021 while undergoing treatment at VIMSAR Burla. The insured Motor Cycle also get extensively damaged. On receiving information Tarava Police started investigation about the accident by registering P.S. Case No.17 Dt.19-01-2021 which corresponded by GR No. 18/21 of the court of JMFC Tarava and finally submitted FRT No Clue. Being the nominee the Complainant informed about the fact of the accident to the Opposite Party No.1(one) through Registered Post and raised claim for reimbursement of the repair cost of the vehicle and ₹ 15,00,000/-(Rupees fifteen lakh)only compensation for accidental death of owner driver/insured and supplied necessary documents. A pleader notice was served when the Opposite Party remained silent. But till date the Opposite Party No.1(one) did not settle the claim of the Complainant. Hence the Complainant filed this case before this Commission.

2)         The case of the Opposite Parties is that Opposite Party No.1(one) file version and Opposite Party No.2(two) did not appear and set ex-parte. The Opposite Party No.1(one) admitted that the policy No. 3193028983 was issued in favour of the insured Ananga Suna and the policy was valid from 26-12-2020 to 25-12-2025. The Opposite Party No.1(one) insurance company submitted that the Complainant has not communicated the fact of loss to the insurance company till date. Such conduct on the part of the Complainant has the effect of contravention of terms of contract of insurance. Hence the complaint should be dismissed.

3)         Perused of complaint petition, version and documents filed by the Parties and following issues are framed :-

Issues

1. Whether the Opposite Parties are deficient in service ?
2. Whether the Complainant is entitled to get relief ?

Issue No.1(one)

4)         The policy is admitted and the accident is admitted and death of the insured is admitted. The Opposite Party denied the claim on the ground that the Complainant did not informed the Opposite Party about the occurrence. After perusal of record it reveals that the Complainant filed the letter dated 07-06-2021 where she informed the Opposite Party about the accident of her husband Ananga Suna and requested to process the claim and disburse the amount of ₹ 15,00,000/-(Rupees fifteen lakh)only. Again on 29-08-2022 the Complainant sent pleader notice through her advocate Jagannath Sarangi to settle the claim. The Complainant filed both letter dated 07-06-2021 and pleader notice dated 29-08-2022 which tracking report and postal receipt. Hence the plea of the Opposite Party that the Complainant did not inform is not acceptable. The Opposite Party is deficient in service for non-settlement of claim of the Complainant. The Opposite Party No.2(two) is the financer  who is not liable in  this case. The issue is answered accordingly.

Issue No.2(two)

5)         For deficiency in service of the Opposite Party the Complainant is entitled to get relief. The husband of the Complainant had paid premium of ₹ 330/-(Rupees three hundred thirty)only for compulsory PA cover and ₹ 1,155/-(Rupees one thousand one hundred fifty five)only for own damage of the vehicle. When the Opposite Party received premium for own damage and PA cover it was the duty of the Opposite Party to settle the claim. Accordingly the Complainant is entitled to get the IDV of the vehicle and ₹ 15,00,000/-(Rupees fifteen lakh)only for PA cover. The issue is answered accordingly.

            As per supra discussion the following order passed:-

                                                            O  R  D  E  R

6)         The Complaint is allowed on contest against the Opposite Party No.1(one) and dismissed against Opposite Party No.2(two). The Opposite Party No.1(one) is directed to pay ₹ 15,00,000/-(Rupees fifteen lakh)only for PA cover and ₹ 68,923/-(Rupees sixty eight thousand nine hundred twenty three)only the IDV of the vehicle to the Complainant within one month from the date of this Order. Further the Opposite Party No.1(one) is directed to pay ₹ 40,000/-(Rupees forty thousand)only compensation for deficiency in service and ₹ 10,000/-(Rupees ten thousand)only for litigation expenses to the Complainant, failing which, the entire awarded amount shall carry 12%(twelve percent) interest per annum till realization.

            Order pronounced in the open court on 30^th day of July 2024.

                        Supply free copies to the Parties.

                                                                                             Typed to my dictation

                                                                                              and corrected by me.                                                                                                     

                                    I agree,                                            ( Smt.Jigeesha Mishra)

                                                                                                    P r e s i d e n t.

                       (Smt. Anju Agrawal)

                             M e m b e r(w).