Orissa

Jajapur

CC/137/2020

Prasant Kumar Sahoo. - Complainant(s)

Versus

Authorised Signatory,IFFCO TOKIO General Insurance Co.Ltd. - Opp.Party(s)

Alok Kumar Pani

09 Feb 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION :  JAJPUR.

Presents:-    1.    Smt. Susmita Mishra ,      President,

                                                        2.   Sri Bibekananda Das        Member .      

C.C. Case No. 137 / 2020.

Prasant kumar Sahoo,S/O  Prahallad Sahoo

Vill/P.O- Singhpur,

P.S:-  Binjharpur,

 Dist:- Jajpur.                                                               .  .  .  .  Complainant.

                   Versus.

1. Authorised Signatory,IFFCO TOKIO General Insurance Co.Ltd,,Regd.

Office at-IFFCO Sadan,C.I,Dist Center,New Delhi

2. Authorised Officer,IFFCO-TOKIO General Insurance Co.Ltd

At.Panikoili (Mallik Complex),Dist. jajpur.

3. Authorised Signatory, Aditya Motors, N.H.5, Bamphakuda,,

Pulnakhara, Cuttack

                                                              . ...Opp. Parties.

                             Counsels appeared for the parties. 

For the Complainant :-                Sri  P.K.Das, Advocate & associates.

For the Opp. Parties No.1 and 2   :-  Mr.  K.Ghosh,  Advocate.

Date of filing Complaint     :-     13.11.2020,

Date of Argument            :-       10.11.2023,

Date of Oder                    :-       09.02.2024.

MR. BIBEKANANDA DAS, MEMBER

                   The complainant has filed the C.C.Case U/S-35 of C.P.Act,2019 seeking the following reliefs: “ the O.D claim  of the complainant be allowed  and also the O.ps be directed to pay the full I.D.V in respect of damaged ambulance along with interest @8% per annum and Rs.30,000/- towards mental agony to the complainant.”

                   The brief fact of this case is that, the complainant is the registered owner of a Mahindra Bolero Plus Ambulance bearing Regd. No.OD-05-AP-2782. The said ambulance was insured with O.P.no.1 through its branch office O.P.no.2  vide policy No. M6769216 valid from 21.03.2019 to 20.03.2020 with sum assured of Rs.6,89,742/- and premium of Rs.23,399/- has been paid for the same.

                   That, on dated 04.12.2019 the ambulance met with an accident and it was severely damaged and  the said fact was immediately informed to O.P.no.2 both in writing and over telephone. Then O.P.no.2 instructed the complainant to shift the damaged ambulance to O.P.no.3, who is the authorized service center of Mahindra vehicles. Since the ambulance was seized by the police on dated 04.12.2019 and subsequently  when the vehicle was released on dated 15.12.2019, the complainant  as  per instruction of O.P.no.2 shifted the same to O.P.no.3 and O.p.no.3 issued  an repairing estimated cost which amounts to Rs.7,38,162/- ( Xerox copy annexed) .Though O.P.no.2 received the above quotation from the complainant but did not settle the genuine claim of  complainant for which the complainant compelled to approach this Hon’ble Commission.

                   The O.ps on the contrary submitted in their written version that, after receipt of intimation appointed one IRDA licensed surveyor Mr. Sushanta Kumar Mohapatra who submitted his report with assessment of Rs.1,75,000/- and while further proceeding of this claim the O.ps requested vide their letter dated 02.01.2020 and dated 21.11.2020  to the complainant to provide the following documents:-

1. Zimmanana  & seizume list
2. Original repair estimate
3. Details of passengers travelling in the vehicle.

                    But the complainant not provided the above said documents for which the O.Ps left no other option then to close the claim as “ No claim” and intimated same to the complainant.

                   Taking into all the facts and circumstances as stated above, it is our considered view that the O.ps have committed deficiency in service and adopted unfair trade practice in repudiating the claim of the complainant. It is not in dispute that the vehicle belonging to the complainant was insured with the O.Ps.  It is also not in dispute that the same was valid at the time of accident. It is also not in dispute that  the complainant paid a sum  of Rs.23,399/- to the O.ps towards premium. It is also not  disputed that for the insured damages vehicle an F.I.R has been lodged and registered before the police on the very day of accident. But the complainant has been wrongly denied the Insurance claim  by the O.ps  and non settlement of claim can be said to be deficiency in service.

In the present case the Insurance company has become too technical while settling the claim and has acted arbitrarily. The complainant has asked to furnish certain documents before the O.Ps for settlement of claim, but no evidence has been adduced by the O.Ps nor a single scrap of paper has been filed in this case to prove that they have given several reminders to the complainant to provide such documents and on the contrary the complainant has filed a copy of a letter dated 09.12.2020  with posted acknowledgement  which shows that even after receipt of the letter along with the relevant documents the O.ps had not settled the genuine claim of the complainant. So, the contention made in the written version of the O.ps is not acceptable to this Commission. That apart the survey report has also not submitted in this case by the O.ps in support of their case. But the complainant has submitted a repair estimate quotation of damaged ambulance from O.P.no.3 who is the authorized service center of Mahindra vehicle. More over in absence of any survey report we are inclined to accept the estimate submitted by the complainant towards  repairing cost of the vehicle.

 From the above fact, it is found that the O.ps ( Insurance companies) are refusing the claim an flimsy  ground and / or technical grounds. While settling the claims, the insurance company should not be too technical and ask for documents and we are of the opinion that the complainant is entitled to the entire amount covered under the policy. The accident took place within the validity period  and the vehicle was insured for Rs.6,89,742/- .The complainant can not be made liable for payment of stock yard/ parking charges  and other related charges on the state in which the vehicle remained with the repairer. It is our considered view that the O.ps have accepted the premium from the complainant and it is the duty of the insurer to compensate the insured in uncertain. Future event and it is a  contract to indemnify the insured. None-settlement of claim on silly ground and also delay for making payment of claimed amount is a clear violation  of law which defined U/S 2(11) of C.P.Act,2019. The O.ps with holding claimed amount deliberately on irrevalent grounds are clear deficiency of O.ps in rendering service to the complainant which should be duly compensated by the O.ps.  Hence the order.

O R D E R.

We therefore, directing the O.P.no.1 and 2 to  pay Rs.6,89,742/- along with interest  @ 9%  per annum  from the date of claim , i.e from 04.12.2019  till its realization to the complainant and further the O.P.no.1 and 2 shall pay Rs.60,000/- towards compensation and litigation cost within a period of 45 days from the date of receipt of this order.  failing which the O.Ps shall be liable for execution proceeding as per C.P.Act, 2019. The Complainant is  exempted to pay any stock yard /parking charges or any other related charges to the O.Ps.   However,  the O.P.no.3 is at liberty  to realise the charges if any, from O.P.no.1 & 2  as per law. The C.C.Case No.137/2020 is  allowed and accordingly disposed off.

                    Issue extract of the order to the parties for compliance.

                    Judgment pronounced in the Open Commission on this the 9th day of February, 2024.