Charanjit Singh, President

1        The complainant has filed the present complaint by invoking the provisions of Consumer Protection Act under Section 12 and 13 against the opposite parties on the allegations that the complainant is peace loving and law abiding citizen, having great respect towards law of nation and is prominent member of Amritsar Bar Association, Amritsar being an Advocate.  It is an accidental case and real fact of the case are that deceased Sunil Kumar was running his shop of repair of all kind of electronic goods and used to go to the shop at about 8.A.M. in the morning and used to come back to the house at about 6.P.M. in the evening and on ill fated day of 5.1.2019 Roshan Lal Dheer son of Diwan Chand along with his neighbour who is none else but his nephew namely Somnath son of Charan Dass, R/o Khemkaran were coming on Chhota Hathi to their house at Khemkaran and said Sunil Kumar deceased along with his Assistant namely Lovejeet Singh @ Babbu son of Tarsem Singh R/o Khemkaran were going ahead to the said Chhota Hathi on their motor cycle make Bajaj CT-100 and they were being followed by said Roshan Lal etc. This motor cycle make Bajaj CT-100 was being driven by Sunil Kumar and said Lovejeet Singh @ Babbu was pillion rider on the same and it was the time of 6.30.P.M. when the motor cycle of Sunil Kumar reached opposite to the BSF Head Quarter Khemkaran then from backside Mini Bus of Bandala Transport bearing no. PB-03-Q-9378 came at very high speed, without blowing any horn, rashly, negligently and in a zigzag manner and driver of said bus hit the bus against the motor cycle of Sunil Kumar due to which Sunil Kumar fell towards Bus side and said Lovejeet Singh @ Babbu fell on other side on the road due to which side of the bus hit with Sunil Kumar and backside Tyres of said bus collided the head of Sunil Kumar due to which he died at the spot. The accident took place due to rash, negligent illegal, fast driving of said Mini Bus bearing no. PB-03-Q-9378. An FIR bearing No. 0002 dated 5.1.2019 u/s 304/279 IPC, PS. Khemkaran, Tarn Taran on the statement of Roshan Lal Dhir son of Diwan Chand was registered.  The deceased was electrician by profession and was running his shop of repair of all kind of electronic goods at Amarkot and was earning about Rs 25,000- per month. The deceased was hale and hearty and was not suffering from any ailment. The complainant were fully dependent upon the income of deceased. The deceased used to spend his entire income for the benefit and welfare of his family members i.e. complainant. The complainant had lost their husband/father in this accident. A great set back has been caused to the complainant due to this accident. Transportation and cremation expenses were also incurred by complainant. As per the insurance cover note basic third party liability Rs.720/- and P.A. cover for owner-Driver Rs.50/- totaling Rs. 770/- stood deduced by the Opposite Party No.1 and since P.A. cover for driver and owner stood deducted to the tune of Rs. 50/- and as such the complainants are legally entitled to compensation from the opposite party No..1. The complainant approached the opposite party No.1 number of times for getting the claim but the opposite party refused to pay the same. Since owner of motor cycle paid the PA cover of driver and as such, the opposite Party is liable to pay compensation. The complainants prayed the following reliefs:-

1. The opposite party No. 1 be directed to pay a sum of Rs. 15,00,000/- towards the compensation to the complainants alongwith interest @ 18% from the date of entitlement till realisation.
2. The opposite party may be directed to pay Rs. 1,00,000/- towards compensation to the complainant for causing him mental harassment, agony, inconvenience.
3. The opposite party may be directed to pay Rs. 20,000/- towards litigation expenses.

Alongwith the complaint, the complainant has placed on record affidavit of complainant Ex. C-1, copy of FIR No. 2 dated 5.1.2019 U/s 304-A/279 IPC P.S. Khemkaran Ex. C-2, Copy of Post Mortem of deceased Sunil Kumar Ex. C-3, Copy of driving license of deceased Sunil Kumar Ex. C-4, Copy of insurance policy vehicle dated 17.4.2018 of insured Rajesh Dheer Ex. C-5, Copy of Adhar Card of complainant Sarita Ex. C-6, Copy of Adhar Card of complainant Payal Ex. C-7, Copy of Adhar Card of complainant Sahil Ex. C-8, Copy of Adhar Card of complainant Vansita Ex. C-9, Copy of Adhar Card of complainant Yuvraj Dheer Ex. C-10, Copy of R.C. of Motor cycle Bajaj C.T. 100 Ex. C-11.

2        Notice of this complaint was sent to the opposite parties and opposite party No. 1 appeared through counsel and filed written version by interalia pleadings that the present complaint is legally not maintainable, therefore, liable to be dismissed. The complainants have concealed the true and material facts from this Commission. The complainants are estopped by their own act and conduct from filing the present complaint. The complainants have filed the present complaint without any cause of action against the opposite party No. 1 , therefore, liable to be dismissed. The complainants have no locus standi and no cause of action to file the present complaint.  Insurance company had issued an insurance policy in the name of Mr. Rajesh Dheer for his vehicle Bajaj CT-100 bearing policy No. OG-19-1217-1802-00002881 which was valid from 17^th April, 2018 to 16^th  April, 2019 and the said policy is subjected to its terms, conditions and limitations thereof. On receiving claim intimation on 1.3.2019 of the accident of the vehicle on 5.1.2019, the insurance company had scrutinized claim and it was found that there has been violation of condition No. 1 of the terms and conditions of the insurance policy as the intimation has been given to insurance company after 2 months delay, therefore this petition is liable to be dismissed on this ground alone. Condition No. 1 of the terms and conditions of the insurance policy is stated as under:-

Notice shall be given in writing to the Company immediately upon the occurrence of any accidental loss or damage and in the event of any claim and thereafter the Insured shall give all such information and assistance as the Company shall require. Every letter claim writ summons and/or process or copy there of shall be forwarded to the Company immediately on receipt by the Insured. Notice shall also be given in writing to the Company immediately the Insured shall have knowledge of any impending Prosecution Inquest or Fatal Injury in respect of any occurrence which may give rise to a claim under this policy. In case of theft or other criminal act which may be the subject of a claim under thus Policy the Insured shall give immediate notice to the Police and co-operate with the Company in securing the conviction of the offender

The insurance company has sent letters dated 8.3.2019 and 16.3.2019 to the insured Rajesh Dheer (Opposite party no. 2) and asked for certain requisite documents and information but no documents were provided to this insurance company till date. Following requirements are not completed by the complainant till date:

1. Produce vehicle for initial survey.
2. Claim form duly filled and signed by the insured (Blank form enclosed herewith)
3. Copy of Driving license along with original for verification
4. Copy of FIR along with original for verification and translation in English if FIR is in regional language.
5. Estimates of repairs
6. KYC form duly filled and signed by insured along with residence proof and photo ID proof
7. NEFT form duly filled and signed by insured along with cancelled cheque on which name and account number should be pre-printed by bank or bank passbook or bank account statement
8. Details of third party involved in the accident
9. Details of injuries sustained to driver, pillion rider or third party involved in the accident
10. Copy of signature ID Proof along with original for verification
11. Copy of PAN Card along with original for verification/Form 60.

The insured Rajesh Dheer did not fulfill the above requirements till date and not provided the documents which were necessary for processing the claim therefore, the claim of the alleged death of Mr. Sunil Kumar was closed on the ground of non-cooperation and non-submission of essential requirement and intimation regarding the same was given to the insured vide letter dated 30.03.2019. The complainant is her petition has stated that her husband was driving the vehicle of Mr. Rajesh Dheer (insured with this answering insurance company) and this insurance company only indemnifies for PA Claim as Owner-driver to the insured. In this captioned case, since the insured owner-driver of the vehicle was not driving the vehicle at the time of the alleged accident, therefore complainant is not entitled to get any PA claim for her husband who was not insured with this answering insurance company and her husband was not falling under the category of owner- driver. Relevant section III of policy terms and conditions is stated as under:

SECTION III- PERSONAL ACCIDENT COVER FOR OWNER -

          DRIVER

Subject otherwise to the terms exceptions conditions and limitations of this policy, the Company undertakes to pay compensation as per the following scale for bodily injury/ death sustained by the owner driver of the vehicle, in direct connection with the vehicle insured whilst mounting into / dismounting from or traveling in the insured vehicle as a co-driver, caused by violent accidental external and visible means which independent of any other cause shall within six calendar months of such injury result in :

This cover is subject to:

(a)     The owner-driver is the registered owner of the vehicle insured herein;

          (b)     The owner driver is the insured named in this policy.

(c)      The owner-driver holds an effective driving license, in accordance with the provisions of Rule 3 of the Central Motor Vehicles Rules, 1989, at the time of the accident.

The husband of the complainant was driving the vehicle at the time of the alleged accident and he was not insured with this insurance company, therefore this insurance company is not liable to indemnify the PA Claim of the husband of the complainant. Therefore this petition is liable to be dismissed on this ground alone. There is no deficiency in service on the part of this insurance company, therefore this petition is liable to be dismissed with costs.  The opposite party No.1  has denied the other contents of the complaint and prayed for dismissal of the same. Alongwith the written version, the opposite party No. 1 has placed on record affidavit of Jai Singh Assistant Manager Ex. OP1/1, Self attested copy of Power of attorney/ authority letter Ex. OP1/2, self attested copy of policy Ex. OP1/3, Self attested copy of terms and conditions Ex. OP1/4, Self attested copy of letter dated 22.2.2019 Ex. OP1/5, Self attested copy of letter dated 8.3.2019 Ex. OP1/6, Self attested copy of letter dated 16.3.2019 Ex. OP1/7, self attested copy of repudiation letter dated 30.3.2019 is Ex. OP1/8.

3        Notice of this complaint was issued to the opposite party No. 2 but none has appeared on behalf of opposite party No. 2, therefore, opposite party No. 2 is proceeded against exparte.

4        We have heard the Ld. counsel for the complainant and opposite party No. 1 and have carefully gone through the record placed on the file.

5        Without touching the merits of the case first of all we have to see the repudiation letter which is reproduced as follows:-

“This is with reference to your claim and letter sent to you on 8.3.2019 and 16.3.2019 for which your good self have failed to submit any reply till date

Due to noncooperation and non-submission of essential requirements we are unable to process your claim and hence the same stands repudiated

Kindly note that nothing contained in this letter is or should be construed as a waiver of any one or more rights on our part and all our rights under and in relation to the policy remain fully reserved.”

          Now we have to see the copies of letters dated 8.3.2019 and 16.3.2019 which are Ex. OP1/6 and OP1/7 respectively and vide these applications, the opposite parties have demanded the following documents

1. Produce vehicle for initial survey.
2. Claim form duly filled and signed by the insured (Blank form enclosed herewith)
3. Copy of vehicle registration certificate alongwith original for verification
4. Copy of Driving license along with original for verification
5. Copy of FIR along with original for verification and translation in English if FIR is in regional language.
6. Estimates of repairs
7. KYC form duly filled and signed by insured along with residence proof and photo ID proof.
8. NEFT form duly filled and signed by insured along with cancelled cheque on which name and account number should be pre-printed by bank or bank passbook or bank account statement
9. Details of third party involved in the accident
10. Details of injuries sustained to driver, pillion rider or third party involved in the accident
11. Copy of signature ID Proof along with original for verification
12. Copy of PAN Card along with original for verification/Form 60.

The opposite party No. 1 has placed on record letters Ex. OP1/6, OP1/7  and OP1/8 but the opposite party No. 1 has not placed on record receipts and has also not placed on record any mode of delivery of above said documents to the complainant so far. According to opposite party No. 1 they have not decided the present case so far due to nonsubmission of requisite documents by the complainant and the complainant has also not placed on record any document which proves that the said documents have been submitted by the complainant to the opposite party No. 1. As such the claim is still pending due to non submission of requisite documents.

6        The claim has not been decided so far and is still pending due to non providing of documents. In case Balu Waman Kadam vs. ICICI Lombard General Insurance Co. IV (2013) CPJ 16A (CN) (Mah.), the matter was similar, wherein the Insurance Company was asking the complainant to submit the documents again and again and the complainant was alleging that he had already submitted the requisite documents to the Insurance Company. In such circumstances, the Hon’ble State Consumer Disputes Redressal Commission Maharashtra disposed of the matter, by directing the Insurance Company to reconsider the claim of the complainant within one month on receipt of the required documents from the complainant.        While relying upon the above said authority, the Hon’ble State Commission, Punjab, Chandigarh passed the similar orders in case M/s Trends, through its Proprietor vs The Oriental Insurance Company Limited & Anr. Consumer Complaint No.245 of 2015 decided on 04.08.2017; and M/s Gurbir Rice Mills v. United India Insurance Company Ltd. & Ors. Consumer Complaint No.404 of 2016, decided on 09.10.2017, directing the Insurance Company to reconsider the claim of the complainant after submission of requisite documents by the complainant to it. 

7        In view of our above discussion as well as keeping in view the ratio of above said judgments, we are of the opinion that the ends of justice would be met, if the Insurance Company be directed to decide the claim of the complainant, after the complainant submit all the requisite documents.

8        In view of the above discussion, the present complaint is disposed of with the direction to the complainant to submit the claim alongwith documents to the opposite party No. 1-Insurance Company  for deciding the claim within a period of 30 days from the date of receipt of copy of order and on approaching the complainant for supplying the requisite documents, the opposite party No. 1 will issue proper receipt acknowledging the same. The opposite party No. 1 shall decide the claim of the complainant within a further period of two months therefrom and in case of failure on the part of the opposite party No. 1 the claim case of the complainant deemed to have been accepted.  Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Commission and due to COVID-19. Copies of the order be furnished to the parties as per rules. File is ordered to be consigned to the record room.

Announced in Open Commission.

30.01.2024