KUNDAN KUMAR KUMAI

This is an Appeal under section 41 of the Consumer Protection Act, 2019, preferred against the judgement and order dated 13/12/2022, passed by the Ld. DCDRC, Raiganj, in Consumer Complaint No.34/2021.

Brief facts of the Appellant’s case is that, the husband and father of the Appellants, being the owner of Pulsar (Bajaj) Motor Cycle bearing no.BR-37B-4098 and engine no. JEGBSK 10749 and chassis no. MD2JDJDZZSCK 10727, had been insured by the Respondent/Insurance Company, by Policy No. OG-20-2404-1802-00021206 and valid from 15/03/20 to midnight 14/03/21 and also had compulsory PA Cover (owner-driver) amounting to Rs.15,00,000/- only from 15/03/20 to midnight 14/03/21 and a premium of Rs.331 as PA Cover for owner-driver had been paid. The deceased had a valid driving license being WB-60/53396 valid from 14/05/2010 to 13/05/2022, met with an accident while driving the aforesaid motor cycle on 16/06/2020 at 1:15 PM while driving to his office, when a four-wheeler from the opposite direction, dashed the deceased head on, causing severe multiple injuries and after being taken to Lodhan Hospital, the doctors referred him to Islampur Hospital, where the doctors of Islampur Hospital, had declared him dead. The younger brother of the deceased lodged a written complaint before the Goalpukhur Police Station, where Goalpukhur P.S. Case No.172/2020 dated 18/06/2020 under section 279/304A of the IPC had been started. After completion of investigation charge-sheet against the driver of the four-wheeler had been lodged. Thereafter, Ld. Advocate Sujan Sundar Sil requested the Respondent/Insurance Company for disbursement of the compulsory PA Cover amounting to Rs.15,00,000/- by a letter dated 08/07/2020. Despite receiving the letter on 03/08/2020 the Respondent/Insurance Company did not respond, following which the Appellant had filed the Case before the DCDRC, Raiganj with necessary prayers. Hence, this Case.

The Respondent/Insurance Company appeared to contest the claim by filing written version wherein they challenged that the Appellants were neither consumer nor the dispute a ‘consumer dispute’. They admitted that the vehicle in question, had been covered by Policy No. OG-20-2404-1802-00021206 and the same had been valid from 15/03/20 to midnight 14/03/21 and also had compulsory PA Cover (owner-driver) amounting to Rs.15,00,000/- only from 15/03/20 to midnight 14/03/21. It is also admitted that upon intimation from the Appellant, the Respondent/Insurance Company had registered the claim and had sought necessary documents required for processing the claim, but the Appellant had failed to do so. That apart the Respondent/Insurance Company had also deputed a surveyor, to assess the alleged damage of the vehicle in question. It is further mentioned that the Appellant had failed to intimate, the Respondent/Insurance Company regarding the accident, within the stipulated time and had denied that the deceased had a valid and effective driving license on the date of accident and thereafter the deceased had violated the Provisions of the Motor Vehicle Act by driving without helmet and without valid permit and fitness. It was also mentioned that the concerned Police Station had failed to forward all the relevant documents within 30 days from the date of information, as per the Provisions section 158(6) of the M. V. Act. It was therefore prayed that the consumer complaint filed be dismissed.

After going through the evidence and hearing the Ld. Advocates, the Ld. DCDRC, Raiganj passed the impugned order, dismissing the Case.

Being aggrieved by the impugned order, the Appellants preferred this instant appeal, on the ground, that the Ld. DCDRC, Raigunj, had erred in law and facts, while passing the impugned order.

Decisions with Reasons

The Ld. Advocate for the Appellant, at the time of final hearing submitted that the younger brother of the deceased lodged a complaint before the Goalpukhur P.S. on 18/6/2020, after two days of the accident on 16/6/2020. Thereafter, an Advocate’s letter dated 8/7/2020, had also intimated the Respondent/Insurance Company regarding the accident and requested for disbursement of the claim amount. The Respondent/Insurance Company had received the letter on 03/08/2020, but had not complied with the same. Moreover, the Respondent/Insurance Company, admitted vide para 10 of the written version, regarding the intimation of the accident and the only grievance was that the Appellants, had failed to furnish the requisite documents. Moreover, vide para 11 of the written version, the Respondent/Insurance Company had deputed a surveyor, but somehow failed to submit the said Surveyor’s report. As far as the non-compliance of the section 158(6) of the M. V. Act is concerned, the Appellants should not be penalized for such non-compliance. The Ld. Advocate has assailed the impugned order, on the ground that no claim had been submitted on behalf of the Appellants, but the Respondent/Insurance Company had already registered the claim based on such letter. As far as the delay in lodging the claim is concerned, the Circular being IRDA/HLTH/MISC/CIR/216/09/2011 dated 20/09/2011 lays down that, claims on technical grounds should not be rejected mechanically. He has relied in the judgement passed in Om Prakash Vs. Reliance General Insurance & Anr. decided on 04/10/2017, by the Hon’ble Supreme Court and in United India Insurance Co. Ltd. Vs. Surinder Singh decided on 09/02/2021, by the Ld. State Consumer Disputes Redressal Commission, Chandigarh, Punjab.

Ld. Advocate on behalf of the Respondent/Insurance Company, has countered the argument by submitting that the Appellants were required to lodge the claim towards PA Coverage by filing Claim Form, Driving License of the deceased, Registration Certificate, FIR, PM Report and the Appellant’s I Card, but the same was not complied. That apart, the claim had to be filed by the Appellants themselves and not through any engaged agent. Hence the Appeal be dismissed.

The Ld. DCDRC, Raiganj while passing the impugned order had decided that the accident which occurred on 16/06/2020, resulting in the death of the deceased had not been disputed. He had also mentioned that the younger brother of the deceased had lodged an FIR on 18/06/2020, being Goalpukhur P.S. Case No.172/2020 dated 18/06/2020, under section 279/304A of the IPC, which had resulted in the charge-sheet and the same also had not been disputed. The Ld. DCDRC, Raiganj had also decided and overruled the objection of the Respondent/Insurance Company, with regard to the lack of driving license of the deceased at the time of accident. Hence, with the above factors being decided in favour of the Appellants and there being no Appeal against the above. It can be safely concluded that the Respondent/Insurance Company had acceded the above positions in favour of the Appellants.

Since the Ld. DCDRF, Raiganj did not pass any opinion with regard to the non-compliance of the provisions of section 158(6) of the M.V. Act, 1988, by the Goalpukhur P.S.  it can be stated that such non-compliance by the Goalpukhur cannot be held against the Appellants and they should not be penalized for something, they were not even aware of. Hence, this point is also decided in favour of the Appellants.

Now the only point that needs to be decided is whether the failure, on the part of the Appellants to lodge the claim, before the Respondent/Insurance Company, after the accident, can be termed as an illegality or irregularity. It is undisputed position that the claim on behalf of the Appellants, to the Respondent/Insurance Company had been made for the first time by an Advocate through his letter dated 08/07/2020 forwarding the Insurance Policy, Adhar Card of the Appellant, birth certificate of another Appellant, driving license of the deceased and death certificate of the deceased. On the basis of the above letter, the Respondent/Insurance Company in their written version at paragraph 10, registered the claim. That apart in paragraph 11 Respondent/Insurance Company had admitted to deputing a surveyor. Therefore, when nothing is disputed with regard to the accident and the claim the only reason to not honour the claim, on the ground, that the same was not submitted by the Appellants themselves, does appear to be unfair and interpreting the provision with the technical mindset to deprive the Appellants. In fact, the principles percolating from the judgement passed in Om Prakash Vs. Reliance General Insurance & Anr. decided on 4/10/2017 by the Hon’ble Supreme Court and in United India Insurance Co. Ltd. Vs. Surinder Singh decided on 9/2/21 by the Ld. State Consumer Disputes Redressal Commission, Chandigarh, Punjab, discourage the Insurance Companies from such practice so that they do not shatter the confidence of the Claimants in the Insurance Companies. At best it appears to be an irregularity. With the accident undisputed and the claimants also with their Aadhar cards identified, to insist for the claim form and not allow the claim, appears to be a bit too technical. Hence, when the claim is admitted, the Appellants are entitled to claim under the compulsory PA cover amounting to Rs.15,00,000/- (Rupees fifteen lakhs) only along with the compensation of Rs.50,000/- (Rupees fifty thousand) only for mental pain and agony and the litigation cost of Rs.10,000/- (Rupees ten thousand) only. As a result, the instant Appeal succeeds.

It is therefore

It, is therefore

Ordered

That the instant Appeal be and the same is allowed on contest but without cost.

The impugned order is hereby set aside.

The Respondent/Insurance Company is directed to issue Cheques amounting to Rs. 5,20,000/- (Rupees five lakhs twenty thousand) only each within 30 (thirty) days from the date of receipt of this Order failing which interest @ 8% would have to be levied upon the above amounts till the date of realization.

On receipt of the above Cheque the Appellant no.1 shall deposit the Cheques of the minor Appellants 2 & 3 in a Fixed Deposit in a Nationalized Bank, till the minor Appellants 2 & 3 attain majority, with an intimation to the Jt. Registrar of this Circuit Bench of such compliance.

Copy of the Order, be sent to the Parties, free of cost.

Copy of the Order, be sent to the Ld. DCDRC, Raiganj, for necessary information.