Orissa

Cuttak

CC/134/2016

Kalpana Das - Complainant(s)

Versus

Branch Manager,Reliance General Insurance Co Ltd - Opp.Party(s)

R K Pattanaik

27 Feb 2018

ORDER

IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL FORUM,CUTTACK.

C.C No.134/2016

Kalpana Das,

w/O: Late Rabindra Das,

At:Baramana,PO:Purunabaulamal,

P.S:Jenapur,Dist:Jajpur.                                                                                … Complainant.

 

                Vrs.

 

 

1.         Branch Manager,

Reliance General Insurance Co. Ltd.,

1^st Floor,Tulasi Complex,

Panposh Road,Rourkela,Odisha-769004.

 

2.         Managing Director,

 Reliance General Insurance Co. Ltd.,

 570, Naigaum Cross Road,Next to

 Royal Industrial Estate,Wadala(W),

 Mumbai-400031.

 

3.        Regional Manager,

Reliance General Insurance Co. Ltd.,

2^nd floor,5 Janpath,Unit No.1,

Bhubaneswar-751001,Dist:Khurda.                                          … Opp. Parties.

 

Present:               Sri Dhruba Charan Barik,LL.B. President.

Sri Bichitra Nanda Tripathy, Member.

Smt. Sarmistha Nath, Member (W).

 

Date of filing:   03.12.2013

Date of Order: 27.02.2018

 

For the complainant:                 Sri R.K.Pattnaik,Adv. & Associates.

For the O.Ps.                :               Sri Ranjan Pati,Adv. & Associates.

 

Sri Bichitra Nanda Tripathy,Member.

                The case of the complainant is against deficiency in service on the part of the O.Ps.        

1. The husband of the complainant had insured his vehicle with O.P No.1 under Reliance Goods Carrying Vehicle Package Policy vide Policy No.2408552334000314 for the period from 26.03.2015 to 25.03.2016 on payment of a premium of Rs.46,491/-(Annexure-1).   The sum assured under the policy was Rs.22,00,000/- The said vehicle met with an accident at N.H-55 near Babula Petrol Pump under Gurudijhatia police station on 19.05.2015 at about 5.15 A.M.  Due to such an accident, the front position of the vehicle was completely damaged.  The vehicle (truck) was carrying chips from Chadheidhara to Athagarh.  The insured intimated such facts at Gurudijhatia police station vide station diary entry No.353 & 358.(Annexure-2).  The facts of accident was also intimated to O.P No.1 & 2.  The O.Ps deputed their surveyor for assessment of the loss and after such assessment the vehicle was taken to Trupti  Automobiles,Manguli,Cuttack for repair.  The said garage is the authorized dealer for TATA Motors and also repairs such vehicle.  M/s. Trupti Automobiles gave an estimate of Rs.8,66,861/- towards repair of the said vehicle(Annexure-3).  The insured submitted documents to O.Ps and waited eagerly for settlement of such claim but on 03.08.2015 the O.Ps intimated that they have repudiated the claim of the insured on the ground that at the relevant point of accident the subject vehicle has committed breach of policy condition no.1.   Since the driver of the vehicle remain unhurt and have escaped without any injury, even after such severe accident, the O.Ps concluded that at the material point of accident some other man was driving the vehicle other than the driver.(Annexure-4).  The husband of the complainant (insured) replied to the O.Ps that the driver has escaped narrowly which cannot be termed as violation of policy condition.  Hence the claim should not be repudiated.(Annexure-5).  The cause of repudiation of the claim was on the ground that the driver of the vehicle was not injured.  Since the driver had a valid driving license, the repudiation of such claim was a fundamental breach under the policy contract.  The husband of the complainant passed away on 02.09.2016.

Finding no other way, the complainant has taken shelter of the Hon’ble Forum.He has prayed to direct the O.Ps to pay the estimated amount for repair i.e. Rs.8,66,861/- along with interest @ 9%from the date of submission of claim till final payment along with compensation for mental agony and harassment amounting to Rs.50,000/- and cost of litigation amounting to Rs.20,000/-.

2. The O.Ps vide their written version dt.04.03.2017  have stated that a Good Carrying Commercial Vehicle Package Policy was issued in favour of one Rabindra Das vide Policy No.2408552334000314 covering risk of TATA/LPK 2518TC/5883 bearing Regd. No.OD-04-C-6044 and was valid from 26.03.2015 to 25.03.2016 subject to certain terms and conditions of the Insurance Company.(Annexure-A & A-1).  During the validity of the said policy, the concerned vehicle met with an accident as a result of which the chassis, cabin as well as the front portion of the engine of the vehicle was completely damaged but not sustained any injury.  The net assessed loss was Rs.6,05.000/-(copy of survey report vide Annexure-B).  The claim was repudiated by the O.Ps vide their letter dt.30.09.2015 on the ground that the driver who was shown as driving the vehicle at the material time of accident was not actually driving the vehicle at the material time of accident since the driver has not sustained any injury due to such accident. Rather the said driver had been swapped in place of the driver who was actually driving the vehicle at the material time of such accident had no valid D.L.  Since the insured failed to furnish correct informations and assistance to the Company, his claim is not payable (Annexure-C).  They have also stated that even if it is proved that the vehicle in question was repaired by the Trupti Auto, then also no claim can be settled on the basis of estimate given by the repairer and in absence of bill towards payment of cost incurred towards purchase of parts. Further the claim of the complainant is not payable due to deliberate and willful violation of condition No.1 of the Insurance policy.  The claim is liable to be dismissed since the complainant has not approached the Forum with clean hands.
3. We have gone through the case records in details and heard the advocates from both the sides at length.  The husband of the complainant had insured his Tata LPK 2518 TC/5883 truck bearing Regd. No.OD-04-C-6044 with the O.P, Insurance Company.  The said truck met with an accident on 19.05.2015 when the insurance policy was in force.  The IDV for the policy was Rs.22,00,000/-. The estimate for repair of the said vehicle was for Rs.8,66,681.00 as obtained by the insured from M/s. Trupti Automobiles,Manguli,Cuttack.  The surveyor Mr. M.K.Singh vide his letter dt.18..08.2015 has assessed the total loss at Rs.7,48,741.25 and net loss at Rs.6,05,000/- excluding salvage value which was calculated at Rs.1,43,741.25.  The Insurance Company repudiated the claim on the plea that the driver was not sustained any injury in spite of the fact that the truck was damaged a lot in the front side.  The O.P Insurance Company also suspected that some other person was driving the said truck at the material time of accident who had no valid driving license but failed to prove the same.  From the report of the surveyor it is clear that Sri Pankj Lochan Sahoo was driving the vehicle and was having a valid license.  The report of the IIC,Gurudijhatia also clearly states that Sri Pankaj Lochan Sahoo was driving the vehicle and was having a valid driving license.  Hence the plea of the O.Ps that “some other man was driving the vehicle since the driver was not injured in the accident” appears improper.  The O.Ps also failed to prove that some other person was driving the vehicle at the material time of accident.  Hence the O.Ps are found deficient in service.

 

ORDER

Basing on the facts and circumstances, the O.Ps are directed to settle the claim at Rs6,05,000/-.(The net assessed loss as calculated by the Surveyor and Loss Assessor, Mr. M.K.Singh vide his letter dt.18.08.2015).  The O.Ps will pay interest @ 9% per annum on the said amount from 03.08.2015(the date of repudiation of the claim) till the date of actual payment.  The O.Ps will also pay a sum of Rs.20,000/- towards cost of litigation.  The above payment shall be made within a period of 45 days from the date of receipt of this order

Typed to dictation, corrected and pronounced by the Hon’ble Member in the Open Court on this the 27^th day of February,2018  under the seal and signature of this Forum.

              (Sri B.N.Tripathy )

                                                                                                                     Member.

 

                                                                                                                                               

                                                                                                               (  Sri D.C.Barik )

                                                                                                                     President.

                                                                                                            (Smt. Sarmistha Nath) 

                                                                                                           Member(W).