Orissa

Sambalpur

CC/47/2014

Mohan Naik - Complainant(s)

Versus

Divisional Manager, Oriental Insurance Co.Ltd. - Opp.Party(s)

H.N. Sarngi

04 Mar 2016

ORDER

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Complaint Case No. CC/47/2014
 
1. Mohan Naik
Resident of Gumkarma, Po./Ps.-Rengali, Dist.-Sambalpur.
...........Complainant(s)
Versus
1. Divisional Manager, Oriental Insurance Co.Ltd.
At/po-VSS Marg, Sambalpur, Dist- Sambalpur
............Opp.Party(s)
 
BEFORE: 
  A.P.MUND PRESIDENT
 HON'BLE MR. JUSTICE K.D.DASH MEMBER
 
For the Complainant:
For the Opp. Party:
ORDER

SHRI A.P. MUND, PRESIDENT:- Complainant Mohan Naik has filed this case against the O.P. alleging deficiency in service. Case of the complainant is that he is the registered owner and driver of vehicle Mahindra Bolero XL 2WD bearing Regd.No.OD-23-0083. The said vehicle was comprehensively insured with the O.P. vide Policy No.345600/31/2014/2000480 valid for the period from 17.8.2013 to mid-night of 16.8.2014.During the validity period of insurance the insured vehicle met with an accident on 09.3.2014 and got severely damaged. Claim was duly lodged with the O.P. after the accident. 
    2. Further submission of the complainant that after lodging the claim, O.P. found that the Driving License submitted by the complainant  was not valid and asked him to clarify the position of the validity of the D.L. tendered by him vide their Letter dt.19.4.2014. Complainant submitted a Xerox copy of his Driving License along with his letter dt.16.7.2014 stating that he has not committed any violation of terms and conditions of the Insurance Policy as alleged by the O.P. But O.P. did not settle the claim. So, complainant alleges that the O.P. is deficient in settling his claim even after submission of claim form and necessary documents. On the basis of above, complainant has filed this case praying to direct the O.P. to settle the claim, pay compensation of Rs.50,000/- with penal interest @ 18% for mental agony, harassment and financial loss, pay cost of the proceeding and any other appropriate reliefs.

    In order to support his case, complainant has filed Xerox copies of following documents:

(1) Certificate of fitness of the vehicle (2) Insurance Policy (3) Premium deposit slip (4) Certificate of registration and registration certificate particulars (5) Driving License with D.L. Smart card (6) Letter dt.19.4.2014 issued by the O.P. to the complainant (7) Reply submitted by the complainant .
    3. O.P. appeared through its Advocate and filed written version and admitted regarding issue of one Passenger Carrying Commercial Vehicle Policy of Insurance in favour of the vehicle of the complainant. According to the O.P. the policy was issued subject to certain terms and conditions, warranty and exclusion clause as per the policy. O.P. in its version states that the driver’s clause of the policy of insurance specifically speaks that the insured vehicle must be driven by a person including the insured provided that he holds an effective Driving License at the time of accident and is not disqualified from holding or obtaining such a license. If the Driver’s clause is violated by the insured, then the insurer cannot indemnify any loss arising out of any accident of the vehicle.
    4. The further submission of the O.P. is that after receipt of intimation regarding the accident, the O.P. deputed one surveyor to inspect the vehicle at the spot and assess about the damages. After assessment by the surveyor, the insured vehicle was taken by the insured to the garage for necessary repairs. Another surveyor was deputed to assess the loss and submit his report about the loss caused to the vehicle and the surveyor pegged the loss at Rs.33,500/- after deducting the depreciation, policy excess and salvage etc. 
    5. Before settlement of the claim, the O.P. found that at the relevant time of accident the D.L.No.OR-1520050033746 belongs to the driver/complainant was ineffective to drive a passenger carrying vehicle. Though the D.L. was effective from 22.4.2013 to 21.4.2016, it was valid only to drive goods transport vehicle, but not to drive light passenger carrying vehicle. The R.T.O., Sambalpur also confirmed this matter vide his letter No.2187/RTO dt.22.6.2014 that the holder of the said D.L. has not been authorised to drive No.OD-23-0083. 
    6. The O.P. issued a show cause notice to the complainant, which was not replied by him, so the O.P. was forced to repudiate the claim on the ground of violation of policy condition. O.P. further submits that the claim of the complainant is not a fit case for settlement since the claim ex-facie is not maintainable because of violation condition of Drivers clause of the policy of insurance. The Drivers Clause of the Policy of Insurance goes to the root of the matter and it is a fundamental breach of the Policy condition and hence the complainant-insured is not entitled for any claim or compensation in this particular claim. In order to support its case O.P. has filed a list of document and copies thereof, which are Xerox copies of:
    (1) Passenger Carrying Commercial Vehicle Package Policy of Insurance bearing No.345600/31/2014/3339 with conditions for M & M Bolero Plus bearing No.OD-23-0083 (2) Claim form submitted by the insured (3) Spot survey report (4) Final survey report (5) Certified copy of the Driving License No.OR-1520050033746 (6) Information of the R.T.O., Sambalpur supplied to Sri J.P. Pandia, Advocate under the R.T.I. Act (7) Letter of show cause dated 19.4.2014.

    7. Heard the arguments from both sides and perused the complaint petition, written version and documents filed by the parties and placed on record. The Policy of Insurance has a Drivers Clause which reads as follows:                                
    “ The Drivers  Clause of the Policy of Insurance specifically speaks that the insured vehicle must be driven by a person including the insured provided that he holds an effective Driving License at the time of accident and is not disqualified from holding  or obtaining such a license, if the Drivers Clause is violated by the insured, then the insurer cannot indemnify any loss arising out of any accident of the vehicle”.
    8. The alleged insurance policy is a Passenger Carrying Commercial Vehicle Package Policy which carries the above Drivers clause. The vehicle was registered as a transport vehicle. The D.L. submitted by the complainant-driver belongs to himself bearing No.OR-15-20050033746 which was not endorsed for driving passenger vehicle.  The letter of the R.T.O., Sambalpur clearly states that the holder of the above D.L. belongs to the complainant-driver. 
    9. On the basis of the above, we find that complainant has violated the Drivers Clause of the Insurance Policy. According to the O.P., for violation of the Drivers Clause of the Policy, it has repudiated the claim of the complainant. But no repudiation letter has been filed before this Forum. Only in para-3 (iv)  of the written version O.P. has stated that the claim stood repudiated on the ground of violation of policy condition. 
    10. Though the claim of the O.P. is found to be true, in view of the findings of the Hon’ble Supreme Court in the case of Amalendu Sahu  Vrs. Oriental Insurance Co.Ltd., the complainant is entitled to get 75% of assessed value as per report of the surveyor. As such applying the ratio of decision of the Honble Supreme Court in the reported case to the present case, we allow the case of the complainant against the O.P. on contest. Admittedly the surveyor has estimated the loss at Rs.35,500/-. So, complainant is entitled to get 75% of the said amount. 

    11. We accordingly direct the O.P. to pay to the complainant Rs.26,625/-(Rupees Twenty-six thousand six hundred twenty-five) being 75% of the assessed value of Rs.35,500/-  along with interest @ 9(Nine) per cent per annum from the date of surveyors report i.e. 28.4.2014 till the date of payment. The O.P. is further directed to pay to the complainant Rs.5,000/-(Rupees Five thousand) towards cost of the proceeding. O.P. has to comply this order within one month from the date of order.

 
 
[ A.P.MUND]
PRESIDENT
 
[HON'BLE MR. JUSTICE K.D.DASH]
MEMBER

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