DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, KANDHAMAL, PHULBANI
C.C.NO.12 OF 2017
Present: Sri Rabindranath Mishra - President.
Miss Sudhiralaxmi Pattanaik - Member .
Sri Purna Chandra Tripathy - Member .
Biyatkesh Tripathy, aged – 28 years
S/O: Ashok Kumar Tripathy At: NadikhandiSahi,
Back side of Telephone Bhawan Po/PS: Phulbani
Dist: kandhamal ……………………….. Complainant.
Versus.
1. G.M., IFFCO-TOKIO General Insurance Company Ltd,
Regd Office- IFFCO SADAN C-1, District Center, Saket
NEW DELHI- 110017.
2. D.G.M IFFCO- TOKIO General Insurance Service Centre
Satellite Office, Ist and 2nd Floor, H>I.G-22,
B.D.A. Colony, Jayadev Vihar, Bhubaneswar- 751013. …………………………….. OPP. Parties.
For the Complainant: Sri Subhakanta Mohapatra, Advocate and his Associate
For the OPP. Parties: Sri V.V Ramadas Advocate,Phulbani
Date of Order: 31-07-2017
O R D E R
The case of the Complainant in brief is that he had purchased a motorcycle bearing Registration No. OD-12-A-0695 and insured the vehicle under the O.Ps vide policy No.95283008, valid from 30.11.2015 to 29.11.2016. The Complainant met an accident at Banigochha on 24-07-2016 when he was coming from Bhubaneswar to Phulbani , as a result of which he sustained severe broken injury on his right leg and the motor cycle was also damaged . He shifted to the Patro Hospital Berhampur for better treatment and he was admitted in the said hospital. The father of the Complainant lodged F.I.R at Banigochha police station on 28-07-2016 vide PS case No 37/2016. The
-2-
Complainant intimated the O.Ps in Toll-free number in the month of August 2016. Then on 23-10-2016 he telephoned to the Customer care of the Insurance Company for the purpose. So, the surveyor was engaged on 27-10-2016 for assessment of the damaged vehicle and injuries of the Complainant. On 31-01-2017 the claim of the Complainant was rejected by the O.Ps due to delayed intimation. Hence, this complaint is filed by the Complainant claiming Rs. 26,000/- towards the loss of his vehicle and Rs. 1, 00000/- towards his injury due to negligence and deficiency in service of the O.ps. He also claimed compensation of Rs. 50,000/- only towards his mental agony and accidental cost and Rs. 10,000/- towards cost of litigation.
The case of the O.ps as per their version is that the Complainant has failed to intimate his claim in time for which the claim has been rejected due to violation of the General conditions of the policy. The Insurance Company received the claim intimation from the Complainant after 91 days from the date of loss it is on 24-07-2016 for which the claim has been repudiated by the O.Ps. Hence, the complaint is not maintainable and the O.ps have not committed any deficiency in service on their part.
During the course of hearing the Complainant has filed an affidavit in token of his evidence. He was examined, cross examined and Exit-1 to Exit-8/11 were marked upon the documents filed by him. We have heard the learned counsel appearing for both the parties. We have also gone through the complaint petition, the affidavit filed by the Complainant, the version filed by the O.Ps, written arguments and the documents filed by both the parties in support of their case.
The main point of consideration in this case is that whether the claim of the Complainant after 91 days of the date of occurrence is justified? The claim application was not considered by the O.Ps on this ground as reveals from Exit-4 dated. 24-01-2017 after 3 months from the date of the claim application of the Complainant. It is seen from the survey report of the Insurance Surveyor and loss Assessor that due to grievous injury of the insured, this caused the delay in intimating the Insurance Company .So, the grievous injury of the Complainant is admitted by the O.P. It is well settled that due to delay in filing the claim application, the settlement of the claim cannot be denied by the Insurance Company as he had received the premium from the insured. .
In this case it is admitted fact that the vehicle was insured under the O.P and the policy was valid from 30-11-2015 to 29-11-2016. It is also admitted fact that the Complainant met a road accident on 24-07-2016 and sustained severe injury. It is seen from Exit-6, the Retail Invoice that the repairing cost of the vehicle was Rs. 25,060/-. The Complainant had submitted the medical bills amounting Rs. 1, 14,926.50 paisa, but the final assessment was Rs. 12,465/- as per the report of the surveyor which is very less than the repairing cost. No suitable explanation was given by the O.P why the information of repudiation was given to the Complainant after 3 months from the date of his claim application. No specific reason was also given by the O.Ps as to why the retail Invoice given by the Show Room of the vehicle will not be accepted. In view of the admitted fact as mentioned above,
-3-
the Complainant is entitled to get relief in Part. Hence, the O.P is directed to pay the cost towards the damage of the vehicle to the tune of Rs. 23,560/-to the Complainant after deducting the rest amount towards depreciation charge. The O.P is further directed to pay Rs. 40,000/- to the Complainant towards the personal accident cover for owner driver which is 40 % of the Insured amount basing on the injury and treatment of the Complainant. No further compensation is allowed in the above circumstances of the case. The above order be complied within 30 days from the date of receipt of this order , otherwise the Complainant shall be entitled to get interest at the rate of 8 % per annum on the entire awarded amount from the date of the Judgment till the date of payment .
The C. C is disposed of accordingly. Supply free copies of this order to both the parties .
MEMBER MEMBER PRESIDENT
