Haryana

Karnal

124/2011

Raj Bala W/o Shiv Kumar - Complainant(s)

Versus

ICICI Lombard General Insurance Company Limited - Opp.Party(s)

Sudhakar Mittal

27 Dec 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

                                                               Complaint No.124 of 2011

                                                             Date of instt.:28.02.2011

                                                              Date of decision:27.12.2016

 

Raj Bala wife of late Shri Shiv Kumar, resident of New Anaj Mandi, Nissing, Tehsil Nissing, District Karnal.

 

                                                                   ……..Complainant.

                                      Vs.

1. ICICI Lombard General Insurance Company Limited, having one of its office at SCO no. sector 12 U.E. Karnal.

2. ICICI Lombard General Insurance Company Limited, through its Manager/authorized signatory, SCO no.24-25, First Floor, Sector-8, Chandigarh.

 

                                                                   ………… Opposite Parties.

 

                     Complaint u/s 12  of the Consumer Protection Act.

 

Before                   Sh.K.C.Sharma……….President.

                   Sh.Anil Sharma…….Member.

 

Present:-      Sh.Subodh Gupta Advocate for the complainant.

                    Sh. Vinod Sharma Advocate for the Opposite parties.

                  

 ORDER:

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer protection Act 1986, on the averments that her husband Shiv Kumar (since deceased) got insured his car bearing registration no.HR-05V-5853 from opposite parties, vide policy no.MAR-10084015, valid from 30.01.2010 to 2010. On 02.04.2004, the said car met with an accident with the truck bearing registration no.HR-46A-5185 near Power House, Nagurana, Police Station Alewa.  At the time of accident, the car was being driven by Shiv Kumar. He died in the said accident and the car was badly damaged. A case bearing First Information Report no.72 dated 2.4.2009 was registered in Police Station Alewe regarding the said accident. She informed the officials of the opposite party regarding the death of her husband and submitted claim alongwith necessary documents under personal accident claim of the insured, on 2.7.2009. As per section IIIrd in the Head of Personal Accident of the Policy she is entitled to sum of Rs.2 lacs from the opposite party. She approached the opposite party a number of times for payment of the claim, but nothing was done. Such act and conduct of the opposite parties caused her mental pain, agony and harassment apart from financial loss.

2.                Notice of the complaint was given to the opposite parties, who put into appearance and filed written statement. Objections have  been raised that the complainant has no locus standi and cause of action to file the complaint; that the complaint is not legally maintainable; that the complainant is estopped from filing the complaint by her acts and conduct; that the complainant has not approached this forum with clean hands and that the complaint is vague, indefinite an abuse of process of law.

                   On merits it has been submitted that there was no deficiency in service or unfair trade practice on the part of the opposite party. The claim of the complainant was thoroughly investigated by the opposite party and on perusal of the documents submitted by the complainant it was found that death of the cow of the complainant had occurred due to mis-management of the farm and stable, as the complainant did not provide any treatment to the ailing cow. Cause of death was excluded from cover under clause 8 of the policy, therefore, the claim of the complainant was rightly repudiated.

3.                In evidence of the complainant, her affidavit Ex.C1 and documents Ex. C2 to C6 have been tendered.

4.                On the other hand, in evidence of the opposite parties, affidavit of Inderjit Singh Legal Manager Ex.R1 has been tendered.

5.                We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned counsel for the parties.

6.                A perusal of the copy of the insurance policy Ex.C2 shows that car bearing registration no.HR-05V-5853 owned by Shiv Kumar was insured with opposite party for the period of 31.01.2009 to 30.01.2010. It was mentioned in the policy that the cover under section IIIrd for owner- driver is Rs.2 lacs. As per case of the complainant, the said car met with an accident on 2.4.2009, while the same was being driven by insured Shiv Kumar and in the said accident owner insured had died and the car was badly damaged. The complainant has also produced the copy of First Information Report Ex.C3 and copy of the Post Mortem Report Ex.C4. This documentary evidence of the complainant lends support to the contents of her affidavit  Ex.C1, that her husband Shiv Kumar had died in the said accident and at the time of accident he was driving the said car. The complainant has further alleged that she had lodged claim with the opposite parties and submitted necessary documents, but nothing was done by the opposite parties.

7.                It is worth pointing out at the very outset that the written statement filed by the opposite parties does not relate to the claim of the complainant. It appears that due to some inadvertence the written statement was filed regarding the death of some cow, whereas the complainant lodged the claim in respect of death of her husband Shiv Kumar the owner-cum-driver of the insured car no. HR-05V-5853 at the time of accident under section IIIrd of the policy cover. Therefore, written statement filed by the opposite parties does not render any help to them.

8.                  Inderjit Singh the legal manager of opposite parties in his affidavit Ex.R1 has submitted that no claim was lodged by the complainant with the opposite party, therefore, in the absence of intimation or lodging of the claim, the complainant being premature is not sustainable and as such there was no deficiency in service on the part of the opposite parties. It has also been submitted that the complainant was to adopt the particular procedure laid down by the Insurance Regulatory and Development Authority and complete necessary formalities as mentioned in para no.6 of the affidavit, but she had not completed all those formalities and the complaint is abuse of process of law. The affidavit Ex.R1 is altogether different from the contents of the written statement filed by the opposite parties. It is settled proposition of law that evidence beyond pleadings cannot be looked into. Therefore, the affidavit of Inderjit Singh Ex.R1 cannot be taken into consideration. Even otherwise, the affidavit cannot be taken to be the gospel truth and the same is not sufficient to rebut the overwhelming evidence of the complainant regarding the death of her husband in the accident and the claim lodged by her with the opposite parties.

9.                From the evidence of the complainant, it stands established that the car no. HR-05V-5853 owned by her husband Shiv Kumar was insured with the opposite parties for the period of 31.01.2009 to 30.01.2010, the said car met with an accident on 2.4.2009 while being driven by Shiv Kumar and in that accident Shiv Kumar had died and the car was damaged. As per policy condition the death of owner- driver was covered upto claim of Rs.2 lacs. Therefore, the complainant is entitled to get claim of Rs.2 lacs from the opposite party. Not making the payment of the claim to the complainant by the opposite party amounted to deficiency in service.

9.                As a sequel of aforesaid discussion, we accept the present complaint and direct the opposite parties to pay Rs.2,00,000/- as insured amount to the complainant with interest @ 9% per annum from the date of filing the complaint till its realization. We further direct the opposite party to pay Rs.5500/- to the complainant on account of mental agony and harassment suffered by her and for the litigation expenses. This order shall be complied within 30 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 27.12.2016

                                                                                      (K.C.Sharma)

                                                                                         President,

                                                                             District Consumer Disputes

                                                                             Redressal Forum, Karnal.

                             (Anil Sharma)

                               Member