Chandigarh

StateCommission

A/139/2024

JANKI DEVI - Complainant(s)

Versus

ICICI LOMBARD GENERAL INSURANCE COMPANY LTD THROUGH ITS BRANCH MANAGER/DIRCTOR/AURTHORIZED SIGNATORY - Opp.Party(s)

DEEPAK AGGARWAL

25 Nov 2024

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

UNION TERRITORY, CHANDIGARH

 

Appeal No.	139 of 2024
Date of Institution	05.04.2024
Date of Decision	25.11.2024

 

 

Janki Devi w/o Late Hum Bahadur Baral, resident of H.No.675, Shiva Enclave Bhabhat Road, Zirakpur, Dera Bassi, SAS Nagar, Mohali, Pb-140603.

 

        …..Appellant/Complainant

 

Versus

ICICI Lombard General Insurance Company Ltd., Plot No.149, Fourth the Statement, Industrial Area, Chandigarh 160002 through its Branch Manager/Director/Authorized Signatory.

Registered Office & Corp. Office: ICICI Lombard GIC Ltd., ICICI Lombard House 414, Veer Savarkar Marg, Near Siddhi Vinayaka Temple, Prabhadevi, Mumbai 400025.

                                               

         …..Respondent/Opposite Party

 

Appeal under Section 41 of the Consumer Protection Act, 2019.

 

BEFORE:     MRS. PADMA PANDEY, PRESIDING MEMBER

                   MR. PREETINDER SINGH, MEMBER

 

Argued by:   Sh. Deepak Aggarwal, Advocate for the appellant.

                    Sh. Ankur Gupta, Advocate for the respondent (on V.C).

                          

PER PADMA PANDEY, PRESIDING MEMBER

              This appeal is directed against an order dated 06.03.2024, rendered by District Consumer Disputes Redressal Commission-I, U.T., Chandigarh (hereinafter to be called as the District Commission only), vide it partly allowed the Consumer Complaint bearing No.852 of 2022, filed by the complainant (now appellant) and directed the Opposite Party (now respondent), as under:-

“4. In the light of the aforesaid discussion, the present consumer complaint succeeds, the same is hereby partly allowed and the OP is directed as under:-

1. to pay ₹11,25,000/- to the complainant alongwith interest @ 9% per annum from the date of repudiation of the claim i.e. 28.7.2022 onwards.
2. to pay an amount of ₹20,000/- to the complainant as compensation for causing mental agony and harassment;
3. to pay ₹10,000/- to the complainant as costs of litigation.

5. This order be complied with by the OP within thirty days from the date of receipt of its certified copy, failing which, the payable amounts, mentioned at Sr.No.(i) & (ii) above, shall carry interest @ 12% per annum from the date of this order, till realization, apart from compliance of direction at Sr.No.(iii) above.” 

2.    The facts in brief, are that, the complainant's late husband, Hum Bahadur Baral, was the owner of a Honda motorcycle (Registration No.PB 70H 3057), which was insured with the OP (Insurance Company). The insurance policy (Annexure C-1) was valid from 05.06.2022 to 04.06.2023, and the insured declared value (IDV) of the motorcycle was Rs.64,867/-. The policy also included personal accident coverage for the owner/driver. On 14.06.2022, the complainant's husband, Hum Bahadur Baral, was driving his Honda motorcycle towards Zirakpur when he tragically met with an accident. As a result of the collision, Hum Bahadur Baral succumbed to his injuries, leading to his death. The motorcycle was also damaged in the incident. To support the claim, the complainant has submitted the copy of Death Certificate (Annexure C-3) and Postmortem Report (Annexure C-4). After the accident on 14.06.2022, the complainant promptly informed the police about the incident. As a result, a General Diary (GD) entry (Annexure C-5) was recorded at Thana Dhakoli, District SAS Nagar Mohali.
3.        On the death of her husband, the complainant, as the nominee in the insurance policy, is entitled to the personal accident cover of Rs.15.00 lakhs as per the terms of the policy. After the tragic death of her husband, the complainant was left in a state of depression and mental shock, as she had no one to support her and her two young children during this difficult time. Despite this immense emotional distress, the complainant proceeded with the insurance claim for the personal accident cover entitled to her as the nominee. However, the OP (Insurance Company) illegally and wrongfully repudiated her claim. The repudiation was communicated to the complainant via letter dated 28.07.2022 vide Annexure C-7. The reason cited for the rejection was that at the time of the accident, the deceased husband of the complainant/insured was allegedly not possessing a valid driving license. The complainant further alleges that, in fact, her husband (the insured) was in possession of a learner’s driving license at the time of the accident, as evidenced by the learner’s driving license (Annexure C-6) provided by the complainant and stated that the OP’s claim that the insured did not have a valid driving license is therefore incorrect and unjustified. Furthermore, the complainant asserts that the OP failed to conduct a thorough investigation into the claim. It was stated that the aforesaid acts of the Opposite Party, amounted to deficiency, in rendering service, as also indulgence into unfair trade practice. When the grievance of the complainant, was not redressed, left with no alternative, a complaint was filed. 
4.        The Opposite Party filed written version, but, since the same was not filed within the prescribed period, its defence was struck off by the learned District Commission vide order dated 31.7.2023.
5.  The Complainant led evidence, in support of his case.
6. After hearing the Counsels for the parties, and, on going through the evidence, and record of the case, the District Commission, partly allowed the complaint, in the manner, referred to, in the opening para of the instant order.
7. Feeling aggrieved, the instant appeal, has been filed by the appellant/complainant, with a prayer that respondent insurance company may be directed to pay full claimed amount alongwith interest @12% p.a. from the date of illegal repudiation till realization and to enhance compensation and cost of litigation.
8. We have heard the learned counsel for the parties and have gone through the evidence, and record of the case, carefully.
9. After giving our thoughtful consideration, to the contentions, advanced by the Counsel for the Appellant, and the evidence, on record, we are of the considered opinion, that the appeal is liable to be dismissed for the reasons to be recorded hereinafter.
10. Counsel for the appellant submitted that the deceased husband of the appellant was the registered owner of the motorcycle and the motorcycle was insured by him with the respondent under the policy vide Annexure C-1, which was valid from 05.06.2022 to 04.06.2023. The policy also covered personal accident risk for the owner-driver, with a sum assured of Rs.15.00 lacs. The motorcycle met with an accident on the relevant date, time, and place, which unfortunately resulted in the death of her husband. It was stated that the respondent was unjustified in repudiating the claim of the appellant (who is the nominee of her husband, the deceased insured) based on the ground that the deceased did not have a proper driving license. It was further stated that the respondent rejected the claim vide letter dated 28.07.2022 (Annexure C-7), asserting that the deceased insured, Hum Bahadur Baral, did not hold a valid driving license, which they argue is a violation of the policy terms and conditions. Counsel for the appellant stated that the copy of the General Diary Details (Annexure C-5), which clearly indicates that the deceased insured was driving the subject motorcycle when it skidded on the gravel. The skid caused the motorcycle to fall on the road, leading to head injuries that ultimately resulted in his death. It was further stated that despite of death case and genuine claim, Opposite Party illegally repudiated the claim and thus fully indulged in unfair trade practices. The Learned District Commission has relied upon the Hon’ble National Commission in the case of New India Assurance Co. Ltd. Vs. Narayan Prasad Appaprasad Pathak, II (2006) CPJ 144 in which guidelines are there for settling the claim on ‘non-standard basis’ in case of violation of the terms and conditions of the policy. As such, we are of the considered opinion that the learned District Commission has partly allowed the complaint on non-standard basis as stated above. Hence, the appellant’s plea of asking for full claimed amount alongwith interest @ 12% p.a. from the date of repudiation till realization and also compensation and litigation cannot be acceded to and accordingly the said appeal is dismissed.
11. In view of the above discussion, it is held that the order passed by the District Commission, being based on the correct appreciation of evidence, and law, on the point, does not suffer from any illegality or perversity, warranting the interference of this Commission.
12. For the reasons recorded above, the appeal, being devoid of merit, must fail, and the same is dismissed, with no order as to costs. The order of the District Commission is upheld.
13.  Certified copies of this order, be sent to the parties, free of charge.
14.  The file be consigned to Record Room, after completion

 

Pronounced.

25.11.2024            

                                                

                                                                        Sd/-

                                                                        [PADMA PANDEY]

PRESIDING MEMBER

 

                                                                             Sd/-

[PREETINDER SINGH]

MEMBER

 

Gp