District Consumer Disputes Redressal Forum Dumk

Complaint Case No- 01/2016

Date of filing                         Date of Admission      Date of Order

25.01.2016                            28.01.2016                 31.03.2018

Sudha Kumari, W/o Er. Raghubir Prasad Sah r/o plot no. 246, Magistrate Colony, Bandarjori (Police Line), P.O- Dumka,  P.S- Dumka Town, District- Dumka. (Jharkhand) Pin- 814101.

 (Respresented by Shri Pankaj Kumar Gupta, Advocate)

                                                                                                                                              ………….. Complainant.                                   

Versus

1.  ICICI, Lombard General Insurance Company Ltd. ICICI Lombard House, 414 Veer Savarkar Marg, Near Siddhi Vinayak Temple Prabhadevi, Mumbai- 400025, Having ist Branch office at  Shree Ram City 4^th Floor, Office No. 410 Main Road, Saraidhela Dhanbad, (Jharkhand) Pin- 828127.

          (Respresented by Shri N.K. Sharma, Advocate )

                                                     ………. Opposite Party                                

BEFORE:-

PRESIDENT:-    Shri Ram Naresh Mishra

MEMBER :-        Smt. Dr. Babita Kumari Agrawal

O R D E R

           The present  Complaint has been filed by the complainant Sudha Kumari  against the opposite party i.e. ICICI Lombard General Insurance Company Ltd. having its branch office at  main road Saraidhela, Dhanbad u/s-12 of the Consumer Protection Act-1986 for  illegally and arbitrarily not settling the claim of the complainant in gross negligency and deficiency in service as well as unfair trade practices and thereby causing mental tension, agony, harassment, injury, loss and damages to him i.e. the complainant. The complainant has prayed to direct the 0pposite party to pay a sum of Rs.1,00,000/-(One lac) towards the damaged cost to the vehicle, further direct to pay compensation a sum of Rs.50,000/-(Fifty thousand) towards mental tension ,agony, harassment, injury and loss and also  direct to pay Rs.10,000/-(Ten thousand)towards cost litigation.   It has also prayed to allow interest at the rate of 18% p.a. on the awarded amount.

                        That the complainant is the registered owner of a  vehicle i.e. Hyundai I10 ERA Car bearing registration No-JH04C-6665. The said vehicle is insured under private car package insurance policy bearing Policy No.3001/I-24339517/00/000 valid and effective from 09.02.2014 to 08.02.2015. In the said policy entire risk and  liabilites   including damages caused  to the vehicle was fully covered.     

                       The further case of the complainant is that her aforesaid vehicle met with an accident on 05.05.2014 at about 13.45 p.m. near Haripur toll tax barrier within P.S. Dumka (muffasil) while She was returning from Bashukinath temple after worshipping Lord Shiva. In the said accident    a truck bearing registration No.UP57T-1181 driven by its  driver rashly and negligency dashed against the complainant car causing injuries to her and other occupants  and damages to her said vehicle and for that an F.I.R. was registered  vide  Dumka (Muffasil) P.S.case No.60/14,u/s-279,337,338,and 427 I.P.C against the driver of the offending vehicle UP57T-1181.                

                      The further case of the complainant is that the information with respect to the damages  to the vehicle in accident was given to the Insurance Company ,whereupon the company deputed a surveyor Mr. Ashok Kumar Agrawal. who surveyed and assessed the loss caused to the vehicle and submitted report to  the Insurance Company. It is asserted that the complainant submitted copy of registration certificate, Driving Licence, Insurance Policy, Estimate, Claim form, Tax token, copy of F.I.R, Voter ID Card, Towing Bill and cancelled cheque to the Surveyor Mr. Ashok Kumar Agrawal, who inturn submitted the same to Insurance Company along with his report. It is further asserted that the complainant submitted duly filled claim form before the Insurance Company, whereupon insurance company   registered  claim as  No.MOTO-3781131.

          3. Having received notice the opposite party appeared on   03.03.2016 and contested the case by filing its written statement on 10.05.2016.                 

                   4. The opposite party in its written statement besides taking preliminary objections such as maintainability and lack of cause of action  admitted that after receiving information about accident it  registered claim  and deputed an independent investigator namely Mr. Ashok kumar Agrawal showing its efficiency  deficiency in service. It is alleged that the complainant deliberately concealed the actual facts and did not submit the documents required by this Opposite party. It is further asserted that for settling of own damages claim  insurer required to submit  duly filled up claim from Original estimate of repairing, Original invoice Original pay receipt, proof of release of vehicle original policy/ Cover note, Copy of driving licence, Copy of registration certificate and copy of F.I.R. The O. P. sent many  request letter,s but  the complainant failed to submitt the documents . It is also alleged that the insurance company sent written letter to the complainant firstly on 10.07.2014, secondly 03.07.2014,both through courier ,which where  received by the complainant but  where replied negatively on the pretext that that she had already handed over the required papers to the investigator and thus the complainant never submitted required papers to this answering company. It is further claimed that for want of deficiency in service of  this answering opposite party, no. cause of action ever arosed  against  it and accordingly    prayed to dismiss the complaint as it is  not maintainable.

5
. We have heard the argument of both the parties and gone through the record along with the materials/documents attached therein.

6. In support of their respective cases the parties have adduced evidence. The complainant has filed affidavited  statement of four witness including the complainant herself, out of them C.W.No-1 Sudha  Kumari is the complainant,  C.W.-2 Er. Raghubir  Prasad  Sah is the driver of the accident Vehicle, C.W-3 Tarun kumar Mandal is the witness of the accident and  C.W.-4 Suresh Prasad Sah is the witness on facts. Besides oral evidence complainant has led following documentary evidence :-

Ext- 1:-  Photocopy of F.I.R i. e. Dumka (M) P.S.Case     .

              no- 60/14 dated- 05.05.2014,   G.R. No. 604/14;

Ext-2:- Written application (F.I.R)of Er. Raghubir Prasad                                                             

             Sah dated- 05.05.14;

Ext 3 :- Medical certificate of complainant Mrs. Sudha

             Kumari, dated- 05.05.14 ;

Ext 4 :- Medical certificate of  Raghubir Pd. Sah dated-

              05.05.2014;

Ext 5 :- Intimation letter dated- 10.07.14 of Mr. Gourav

             Sengupta of the  Insurance Company to Sudha

             Kumari;

Ext 6 :- Reply letter of Mrs. Sudha Kumari,  W/o Sri     

             Raghubir Pd. Sah, dated- 21.07.14 to Gourav

             Sengupta of Insurance Company;

Ext 7 :- Letter of Mr. Ameya Sukhi, Customer Service

             (motor)   Insurance Company dated 27.10.14;

Ext 8 :- Reply Letter of complainant Mrs. Sudha Kumari,

             dated- 11.11.14 to Mr. Ameya Sakhi, coustmer

             Service (Motor);

Ext 9 :- Photocopy of postal receipt, dated- 11.11.14;

Ext 10 :- Courier bill receipt – 03 copies dated- 11.11.14;

Ext 11 : - Letter of Manager, Customer support,;

               ICICI, Lombard GIC, dated- 24.11.14 to Mrs.

               Sudha Kumari;

Ext 12 :- Reply letter of complainant Mrs. Sudha Kumari,

               dated – 13.12.14 to Manager, Custmer Service

               (Motor);

Ext 13 :- Postal bill receipt dated- 16.12.14;

Ext 14 :- Courier bill receipt – 02 copies, dated- 16.12.14;

Ext 15 :- Reply letter of complainant Mrs. Sudha Kumari,

              dated- 16.01.15. to Chanchal Kumar

               Ghose, ICICI, Lombard GIC, Ltd;

Ext 16 :- Courier bill receipt – 01 copy, dated- 16.01.15

Ext 17 :- Letter of Advocate Mr. P.K. Gupta, dated-

               10.10.15 to Surveyor A.K. Agrawal;

Ext 18 :- Reply of Mr. Ashok Kumar Agrawal, Surveyor

               and loss Assessor dated – 14.10.15;

Ext 19 :- Pleaders notice dated- 15.12.15 to Manager;

               Customer Service (Motor), ICICI Lombard GIC

               Ltd;

Ext 20 :- Registration Certificate of vehicle no. JH04C-

               6665, owner Mrs. Sudha Kumari, W/o- Er. 

               Raghubir Pd. Sah;

Ext. 21 :- Insurance certificate of policy no –

      3001/56253749/00/000 policy issued on –  

      06.02.2014in the name of Sudha Kumari,Owner

      of vehicle bearing  registration no. JH04C- 6665;

Ext 22 :- Driving License of Er. Raghubir Pd. Sah, S/o

                Balram Sah- D/L No- Jh-04/2010/0005645;     

Ext 23 :- Aadhar card of Mrs. Sudha Kumari;

Ext 24 :- Maa Tara recovery service bill  no- MTRS/14-

               15/011 dated 05.05.2014 of Vehicle no. JH-

               04C6665;

Ext 25 :- Tax invoice of Bhagat Automobiles

               dated30.07.14 – 02 copies;

Ext 26 :- Cash Memo of Sheesh Auto Sales, Bhagalpur    

                road, Dudhani, Dumka dated – 25.08.14;

Ext 27 :- Tax Invoice of Bhagat Automoblies  dated-

               10.09.14- 03 copies;

On the other hand the answering O.P. has only filed an  affidivated statement of  a  witness as O.P.W.no.1  Dipankar Roy, Manager (legal claims), ICICI Lombard General Insurance Company Ltd. Ranchi, however it has not adduced any documentary evidence.

7-Now, the only point for discussion is whether the complainant is entitled  to get the reliefs claim ?

8-The admitted position of the case is that Mrs Sudha Kumari, the registered owner of the vehicle i.e.  Hundai I-10.ERA car bearing registration No-Jh O4C-6665 got her vehicle insured under private car pakage policy with ICICI Lombard General Insurance Company Ltd. and the said   policy was valid and effective from 09.02.2014 to 08.02.2015. The said      vehicle met with on accident on 05.05.2014 at about 13.45p.m. near Haripur Toll Tax barrier within P.S.- Dumka (muffasial) while returning from Bashukinath temple causing injuries  to the occupant and damages  to the vehicle for which Dumka (M)   Case No-60/2014 was registered against the driver of the offending truck. It is an also admitted fact that information with regard  to accident was given O.P. Company and the Company  deputed its surveyor  Mr. A.K. Agrawal. The complainant has claimed that she submitted all the relevant papers i.e. registration certificate, DL, Insurance Policy, estimate, claim form, Tax token, Copy of F.I.R, Voter I.D. card, Towing bill and Cancelled chaque to the surveyor, who inturn submitted all the documents  to the O.P. Insurance Company along with his report. It is also claimed by  the complainant that the O.P. Insurance Company despite receiving all the   papers and the surveyors report willfully delayed in settling the claim. On the other hand the O.P. Insurance Company has asserted that as per rule the insured/ owner should have submitted required papers along with duly filled claim form directly to the insurer .It is also asserted by the O.P. Insurance Company that it  had send letter’s dated 03.07.2014  and 10.07.2014 through Courier Service to the complainant ,who despite receiving did not reply and hence lastly vide letter 27.01.2014 intimated to the complainant about its inability to process  her claim  and closed her claim file. 

9
. The complainant has filed letter of O.P. Insurance company dated 10.07.2014 (Ext-5) and photo copy of her reply dated 21.07.2014 and from perusal of these two letter and reply it is evident that all the documents except bill as required by the  O.P. company were  submitted before the Surveyor Mr. A.K. Agrawal while he come for Survey of the vehicle at Dumka. Further from perusal of letter of O.P. Company dated 27.10.2014 (Ext.7) and its reply sent by the Complainant dated 11.11.2014(Ext-8) it appears that further demand of the required documents by the O.P. Company was replied by the complainant stating that the documents as required were submitted to the Surveyor, who inturn sent them to Mr. Gourv Sengupta through courier vide receipt no.1423 dated 23.09.2014  The complainant also sent copies of her reply letter dated 11.11.2014 to Mr. Gourav Sengupta and Mr. Chanchal through courier and photocopies of Couriers consignment has also been filed vide Ext-10. The reply letters i.e.Ext-6 and Ext-8 clearly shows that the complainant has repeatedly gave  details about transmission of required documents to Mr. Amey Sukhi, Manager ,Customer Service (Motor), Mr. Gourv Sengupta and Mr. Chanchal the officers of ICICI Lombard G.I. Company. Dhanbad. Further letter of Manager, Customer support ICICI Lombard G.I.C. Ltd. dated 27.11.2014 (Ext.11) Confirms that information given and documents sent through Surveyor Mr. A.K. Agrwal was received by the O.P. Company however it again demanded all claim related documents and this letter was replied by the complainant vide her reply dated 13.12.2014(Ext.12) in which she clearly said that while she submitted all the documents  her claim is not settled. We find that O.P’s letter dated 27.11.2014(Ext.11)  while admits about  receiving of all the documents but further demanding other related document without mentioning the required documents, is merely a delaying tactics of O.P. Company .The complainant has filed photocopy of her last letter dated 16.01.2015,which is sent to Mr. Chanchal Kumar Ghose of O.P. Company, in which she again says that as per telephonic talk of Shri  Manvendra jee on 12.01.2015. She is transmitting further required documents i.e. vehicle registration Certificate, Aadhar card, F.I.R. copy D.L. of  driver R. P. Sah, Policy certificate, Medical  certificates of Sudha Kumari and R.P. Sah. The complainant has also filed photocopy of Courier receipt dated 16.01.2015 all these letters clearly show that all the related documents for settling claim were met by the complainant, The complainant has filed her advocates letter and reply of Mr. A.K. Agrawal dated 14.10.2015 showing that surveyor had submitted all document and report to the O.P. insurance company. Further complainant has filed photocopy of her pleader’s notice dated 15.12.2015 sent to Manager, Customer Service (Motor)/customer support ICICI Lombard G.I. Comp. Ltd. Mumbai wherein she requesterd to settle her lawful claim, but it was not replied, showing that the company without any genuine and lawful ground has willfully did not settle the claim.

 
         Complainant herself (C.W.1) in her affidavited statement has fully supported her entire case and claimed that due to non settlement of her claim by the O.P. Company she sustained mental agony, harassment, loss and damages and it was gross negligency and deficiency in service of the company.C.W.2 the driver of the vehicle,C.W.No.3 Tarun Kumar Mandal, the eye witness of the accident and C.W.No,4 Suresh Prasad Sah, another eye witness of the occurrence have fully corroborated the version of the complainant. whereas the O.P. Company neither in  its written statement nor   in the affidavited  statement  of its witness (O.P. W.No-1) Dipankar Roy have answered to the facts and evidence brought on the record. The O.P. Company  have not even correctly mentioned the facts in \to W.S. as reveated from the documents brought by the complainant specially letter dated 27.11.2014 (Ext,11) in which it has admitted the receiving the documents transmitted by the complainant. Further O.P. Company has no answer to the letter dated 16.01.2015 sent by the complainant showing that she again sent all the documents to the c Company but even then her claim was not settled. All these facts and evidence available on the record show the complainant claim has neither been denied nor refused by the O.P. Company but deliberately not settled.  The company despite receiving all the documents  remain unsatisfied showing its hardened and callous attitude towards settlement of cliaim.

10. Having regards to the facts and circumstances of the case and also going through the evidence brought on the record, we fined that the complainant furnished all the required documents to the O.P. Company after the accident of the vehicle,in which she herself and her husband were injured and the vehicle was badly demaged but her claim was not settled not any payment was made. The O.P. Insurance Company has thus acted arbitrarily, despotic and Capricious manner and it was  negligent and deficient in sendering service to thecomplinant ,who is a consumer. We are thus of opinion that the complainant is \entitled to get damages i.e. value of goods Rs.93,087/-(Ninety three thousand eighty seven),Compensation amount Rs.20,000/-(Twenty thousand)and cost of litigation Rs.5,000/-Five thousand).

It is therefore ,

                                                                           O R D E R E D

That the complainant case be and the same is allowed on contest with cost. The O.P. ICICI Lombard General Insurance Company Ltd.  is directed to make the payment of the Principal damages amount of Rs. 93,087/-(Ninety three thousand eighty seven) along with 12% intrest per annum from the date of accident i.e.05.05.2014 till its payment. The O.P.is further directed to pay a compensation of Rs.20,000/-(Twenty thousand) and Rs.5,000/-(Five thousand) by way  of cost of litigation to the complainant.

The order must be complied within one month from the date of receipt of the copy of the order, failing which necessary legal action will be taken against O.P. Insurance Company.

The o/c is directed to furnish copy of the order to the parties or to their concerned advocates free of cost.

This case, thus, stands disposed off.