Haryana

Karnal

CC/843/2019

Shkuntla - Complainant(s)

Versus

Iffco Tokio General Insurance Company Limited - Opp.Party(s)

Surinder Saini

20 Dec 2022

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No. 843 of 2019

                                                        Date of instt.27.12.2019

                                                        Date of Decision:20.12.2022

 

Shkuntla (age 52 years) widow of Shri Mahinder Pal, resident of village Sheikhpura, Karnal.

                                               …….Complainant.

                                              Versus

 

Iffco-Tokio General Insurance Company Limited, Sector-12, Karnal through its Branch Manager.

                                                                         …..Opposite Party.

 

Complaint Under Section 12 of the Consumer Protection Act, 1986 and after amendment Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.

              Shri Vineet Kaushik……Member

      Dr. Rekha Chaudhary…….Member

                   

Argued by: Shri Surinder Saini, counsel for the complainant.

                   Shri A.K.Vohra, counsel for the opposite party.

 

                    (Jaswant Singh President)

ORDER:   

                

                The complainant has filed the present complaint Under Section 12 of the Consumer Protection Act, 1986 as after amendment under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that husband of complainant namely Mahinder Pal met with an accident on 28.07.2019 and lateron he had died in Dua Hospital, Karnal, due to the injuries sustained in the said accident. His post mortem was conducted on 05.08.2019. An FIR bearing no.847 dated 05.08.2019 under section 279, 304A IPC in Police Station Sadar, Karnal was lodged by the brother of the deceased Mahinder Pal. The motorcycle of the deceased bearing registration no.HR-05AY-1760 was insured with the OP. In that policy, accidental death of owner-driver is insured for Rs.15.00 lakh.  Mahinder Pal was the registered owner of the abovesaid motorcycle and had died in the accident while driving his motorcycle. After the death of her husband complainant being nominee in the insurance policy visited the office of the OP so many times and completed all the formalities and also requested to settle the her claim but till date, OP has not settled the claim and not paid the insured amount to the complainant. Then complainant sent a legal notice dated 10.12.2019 to the OP but it also did not yield any result. In this way there is deficiency in service on the part of the OPs. Hence this complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability and concealment of true and material facts. On merits, it is pleaded that OP is willing on settling the matter as per the terms and conditions of the insurance policy. Upon intimation of the death of insured, the OP immediately appointed Mr. Mahesh Kalra to investigate the matter, Mr. Kalra contacted the complainants and requested for a valid Driver’s licence of the deceased. Upon persistent requests a license annexed valid upto 08.04.2018 and not covering the date of accident i.e. 28.07.2019 was submitted. Upon which letters dated 09.03.2020 and 19.03.2020 were sent asking for a Driver’s license which is valid on the date of accident. Despite these letters the complainant has failed to submit a valid driving licence of Mr. Mahinder Pal which was valid as on date of loss. The OP has nowhere repudiated the claim or denied and has not even closed the claim upon non-furnishing of the relevant documents at the end of the complainant. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.C1, postal receipt Ex.C2, copy of letter dated 01.10.2019 regarding request for releasing the claim Ex.C3, copy of RC Ex.C4, copy of insurance policy Ex.C5, copy of Aadhar card of Mahinder Pal Ex.C6, copy of Aadhar card of complainant Ex.C7, copy of death certificate Ex.C8, copy of FIR Ex.C9, copy of post mortem report Ex.C10, postal receipt Ex.C11, copy of legal notice Ex.C12 and closed the evidence on 25.03.2022 by suffering separate statement

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Devendra Kumar Ex.OP1/A, affidavit of Mahesh Kalra Investigator Ex.OP2/A, copy of insurance policy Ex.O1, copy of letters dated 09.03.2020, 19.03.2020 Ex.O2 and Ex.O3, copy of driving licence Ex.O4 (repeated Ex.O16), copy of case law of National Commission Ex.O5, copy of letter dated 06.03.2020 regarding intimation of claim Ex.O6, copy of letter dated 16.03.2020 Ex.O7, copy of letters dated 28.09.2019 Ex.O8, postal receipt Ex.O9, copy of letters dated 02.10.2019, 31.08.2022, 23.10.2019 and their respective postal receipts Ex.O10 to Ex.O15, copy of intimation letter dated 07.03.2020 Ex.O17 and Ex.O18, copy of intimation letter dated 01.03.2020 Ex.C19, copy of FIR Ex.C20 and closed the evidence on 31.08.2022 by suffering separate statement.

6.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that husband of complainant namely Mahinder Pal met with an accident on 28.07.2019 and lateron he died due to the injuries sustained in the said accident. The post mortem of dead body was conducted on 05.08.2019. An FIR bearing no.847 dated 05.08.2019 under section 279, 304A IPC in Police Station Sadar, Karnal was lodged. The motorcycle of the deceased bearing registration no.HR-05AY-1760 was insured with the OP. In that policy, accidental death of owner-driver is insured for Rs.15.00 lakh.  Mahinder Pal was the registered owner of the abovesaid motorcycle and had died in the accident while driving his motorcycle. After the death of her husband complainant being nominee in the insurance policy visited the office of the OP so many times and completed all the formalities  and also requested to settle the her claim but  OP did not do so and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that complainant has failed to submit a valid driving licence of Mr. Mahinder Pal which was valid as on the date of loss. The OP has nowhere repudiated the claim or denied and has not even closed the claim upon non-furnishing of the relevant documents at the end of the complainant and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, the deceased Mahinder Pal had expired during the subsistence of the insurance policy It is also admitted the sum insured under the policy in question is Rs.15,00,000/-.

11.           The claim of the complainant has not been settled by the OP on the ground that complainant has failed to submit the valid driving licence of her husband Mr. Mahinder Pal.

12.           As per version of the OP, the driving licence of deceased life assured  submitted by the complainant valid upto 08.04.2018 and not covering on the date of accident i.e. 28.07.2019 . OPs sent letters dated 09.03.2020 and 19.03.2020 to the complainant and asked for submitted the valid Driving license which was valid on the date of accident. Despite these letters the complainant has failed to submit a valid driving licence of her husband namely Mr. Mahinder Pal. The claim of the complainant has not been decided by the OP till date and same is pending with them. The husband of the complainant had died in roadside accident and complainant has already submitted the driving licence which was in her possession. If the driving licence has not renewed it does not mean that the deceased was not competent to drive the vehicle.

13.           For the sake of gravity, if it is presumed that deceased had violated the terms and conditions of the insurance policy, in that eventuality, the claim of the complainant cannot be repudiated in toto.  In this regard, we can relied upon the case laws cited in Revision Petition no.1870 of 2015(NC) decided on 14.08.2018 titled as New India Assurance Co. Ltd. Versus Thirath Singh Brar,  and authority of our own Hon’ble State Commission in First Appeal no.717 of 2016 decided on 6.4.2017 titled as United India Insurance Company Limited and others Versus Anshul Bansal.  In both judgments it was held that in case of any breach of warranty/condition of the policy the insurer is liable to pay 75% of admissible claim on non-standard basis.

14.           Keeping in view the ratio of the law laid down in the abovesaid authorities and the facts and circumstances of the present complaint, we are of the considered view that the act of the OPs amounts to deficiency in service and unfair trade practice while repudiating the claim of the complainant in toto. Hence, complainant is entitled to get 75% only of the admissible claim on non-standard basis.

15.           As per insurance policy Ex.C5/Ex.O1, the insured amount is Rs.15.00 lakh.  Hence the complainant is entitled for Rs.11,25,000/- i.e. 75% of the insured amount alongwith interest, compensation and litigation expenses etc.

16.           In view of the above discussion, we partly allow the present complaint and direct the OP to pay Rs.11,25,000/- to the complainant alongwith interest @ 9% per annum from the date of filing of the complaint till its realization. We further direct the OP to pay Rs.25,000/- to the complainant on account of mental agony and harassment suffered by her and Rs.11,000/-for the litigation expense. This order shall be complied within 45 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: 20.12.2022                                                                    

                                                                      President,

                                                      District Consumer Disputes

                                                      Redressal Commission, Karnal.

 

 

 

                (Vineet Kaushik)                (Dr. Rekha Chaudhary)

                        Member                             Member

 

Sushma

Stenographer