BEFORE THE A.P. STATE CONSUMER DISPUTES REDRESSAL COMMISSION
AT HYDERABAD.
F.A 1070 /2010 against C.C. 103/2008, Dist. Forum, Guntur.
Between:
1. The Branch Manager
Bajaj Allianz General Insurance Company Ltd.
Near Blue Fox Bar, 7/1 Arundelpet
Guntur.
2. Bajaj Allianz General Insurance Company Ltd.
D. No. 10-1-44/9, 3rd Floor
CBM Compound, PJ Plaza
Visakapatnam. *** Appellants
O.Ps
And
Kunchala Annapurna
W/o. Srinu
R/o. Padamara Mangalipalem Village
Kandukur Mandal
Prakasham Dist. *** Respondent/
Complainant
Counsel for the Appellants: Mr. N. Mohan Krishna
Counsel for the Respondent: Admission Stage
CORAM:
HON’BLE SRI JUSTICE D. APPA RAO, PRESIDENT
SMT. M. SHREESHA, MEMBER.
&
SRI R. L. NARASIMHA RAO, MEMBER
TUESDAY, THIS THE TWENTY SIXTH DAY OF OCTOBER TWO THOUSAND TEN
Oral Order: (Per Hon’ble Justice D. Appa Rao, President)
*****
1) Having heard the learned counsel for the appellant, and having perused the material on record, we are of the opinion that the matter can be disposed of at the stage of admission.
2) This is an appeal preferred by the opposite party insurance company against the order of the Dist. Forum directing it process and settle the claim on submission of legal heir certificate etc. by the complainant and also pay Rs. 1 lakh together with costs of Rs. 1,000/-.
3) The case of the complainant in brief is that the insurance company had issued a policy on the motorcycle owned by her husband for a sum of Rs. 1 lakh covering the period from 28.9.2007 to 27.9.2008. While so on 29.9.2007 at about 11. 00 a.m. when her husband was proceeding on motor cycle from Kandukuru to Jonnalagadda at the time when he reached Yedugundlapadu village, driver of the lorry bearing No. CG 17 H 1369 coming in opposite direction rashly and negligently dashed against the motorcycle due to which he sustained injuries. Immediately he was shifted to government hospital, Ongole where he died. On a report the police registered a case in Crime No. 128/2007 u/s 304A IPC against driver of the lorry. An inquest followed by post-mortem examination was conducted. When claim was made the same was repudiated on the ground that he was not having valid driving license. Therefore she filed the complaint claiming the amount covered under the policy together with compensation and costs.
4) The appellant insurance company resisted the case. While admitting issuance of policy it alleged that they came to know about the death of the assured on receipt of legal notice. In the absence of required documents, settling the claim will not arise. At any rate the complainant had to prove that the deceased was having a valid driving licence to drive the vehicle. Therefore it prayed for dismissal of the complaint with costs.
5) The complainant in proof of her case filed her affidavit evidence and got Exs. A1 to A9 marked while appellant filed Ex. B1 conditions of the policy.
6) The Dist. Forum after considering the evidence placed on record opined that the complainant had proved that the deceased died in a motorcycle accident vide FIR Ex. A1 followed by M.V.I. report Ex. A2, certificate of registration Ex. A3 and inquest report Ex. A5 etc. Except taking the plea that the deceased was not having valid driving license it could not prove that he was not having driving license. Therefore the complainant was directed to produce legal heir certificate and on such production the insurance company to pay Rs. 1 lakh within a month together with costs of Rs. 1,000/-.
7) Aggrieved by the said decision, the insurance company preferred the appeal contending that the Dist. Forum did not appreciate either facts or law in correct perspective. It ought to have seen that the complainant had to prove that driver of the vehicle has effective and valid driving license at the time when the accident took place, and non-furnishing of the same would entail repudiation of the claim and therefore it prayed for dismissal of the complaint.
8) The point that arises for consideration is whether the order of the Dist. Forum is vitiated by mis-appreciation of fact or law?
9) It is not in dispute that the complainant’s husband had obtained a policy for the motorcycle owned by him covering the period from 28.9.2007 to 27.9.2008 for a sum of Rs. 1 lakh vide Ex. A4. It is also not in dispute that on the very next day i.e., on 29.9.2007 he met with accident. He died in a motorcycle accident vide copy of FIR Ex. A1 followed by Ex. A5 inquest. The insurance company obviously satisfied with temporary certificate of registration Ex. A3 issued policy. When the complainant wife of the deceased an illiterate residing in a remote village at Padamara Mangalipalem of Kandukur Mandal in Prakasham Dist. submitted the claim it had repudiated on the ground that the complainant did not file the driving license. It may be stated herein that invariably the insurance company whenever the complainants could file copy of FIR, inquest report, post-mortem examination report etc. investigate the matter by approaching the transport authorities verify the driving license of the assured. The insurance company could not have issued the insurance policy without even verification of driving license. It is not as though the insurance company had issued the policy to the assured when he furnished the proposal. It was rooted through an agent. If really the insurance company has any doubt as to holding of driving license it could have addressed a letter to the concerned RTA authorities or verify with the police in view of the fact that a case was registered and even MVI report Ex. A2 was filed, denying the claim on some ground or other will not arise. We may state that it has become routine for these insurance companies to repudiate the claims on one ground or other unable to bear payment of amounts in cases where the accident took place
immediately on the next day of issuance of policy. Undoubtedly they would find out one ground or other to repudiate without, verifying whether the repudiation was just or not. The complainant an illiterate lady could not have known all these technicalities and more so whether her husband was having a valid driving license. It is for the insurance company to find out whether the deceased was having valid driving license or not as it was repudiating the claim on the said ground. It has wherewithal to verify these facts. It cannot abdicate its function. The burden of proof cannot be placed on the complainant in such circumstance. We need not emphasise that provisions of Evidence Act have no application to a matter arising under C.P. Act (vide objects and reasons mentioned for passing of the Act. The doctrine of Uberrima fides equally applies to the insurance company. The insurance company did not bother to verify the driving license in order to repudiate the payment of amount assured under the policy. We do no see any mis-appreciation of fact or law by the Dist. Forum in this regard. We do not see any merits in the appeal.
11) In the result the appeal is dismissed at the stage of admission. No costs. Time for compliance four weeks.
1) _______________________________
PRESIDENT
2) ________________________________
MEMBER
3) ________________________________
MEMBER
Dt. 26. 10. 2010.
*pnr
UP LOAD – O.K.”
