SMT. RAVI SUSHA : PRESIDENT
Complainant filed this complaint U/S 35 of the Consumer Protection Act 2019 for getting an order directing opposite party to pay Rs.15,50,000/- towards the policy claim and incidental claim of the insured vehicle bearing No.KL78-A-5670 to the complainants.
The brief facts of the complainant’s case are that the complainants are the legal heirs of deceased Albin George. The deceased was having a valid driving license and insurance of his scooter bearing No.KL 78 A-5670. The period of insurance coverage is from 10/9/2020 to 9/9/2025. The premium collected by the OP includes PA to owner driver and the claim is limited to Rs.15,00,000/- as per policy. On 17/9/2022 at about 14.45 p.m the insured was riding his vehicle , the scooter hit to the Noochyad bridge side and the scooter capsized and the insured ( Albin George) sustained severe injuries and succumbed to death. Consequentially Ulikkal police was registered a crime No.514/2022. After the death of insured, the complainants approached OP to get the compensation but the OP denied to discharge the claim. The denial of the claim by the OP is absolutely illegal and deficiency of service and unlawful trade practice. Hence this complaint.
After receiving notice, OP filed written version admitting the policy of the vehicle bearing No.KL-78-A-5670. Also admitted the existence of policy on the date of accident happened to the insured. But the OP denied the allegations raised by the complainants against OP. It is stated that the complaint is a non-intimated premature claim of CPA. There is no cause of action in this case as nowhere in the complaint it is mentioned that complainant has intimated a claim to company or sent a legal notice. It is further submitted that the contents in the complaint are wrong, incorrect, misconceived. It is submitted that mere pleadings cannot take place or proof unless and until proved by any cogent , convenience and conclusive evidence. The OP does not have any knowledge about the alleged accident. There is no cause of action for this complaint. As the insurer this OP has not meted out any kind of negligence, unfair trade practice or deficiency of service. It is submitted that the complainant has not suffered any kind of pain or mental agony. The complainant is not entitled to any kind of compensation . Hence prayed for the dismissal of the complaint. same.
At the evidence stage, 1st complainant filed her chief affidavit and was examined as PW1. Marked Exts.A1 to A7. PW1 was subjected to cross-examination for OP. After that the learned counsel of complainants made argument .
Here there is no dispute with regard to the facts that (a) the deceased Albin George has taken Magma HDI, General Insurance from OP to the motor vehicle bearing Reg.No.KL7820190022474 (b) Mr.Albin George met with an accident on 17/9/2022 (c) FIS was taken on 18/9/2022 and Ulikkal police station has registered a crime having No.514/2022 U/s 174 Cr.PC with respect to the accident and final report was registered U/S 279 IPC (d) Further, postmortem was conducted on the body of Albin (insured )and noted the Ante mortem injuries found on the body and opinioned that died of fracture of upper cervical spine. Ext.A4 shows the RC of the vehicle in dispute and deceased Albin George is the registered owner of the vehicle. Ext.A5 shows the insured Albin George has valid driving license during the accidental period. Ext.A6 is the insurance certificate, in which IDV value of the vehicle is Rs.1,07,363/-. PA owner –driver Rs.15,00,000/- tenure 5 years. It also shows that the insured has paid total premium of Rs.11331.00. Here from Exts.A2&A3 it is evident that accident was happened while the insured deceased Albin George was driving the insured vehicle. Hence from the available evidence deceased benefits as mentioned in the liability column PA owner- driver, which is limited to Rs.15,00,000/-.
Here OP’s contention is that complainants have not informed to OP and also not complaint before the grievance cell of OP. During cross-examination PW1 deposed that the incident was informed to OP on tomorrow itself. Ext.A2 FIR shows that incident was informed to the concerned police station on the very next day of accident and crime was also registered. Further on perusal of Ext.A2, there is no remark that the accident was happened due to the rash and negligent driving of the insured Albin George.
Hence considering the entire facts and circumstances of this case, we are of the view that the complainants 1 to 3 as legal heirs of the deceased Albin George(Ext.A7) are entitled to get the policy benefit ( ie, PA to owner driver) of Ext.A6 policy. As per Ext.A6 policy PA to owner driver benefit amounts to Rs.15,00,000/-.
In the result complaint is allowed in part. Opposite party is directed to pay Rs.15,00,000/- policy benefit together with Rs.25,000/- towards compensation and Rs.10,000/- towards cost of the proceedings of this complaint equally to the complainants 1 to 3 within a period of one month from the date of receipt of the certified copy of this order. Failing which the amount Rs.15,00,000/-carries interest @9% per annum from the date of order till realization. Complainant can execute the order as per the provision in Consumer Protection Act 2019.
Exts:
A1- Death certificate of Albin George
A2-True copy of FIR
A3-post mortem certificate
A4-Copy of RC
A5- copy of driving license
A6- insurance policy
A7-family membership certificate
PW1-Mini.P.K-1st complainant
Sd/ Sd/ Sd/
PRESIDENT MEMBER MEMBER
Ravi Susha Molykutty Mathew Sajeesh K.P
eva
/Forwarded by Order/
ASSISTANT REGISTRAR
