Haryana

Karnal

CC/178/2015

Rani Devi W/o Lakhvinder Singh - Complainant(s)

Versus

Magma HDI General Insurance Company - Opp.Party(s)

Sh. G.P.S. Gareta

20 Sep 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL. 

                                                     Complaint No. 178 of 2015

                                                     Date of instt. 04.08.2015

                                                       Date of decision 20.09.2017

 

Rani Devi wife of late Sh. Lakhvinder Singh resident of village Sambhi, Tehsil Nigdhu, District

                                                                   ……..Complainant.

                                        Vs.

Magma HDI General Insurance Company, registered office 24, Park Street, Kolkata 0700016

                                                                    ..… Opposite Party.

 

       Complaint u/s 12  of the Consumer Protection Act.

 

Before     Sh.Jagmal Singh……….President.

                Ms. Veena Rani………..Member

                Sh.Anil Sharma……...Member.

 

Present:-  Shri G.P.S. Gereta, Advocate for complainant.

                 Shri Anil Kumar Vij, Advocate for opposite party.

               

                  (Jagmal Singh President)

 

ORDER

                This complaint has been filed by the complainant u/s 12 of the Consumer protection Act 1986, on the averments that the husband of the complainant namely Lakhvinder Singh is the registered owner of Car bearing Registration No. HR-05-A-5668 and the said car has been fully insured with the opposite party. She also stated that the husband of the complainant had expired on 14.09.2014 and at that time the complainant was pregnant, and the complainant could not tolerate the sudden death of her husband and due to this reason the complainant remained ill and the pregnancy of the complainant was miscarriage. The doctors advised the complainant for exclusive breast feed for 4 months, and no heavy manual labour for 45 days and as per the advise of the doctor the complainant remained lying on bed for about 4 month. On dated 03.01.2015 due to rain the aforesaid car met with an accident. Thereafter, the said vehicle was taken in Samta Motors Karnal where the same was repaired and sum of Rs. 1,03,000/- has been spent by the complainant on its repair. The opposite party has repudiated the claim of the complainant vide letter dated 25.02.2015. The complainant has no source of income after the death of her husband and she has paid the aforesaid amount of Rs. 1,03,000/- to Samta Motors after taking the same from her relatives. Complainant served a legal notice dated 16.05.2015 upon the opposite party requesting thereby to settle the claim. In spite of repeated requests made by the complainant the opposite party has not settled the claim of the complainant. 

2.                     Notice of the complaint was given to the opposite party. Opposite party appeared and filed written statement raising preliminary objections regarding maintainability; this forum has no jurisdiction, complaint is false and frivolous; no locus standi; no cause of action; that the complainant has not approached this forum with clean hands and concealed the true and material fact from this Forum. On merits, it has been submitted that Lakhvinder Singh the husband of  complainant took the Private Car Package Policy of Vehicle bearing registration No. HR-05A-5668 having Engine No.051960, Chassis No. 046590M, Model 2014  for the sum insured of Rs. 5,43,400/- vide Policy No. P0014100003/4101/365996 valid from 19.03.2014 to 18.03.2015. The car was hypothecated with Mahindra & Mahindra Financial Services Ltd. It is further stated that no intimation was received regarding the death of insured namely Lakhvinder Singh from the complainant. On receipt of intimation regarding the damage of the car no. HR-05A-5668 in the accident, the opposite party immediately registered the claim of the insured/complainant vide claim no. C/15/1000034101/05052501/1 and deputed Sh. Virender Kumar Surveyor and loss assessor who is approved from the IRDA. The surveyor submitted his survey report before the insurance company. After receiving the surveyor report. It is further contended that insured Mr. Lakhvinder Singh expired in the month of September 2014 and the said claim intimated on 27.01.2015 approximately delayed by 4 months  which is totally violation of the policy terms and conditions. The opposite party has repudiated the claim on 25.02.2015 and informed the complainant vide letter dated 25.02.2015. Hence there was no deficiency in service on the part of the opposite party.

3.             Complainant tendered into evidence his affidavit Ex.CW1/A and documents Ex.C1 to Ex.C11.

4.             On the other hand, opposite parties tendered into evidence affidavit of Nimisha Shahani, authorized Signatory Ex.OP1/A, and documents Ex.OP1 to Ex.OP8.

5.             We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned counsel for the parties.

6.             From the pleadings and evidence of the case, it is admitted case of the parties that the deceased Lakhvinder Singh, the husband of the complainant was the owner of the Car bearing registration no. HR-05A-5668 which was fully insured with the Opposite party vide policy No. P00/4100003/4101/365996 valid from 19.03.2014 to 18.03.2015. It is also not disputed that said Lakhvinder Singh has died on 14.09.2014 and the said car met with an accident on 03.01.2015. According to the Opposite party, the insured Lakhvinder Singh expired in the month of September, 2014 and the said claim was intimated on 27.01.2015 approximately delayed by 4 months which is a violation of the term and condition of the policy. The fact that the intimation about the accident in question was given on 27.01.2015 has not been denied by the complainant. The complainant alleges that after the death of her husband on 14.09.2014 there was miscarriage of her pregnancy due to which she remained on bed for 4 months and due to this reason she could not lodge the claim. To prove this fact the complainant has placed on the file a document Ex. C-4. But this document neither bear the signature of any doctor nor it is on the pad of any hospital or doctor. So this document is not a sufficient evidence to prove the contention of the complainant.

                As already stated above that the accident in question has taken place on 03.01.2015 and the intimation about this accident was given by the complainant to the Opposite party on 27.01.2015, so there is delay of 24 days only and not of 4 months. According to condition No.9 of the policy, for information in case of death, the permissible period is of 3 months. It is admitted case of the OP that the intimation about death was given 27.01.2015. So the contention of Opposite party that there was delay of 4 months in giving the intimation regarding death is not correct, because the permissible period is to be deducted in counting the delay. Hence after deducting the permissible period, there is delay of approximately one month only. No doubt there is delay of about one month approximately which is also a violation of the terms and condition of the policy but for this violation of term and condition, the OP should not deny the claim of the complainant in its entirety and the same should have been settled on the basis of non-standard. In this regard, reliance can be made to authority titled as  Mohammad Ejaj Vs. UII, 2014(4), CLT page 161(Hon’ble State Commission, Haryana), wherein it has been held that Insurance Claim- Repudiation –On the ground that there was delay of 15 days in lodging the F.I.R and 36 days in giving intimation to the Insurance Company-IRDA have given direction to the Insurance Companies not to reject genuine claims simply because of late registration of F.I.R and late intimation to the Insurance Company-Held-IRDA is the controlling authority of all Insurance Companies and being a statutory body, is competent to frame guidelines and issue instructions to Insurance Companies which are binding upon them-Appeal accepted. In the authority cited in 2016(2) CLT page 434 (Hon’ble State Commission, Haryana) titled as Future General India Insurance Co. Ltd Vs. Satbir, it has been held that Insurance claim-Theft of insured tractor-Prompt FIR-Delay of 66 days in intimation to insurance company-Held-In the Circular Ref:IRDA/HLTH/MISC/CIR/216/09/2011 dated September 20, 2011 issued by ‘IRDA’, it has been mentioned  that genuine claims should not be rejected  on account of delay in intimation, and that, the insurer’s decision to reject a claim must be based on “ sound logic” and “ valid grounds”-Insurance company is liable to indemnify the loss suffered by the complainant-Appeal dismissed. In authority titled as United India Insurance Co. Ltd. Vs. Gian Singh reported in II(2006) CPJ page 83(NC), it has been held by Hon’ble National Commission  that in case of violation of condition of policy as to nature of use of the vehicle, the claim ought to be settled on non-standard basis.

7.             In view of the above authorities as well as the facts and circumstances of the case, we are of the considered view that the claim in respect of the vehicle in question should have been settled by the opposite party on basis of guidelines of non-standard settlement. Hence, the Opposite party has wrongly repudiated the claim of the complainant in toto.

                According to the complainant, she has spent a sum of Rs. 1,03,000/- on the repair of the car. The opposite party has placed a report of surveyor Ex. R-4 and Ex.R-5. In Ex.R-4, the surveyor has assessed amount for the parts as Rs. 62,593.5/- and labour charges has been taken as nil whereas for the labour charges, surveyor has attached the documents Ex.R-5.  The labour charges are very much necessary to be assessed by the surveyor but the surveyor has not assessed the same. So, the report of the surveyor is not complete.  If the cost of the parts and the estimate of the labour charges placed on the filed by the opposite party are taken into consideration then the same exceeds the amount of actual expenditure made by the complainant. So, in these circumstances, it is in the interest of justice that the amount of Rs. 1,03,000/-  be taken for the settlement of the claim of the complainant on non-standard basis.

                Thus, in view of the above discussions, we allow the complaint and direct the opposite party to settle the claim of the complainant on non-standard basis and to pay Rs. 77,250/- i.e. 75% of Rs. 1,03,000/-. The order be complied within 30 days, failing the complainant shall be entitled to interest of @ 6% from the date of commencement of this order till its realization. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 20.09.2017

                                                                     (Jagmal Singh)

                                                                        President,

                                                            District Consumer Disputes

                                                            Redressal Forum, Karnal.

                (Veena Rani)   (Anil Sharma)

                  Member             Member

 

 

 

Present:    Shri G.P.S. Gereta, Advocate for complainant.

                 Shri Anil Kumar Vij, Advocate for opposite party.

             

                Remaining arguments heard. Order announced. Vide our separate detailed order of even date, the present complaint has been allowed. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 20.09.2017

                                                                     (Jagmal Singh)

                                                                        President,

                                                            District Consumer Disputes

                                                            Redressal Forum, Karnal.

                (Veena Rani)   (Anil Sharma)

                  Member             Member