IN THE CONSUMER DISPUTES REDRESSAL FORUM, PATHANAMTHITTA. Dated this the 14th day of February, 2011. Present:- Sri. Jacob Stephen (President) Smt. C. Lathika Bhai (Member) Sri. N. Premkumar (Member) C.C.No.106/10 (Filed on 30.07.2010)Between: Elsy Jose, W/o. Jose John, Mettayil House, Thadiyoor. P.O., Ranny Taluk, Pathanamthitta. (By Adv. Lalu John) ..... Complainant And: Manager, Oriental Insurance Co. Ltd., Branch Office, Neduvelil Building, 1st Floor, Pazhavangadi. P.O., Ranny, Pathanamthitta. (By Adv. P.D. Varghese) ..... Opposite party. O R D E RSmt. C. Lathika Bhai (Member): The complainant has filed this complaint against the opposite party for getting a relief from the Forum. 2. The facts of the complaint is as follows: The complainant is the wife of Late M.J. Jose who was the registered owner of KL-03/M-8258 TVS Motor Cycle. The complainant’s husband, M.J. Jose died on 3.3.09 in a motor accident near Vennikulam JUnction at 9.00 p.m. on Thadiyoor-Vennikulam Road. Koipuram police registered a Crime in connection with the above incident as Crime No.126/09. The above said vehicle was insured with the opposite party vide policy No.441904/31/2009/2858. The period of cover was from 16.9.08 to 15.9.09. The policy envisaged a personal accident cover for owner-driver. The matter was reported to the opposite parties. But the opposite parties are not taken any steps to settle the claim. They are not ready to allow the Personal Accident benefit to the complainant. The non-settlement of the complainant’s claim by the opposite party’s amounts to a deficiency in service and which caused mental agony, financial loss and inconveniences to the complainant. Hence the complainant filed this complaint for directing the opposite party to pay the P.A. benefit with interest to the complainant along with compensation and cost. The complainant prays for granting the reliefs. 3. The opposite party has filed a version stating the following contentions: The complaint is not maintainable either in law or on facts and liable to be dismissed in limine. This opposite party admitted the policy issued to Mr.Jose. M.J. The claim is barred by limitation. No information regarding the death of insured M.J. Jose alleged in the complaint was given to the opposite party and no claim is filed before them. Unless proper claim form is filed within the stipulated period, the applicant is not entitled to claim any benefit under the policy. There is no laches on the part of the opposite parties. Hence the opposite party prays for the dismissal of the complaint. 4. On the above pleadings, the following points are raised for consideration:- (1) Whether the complaint is maintainable before the Forum? (2) Whether the reliefs sought for in the complaint are allowable? (3) Reliefs and Costs? 5. The evidence in this case consists of the proof affidavit and Ext.A1 to A7 produced by the complainant. For the opposite party, the Divisional Manager of the opposite party filed a proof affidavit. There is no documentary evidence from the part of opposite party. After closure of the evidence, both sides heard. 6. Point Nos.1 to 3:- The complainant’s case is that her deceased husband was the owner of KL-03/M-8258 Motorcycle who died in a motor accident. The above said vehicle was insured with the opposite party and during the coverage period the accident was occurred. As per the policy there is a personal accident cover to the owner-driver of the insured vehicle. Hence the complainant filed this complaint against the opposite parties for getting the Personal Accident benefit as per the policy along with compensation and cost. 7. In order to prove the complainant’s case, the complainant filed a proof affidavit and Ext.A1 to A7. Ext.A1 is the R.C. Book of the vehicle KL-03/M-8258 Motorcycle. Ext.A2 is the copy of the insurance policy certificate of the vehicle. Ext.A3 and A4 are the certified copies of FIR and FIS in Crime No.126/09 of Koipuram police. Ext.A5 is the scene mahazar and Ext.A6 is the postmortem certificate and Ext.A7 is the final report in Crime No.126/09. 8. The opposite party contended that the complaint is not maintainable either in law or on facts. No information regarding the death of insured M.J. Jose was given to the opposite party and no claim is filed to the opposite party. Without filing proper claim form within the stipulated period, the insured is not entitled to claim any benefit under the policy. 9. In order to prove the contentions of opposite party, the Divisional Manager of opposite party has filed a proof affidavit. 10. On going through the documents filed by the complainant, the materials on records shows that the owner of the insured vehicle KL.03/M-8258 is the complainant’s deceased husband Mr. M.J. Jose. Ext.A3 and A4 shows that he died due to the accident while he was driving the insured vehicle. Ext.A2 shows that the accident and death was during the valid coverage period. The only question to be considered is whether the complainant has filed a proper claim form with relevant documents before the opposite party for getting P.A. benefit as per the policy from the opposite party? The main contention of the opposite party is that there is no information regarding the death of the owner of the insured vehicle or no claim was filed by the complainant before them. There is no evidence from the part of the complainant that she had filed a proper claim before the opposite party for getting the P.A benefit envisaged in the policy due to the death of her husband and it was repudiated by the opposite party. Without repudiating the complainant’s claim there is no cause of action for filing this complaint. In the circumstances, we came to a conclusion that the complaint is not maintainable before the Forum, hence the complaint is liable to be dismissed. However, the complainant has the liberty to file a proper claim with relevant documents for processing the claim before the opposite party within two weeks from the date of receipt of this order. Opposite party is also directed to accept the claim form from the complainant without considering the delay caused for filing the claim. 11. In the result, this complaint is dismissed with above directions. No cost. Declared in the Open Forum on this the 14th day of February, 2011. (Sd/-) C. Lathika Bhai, (Member) Sri. Jacob Stephen (President) : (Sd/-) Sri. N. Premkumar (Member) : (Sd/-) Appendix: Witness examined on the side of the complainant: Nil. Exhibits marked on the side of the complainant: A1 : Photocopy of the R.C. Book of the vehicle. A2 : Photocopy of the insurance policy certificate of the vehicle. A3 : Photocopy of FIR in Crime No.126/09 of Koipuram police Station. A4 : Photocopy of FIS in Crime No.126/09 of Koipuram police Station. A5 : Photocopy of the scene mahazar A6 : Photocopy of the Post mortem certificate issued by the Asst. Surgeon, Govt. Hospital, Kozhencherry. A7 : Photocopy of the Final report in Crime No.126/09. Witness examined on the side of the opposite party: Nil. Exhibits marked on the side of the opposite party: Nil. (By Order) Senior Superintendent. Copy to:- (1) Elsy Jose, Mettayil House, Thadiyoor. P.O., Ranny Taluk, Pathanamthitta. (2) Manager, Oriental Insurance Co. Ltd., Branch Office, Neduvelil Building, 1st Floor, Pazhavangadi. P.O., Ranny, Pathanamthitta. (3) The Stock File. | 
