Date of filing:06.06.2022
Date of Disposal:21.11.2022
BEFORE THE III ADDITIONAL BANGALORE URBAN
DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,
BENGALURU – 560 027.
DATED THIS THE 21st DAY OF NOVEMBER, 2022
CONSUMER COMPLAINT NO.117/2022
PRESENT:
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SRI.RAJU K.S,
SMT.REKHA SAYANNAVAR:MEMBER
Smt. Mangala.C
W/o Late Lingaraju K.R.,
Aged about 42 years ……COMPLAINANT No.1
Sri Manoj K.L
S/o Late Lingaraju K.R
Aged about 22 years ……COMPLAINANT No.2
Yashaswini K.L
D/o Late Lingaraju K.R
Aged about 20 years……COMPLAINANT No.3
Smt. Ammajamma
W/o Late K.Ramaiah
Aged about 80 years……COMPLAINANT No.4
All are residents of Kurubarahalli
Debbegetta Post, Dodderi Hobli
Madhugiri Taluk
Tumkur District 572 112.
(Sri K.R Ramesh Adv. For complainants)
M/s HDFC ERGO General
Insurance Company Limited
No.25/1, 2nd Floor
Building No.2,
Building, MG Road
Bangalore 560 001
Rep. by its Manager.……OPPOSITE PARTY
(Sri SN Ram Prasad Adv. For opposite party)
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//JUDGEMENT//
BY SRI. RAJU K.S, MEMBER
The complainants have filed this complaint u/s 34 of the Consumer Protection Act 2019 seeking for a direction to the Opposite party to pay Rs. 15,00,000/- to the complainants with interest @ 12% per annum with Rs.1,00,000/- compensation for hardship and inconvenience caused by the Opposite party.
2. The complainant No.1 is the wife of one Lingaraju K.R 2nd and 3rd complainants are the children of late Lingaraju KR and complainant No.4 is mother of Late Lingaraju KR. The said LIngaraju KR had purchased a Hero Honda Motor cycle Splender+. The said motor cycle was registered on 29.11.2019 under registration No. KA-64-S 3710. The said motor vehicle having chassis No.MBLHAW081KHJ28857 and Engine No. HA10AGKHJ45071. The said motor cycle was insured by the opposite party under insurance policy No.23129110003235100000 for five years i.e valid from 18.10.2019 to 17.10.2024. The said insurance policy was package policy and the opposite party has collected Rs.8,343/- as premium from late Lingaraju KR. Further the said policy having coverage of Rs.15,00,000/- PA in case of death of insured. Further the said Lingaraju has nominated his father K Ramaiah as his nominee in the said policy. The father of the deceased Lingaraju has died before the death of the Lingaraju.
3. The said Lingaraju has met with a road accident at Hosakere Village, Medigeshi Hobli, Madhugeri Taluk, Tumakuru District on 07.01.2022 with a lorry bearing Reg. No. AP02 TD 1180. In this untoward incident the said Lingaraju had died on 11.01.2022 due to injuries sustained in the road accident. A case has been registered against lorry driver under Crime No.2/2022 by Medigeshi Police station.
4. The complainants have made claim of Rs.15,00,000/- personal assurance amount to Opposite party, after death of deceased Lingaraju. The opposite party has denied to give the claim form by stating th at no such coverage under the policy. Further the opposite party has not honoured the claim of the complainants. Inspite of issuance of legal notice dated 27.04.2022 the opposite party has not honoured the claim of the complainants for which they are legally entitled. Thereby the opposite party has made deficiency of service to the complainant. Hence prayed for grant of relief as sought for.
5. The opposite party filed his version and denied the claim of the complainants. The Opposite party has taken specific contention that the own damage coverage for PA was only for the period from 18.10.2019 to 17.10.2020. Further the alleged accident has occurred on 07.01.2022 and same was intimated to insurer on 06.04.2022. There was delay of four months in intimating the accident. The insurer has honoured the own damage claim of the vehicle and paid the requisite cost for the repair of the vehicle as claimed. Further the opposite party submitted that, under the subject policy the complainants have only registered a motor own damage claim and same was settled regardless of delay in intimation. The complainants have not made any claim under personal accident coverage or have not filed any relevant document to vindicate the claim in respect of the death of deceased Lingaraju. Hence the complainants cannot saddled the issue for the fault of their own. In the absence of the any legal claim the complaint is premature and even if they intend to move their claim the condition is very clear for the loss or injury has to be intimated within six months from the date of alleged injury. Hence sought for dismissal of the complaint.
6. The complainant No.1 examined as PW-1 and got marked Ex. P1 to P8 documents and filed their written arguments.
7. On the basis of the pleading and documents, the points that would arise for consideration are as under:
i) Whether the complainants prove the deficiency of service on the part of the opposite party?
ii) Whether the complainants are entitled for the reliefs as sought in the complaint?
iii) What order?
8. Our findings on the aforesaid points are as follows:
Point No.1 : In affirmative.
Point No.2 : Partly in affirmative.
Point No.3 : As per the final order for the following;
REASONS
9. POINT NO.1:- It is undisputed fact that the complainant No.1 is the wife, complainant No.2 and 3 are children and complainant No.4 is the mother of deceased Lingaraju KR he has purchased Hero Honda Splender Motor cycle bearing Registration No.KA-64 S-3710. Further it is also undisputed fact that the above said motor cycle has been insured with the opposite party under policy No.231290003835100000 for the period from 18.10.2019 to 17.10.2024 by paying Rs.8,343/-. Further the said Lingraju has met with a road accident on 07.01.2022 at Hosakere Village, Madhugiri Taluk, Tumkuru District. At the time of accident the deceased Lingaraju was riding his motor cycle bearing No. KA-64 S-3710 which, has colluded with lorry bearing Reg. No.AP-02 TD-1180. This accident occurred due to rash and negligent driving by the lorry driver. The Medigishi police has registered a case under Crime NO.02/2022 against lorry driver. At the time of accident the deceased Lingaraju was having valid driving license.
10. The complainants have alleged that the opposite party has refused to issue claim form by stating that no such coverage is available under the policy. The complainants have filed policy document i.e. Ex P4, in which Section B liability premium computation (Section-II) in fourth line shows that “compulsory PA covered (Owner/Driver) has paid Rs.375/-.” Same is also reflected in the policy document filed by the opposite party. Further in the policy document under head CPA was shown for the period of 18.10.2019 to 17.10.2020 Rs.15,00,000/- and further period of policy was shown as ‘nil’. The opposite party has his specific contention in para 5 and 6 of his version that “The opposite party has registered a motor own damage claim viz claim NO. C230022009957 for an alleged accident occurred on 07.01.2022 and intimated to him on 06.04.2022 for a damage caused due to external means. After assessing the loss even there was delay in intimation of the loss the insurer had honoured the motor own damage claim and paid to the repairer, thereby closing the claim as complied. Further as per opposite party records the subject policy the complainant has only registered a motor own damage claim for the insured motor cycle which was also settled regardless of the delay in intimation. That the complainant has failed to make a claim under the personal accident coverage and produce the relevant document to vindicate the claim and to pay for it. The entire process of claim registration is system generated and unique claim number gets generated.”
11. Further since the complainants have not made or intimated a claim under personal accident it is obvious about the denial of the claim. This dereliction of intimation by the complainants cannot be saddled on the insurer. As per subject policy condition No.3 any loss /injury has to be intimated within six months.
12. Now the question arise before this commission is that whether the complainants have made any claim with the opposite party and the claim has been honoured. As per Ex P8 the complainants have issued a legal notice dated 27.04.2022 through their advocate and the same was duly received by the opposite party. Further as per Ex P4 policy document the opposite party has received Rs.375/- premium towards compulsory PA cover for owner/driver, and the same has not been denied by the opposite party. The policy availed by the deceased Lingaraju was a package policy which is valid from 18.10.2019 to 17.10.2024. Since the conditions of the policy and premium received are applicable throughout the policy period, the opposite party has to pay Rs.15,00,000/- PA for owner cum driver. Any deviation in the policy for a specific period is to be specifically mentioned by the opposite party and the same shall be agreed by the insured person. In this case the opposite party agreed to indemnify the compulsory PA cover for owner driver and received Rs.375/- as premium for the whole policy period. Any deviation on the policy amounts to unfair trade practice within the meaning of Section 2 (47) of Consumer Protection Act, 2019. Hence without hesitation we came to conclusion that as per the policy under Ex P4 the opposite party is liable to pay Rs.15,00,000/- PA to the complainants as assured. Hence the Opposite party is liable to pay non-payment amounts to deficiency of service. Hence we answered Point No.1 in affirmative.
13. POINT NO.2:- In this complaint as per Ex. P4 insurance policy, the compulsory PA covered is Rs.15,00,000/-. The opposite party has to pay Rs.15,00,000/- PA to the complainants as assured in the insurance policy with interest @ 9% per annum from the date of accident i.e. 11.01.2022. In addition to that the opposite party has to pay Rs.20,000/- to the complainants for the inconvenience and mental agony suffered. Further the complainants also entitle to Rs.10,000/- as litigation cost payable by the opposite party. Hence we answer Point No.2 partly in affirmative.
14. POINT NO.3:- In view of the discussion made above, we proceed to pass the following;
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The complaint is allowed in part with cost.
The opposite party has to pay Rs.15,00,000/- to the complainants with interest @ 9% per annum from the date of accident i.e. 11.01.2022 till realization.
Further the opposite party has to pay a sum of Rs.20,000/- to complainants as compensation for mental agony and inconvenience, and Rs.10,000/- towards litigation cost.
The opposite party shall comply the order within 30 days. In case, they fail to comply the order within the said period, the above said amount carries interest at the rate of 9% p.a. from the date of order till realization.
Supply free copy of this order to both the parties and return extra copies of the pleading and evidence to the parties.
Applications pending, if any, stand disposed of in terms of the aforesaid judgment.
(Dictated to the Stenographer, typed by him, the transcript corrected, revised and then pronounced in the open Commission on 21st day of November, 2022)
- REKHA SAYANNAVAR) (RAJU K.S) (SHIVARAMA. K)
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//ANNEXURE//
Witness examined for the complainants side:
Smt. Mangala C, the complainant has filed his affidavit.
Documents marked for the complainants side:
1: Notarized copies of five Aadhar card.
2: Death certificate of Late K Ramaiah.
3: Death certificate of Late Lingaraju KR.
4: Notarized copy of insurance policy
5: Notarized copy of RC.
6: Notarized copy of Driving license.
7: Certified copy of charge sheet with annexures.
8: Office copy of the legal notice dt.27.04.2022.
Witness examined for the opposite party side:
Documents marked for the Opposite Party side:
- REKHA SAYANNAVAR) (RAJU K.S) (SHIVARAMA, K)
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