Andhra Pradesh

Chittoor-II at triputi

CC/8/2016

Ananthaneni Kumari, W/o. A.Raghava Naidu - Complainant(s)

Versus

M/S IFFCO TOKIO Gen. Insurance Co. Ltd., Rep. by its Manager - Opp.Party(s)

T.Rajasekhar

30 Jan 2017

ORDER

Filing Date: 29.01.2016

Order Date:30.01.2017

 

 

 

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II,

CHITTOOR AT TIRUPATI

 

 

      PRESENT: Sri.M.Ramakrishnaiah, President ,

        Smt. T.Anitha, Member

 

 

 

MONDAY THE THIRTIETH DAY OF JANUARY, TWO THOUSAND AND SEVENTEEN

 

 

 

C.C.No.08/2016

 

 

Between

 

 

Smt. Ananthaneni Kumari,

W/o. A.Raghava Naidu,

D.No.18-6-150, 6^th Cross, Sundaraiah Nagar,

Tirupati.                                                                                             … Complainant.

 

 

 

 

 

And

 

 

1.         M/s. IFFCO-TOKIO Gen. Insurance Co. Ltd.,

            Rep. by its Manager,

            19-11-19, 2^nd Floor, Opp. Andhra Bank,

            Near Ramanuja Circle,

            Tiruchanur Road,

            Tirupati – 517 501.

 

2.         M/s. IFFCO – TOKIO Gen. Insurance Co. Ltd.,

            Rep. by its General Manager,

            IFFCO Sadan C1 District,

            Centre, Saket,

            New Delhi – 110 017.

 

3.         M/s. IFFCO – TOKIO Gen. Insurance Co. Ltd.,

            Rep. by its General Manager,

            14^th Cross Road, Kumaraswamy Layout,

            Bengaluru,

            Karnataka.

 

4.         M/s. IFFCO – TOKIO Gen. Insurance Co. Ltd.,

            Rep. by its General Manager,

            No.201B, 2^nd Floor, Shangri-La-Plaza,

            K.B.R.Park Road,

            Banjara Hills,

            Road No.2,

            Hyderabad – 500 034.

 

5.         M/s. IFFCO – TOKIO Gen. Insurance Co. Ltd.,

            Rep. by its General Manager,

            2^nd Floor, Above Con Agra Foods,

            Road No.31, Lane Opp. DBR Diagnostics,

            S.D.Road,

            Secunderabad – 500 003.                                                   …  Opposite parties.

 

 

 

 

            This complaint coming on before us for final hearing on 19.01.17 and upon perusing the complaint, written version and other relevant material papers on record and on hearing Sri.T.Rajasekhar, counsel for complainant, and Sri.Prem Kumar Karanam, counsel for opposite party No.3, and opposite parties 1, 2, 4 and 5, remained exparte, and having stood over till this day for consideration, this Forum makes the following:-

ORDER

DELIVERED BY SRI. M.RAMAKRISHNAIAH, PRESIDENT

ON BEHALF OF THE BENCH

           

            This complaint is filed under Sections–12 and 14 of C.P.Act 1986, by the complainant  for the following reliefs against the opposite parties 1 to 5, 1) to direct the opposite party No.1, to pay Rs.6,24,150/- with interest at 18% p.a. from the date of accident i.e. 11.05.2014, till realization, 2) to direct the opposite party No.1 to pay Rs.1,00,000/- for deficiency in service on the part of the opposite parties and for causing mental agony, 3) to direct the opposite party No.1, to pay Rs.10,000/- towards costs of the litigation. No relief is claimed against opposite parties 2 to 5 as they were added as formal parties.    

            2.  The brief averments of the complaint are:-  that the complainant has purchased HYUNDAI GRAND i10 ASTA 1.1 CRD from R.K.Hyundai, Tirupati, on 06.02.2014, on hire purchase basis duly hypothecating the vehicle with Mahindra and Mahindra Financial Services Ltd. The registration number of the vehicle is AP-03-BH-1414 in the name of the complainant. The vehicle was insured with opposite parties for a sum of Rs.6,24,150/- vide policy No.1-2L 187KB P400 Policy No.86747090 vide its Cover Note No.74017968, commencing from 06.02.2014 to 05.02.2015. Unfortunately, the vehicle met with accident on 11.05.2014. A case in Crime No.68/2014 registered under Vayalpad P.S. The insurance surveyor also inspected the vehicle in the showroom and submitted his report. Immediately, after the accident on the instructions of the officials of opposite party No.1, complainant submitted her claim form in the office of opposite party No.1 on 22.07.2014, and the concerned staff of opposite party No.1 made assurance that procedure will be followed and claim will be settled soon.

            3.  That the complainant also submitted repair estimate from R.K.Enterprises, to opposite party No.1, for a sum of Rs.5,17,515.91/- along with required documents. Despite several representations of the complainant, opposite party No.1 did not settle the claim of Rs.6,24,150/- so far. The opposite parties have to settle the claim within 170 days from the date of accident. The opposite party No.1 harassing the complainant without settling her claim and thus adopting unfair trade practice. There is deficiency in service on the part of opposite party No.1. Complainant also got issued legal notice on 24.04.2015 to opposite parties 1 to 5 requesting them to settle the claim. Opposite parties 1, 2 and 4 received the notice, but failed to settle the claim. Complainant is regularly paying the installments to the finance company. Hence the complaint.

            4.  Opposite parties 1, 2, 4 and 5 remained exparte.

            5.  Opposite party No.3 alone is the contesting party. Opposite party No.3 filed its written version denying parawise allegations in the complaint and further contended that the complainant insured her Hyundai Grand i10 Asta 1.1 CRD bearing No. AP-03-BH-1414 with opposite party No.1 on 14.02.2014 for one year from 06.02.2014 to 05.02.2015 as “a private car” package policy. The car met with an accident on 11.05.2014 near Nagendra Dabha Hotel in Tirupati - Mandanapalle road, Vayalpad, and the same was intimated to opposite party only on 22.07.2014 i.e. about 2 months 11 days after the accident. That immediately after receiving the claim intimation, opposite party No.1 deputed its surveyor K.N.Reddy, IRDA. He submitted report after conducting the survey on damaged vehicle, assessing the damages and estimated the damage value i.e. assessing the loss of damaged parts in a sum of Rs.2,89,371/-. On receipt of the report, opposite party No.1 requested the complainant to submit the name of the person who was on wheels by the time of accident along with his driving licence, as there is discrepancy in the name of the person who drove the vehicle by the time of accident and also asked the reasons for non-intimation of accident to opposite party No.1. Inspite of the said letter, complainant did not comply with the demands / requirements. That the complainant without submitting necessary documents for processing the claim, making wild allegations against the opposite parties, that the opposite parties are not settling her claim. As per condition No.1 of the policy notice shall be given in writing to the insurance company immediately upon the occurrence of any accident. The complainant did not comply the condition No.1 of the policy. The accident was brought to the notice of the company after lapse of 71 days. That this opposite party did not give reply to the notice dt:24.04.2015, as it was with all false allegations. The complainant neither submitted the documents required nor assigned any valid reasons for the delay in intimation to the insurance company about the accident, as per the notice dt:06.11.2015 given by the opposite party, as such her claim could not be processed due to non-compliance of condition No.1, of the policy and non-submission of the documents required. Complaint therefore is pre-mature. There is no deficiency in service on the part of the opposite party. In view of the delayed intimation, the opposite party is not liable to accept the claim and prays the Forum to dismiss the complaint with costs.

            6.  For the complainant, the complainant herself filed her evidence affidavit as P.W.1 and got marked Exs.A1 to A9 on her behalf. R.W.1 filed his evidence affidavit on behalf of opposite party No.3, and got marked Exs.B1 and B2.    

            7.  Now the points for consideration are:-

            (i).  Whether the complaint is pre-mature and liable for dismissal for non-

                   compliance of condition No.1 of the policy?  

            (ii).  Whether the complainant is entitled for the reliefs sought for?

            (iii).  To what relief?

            8.  Point No.(i):-  in order to answer this point, it is the duty of the complainant to furnish that she has complied with condition No.1 of the policy and also that she has given intimation in writing to the opposite party about the accident that was occurred on 11.05.2014. The complainant in her complaint, in her evidence affidavit and also in her written arguments, did not furnish where the accident took place, by what time the accident took place, and when she lodged complaint before Vayalpad P.S. Nowhere it is mentioned that immediately after the accident, the complainant has intimated the opposite party about the accident in writing. The complainant simply mentioned that the surveyor also inspected the vehicle in the showroom, but when it was inspected was not mentioned. Simply, the complainant is contending that her claim application was made on 22.07.2014 in the office of opposite party No.1. Her claim is still pending and the opposite parties could not settle her claim so far, as such she was forced to issue notice on 24.04.2015, that though opposite parties 1, 2 and 4 received the notice, did not give reply and also they failed to settle her claim. For these queries, opposite party No.3 contending that complainant failed to intimate the insurance company about the accident immediately after the occurrence, as it was an obligation on the part of the complainant. Condition No.1 of the insurance policy runs as follows – “Notice shall be given in writing to the company immediately upon the occurrence of any accident loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require. Every letter, claim, writ summons and / or process or copy thereof shall be forwarded to the company immediately on receipt by the insured. Notice shall also be given in writing to the company immediately the insured shall have knowledge of any impending prosecution inquest or fatal inquiry in respect of any occurrence which may give rise to a claim under this policy. In case of theft or criminal act which may be the subject of a claim under this policy, the insured shall give immediate notice to the police and co-operate with the company in securing the conviction of the offender”.  The complainant is under obligation to intimate the accident immediately after the occurrence to the insurer, but she failed to comply with condition No.1 of the insurance policy. The complainant though filed Ex.A1 insurance policy, she has filed only first page and other terms and conditions of the insurance policy was not filed. Thus, it is only a part of the document, which cannot be accepted. What made the complainant not to furnish the copy of the insurance policy in full form? That apart the complainant nowhere mentioned the reasons for the delayed intimation. The accident was occurred on 11.05.2014, intimation was given by way of submitting the claim form only on 22.07.2014. Therefore, there was delay of 71 days in intimation. Even then there was no specific intimation in writing about the accident to the opposite parties.

            9.  Another ground that was urged by the opposite parties is that the opposite party No.3, given notice to the complainant requiring to submit certain documents such as the name of the person who drove the vehicle at the time of accident and also his driving licence. Similarly, the complainant also requested to furnish the valid reasons for the delay in intimation, as per their notice dt:06.11.2015, but the complainant though received the notice did not choose to either give reply or to comply with the requirements, so as to enable the opposite party No.3 to process her claim. Because of non-compliance of condition No.1, and non-furnishing of the required documents mentioned in the notice dt:06.11.2015, opposite party No.3 could not process her claim, thus claim is still pending. Instead of complying with the conditions mentioned in the policy condition No.1 and also instead of complying with the requirements in the notice dt:06.11.2015, the complainant filed this complaint, as if there were latches on the part of opposite party. Therefore, this claim is not maintainable. In this regard, the opposite party relied on a decision of the Hon’ble National Commission in Revision Petition No.4749/2013 – Sri Ram General Insurance Co. Ltd, Jaipur, Rajasthan Vs. Mahender Jat, Ajmer District, Rajasthan – the brief averments of the complaint are that the complainant’s vehicle bearing No.RJ01-SJ-9942 was stolen on the night of 17.12.2010 from the rented house of the respondent / complainant by some unknown person, for which an FIR No.442 of 2010 had been lodged with police station Kekri. The police submitted final untraced report of the property. The respondent intimated the company regarding the theft of the above said vehicle on its Toll Free Number 1800 180 7474 and intimated to the agent on 18.12.2010, whereby the respondent was informed to give written information to the Branch Manager, Shriram General Insurance Company Ltd., along with the copy of FIR and other documents. The respondent / complainant sent the copy of FIR to the Branch Office at Ajmer, immediately after receiving the same from the police station, after completion of all the formalities, the petitioner Insurance Company vide its letter dt:02.02.2011 repudiated the claim of the respondent stating that the vehicle was stolen on 17.12.2010 and intimation regarding the theft of the vehicle was given to the company only on 07.01.2011 for the first time which amounts to violation of policy terms and conditions. The act of the petitioner / opposite party amounts grave deficiency in service and the respondent / complainant suffered mental agony and financial loss.

            10.  The petitioner / opposite party in the written statement has stated that the complaint was not maintainable because the respondent / complainant violated the policy condition by not giving written intimation regarding the incident to insurance company immediately, which was an important condition. Due to the delayed intimation after 21 days on 07.01.2011, the Insurance Company was deprived from carrying on investigation and retrieve the vehicle. The respondent / complainant could also have approach the branch office of the insurance company to intimate regarding the theft of the vehicle in compliance of the policy conditions and got registered the theft intimation with immediate effect or could have intimated through post but no such action was taken by the respondent and no such intimation was given to the insurance company till 07.01.2011. Yet the insurance company being fair enough acted upon natural justice and gave an opportunity to the respondent / complainant to explain the cause of delayed intimation vide its letter dt:18.01.2011. This letter was not replied by the respondent / complainant but rather he preferred the present complaint before the District Forum. The District Forum dismissed the complaint on 17.02.2012. Being aggrieved by the said order, the respondent / complainant preferred appeal before the State Commission, which was allowed. Hence the Revision Petition. The Hon’ble National Commission allowed the Revision Petition of the Insurance Company, setting aside the order the State Commission, confirming the order of the District Forum in dismissing the complaint. The facts of the above decision are similar to that of the case on hand and it is therefore squarely applicable to the case on hand. The opposite parties also relied on another decision of the Hon’ble National Commission in R.P.No.2479/2015 – Reliance General Insurance Company Ltd. Vs. Jai Prakash, in which the brief facts are that the complainant, who own a truck dumper bearing No.RJ-23-GA-4786, got the same insured with the petitioner company for the period from 10.10.2010 to 09.10.2011. During the subsistence of the insurance policy, the vehicle was stolen between 06/07.06.2011 and a report with the concerned police station was lodged on 07.09.2011. The claim lodged by the complainant was however rejected by the insurance company on account of delayed intimation of the theft to it. Being aggrieved, the complainant approached the District Forum by way of complaint. The petitioner / opposite party resisted the complaint on the same ground on which the claim was repudiated. The District Forum vide its order dt:29.10.2014 allowed the complaint and directed the payment of Rs.9,50,000/- to the complainant along with interest at 9% p.a. from the date of filing the complaint. Being aggrieved by the order of the District Forum, the Insurance Company approached the concerned State Commission by way of appeal, the said appeal was dismissed vide order dt:02.06.2015. The insurer fled the revision petition before the Hon’ble National Commission. Their Lordships of National Commission while referring one of the condition of the insurance policy viz. “notice shall be given in writing to the company immediately upon the occurrence of any accident, loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require. Every letter claim writ summons and / or process or copy thereof shall be forwarded to the company immediately on receipt by the insured. Notice shall also be given in writing to the company immediately the insured shall have knowledge of any impending prosecution inquest or fatal inquiry in respect of any occurrence which may give rise to a claim under this policy. In case of theft or criminal act which may be the subject of a claim under this policy the insured shall give immediate notice to the police and co-operate with the company in securing the conviction of the offender”. So, in that case also, the complainant failed to comply with the condition referred to above. Therefore, the claim of the complainant was rejected by the insurance company. Their Lordships of National Commission held that “we have no hesitation in holding that the insured was under a contractual obligation to intimate the theft of the vehicle to the insurer immediately after the said theft came to his knowledge and mere intimating the police or lodging an FIR does not amount to sufficient compliance with the terms and conditions of the insurance policy. Since, admittedly, there was substantial delay in intimating the theft of the vehicle to the insurance company, the insurer was entitled to repudiate the claim on account of the aforesaid default on the part of the insured. Consequently, revision petition No.2479/2015 filed by Reliance General Insurance Co. Ltd., is allowed and the complaint filed by the respondent / complainant Jai Prakash is hereby dismissed. No order as to costs.

            11.  Thus in the above said two decisions, the Hon’ble National Commission held that delay in intimation of the accident / theft of the vehicle to the insurance company in writing as required under condition No.1 of the insurance policy is vital to the claim. Therefore, in the case on hand, the complainant failed to intimate the accident to the insurance company immediately after the accident was occurred, but it was informed by way of submitting claim form only about 71 days after the accident. The complainant also failed to inform the name of the person, who drove the vehicle at the time of accident and also failed to submit the driving licence of the person, who drove the vehicle by the time of accident, as required in the letter dt:06.11.2015 issued by the opposite party. Though the opposite party has given opportunity to the complainant to submit the required information and documents, the complainant failed to submit the same, so as to enable the opposite party to process her claim. Therefore, the complaint of the complainant is liable to be dismissed on the following grounds - delayed intimation of 71 days after the accident, non-furnishing the required information to the opposite party and thus the claim is pre-mature. Accordingly, this point is answered.

            12. Point No.(ii):-  in view of the above discussion, we are of the opinion that since the complainant failed to comply with the condition No.1 of the insurance policy referred to above, and that complainant also failed to furnish the information with regard to the name of the person, who drove the vehicle at the time of accident and also not furnished the driving licence of the person, who drove the vehicle at the time of accident, to the insurer, as such there is default on the part of the complainant in complying with the above conditions and therefore the complainant is not entitled to the reliefs sought for. Accordingly, this point is answered.

            13.  Point No.(iii):- in view of our holding on points 1 and 2,  we hold that the complainant is failed to justify her claim, till today she failed to comply with the contractual obligations, as shown in condition No.1 of the insurance policy, as contended by the opposite party. She also failed to furnish the required information, so as to enable the opposite party to process her claim and the complaint is therefore liable to be dismissed.

            In the result, complaint is dismissed. No costs.

Dictated to the stenographer, transcribed and typed by him, corrected and pronounced by me in the Open Forum this the 30^th day of January, 2017.

 

      Sd/-                                                                                                                       Sd/-                          

Lady Member                                                                                                      President

 

APPENDIX OF EVIDENCE

 

 

Witnesses Examined on behalf of Complainant/s.

 

PW-1: Smt. Ananthaneni Kumari (Chief Affidavit filed).

 

Witnesses Examined on behalf of Opposite PartY/S.

 

RW-1: V. Jagmohan Rao (Chief Affidavit filed).

 

EXHIBITS MARKED ON BEHALF OF THE COMPLAINANT/s

 

Exhibits (Ex.A)	Description of Documents
	Original Insurance Policy Documents on behalf of the complainant. Period of Insurance from 06.02.2014 to 05.02.2015. Policy No.: 1-2L187K8.
	Receipt No.1441 issued by R.K. Hyundai, R.K. Enterprises in favour of complainant. Dt: 20.01.2014.
	Document of Electronic Clearing Service (Debit Clearing) Sheet issued by Mahindra & Mahindra Financial Services Ltd., to complainant.  ECS Start Date: 15.02.2014, ECS End Date: 15.12.2018.
	Document of Delivery Challan issued by R.K. Hyundai, R.K. Enterprises to Complainant. Sl.No.823. Dt: 06.02.2014.
	Office copy (Photo copy) of FIR in Crime No.68 of 2014 of Vayalpad P.S. Dt: 11.05.2014.
	Documents of Repair Estimate issued by R.K. Hyundai, R.K. Enterprises to Complainant. Dt: 08.08.2014.
	Photo copy of Report by Motor Vehicles Inspector on Accidents from RTA.
	Office copy of Legal notice issued to the Opposite parties No.1 to 5 by complainant along with postal receipts. Dt: 24.04.2015.
	Postal acknowledgments 3 in number from opposite parties.

 

EXHIBITS MARKED ON BEHALF OF THE OPPOSITE PARTY/s

 

Exhibits (Ex.B)	Description of Documents
	Motor Final Survey Report. Dt: 23.05.2015.
	Letter regarding Accident Claim on vehicle No.AP03BH1414. Dt: 06.11.2015.

 

    

       

                                                                                                                                     Sd/-   

                                                                                                                                 President

     

                                   // TRUE COPY //

// BY ORDER //

 

Head Clerk/Sheristadar,

           Dist. Consumer Forum-II, Tirupati.

   

     

         

Copies to:-     1.  The complainant.

                        2.  The opposite parties.