District Consumer Disputes Redressal Commission ,Faridabad.
Consumer Complaint No. 512/2020.
Date of Institution: 31.12.2020
Date of Order:07.03.2022.
Smt. Sushma Tyagi wife of late ShriSudhir Tyagi, resident of House No. 19, Block4, 122101 Gurgaon.
…….Complainant……..
Versus
United India Insurance Company Limited, Divisional Office 21, SCO-160, Second floor, Commercial Complex, Sec.16, Faridabad- 121002 through its authorized person.
…Opposite party.
Complaint under section-12 of Consumer Protection Act, 1986
Now amended Section 34 of Consumer protection Act 2019.
BEFORE: Amit Arora……………..President
Mukesh Sharma…………Member.
Indira Bhadana………….Member.
PRESENT: Sh. P.K.Tyagi, counsel for the complainant.
Sh. Sachinder Bhatia, counsel for opposite party.
ORDER:
The facts in brief of the complaint are that the husband of the complainant namely Sudhir Tyagi had taken insurance policy bearing No. 2221003117P112884931 valid from 11.12.2017 to 10.12.2018 pertaining to the vehicle No. HR-21E-0097 and the personal accident claim was also covered in respect of the above said policy i.e driver cum owner. During the insurance period on 1.12.2018 the husband of the complainant was coming from Mehandipur Balaji Rajasthan in the car bearing NO. HR-21-E-0097 in the correct lane of the road and when the husband of the complainant reached near Jakhopur Puliya at Alwar Road in the area of P.S. Ramgarh District Alwar a vehicle Dumper bearing No. RJ-40 GA-2730 came from wrong side in a high speed, being driven by rash and negligent manner and hit the car of the husband of the complainant from front side. As a result of the accident the husband of the complainant received grievous injuries. Due to the unfortunate accident caused by the offending vehicle dumper bearing NO. RJ-40-GA-2730 the husband of the complainant had been died and regarding the said accident an FIR No. 532 dated 02.12.2018 under section 279, 304-A of IPC, P.S.Ramgarh District Alwar against the driver of the offending vehicle. After the death of the husband of the complainant, the complainant had submitted the relevant documents for getting the personal accident claim amount but the opposite arty time to time given the false assurances to the complainant and later on rejected the claim on 6.3.2020. The complainant several times requested to the opposite party to make the personal accident claim amount of the deceased but the opposite party totally refused. The complainant sent legal notice dated 05.9.2020 to the opposite party but all in vain. The aforesaid act of opposite party amounts to deficiency of service and hence the complaint. The complainant has prayed for directions to the opposite party to:
a) make the personal accident claim amount of Rs.2,00,000/- alongwith interest @ 24% p.a. to the complainant.
b) pay Rs.2,00,000/- as compensation for causing mental agony and harassment .
c) pay Rs. 11,000 /-as litigation expenses.
2. Opposite party put in appearance through counsel and filed written statement wherein Opposite party refuted claim of the complainant and submitted that the complainant had neither any cause of action nor locus standi to file the present complainant reason being that the complainant filed the complaint for the claim of personal accident of deceased Sudhir Tyagi being the owner of car bearing NO. HR-21E-0097 who met with an accident on 01.12.2018 hit by Dumper and the car of the deceased was insured with the opposite party and the complainant informed to the insurance company on 05.12.2018 and further, the insurance company had deputed the investigator who was appointed through IRDA and after investigating the matter, the insurance company demanding requisite documents from the complainant vide letters dated 09.09.2019 and 06.12.2019 and in this regard asking for photographs wherein the vehicle number was visible or any other document/papers like repair bills, sale receipt of damaged vehicle, superdari from police etc. However, no document/proof had been submitted to the company till date, therefore the insurance company issued the letter dated 06.03.2020 to the complainant stated that due to non submission of documents/proof, file stands as No claim. Hence, in view of the above reasons the claim of the complainant not paid and rightly and legally issued the closure letter dated 06.02.2020 to the complainant and, in view of the above the complainant was not entitled for any claim and compensation from the insurance company and the insurance company had rightly closed the claim of the complainant as per the terms and conditions of the insurance policy. Opposite party denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
3. The parties led evidence in support of their respective versions.
4. We have heard learned counsel for the parties and have gone through the record on the file.
5. In this case the complaint was filed by the complainant against opposite party– United India Insurance Co. Ltd. with the prayer to: a) make the personal accident claim amount of Rs.2,00,000/- alongwith interest @ 24% p.a. to the complainant. b) pay Rs.2,00,000/- as compensation for causing mental agony and harassment . c) pay Rs. 11,000 /-as litigation expenses.
To establish his case the complainant has led in his evidence, Ex.CE1/A- affidavit of Smt. Sushma Tyagi,, Ex.C-1 - Certificate of insurance Private car-Liability only policy, Ex.C-2 – letter dated 06.03.2020 regarding NO Claim letter, Ex.C-3 – legal notice, Ex.C-4 – postal receipt,, Ex.C-5 – FIR, Ex.C-6 – order dated 2.11.2019 passed by Dr. Yashika, Motor Accident Claim Tribunal – Gurugram, UID-HR-0185.
On the other hand counsel for the opposite party strongly agitated and opposed. As per the evidence of the opposite party Ex.RW1/A – affidavit of Shri Dinish Kumar, Administrator Officer, United India Insurance Co. Ltd., Divisional Office-21, SCO-106, 2nd floor, Commercial Complex, Sector-16, Faridabad, Ex.R1 – NO Claim letter dated 06.03.2020, Ex.R-2 – letter dated09.09.2019 regarding submission of documents, Ex.R-3 – letter dated 6.12.2019, Ex.R4 - Private car Liability only policy from 11.12.2017 to 10.12.2018.
6. In this case, the complaint was filed with the prayer of personal accident claim by the complainant. As per Certificate cum policy schedule vide Ex.C-1 the complainant has paid an extra premium of Rs.100/- for the compulsory PA for Owner Driver valid from 11.12.2017 to 10.12.2018. The husband of the complainant was died on 01.12.2018. Ex.C5 is the FIR of the occurrence. As per No claim letter dated 06.03.2020 vide Ex.R1 on the ground that “in the subject claim, we have been asking for photographs wherein the vehicle number is visible or any other document/paper like repair bills, sale receipt of the damaged vehicle, superdari from the police etc. for us as a proof that the accident took place in the insured vehicle. However, no document/proof has been submitted to us till date. Since there had already been a considerable delay in submission of documents by you. So, we are closing the subject claim file due to non submission of documents/proof as No claim.
7. After going through the evidence led by the parties, the Commission is of the opinion that the complaint is allowed for the personal accident (insured amount), subject to submission of documents as per Ex.R-1 within 30 days from the date of receipt of the copy of order and pay the due amount to the complainant along with interest @ 6% p.a. from the date of filing of complaint till its realization. The opposite party is also directed to pay Rs.2200/- as compensation on account of mental tension, agony and harassment alongwith Rs.2200/- as litigation expenses to the complainant. Copy of this order be given to the parties concerned free of costs and file be consigned to record room.
Announced on: 07.03.2023 (Amit Arora)
President
District Consumer Disputes
Redressal Commission, Faridabad.
(Mukesh Sharma)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
(Indira Bhadana)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
