Chandigarh

StateCommission

A/28/2024

NATIONAL INSURANCE COMPANY - Complainant(s)

Versus

MS. DEEPMALA - Opp.Party(s)

VINOD GUPTA

28 May 2024

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION, U.T. CHANDIGARH

[Additional Bench]

 

Appeal No.	:	A/28/2024
Date  of  Institution	:	18/01/2024
Date   of   Decision	:	28/05/2024

 

 

 

 

 

M/s National Insurance Co. Limited, Regd. Office: 3 Middleton Street, Calcutta 70007, through its duly authorized officer, SCO 333-334, Sector 34-A, Chandigarh.

….Appellant

Vs.

 

Deepmala daughter of Late Sumer Singh, Resident of House No. 193/1, Sector 52, Village Kajheri, Chandigarh.

 

2^nd Address: #3168, LIG Quarters, Sector 52, Chandigarh.

 

…. Respondent

 

 

BEFORE: MRS. PADMA PANDEY   PRESIDING MEMBER

                PREETINDER SINGH      MEMBER

 

PRESENT	:	Sh. Vinod Gupta, Advocate for the Appellant.
		Sh.Harsh Nagra, Advocate for the Respondent.

 

PER PREETINDER SINGH, MEMBER

 

 

1.         This appeal is directed against the order dated 14.12.2023, rendered by the District Consumer Disputes Redressal Commission-II, U.T. Chandigarh (for brevity hereinafter to be referred as “the Ld. District Commission”), vide which, it allowed the Consumer Complaint bearing no. 313 of 2023, in the following manner:-

“12.   In view of the above discussion and findings, the deficiency in service on the part of the OPs stands proved. Therefore, the present complaint stands allowed against OPs with direction to pay a sum insured amount of Rs.15 lacs under P.A. Cover of insured vehicle in question, to the complainant being LR of deceased Sh.Sumer Singh with interest @ 7.5% p.a. from the date of death of deceased i.e. 24.01.2021 till date of actual realization.

 

13.    This order shall be complied with by the Opposite Party within a period of 90 days from the date of receipt of its certified copy.”

 

2.         For the convenience, the parties are being referred to, in the instant Appeal, as position held in Consumer Complaint before the Ld. District Commission.

 

3.         Before the Ld. District Commission, it was the case of the Complainant that she owned Honda Activa scooter bearing registration No.CH-01-BG-7977 which was insured with OP – Insurance Company for the period from 30.09.2020 till 29.09.2021 vide insurance policy Annexure C-1. She had also paid ₹295/- for personal accident cover in the said policy. The said vehicle was being used by the complainant and her father namely Sh.Sumer Singh for doing the local works in the Tricity.  On 14.12.2020, her father was going to his home from Factory on the said vehicle and when he reached Petrol Pump near Axis Bank at Derabassi, the vehicle was slipped and he fell down and become unconscious. He was taken to GMCH, Sector 32, Chandigarh where he was admitted on 14.12.2020 and discharged on 20.12.2020. After discharge, her father again complained about uneasiness and these episodes started repeating, therefore, he was again admitted on 24.01.2021 where he died on 24.01.2021 at 5:50PM.  PMR (Annexure C-4) on the dead body was conducted at the GMCH, Sector 32, Chandigarh and DDR was also registered with the police regarding the said accident. Subsequently, the complainant submitted the claim form with the OP – Insurance Company, but it did not settle the claim on one or the other ground. Hence, the aforesaid Consumer Complaint was filed before the Ld. District Commission, alleging deficiency in service and unfair trade practice on the part of the Opposite Parties.

 

4.         In the reply filed before the Ld. District Commission, the OP – Insurance Company admitted that the vehicle in question was insured under the policy in question. However, it was stated that there was no privity of contract between the deceased father of the complainant and the OP – Insurance Company. The OP – Insurance Company was only liable to indemnify the complainant in whose name the policy was issued and not her family members.  It was further stated that the PA for the owner driver provides coverage only for the registered owner while driving the insured vehicle that’s why it is mentioned as PA for owner driver of the vehicle. It was further stated that the accident took place on 14.12.2020 and thereafter the claim was intimated after a delay of more than 2 years with a mala fide intention on 27.03.2023 through registered post which was against the terms & conditions of the policy as the claim was to be intimated immediate after the accident or within a reasonable period and as such the complainant has violated the condition No.1 of the insurance policy by not intimating the company well within time.  Denying all other allegations and pleading no deficiency in service, the OP – Insurance Company prayed for dismissal of the complaint.

 

5.         On appraisal of the pleadings of the parties and the evidence adduced on the record, Ld. District Commission allowed the Consumer Complaint of the Complainant as noticed in the opening para of this order.  

 

6.         Aggrieved against the aforesaid order passed by the Ld. District Commission, the instant Appeal has been filed by the Appellant/OP – Insurance Company.

 

7.         We have heard the Learned Counsel for the parties and have gone through the evidence and record of the case with utmost care.

 

8.         The core question that falls for consideration before us is as to whether the Ld. District Commission has rightly passed the impugned order by appreciating the entire material placed before it. 

 

9.         After giving our thoughtful consideration, to the contentions raised and material on record, we are of the considered opinion, that the instant Appeal is liable to be dismissed for the reasons to be recorded hereinafter.

 

10.         It is the case of the Appellant/Complainant that the Ld. District Commission while passing the impugned order has failed to appreciate documentary evidence available on record to the effect that personal accident cover was only for the owner of the vehicle and not for the deceased father of the Complainant, which resulted into perverse finding. Further, the Ld. District Commission failed to appreciate the fact that intimation with regard to the accident was given to the OP-Insurance Company after more than two years and also that the Complaint was time barred.  The learned counsel further argued on the similar lines and prayed for acceptance of the present appeal.

 

11.         Conversely, it has been contended on behalf of the Respondent/Complainant that the order passed by the Ld. District Commission is quite just & right and does not call for any interference. The detailed finding of facts has already been recorded by the District Commission while rejecting the stand of the Appellant/OP-Insurance Company. The learned counsel further argued on the similar lines as stated in the complaint filed before the Ld. District Commission and prayed for dismissal of the present appeal. 

 

12.         One of the grounds raised by the appellant/OP in the present appeal is that the P.A. cover is only for the owner of the vehicle and not anybody else as per the terms & conditions of the policy.  The said point has already been elaborately dealt by the Ld. District Commission in Para Nos.9, 10 and 11 of the order impugned before us in the light of the judicial precedents R.P. No.558 of 2018 – United India Insurance Co. Ltd. vs. Gyan Singh Yadav & Anr., decided on 25.09.2018 by the Hon’ble National Consumer Disputes Redressal Commission, New Delhi; CWP No.6472 of 2014 (O&M) – M/s IFFCO TOKIO General Insurance Co. Ltd., vs. Smt. Kavita and Others, decided on 27.2.2020 by the Hon’ble Punjab & Haryana High Court & Civil Appeal No. 9393 of 2019 – Ramkhiladi & Anr. Vs. The United India Insurance Company Limited, 2020 ACJ 627’ decided by the Hon’ble Supreme Court.  It is an admitted fact that the insured has duly paid the additional premium for coverage of compulsory PA for Owner Driver. In the present case, the deceased was not the owner of the insured vehicle. However, he borrowed the vehicle from its real owner and he was authorized to drive the said vehicle by its owner. Therefore, he would step into the shoes of the owner of the insured vehicle. The appellant/OPs have failed to lead any cogent evidence to establish that the deceased was not competent to drive the vehicle in question and was negligent while driving the same. It appears that the appellant-insurance company is only trying to wriggle out from its liability to indemnify the complainant by bringing the case under hyper technical grounds. We are thus, in agreement with the observation of the Ld. District Commission that borrower of the vehicle steps into the shoes of the owner and therefore, the borrower of the vehicle or his/her legal representatives are entitled for personal accident cover. Accordingly, the said contention raised by the appellant/OP is hereby rejected.

 

13.         Another plea taken by the appellant/OP is that the Ld. District Commission has illegally allowed the complaint without taking into consideration that the complaint has not been filed within limitation period as the accident took place on 14.12.2020, whereas the complaint was filed on 03.06.2023, as such, it was barred by limitation. There is no dispute with regard to the date of accident however it is pertinent to mention here that the Complainant sent the claim form to the Appellant/OP through post on 27.03.2023, vide Annexure C-7 and C-8, however the same has neither been rejected nor accepted. It is also not the case of the Appellant/OP that it has not received the said claim form. Thus, the cause of action in the present case is a continuing one. Moreover, this Commission should not succumb to niceties or technicalities in such matters and attempt should be to equate, as far as possible. Hence, we do not find force in the contention raised by the learned counsel for the appellant/OP and the same is hereby rejected.

 

14.         The next plea taken by the appellant/OP is that intimation in regard to the accident was given after more than two years and this fact has not been considered by the Ld. District Commission while passing the impugned order.  Admittedly, vehicle in question insured with the Appellant/OP which also covers risk of compulsory P.A for owner-driver, was driven by Sh.Sumer Singh, deceased, when the scooter got slipped and the deceased suffered injuries and he died due to said accident on 24.01.2021 and DDR No.022 dated 25.01.2021 to this effect was lodged with the Police Station Dera Bassi. The Respondent/Complainant claimed to have made frantic efforts to get the claim, by visiting the Appellant/Opposite Party time and again, but the same failed to fructify. It has come on record that when nothing positive could come out, the Complainant sent the claim form to the Appellant/OP through post on 27.03.2023, however the same has neither been rejected nor accepted. Thus, from above, it can be seen that the DDR was lodged immediately on the next day of the death of Sh. Sumer Singh – father of the Complainant. Of course, it is true that there was a delay on the part of the Complainant in informing and lodging claim before the Insurance Company, nonetheless, it is pertinent to note that the Appellant/OP – Insurance Company has not repudiated the claim on the ground that it was not genuine.  In this view of the matter, we are of the concerted view that the Appellant/OP cannot agitate this issue because the intimation to the police was immediate. The heart & soul of an insurance contract lies in the protection it accords to those who wish to be insured by it. This understanding encapsulates the foundational belief that insurance accords protection & indemnification, preserving the sanctity of trust within its clauses. Effectively, the insurer assumes a fiduciary duty to act in good faith and honour their commitment.  Accordingly, the said contention raised by the appellant/OP is hereby rejected.

 

15.         Sequel to our above discussion, we find that the Ld. District Commission has rightly decided the case and there is no material infirmity and irregularity in the order of the Ld. District Commission. Finding no merit in this appeal filed by the appellant/OP, the same is hereby dismissed & the order of the District Commission is upheld.

 

16.         All the pending application(s), if any, also stands disposed off accordingly.

 

17.         Certified Copies of this order be sent to the parties, free of charge.

 

18.         The file be consigned to Record Room, after completion.

Pronounced

28^th May, 2024                                                                  

                                         Sd/-                         

                                                                (PADMA PANDEY)

PRESIDING MEMBER

 

 

Sd/-

(PREETINDER SINGH)

MEMBER

“Dutt”