Delhi

New Delhi

CC/64/2011

Shivani Gupta - Complainant(s)

Versus

M/S. National Insurance Company.Ltd. - Opp.Party(s)

09 Jun 2016

ORDER

 

 

CONSUMER DISPUTES REDRESSAL FORUM-VI

(DISTT. NEW DELHI),

 ‘M’ BLOCK, 1^STFLOOR, VIKAS BHAWAN, I.P.ESTATE,

 NEW DELHI-110001

 

Case No.C.C./64/2011                                                                                                                           Dated:

In the matter of:

Ms. Shivani Gupta,

W/o Sh. Vikas Sharma,

R/o D-8/8073, Vasant Kunj,

New Delhi-110070

……..COMPLAINANT

 

 

VERSUS

1.     National Insurance Company Ltd.,

        Division No. 10, Flat No.101-106, N-1,

        BMC House, Connaught Circus,

        New Delhi-110001

 

2.     National Insurance Company Ltd.,

        5/C-1&2, B.P. Railway Road,

        Neelam Chowk, NIT,

        Faridabad-121001.

 

3.     National Insurance Company Ltd.,

        Delhi Rigional Office,

        Jeevan Bharti Building,

        Tower-II, Level-IV, 124,

        Connaught Circus,

        New Delhi-110001

 

               .... OPPOSITE PARTIES

 

 

PRESIDENT: S.K. SARVARIA

ORDER

At the very outset, we would like to clarify that, the same one insurance company is impleaded as three opposite parties by giving three different addresses of the same OP insurance company. Therefore, wherever the reference to the opposite party would come it shall come in singular. In this complaint filed under section 12 of The Consumer Protection Act, 1986. The complainant has alleged in brief that she is owner of car bearing number H R 51 U 4716 make Wagon-R, which was insured with OP insurance company vide policy number 6024590, one for the period 3/3/2009 to 2/3/2010. At the time of taking insurance the complainant looking to the fact that she was disabled the car would be driven by her friend/close relative she requested the coverage of Personal Accident Benefits. As such OP insured the said coverage and accordingly charged additional personal accident cover premium of Rs. 200/– and covered the risk of owner/driver to the tune of Rs. 2,00,000/–. The complainant also paid the amount of the said coverage demanded by the OP.

 

On 14/8/2009 the complainant along with her husband, Mr. Vikas Sharma and her father-in-law and mother-in-law was going to Manali from Chandigarh in the said car, which was being driven by her husband. At about 2:15 PM it met with an accident with a tanker bearing registration number PH-11 AM-9305, killing the father-in-law, Shri Virende Sharma, of the complainant at the spot. The husband of the complainant, Shri Vikas Sharma also sustained injuries and was removed to hospital, where he succumbed to the injuries on 22/8/2009 and FIR number 231/2009, dated 14/8/2009 under sections 304A, IPC was registered in the police station Sunder Nagar, Mandy on the same day. The complainant on 25/1/2010 lodged a claim of Rs.2,00,000/– only under the personal accident benefits and also submitted all documents as required by the OP.

 

On 23/7/2010 the OP informed that the claim of the complainant has been repudiated as the policy covers only the life of the owner-driver. The act of the OP in not paying Personal Accident Benefits for Rs. 2,00,000/– despite the fact that the vehicle was insured under the risk of personal accident benefits only amounts to unfair trade practice and deficiency of service on the part of the OP or stop. The complainant, after death of her husband, is totally dependent upon her relatives for all matters, including financial burden. The complaint has prayed for direction to the OP insurance company to make payment in the sum of Rs. 2,00,000/– towards the personal accident benefits amount as covered under the policy, Rs.25,000/– towards the amount spent for conveyance etc. Rs. 1,00,000/– towards mental torture, pain and agony, along with interest at the rate of 24% per annum from the date of death of her husband that is 22/8/2009 and cost of the complainant and legal expenses amounted to Rs. 20,000/-

 

The notice of the complaint was issued to the OP insurance company who contested the complaint and filed reply alleging no deficiency in service on its part. OP has admitted that the insurance policy in question was issued to the complainant for the vehicle in question of the complainant for the period 3/3/2009 to 2/3/2010, subject to terms and conditions contained therein. According to the OP, the complainant had paid the total premium of Rs. 5203/– to the compulsory PA cover premium of Rs.100/– for driver-owner and Rs. 200/– personal accident cover premium of Rs. 1,00,000/- per person for four persons (passengers). The OP did not dispute that the said vehicle insured with the OP met with an accident on 14/8/2009, wherein two persons namely Shri Virender Kumar Sharma and Sh. Vikas Sharma, succumbed to the injuries. The complainant had submitted the claim form dated 27/1/2010 for the death of her husband, claiming the sum of Rs. 2,00,000/– the driver owner of the vehicle. The same is impermissible. According to the OP, the complainant can get the benefit of Rs.1,00,000/– under personal accident cover for unnamed passengers and the OP insurance company is always ready and willing to pay the same to the complainant, subject to production of certified/original post-mortem report, death certificate and proof of her being legal heir of deceased Vikas. But OP has strongly opposed the plea of the complainant that she is entitled to claim the amount of Rs.2,00,000/– on this count. The OP has denied other facts stated in the complaint and has prayed for dismissal of the complaint with costs.

 

In support of her case, the complaint has filed her affidavit in evidence. On behalf of the OP, the affidavit in evidence of Shri G. K. Ahuja, Manager working with the OP insurance company, is filed. Both parties have filed written submissions.

 

We have heard the learned counsel for the parties and have gone through the written arguments filed on their behalf record of the case and relevant provisions of law. No authority is cited from either side.

 

The basic facts regarding personal accident policy issued by the OP to the complainant in respect of vehicle in question owned by the complainant are not in dispute. It is also not disputed that on account of death of father-in-law of the complainant. She has already received the compensation in the sum of Rs. 1,00,000/– on account of death of her father-in-law being passenger but the compensation on account of death of her husband who was driving the vehicle in question belonging to the complainant is in dispute. According to the complainant, she being handicapped was entitled to get the car driven through any other person, including her husband, so she should get the amount of compensation of Rs.2 ,00,000/– from the OP insurance company on account of the death of her husband who was driving the vehicle in question at the time of accident, while according to the OP insurance company, the amount of Rs. 2,00,000/– under the insurance policy in question was in this respect of the insured owner of the vehicle being driver of the vehicle, and not for any other person who was driving the vehicle.

 

 We find great force in the submissions on behalf of the OP since the policy term of the insurance policy in question clearly spells out that the insured amount of Rs.2,00,000/- being 100% is payable on the scale of compensation on account of death of owner-driver. Undisputedly, the deceased husband of the complainant was not owner of the vehicle in question, but was driving it. Therefore, on account of his death, the complainant though is entitled to claim compensation from the OP insurance company as her husband was one of the occupants of the car, but technically he being not owner of the car and complainant being admittedly owner of the car in question, the compensation amount of Rs.. 2,00,000/– cannot be granted to the complainant on account of death of her husband. We would also like to point out here that in the written statement. OP insurance company has conceded that the complainant is entitled to the compensation in the sum of Rs. 100,000/– on account of death of her husband who was driving the car in question. Therefore, we feel that the complainant is entitled to the insurance claim pertaining to her husband who died in the accident in question, in the sum of Rs. 1,00,000/–. Although, the OP insurance company was right in repudiating the insurance claim in the sum of Rs. 2,00,000/– claimed by the complainant on account of death of her husband in the accident in question, but it was not justified in not allowing the insurance claim in the sum of Rs. 1,00,000/– to the complainant, though the same is conceded in the written statement here by the OP insurance company. We also find the claim of compensation made by complainant in the sum of Rs. 1,00,000/– on some higher side. So also the conveys charges in the sum of Rs. 25,000/–

 

In view of the above discussion the complaint is partially allowed and we direct OP insurance company to make the payment in the sum of Rs. 1,00,000/– with simple interest at the rate of 10% per annum from the date of filing of the complaint till realisation of the said amount to the complainant on account of death of her husband in the accident in question. We also direct the OP insurance company to make payment in the sum of Rs.50,000/- to the complainant on account of mental torture, pain and agony suffered by her on account of repudiation of the claim and also an amount in the sum of Rs. 25,000/- towards  conveyance charges , including litigation cost. In case the said amount of compensation and amount towards litigation cost and conveyance charges is not paid within a period of one month from the date of receipt of this order, the OP insurance company, shall be liable to pay along with simple interest at the rate of 10% per annum from the date of this order till realisation of the said amount. A copy of this order reach be sent to both parties free of cost by registered post. This order be sent to server (www.confonet.nic.in ).

File be consigned to record room.    

Announced in open Forum on 9/6/2016

 

 

 

(S K SARVARIA)

PRESIDENT

 

 

(NIPUR CHANDNA)

MEMBER