DISTDRICT CONSUMER DISPUTES REDRESSAL FORUM,SAMBALPUR.
C.C.No 65/2016.
1.Shri Prem Prakash Panigrahi,
Aged 53 years
S/o Late NarendraPanigrahi,R/O Sakhipada,PS- Dhanupali
Po/Dist:-Sambalpur, Pin- 768001,Odisha. ………………………….Copmplainant.
Versus
1.National Insurance Co.Ltd.
Rep. thru Divisional Manager Nayapara,
Sambalpur-768001
2.Edelweiss Insurance Brokers ltd.
Unit No . 102 10th floor,
SakharBhawan 230.,Nariman point,
Mumbai,400021 ……………………………Opp.Party.
For Complainant :
For O.P.s No.1 & 2 & Others :
PRESENT:- SHRI A.P. MUND, PRESIDENT
SMT. S. TRIPATHY, MEMBER
SHRI K.D. DASH, MEMBER
Date of Order: 25.8.2018
SHRI A.P. MUND, PRESIDENT
The complainant sheweth as follows:-
The complainant’s mobile phone was insured by Ops for a sum assured of RS.15000/- covering the risks of theft, burglarly, riot and accidental damage protection etc.
Theft occurred on 16.08.2015 for which claim No.CLM008965 was promptly lodged with Ops with submission of all the documents asked by them for settlement of claims duly acknowledged by the OP-2.
Arbitrarily repudiated the claim vides communication dated 20.05.2016 i.e Annexure-3 on the ground of non-submission of documents.
On the basis of above prays for:-
Indemnify the insured amount of RS.15000/- with interest @18%.
Give compensation of RS.10,000/- to the complainant.
Award exemplary damages against Ops and the award to be deposited in National Consumer Welfare Fund.
Rs.5000/- towards cost of this proceeding.
Reply on behalf of O.P No.2.
That the answering Opposite Party is an Insurance Broker, whose role is only to facilitate the settlement of claims of customers of the mobile store ,vis-à-vis the insurance company, i.e. the National Insurance Company Ltd. Without any consideration. This answering O.P submits that as per the circular bearing reference NO.011/IRDA/Brok-Comm/ Aug-08 dated 25th August,2008 issued by Insurance Regulatory and Development Authority(Hereinafter referred to as IRDA), this opposite Party Provided services to the complainant herein free of charge and as such the complainant cannot be said to be a consumer of Opposite Party No.2 and does not fall within the ambit of “consumer” as defined section 2(d) of the Consumer Protection Act. 1986.
It is submitted that the complainant has alleged paid the premium to the National Insurance Company Ltd. And not to the answering Opposite Party. Thus, the answering Opp.Party is not liable to pay any amount to the complainant.
The present case is the one arising out of a contract of personal service, and availed without any consideration, free of charge which is excluded from the definition of service and deficiency provided under section 2 (1) (o)and( g). The complaint is ex-facie bad in law and therefore, the present complaint is liable to be dismissed qua the answering Opposite Party.
With reference to prayer clause of the Complaint, this opposite party denies that the complainant is entitled to any relief as prayed for by him or otherwise since the complainant has deliberately failed and/ or neglected to provide the necessary documents for processing of his claim in terms of the insurance policy. It is submitted that under the insurance policy, this opposite party was only acting as a facilitator and it is for the insurer to consider his claim according to the terms and conditions of the policy.
Heard the arguments, perused the documents carefully. The case of the complainant is that his insured mobile was lost due to theft which occurred on 16.08.2015. This was intimated to the O.P, who was asked for relevant documents.
It is true that the complainant set some scanned documents which was acknowledged by the O.Ps. But they asked for further document which was not supplied.
On this non supply of documents the claim was repudiated.
The argument of complainant veered around the theme that the O.P’s
Should not have taken a hyper technical stand as a enunciated in ViswaBharati case. The o.Ps are of the opinion that O.P.2 is not responsible and is only a facilitation. OP’s stand is that conditions enumerated in the Insurance Policy are integral part of the policy and any violation will entitle the O.P.No1 to repudiate same.
On close examination we found that the 4 documents supplied by the complainant is sufficient to settle the claim. The other documents are redundant.
Hence we order that the O.P.No.1 and O.P.No.2 are jointly liable to pay RS.15,000/- the purchase Price of the Mobile along with interest at the rate of 9% per annum from the date of theft i.e 16.08.2015 till payment. This order is to be carried out within a period of 30 days of the passing of the order otherwise it will carry interest of 12 % from the date of order till payment .No order as to cost.
Sd/-
Sd/- SHRI A.P.MUND
SMT S.TRIPATHY. Member I agree. PRESIDENT.
Sd/-
SHRI K.D.DASH. Member I agree. Dictated and corrected by me.
Sd/-
PRESIDENT
