District Consumer Disputes Redressal Commission ,Faridabad.

Consumer Complaint  No. 99/2020.

 Date of Institution:17.02.2020.

Date of Order: 03.02.2023.

Smt. Lali Devi W/o late Shri Bhoorelal R/o House No. 956A, Bhoor Colony, Near Ram Sweets, Sector-29, Faridabad, Permanent R/o village Raiur Gadhiya, Tehsil Porsa, Distt. Morena (M.P.)

                                                                   …….Complainant……..

                                                Versus

National Insurance Company Limited, Divisional Office 2 : 5C/1-2, Neelam Chowk, Faridabad.

                                                                   …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.  Sagar Bhatia,  counsel for the complainant.

                             Sh.  Neeraj Gupta, counsel for opposite party.

ORDER:  

The facts in brief of the complaint are that  Shri Bhoore Lal,

since deceased, purchased a  car having Chassis No. MA3EJKDIS00B95039, Engine No. K12MN2316484 and registration NO. HR-38-Z-3683 and the said car was duly insured with the opposite party vide insurance policy No. 39050031181342950416 valid from 31.01.2019 to 30.01.2020.  This was not dismay to mention that the husband of the complainant Shri Bhoore Lal (now deceased) was earning his livelihood solely by self driving aforesaid car bearing Regn. NO. HR-38-Z-3683 which was the only self employment mean of deceased,   The husband of the complainant paid an amount of Rs.26,739/- towards car insurance premium inclusive of Rs.275/- towards Compulsory Personal Accident (PA) Cover of Owner-Driver.  Under the policy, the owner-driver was covered against risk of death due to accident for sum insured of Rs.15,00,000/- and the insured Shri Bhoore  Lal named his wife i.e. complainant as nominee in the policy.  On 09.03.2019 at 1:30 the husband of the complainant was returning to his home village after attending family function while self driving car NO. HR-38-Z-3683 in the meantime as bus bearing Regd. No. MP07-P-1577 came in rash and negligent manner and hit the aforesaid car driven by Bhoore Lal as a result thereof he sustained grievous injuries on his person as well as his car was also completely smashed.  Hew as immediately taken to Govt. Hospital Morena, from there he was referred to Gwalior and the n due to his serious condition he was further referred for Delhi, but he was taken to Medanta Hospital, Gurgaon.  But despite best possible treatment he died in Medanta Hospital on 11.03.2019 and his post moretem was conducted in Civil Hospital, Gurugram on 12.03.2019.  An FIR NO. 0106 dated 11.03.2019 u/s 279/337/427 IPC, P.S.Ambah Distt. Morena was lodged regarding this accident.  The complainant, being nominee and wife of insured, approached the opposite party and submitted claim form alongwith all the requisite & necessary documents as demanded by the officials of opposite party for release of sum insured of Rs.15,00,000/- under the aforesaid policy covering Personal Accidence of Owner-Driver.  The officials assured the complainant that the  claimed amount would be sanctioned and disbursed shortly.   The complainant was shocked and astonish to receive a letter dated 09.01.2020 issued by the opposite party wherein the opposite party in arbitrary, unjustified and unlawful manner and by acting against the law repudiated the claim on presumption that the insured Shri Bhoore Lal was not holding a valid driving license as on the date of accident.  The complainant submitted that Shri Bhoore  Lal was holding valid and effective driving license to drive Light Motor Vehicle.  It was worthwhile to mention that Hon’ble Supreme Court of India and various High Courts as well as Central Govt. had already in clear words held that a person holding license to drive LMV (NT) was competent to drive a transport vehicle and he was not required to obtain an separate endorsement to drive transport vehicle. 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)                disburse the claimed P.a. Insurance amount of Rs.15,00,000/- alongwith interest @ 18% p.a. from the date of accident till actual realization in favour of the complainant.

 b)                pay Rs. 3,00,000/- as compensation for causing mental agony and harassment .

c)                 pay Rs. 50,000 /-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 no cause of action to file the present complaint.  The opposite party had rightly repudiated the claim of the complainant vide letter dated 09.01.2020 the driver of the said vehicle “Mr. Bhoorelal Singh was not holding valid driving license as on date of accident, as per the claim documents and our investigator’s report and our surveyor’s report, hence on the basis of not holding effective driving license for the class of vehicle (registered as commercial vehicle) and the subsequent death of owner driver cause by the same accident the competent authority had accorded to repudiate his above referred claim.  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 National Insurance Co. Ltd. with the prayer to: a)  disburse the claimed P.a. Insurance amount of Rs.15,00,000/- alongwith interest @ 18% p.a. from the date of accident till actual realization in favour of the complainant.  b) pay Rs. 3,00,000/- as compensation for causing mental agony and harassment . c)  pay Rs. 50,000 /-as litigation expenses.

                   To establish his case the complainant  has led in his evidence,  Ex.CW-1/A – affidavit of Lai Devi, death certificate, Ex.C-1 – RC, Ex.C-2 -  certificate cum policy schedule,, Ex.C-3 – FIR,, Ex.C-4 – post mortem report,, Ex.C-5 – Dawa Suchna Patar, Ex.C-6 – letter dated 09.01.2020,, Ex.C-7 – Driving licence.

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 Ms. Kavita Yadav, Officer, National Insurance Co. Ltd., Faridabad, Ex.R-1 – letter dated 09.01.2020, Ex.R-2 –  repudiation letter dated 28.09.2019 , Ex.R-3 – Personal accident Survey report.

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-2 the complainant  has  paid an  extra premium of Rs.275/- for  the compulsory PA Cover Premium (1 year) valid from 31.01.2019  to 30.01.2020.  The  husband of  the complainant was died on 11.03.2019.  Ex.C3 is the FIR of the occurrence and the Ex.C-4 is the post mortem report.  As per repudiation letter dated 09.01.2020 vide Ex.C-6  on the ground that “the vehicle reportedly met with accident on dated 09.03.2019 and the driver of the said vehicle Mr. Bhoorelal Singh was  not holding valid driving licence as on date of accident. Hence you are asked to explain within 15 days of this letter why  your claim should not be repudiated.”  As per the driving licence of  Bhoore Lal vide Ex.C-7 the date of

issuance of licence is 24.11.2019 and valid till (Non Transport) is 23.11.2037.

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 verification of the Driving Licence submitted by the complainant as per Ex.C-7 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:  03.02.2023                                 (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.