DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FATEHGARH SAHIB.
Consumer Complaint No.60 of 2015
Date of institution: 03.07.2015
Date of decision : 12.08.2016
Daljeet Kaur widow of Varinder Singh S/o Amar Singh, R/o Ward No.10, Sirhind, now resident of Ward No.3, Sirhind City, Tehsil and District Fatehgarh Sahib.
……..Complainant
Versus
- National Insurance Company Limited Branch Office, Sirhind, G.T.Road, District Fatehgarh Sahib through its Manager.
- M/s Manglam Honda, Near Todar Mall Gate, G.T.Road, Sirhind, District Fatehgarh Sahib through its Manager.
…..Opposite parties
Complaint under Sections 11 to 14 of the Consumer Protection Act
Quorum
Sh. Ajit Pal Singh Rajput, President
Smt. Veena Chahal, Member
Sh. Amar Bhushan Aggarwal, Member
Present : Sh. M.P.S.Batra Adv. Cl. for the complainant
Sh. Amit Gupta, Adv.Cl. for OP No.1.
OP No.2 exparte.
ORDER
By Ajit Pal Singh Rajput, President.
Complainant, Daljeet Kaur widow of Varinder Singh S/o Amar Singh, R/o Ward No.10, Sirhind, now resident of Ward No.3, Sirhind City, Tehsil and District Fatehgarh Sahib, has filed this complaint against the Opposite parties (hereinafter referred to as “the OPs”) under Sections 11 to 14 of the Consumer Protection Act. The brief facts of the complaint are as under:
2. The husband of the complainant, namely; Varinder Singh( now deceased) purchased one Activa Honda Scooter from OP No.2 on 15.01.2014 and paid the insurance premium alongwith Personal Accident Cover for the said scooter for the period from 15.01.2014 to 14.01.2015. The OPs issued the insurance policy vide cover note bearing No.401204361249 and registration No. PB 23Q-6653 was allotted to the vehicle by the Issuing Authority, Fatehgarh Sahib. On 07.07.2014 the husband of the complainant died in a road accident. The complainant, being the LR of her husband, applied for the insurance claim for the death of her husband along with required documents, but the OPs delayed the matter without any reason. The complainant many times visited the office of the OP at Sirhind and inquired about the matter. The OPs demanded various documents, which were handed over to the OPs. But the claim for the death of her husband had not been given and now they repudiated the claim on the ground that the intimation regarding the death was given late. The complainant informed the OPs regarding the death of her husband in time and the vehicle in question was lying at the premises of OP No.2. The act and conduct of the OPs amounts to deficiency in service/unfair trade practice on their part. Hence this complaint for giving directions to the OPs to pay the insurance claim of Rs.l lakh and further to pay Rs.30,000/- as compensation for mental agony, harassment and unwanted litigation.
3. Notice of the complaint was issued to the OPs. But OP No.2 chose not to appear to contest this complaint. Hence, OP No.2 was proceeded against exparte.
4. The complaint is contested by OP No.1, who filed the written version. In reply to the complaint OP No.1 stated that no personal accidental cover was taken by the husband of the complainant, hence, there is no question of payment of any claim in this regard. The intimation regarding the death of insured was given to the OPs after 59 days from the date of accident. The OPs sought clarification from the complainant regarding the said delay. But the complainant had failed to give any reason for delayed intimation to the OPs. Therefore, there is no deficiency in service on the part of the OPs. After denying the other averments made in the complaint, OPs prayed for dismissal of the complaint.
5. In order to prove the case the complainant tendered in evidence her affidavit Ex. C-1, copy of cover note Ex. C-2, copy of registration certificate Ex. C-3, copy of DDR Ex. C-4, copy of DL of deceased Varinder Singh Ex. C-5, copy of death certificate Ex. C-6, copy of repudiation letter Ex. C-7, copy of new paper Mark C-A and closed the evidence. In rebuttal the OP No.1 tendered in evidence affidavit of Ravinder Kumar Ex. OP-1, attested copy of insurance policies Ex. OP-2 to OP-5 and closed the evidence.
6. The ld. counsel for the complainant has submitted that OP No.1 repudiated the claim of the complainant vide repudiation letter i.e Ex. C-7, in an arbitrary manner. The ld. counsel stated that after sudden demise of her husband, the complainant was under great shock due to loss of her husband and it took time for her to cope with the factual position. He pleaded that the said delay was duly explained to OP No.1 and it was the discretion of OP No.1, whether to consider the genuine explanation given for the delay. The ld. counsel also pleaded that as per Policy i.e Ex.C-2 the Limitation of Liability Clause states; Under Section II 1(i) of the policy-Death or bodily injury. Such amount as is necessary to meet the requirements of the Motor Vehicle Act 1988. Under Section II 1(ii) of the policy-Damage to third party property is Rs.1,00,000/- PA Cover under Section 3 for owner-driver is Rs.1.0 lakhs", the complainant is entitled to the claim. He further pleaded that as per the Clarificatory Circular issued by IRDA dated 16.11.2009 that, "the passengers carried in a private vehicle and the persons travelling in a two wheeler are covered under the terms and conditions of MACA 1432/2008 and the Standard Motor Package Policy the terms and conditions of a package policy cover the risk of a driver or pillion rider and therefore no additional premium is necessary". The ld. counsel argued that if the complainant was not entitled to the claim of her deceased husband, then why OP no.1 had mentioned her name as nominee. He further argued that the policies i.e Ex.OP-2 to Ex.OP-5 placed on record for comparison does not reveal that the complainant is not entitled to the claim. The ld. counsel contented that the claim was repudiated by stating that there was delay in intimation not by stating that no premium was charged for personal accident, thus the plea of OP no.1 cannot be considered by this Forum.
7. On the other hand, the ld. counsel for OP No.1 raised objection to the submissions made by the ld. counsel for the complainant. He stated that the claim had been rightly repudiated, as the complainant was not able to give a reasonable explanation for the delay in intimation of 59 days. The ld. counsel pleaded that in the policy issued to the deceased husband of complainant, no charges for personal accident cover had paid nor the same was purchased, thus the present complaint deserves to be dismissed with special costs. The ld. counsel also referred to case laws titled as; ICICI Lombard General Insurance Co. Ltd. Vs. Chander Prabha and Anr. in Revision Petition No.1202 of 2008 decided on 15.04.2013.
8. After hearing the Ld. Counsel for the parties and going through the pleadings, evidence produced by the parties and the oral arguments and written submissions, we find force in the contentions of the ld. counsel for the complainant. In our view it is understood that in such like situation a young widow cannot be expected to know all the workings and whereabouts of the policies availed by her deceased husband. It is obvious that she must have been under tremendous mental stress and after realizing and understanding her loss; she acted as per the requisite requirements of OP No.1 and sent an intimation. In our opinion the complainant has established her case from the material documents placed on record. We have perused the policy i.e C-2 of the deceased husband and the policies i.e Ex.OP-2 to Ex.OP-5 placed on record by OP no.1, we find that all are similar and the complainant is entitled for the claim. Moreover the claim had been repudiated for delay in intimation of claim and not for nonpayment of premium for personal accident claim. OP No.1 had not been able to give any explanation as to why the name of the complainant was mentioned in the policy as nominee, when OP no.1 never charged any premium as alleged. The case law citied by the ld. counsel for OP no.1 is not applicable to the facts and circumstances of the present case, as in the present case, claim had been repudiated for delay in intimation, for which we feel that the complainant has given a justified explanation.
9 Accordingly, in view of our aforesaid discussions, we find that OP no.1 had committed deficiency in service by repudiating the claim of the complainant. Hence we direct the OP no.1 to pay a sum of Rs.1,00,000/-(One Lakh) on account of personal accident claim of the deceased husband of the complainant. We also find that complainant is entitled to compensation on account of mental agony amounting to Rs.10,000/-( Ten thousands) alongwith litigation cost of Rs.5000/-( Five thousands).OP No.1 is further directed to comply with the order of this Forum within 45 days from the date of receipt of certified copy of this order, otherwise OP No.1 shall be liable to pay 8% interest per annum on the total cost awarded till its realization. The present complaint is hereby partly accepted.
10. The arguments on the complaint were heard on 05.08.2016 and the order was reserved. Now the order be communicated to the parties. Copy of the order be sent to the parties free of cost and thereafter the file be consigned to the record room.
Pronounced
Dated:-12.08.2016
(A.P.S.Rajput) President
(Veena Chahal)
Member
(A.B.Aggarwal)
Member
