Orissa

Jajapur

CC/89/2014

Dharmendu Kumar Rout - Complainant(s)

Versus

New India Assurance Co.Ltd - Opp.Party(s)

Sri Mihir Kumar Mallick,Sri Biplab Kumar Dash,Sri Binay Kumar Mohanty

05 Apr 2017

ORDER

                IN THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, JAJPUR.

                                                        Present:      1.Shri Jiban ballav Das , President

                                                                            2.Sri Pitabas Mohanty, Member,

                                                                            3.Miss Smita Ray, Lady Member.

                                              Dated the 5th day of April,2017.

                                                      C.C.Case No.89 of 2014

Dharmendu Kumar Rout  S/O Dhaneswar Rout

Vill. Jamadhar , P.O.Rekabi Bazar,Via.Kabirpur

P.S.Jajpur Sadar, Dist.-Jajpur.                                                                            …… ……....Complainant .                                                                       .

                   (Versus)

New India Assurance Co. Ltd, Jajpur Road, Division office ,Canara Bank

Building 1^st floor, Main Road. Jajpur Road, Dist. Jajpur .

                                                                                                                          ……………..Opp.Parties.                  

For the Complainant:                           Sri M.K.Mallick,Sr.Adv. Sri B.K.Dash, Sri B.K.Mohanty,

                                                              Sri J.Sahu, Sri N.Das,Mrs D.Solanki, Sri P.Mishra,Advocates.

For the Opp.Party :                            Sri A.Ku.Dash, Advocate.

                                                                                                     Date of order:   05.04.2017.

SHRI  PITABAS  MOHANTY,   MEMBER .

                        The petitioner asserting deficiency  of  service filed this case for redressal of his grievance.

                        The facts are stated by the petitioner in the complaint petition in short is that the petitioner is the  owner of an Indica Car bearing Regd. No.0D-02-6323 . The vehicle was insured with the O.P . During the period   of the Insurance coverage from 21.09.12 to 20.09.13  the vehicle met with an accident on 14.10.12. The complainant availed Rs.26,000/- from the O.P as damage compensation to the vehicle.

                        That for the next coverage period from 25.09.13 to 24.09.14 the O.P has been paid the premium of Rs. 9,253/-  for which the certificate on the value of Rs. 4,80,000/- issued to  Manas kumar Dhal agent of the O.P.

                        That during the period  of the valid policy another accident took place on 10.06.14  for which  the accident was reported by the petitioner  to police as well as lodged the accident claim before the O.P i.e on 11.06.14 and the vehicle was repaired in the authorized service center of Swapna Motors, Bhubaneswar .Subsequently the bill of Rs.1,62,727/- as repair cost of the vehicle of swapna  Motors was  submitted to the O.P. on 02.09.14  and was reminded as 18.09.14 and 22.09.14 for early payment  of the claim amount . That the O.P intimated  the complainant on 22.09.14 about the previous accident claim of Rs.26,000/- under the previous policy and the petitioner was asked to show cause  and  the petitioner submitted his reply on 26.09.14.

                         But the O.P vide  order dt.28.10.14  repudiated the claim of the petitioner . Accordingly the petitioner finding no other way  has filed the present dispute with the prayer to direct the O.P to pay the claim amount to  the petitioner with interest   and be please to pass an interim order directing the O.P to release 75% of the claim amount.

                        After appearance the O.P has  filed the written version taking the following pleas which are  stated below:

1.The case is liable to be dismissed due to  non joinder and mis-joinder of necessary parties and the averments made in the application are all strictly denied by this O.P.

2.That admittedly this O.P had issued insurance policy bearing No.55070031130100003809 against vehicle no.0D-02-6323 of the petitioner after taking necessary premium as alleged by the petitioner.

3.That admittedly the alleged vehicle met with an accident at Keonjhar on 10.06.14 . This O.p after getting information of the alleged loss through telephone immediately deputed Er.M.K. Mahanta, SLA of Keonjhar to conduct spot survey. After conclusion of spot survey the petitioner has shifted the alleged vehicle to Swapna Motors ,Bhubaneswar for necessary repair. After submission of necessary documents and estimate of Rs.1,62,727/ towards repair , the Regional

Office of this O.P has deputed Er. S.Tarai SLA of Bhubaneswar to undertake final survey and accordingly loss has been assessed by the Surveyor to the tune of Rs.1,24,000/-.

                        Subsequently after completion  of necessary formalities when this O.P processed the file for settlement of 1-claim  it came to the knowledge of this O.P  that the alleged vehicle was previously insured with New India Assurance Co. Cuttack D.O.11 vide policy No.55040031120100001794  the above said policy was valid from 21.09.12 to 20.09.13 . During the continuance of the above policy the petitioner has availed an own damage claim of Rs.26,000/- due to an accident dt.14.10.12. The above  claim was processed by Cuttack D.O.II of this O.P .When this O.P received the above information immediately informed the matter to the petitioner vide its letter dt.550700/claim/2014/1870 dt.22.09.14 . This O.P  also sought  for the clarification on the point that why the claim will not be repudiated due to wrong representation of material fact that is the availing a claim in the previous policy  which is contradictory to the policy conditions.

                        That as per terms and conditions made in the policy it is clearly mentioned in the face of the policy which reads as “ IT IS CLARIFIED THAT IN CASE THE DECLARATION REGARDING THE NCB OR OTHER PREVIOUS POLICY DETAILS MADE BY THE INSURED IS FOUND TO BE INCORRECT ALL THE BENEFIT INCLUDING THE CLAIM U/S -1 OF THE POLICY WILL STAND FORFITTED ‘.” But on the other hand when the proposal form was submitted by the petitioner the petitioner willfully suppressed the fact of availing a claim previously and availed 20% discount as NCB  in the current policy.  This is nothing but  the violation of the terms and conditions of policy.

                        That as per above findings this O.P made series of correspondences with the petitioner and finally repudiated the claim vide office letter dt.28.10.14.  That there is absolutely no deficiency in any manner. Rather this O.P has treated the applicant a valued customer and dealt with his claim with utmost care as per guide lines of the company.

                        On the above facts and circumstances the case as made against this O.P is liable to be dismissed with proper cost .

                        On the date of hearing we heard the argument from the advocate for both the parties and after perusal the record and documents in details we are inclined to decide the dispute as per our observations below:-

It is admitted fact that the petitioner has insured the vehicle before the O.P and in the time of accident has been occurred within the subsistence of the policy period. It is stated by the petitioner

he has lodged the claim before the O.P in time. But the O.P has repudiated the grievance claim of petitioner .

                        The next point raised by the O.P is that the petitioner has willfully suppressed the fact of availing a claim previously and availed 20-% discount as no claim bonus in the current policy. In addition  the O.P files the documents/ citations in support of the case which are stated below:

1.Affidavit of Sr. Divisional Manager

2.Collection receipt –cum adjustment voucher

3.Standard proposal form of the policy

4.Copy of the order R.Pno.4470/2014 of Hon’ble N.C.D.R.C. dt. 16.10.14.

On the other hand the petitioner taken the main plea

1. A truth was glimpsed/sensed by the complainant from the documents that the petitioners premium of the vehicle as on or before 25.09.13 was fixed by the O.P in the absence of the petitioner on 25.09.13.
2. It is not the life Insurance,  it is general insurance .
3. 2^nd  Insurance policy was created on 25.09.13
4. In the case of both the policies the O.P is the  insurer .
5. Since the insurer is same,  there was a legal and fair duty on the part of  O.P to make verification before entering into contract on 25.09.13.
6. A privilege  is not in the contract policy which may be withdrawble but the contract on the basis of premium related with insurer liability, can not be repudiated  which is the sole basis of a contract .
7. The 2^nd policy  shows a continuations contractual relationship between the petitioner and the O.P .

In addition the learned adv. for the petitioner filed the documents/ citations in support of his case as stated below:

1.Letter dt.01.10.14by the O.P

2.Letter dt.20.10.14 by the O.P

3. Order of R.P No.3216/2012 of Hon’ble N.C.D.R.C. dt.08.02.2016

4.Order of R.P No.47/ 2012of Hon’ble N.C.D.R.Cdt.28.04.16.

5.R.P.No.3263/2007 order dt.29. 06. 2016 of Hon’ble N.C.D.R.C.

                        In this contest the O.P has taken the main plea  in the written version that the petitioner taken the NCB 20% in the current policy after suppressing the fact  that he has  availed a claim which is contradictory to the policy condition .

On the other handit is our considered view that in both the policies, the O.P is the same insurer . Since the insurer is same, there was a legal and fair duty of the O.P to make verification before entering into the contract but the contract on the basis of premium related with insurer’s liability can not be repudiated .

Hence this order:

The O.Pis directed to settle the claim of the petitioner on non standard basis within two months after receiptof this order, failing which the settle amount will carry 12% interest from the date of filing the present dispute till its realization. No cost.

This order is pronounced in the open Forum on this the 5th day of April,2017. under my hand and seal of the Forum.