Jammu and Kashmir

Jammu

CC/131/2018

SHILPA MAHAJAN - Complainant(s)

Versus

RELIANCE GENERAL INSURANCE - Opp.Party(s)

SARFRAZ SHAH

13 Oct 2018

ORDER

DISTRICT    CONSUMER     DISPUTES   REDRESSAL  FORUM, JAMMU

                (Constituted under J&K Consumer Protection Act,1987)

                                                         

 Case File  No.                 473/DFJ         

 Date of  Institution   :    03-03-2018

 Date of Decision      :     12-09-2018

 

Shelpa Mahajan,

W/O Late Kapil Dev,

R/O Ward No.3 Hakkal,

Jammu Cantt.Jammu.

                                                                                                                                                Complainant

                  V/S

Branch Manager,

Reliance General Insurance Co.

Ist Floor,Aircel Building,Bahu Plaza,

Jammu.

                                                                                                                                                Opposite party

CORAM:

                  Khalil Choudhary              (Distt.& Sessions Judge)    President

                  Ms.Vijay Angral                                                              Member

                  Mr.Ghulam Sarwar Chauhan                                         Member

 

In the matter of: Complaint under section 10 of J&K Consumer

                              Protection Act 1987.

 

Mr.Sarfraz Shah,Advocate for complainant, present.

Mr.Vishnu Gupta,Advocate for OP,present.

 

 

                                                                        ORDER

                                 Complainant being widow of insured, late, Kapil Dev, filed instant complaint on the ground of deficiency in service on the part of OP, in not settling the insurance claim. Grievance of complainant is that her husband,namely,Kapil Dev owned and possessed a vehicle(Motorcycle) bearing registration No.JK02AS-2234,insured with OP,bearing Polciy No.2006272312004837,w.e.f.11-05-2017 to 10-05-2018(copy of RC and Insurance Policy is annexed as Annexures A&B).That on 15-06-2017 at about 11.45 p.m.when husband of complainant was riding on the motorcyle, met with accident, near Shiv Mandir,Narwal Pain,Jammu,resultantly,husband of complainant succumbed to injuries and FIR was registered in the Police Station  Satwari,Jammu(copy of FIR is annexed as Annexure-C).Complainant further submitted that she submitted insurance policy to the office of OP for making payment of compensation to her, but despite receipt of copy of insurance policy and other documents, the complainant did not pay any compensation to her. Constrained by the act of OP complainant issued a legal notice through counsel to OP for payment of compensation, but did not yield any fruitful result. Hence the present complaint. In the final analysis,comp-lainant prays for payment of Rs.4,00,000/-on account of death of the husband of complainant alongwith interest @ 12% per annum from the date of accident and in addition also prays for compensation of Rs.1,00,000/- including litigation expenses.

                       On the other hand,OP filed written version and while denying the allegations of complainant in toto,went on to submit that complaint deserves outright dismissal as no claim/incident/death was intimated to the answering OP in writing till Januaruy,2018 through advocate of notice, contrary to the policy condition 1 that it had to be intimated immediately in writing. The complainant is guilty of breach of condition 1 of the policy and is not entitled. The present complaint is in breach of condition 1 of the policy which provides that notice shall be given in writing to the company immediately after the occurrence of any accident, loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require. It stands settled by Apex Court and Hon’ble National Commission that any delay in intimating the claim to the insurer,de4bars the insured from claiming indemnity from the insurer. The claim came to notice of OP after notice dated 06-01-2018 though the alleged accident as per complaint had taken place on,15-06-2017. Further contention of OP is that complainant failed to provide requisite documents in the shape of duly filled claim form,RC copy,DL,estimate of vehicle, police intimation, spot survey etc.for own damage claim, therefore, in absence of any intimation for OD Claim, the veracity of claim is doubtful and even quantification of loss cannot be determined without surveyor report.Further,complainant also not intimated any PA Claim with requisite documents. The list of requisite documents for personal accident claim is reproduced as under:

1. Original Motor Claim form duly filled and signed by Claimant(in original)
2. Attested copy of FIR
3. Attested copy of the Post Mortem Report
4. Attested Death Certificate
5. Attested copy of driving licence of the insured
6. Attested Vehicle Registration Copy of insured
7. Hospital Records if admitted
8. Police Inquest Report
9. Family Member certificate from gram panchayat/Mandal Revenue Office/Legal heir certificate from Magistrate.
10. No objection certificate from other legal heirs duly notarized on stamp paper.
11. Claimant Bank Pass book copy attested by concern bank branch manager.
12. NEFT details of the claimant certified by the Claimant’s Bank.
13. Photo ID proof of the insured and claimant(Aadhar card/Voter ID)
14. PAN card copy of the Claimant. If PAN card copy is not available, then form 60 may be submitted.

        Therefore, in absence of all these necessary documents,OP was not in a position to settle the claim.Lastly,OP would contend that if complainant would provide requisite documents to OP,it  will settle the claim.

                  In support of the complaint complainant filed her own affidavit. Complainant has placed on record copy of certificate of registration, copy of driving licence,copy of Policy Schedule, copy of FIR and copy of legal notice.

                          We have perused case file and heard L/Cs appearing for the parties at length.

                      At the outset, it is to be noted that we have minutely scanned the case file, but did not find iota of material in the shape of any communication with the OP,whereby claim is either lodged or request made for processing the claim. To the contrary OP has specifically resisted the claim inter alia on the ground that it never turned down the request of complainant to settle the claim, but complainant herself failed to provide abovementioned requisite documents,therefore,OP cannot be blamed or fastened with the liability by holding deficiency in service, once complainant herself failed to discharge duty cast upon her.OP in unequivocal words came up with the version that it is willing to settle the claim, if requisite documents would be provided to it. If that be the position, then in our opinion,OP cannot be held deficient in service, because there is nothing on record, from where, it can be gathered that complainant took requisite steps, for got settling her claim.Therefore,we deem it proper to firstly, provide an opportunity to OP to consider the case, which is only possible in case complainant co-operates and provides requisite information/documents.So,in  the  facts and circumstances of the case, we are of the opinion that complaint can be disposed of with a direction to OP to consider the case of the complainant, after submission of requisite documents by the complainant within stipulated period.

                   Therefore, in view of the aforesaid discussion the complainant is directed to furnish above mentioned requisite documents to the OP within two weeks and thereafter the OP shall consider the claim of the complainant in accordance with the terms and conditions of the Policy of insurance obtained by the insured and settle the claim of the complainant within one month, positively and the report regarding settlement of the claim of the complainant be submitted to this Forum. Copy of this order be provided to parties free of costs. In the facts and circumstances, parties shall bear their own costs. The complaint is accordingly disposed of and file after its due compilation be consigned to records.

         Order per President                                            (Khalil Choudhary)                               

Announced                                                           (Distt.& Sessions Judge)

12-09-2018                                                                    President

                                                                              District Consumer Forum

                                                                                      Jammu.

Agreed by                                                          

                                                                                      

Ms.Vijay Angral          

  Member                                                                                               

 

Mr.Ghulam Sarwar Chauhan

Member