Jammu and Kashmir

Jammu

CC/555/2017

BHUPINDER SINGH - Complainant(s)

Versus

Shree Ram General Insurance - Opp.Party(s)

GS SARKARIA

20 Oct 2018

ORDER

DISTRICT    CONSUMER     DISPUTES   REDRESSAL  FORUM, JAMMU

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

                                                         

 Case File  No.               09/DFJ         

 Date of  Institution   :  05-04-2014

 Date of Decision      :    10-10-2018

 

Bhupinder Singh,

S/O Harbans Singh,

R/O H.No.198,Model Town,

Gangyal Jammu.

                                                                                                                                                Complainant

                     V/S

1.SHRIRAM GENERAL INSURANCE COMPANY LTD.

  Opp.Nirankari Bhawan C/O 3^rd Floor South Block,

  Bahu Plaza,Jammu,Through its Branch Manager.

                                                                                                                                                                Opposite party

CORAM

                  Khalil Choudhary              (Distt.& Sessions Judge)   President

                  Ms.Vijay Angral                                                                Member

                  Mr.Ghulam Sarwar Chouhan                                       Member

 

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

                              Protection Act 1987.

      

Mr.G.S.Sarkaria, Advocate for complainant, present

Mr.Dewakar Sharma,Advocate for OP,present.

                                            

                                           ORDER

                       Grievance of complainant, as disclosed in the complaint is that  he being registered owner of Truck bearing registration No.JK02AA-6857(Annexure-A),got the same insured for personal accident  with OP vide Policy No.10003/31/11/263984 w.e.f.13-10-2010 to 12-10-2011(copy of insurance policy Annexure-B)Complainant further submits that on, 09-06-2011,he was travelling in his truck, when reached at Faizabad.Bye Pass(Uttar Pradesh)the vehicle in question collided with another truck which resulted in an accident and the accident took place during the subsistence of Insurance Policy(Annexure-C)That  in the accident, complainant was seriously injured and both his arms were amputated and complainant spent huge amount on his treatment, besides an amount of Rs.20,000/was also spent on boarding, loading attendants food, transportation etc.Allegation of complainant is that he had raised a claim under Personal Accident to owner-driver with the OPs on account of amputation of his both arms and expenses incurred on the purchase of medicines, treatment and hospitalization and had submitted original treatment record and medical bills with the OP. Complainant further submitted that he made number of personal visits  to the office of OP to enquire about the payment of his claim, but despite lapse of considerable period of time and personal visits, the OP has failed to redress his grievance. Constrained by the act of OP,complainant sent a legal notice to OP,but despite receipt of notice, the OP has not paid personal accident claim to complainant and this act of OP constitutes deficiency in service, hence the complaint. In the final analysis, complainant prays for sum of Rs.5.00 lacs and in addition also prays for sum of Rs.50,000/under different heads.

                  On the other hand,OP has filed written version and resisted the complaint on the ground that complaint under Consumer Protection Act is hopelessly time-barred as the limitation under the Act is two years from the date of cause of action arises to the complainant. The cause of action arose to the complainant on09-06-2011 when the insured vehicle met with the accident and against the said accident the Own Damage Claim was already satisfied way back in the year 2011 and till the date of filing of present complaint, the complainant remained in deep slumber and never approached for the claims, which he ask for in present complaint. That there is no deficiency in service on the part of OP as such the complaint is utterly misconceived. That the complainant has himself failed to fulfill the necessary terms and conditions of the policy. That the IDV  of the vehicle, parts of the damaged truck, which are necessary etc.all factors are considered by surveyor.Therefore,there are no reason to not to consider the report of independent person having professional qualification to assess damage. Rest of the contents of complaint are denied by OP.                                                     

                            Complainant has adduced evidence by way of duly sworn his own affidavit and evidence affidavit of Tejinder Singh. Complainant has placed on record copy of certificate of registration, copy of Policy schedule, copy of FIR copy of legal notice, copy of discharge certificate and original disability certificate.

                    On the other hand OP1 adduced evidence by way of duly sworn affidavit of Sikander Khan Legal Manager.

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

                       Admitted case of complainant is that he got his vehicle bearing registration No.JK02AA-6857, insured with OP,which also includes Personal Accident Cover for owner-driver to the tune of Rs.2.00 lacs.During currency of Insurance Policy, insured vehicle said to have met with accident and complainant also suffered injuries, resultantly, both the arms were amputated in the said accident. Complainant was hospitalized and incurred huge amount on his treatment. Grievance of complainant is that despite claim lodged with OP for reimbursement of expenses incurred on his treatment, in terms of Insurance Policy which covers expenses under Personal Accident Cover, but OP failed to honour the contract of insurance.

                    On the other hand,defence raised by OP is that complaint under Consumer Protection Act is hopelessly time barred as limitation provided under the Act is two years from the date of cause of action arose to complainant.

                       Before heading further, it is to be noted that since parties have lead evidence in the shape of evidence affidavits, which are much or less reproduction of contents of their respective pleadings,therefore,we do not feel it necessary to represent the same again and if need arises, same would be referred hereinafter at appropriate stage.

                  In so far as point of limitation raised by OP,is concerned, same is also misconceived because OP did not file any evidence to show as to when OP has repudiated the claim of complainant and intimated to complainant, while as, positive case set up by the complainant is that  his claim has not been repudiated by OP,t means that the complainant has recurring cause of action against OP.Therefore,n absence of cogent proof as to when OP intimated complainant about the repudiation, the point of limitation cannot run against the complainant.

                             In order to support its contention,OP filed terms and conditions of Insurance Policy, which defines Personal Accident Cover for owner-driver in Section IV to the following effect:

  SECTION IV-PERSONAL ACCIDENT COVER FOR OWNER-DRIVER

Subject otherwise to the terms exceptions conditions and limitations of this policy, the Company undertakes to pay compensation as per the following scale for bodily injurydeath sustained by the owner-driver of the vehicle in direct connection with the vehicle insured or whilst mounting intodismounting from or traveling in the insured vehicle as a co-driver caused by violent accidental external and visible means which independent of any other cause shall within six calendar months of such injury result in

Nature of injury                                                                                Scale of compensation

(i) Death                                                                                                           100

(ii) Loss of two limbs or sight of two eye or one limb

 and sight of one eye     100

(iii) Loss one limb or sight of one eye                                                  50

(iv) Permanent total disablement from injuries

       other than named above                                                             100

               

                       Admittedly as per Disability Certificate placed on record by the complainant, the degree of disability is evaluated by the doctors is to the extent of 100 permanent, as such as per terms and conditions complainant fall in the categories as provided in the table contained under GR 36, therefore, complainant is entitled to PA cover under the terms and conditions of Insurance Policy.             

                     In view of discussion made hereinabove, we did not hesitate to hold that OP unnecessarily entangled complainant into niceties and technicalitieswhich were outside the scope of contractual liability. The conduct of OP just added to the miseries for which complainant would have never thought of at the time of effecting insurance policy rather complainant wanted to have insurance policy to mitigate its sufferings by providing supporting financial plank. Under these circumstances, complainant is required to be suitably compensated for mental pain and agony he underwent after paying premium to the insurer.

                            Therefore, in view of the foregoing reasons the complaint filed by the complainants for redressal of their grievance is allowed and OP IS directed to pay to the complainant an amount of Rs.2.00 lacs alongwith interest  6 per annum w.e.f.05-06-2014 i.etwo months after lodging the claim),till its payment. The complainant is also entitled to compensation of Rs.5000for causing unnecessary harassment and mental agony and litigation charges of Rs.5000The OP  shall  comply the order within two months from the date of receipt of this order. Copy of this order be provided to both the parties as per requirement of the Act. The complaint is accordingly disposed of and file be consigned to records after its due compilation.

Order per President                                              Khalil Choudhary

Announced                                                        (Distt.& Sessions Judge)

10-10-2018                                                               President

Agreed by                                                         District Consumer Forum

                                                                                       Jammu.

Ms.Vijay Angral          

Member

                                                                                

Mr.Ghulam Sarwar Chauhan,

Member