Orissa

Debagarh

CC/24/2019

Sruti Ranjan Amatya, aged about 29 years - Complainant(s)

Versus

Sr. Divisional Manager, Oriental Insurance Company Ltd., - Opp.Party(s)

Sudhansu Kumar Amatya

19 Aug 2019

ORDER

BEFORE THE COURT OF THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, DEOGARH.

CD Case No-  24 /2019.

Present-    Sri Dipak Kumar Mahapatra, President, Smt. Jayanti Pradhan,Member (W) and Smt. Arati Das, Member.

 

Sruti Ranjan Amatya, aged about 29 years,

S/O-Sudhansu Kumar Amatya,

At-Deogarh, Ward No-11,

P.O/P.S/Dist-Deogarh.                                                      …   Complainant

                                                   Versus

1. Sr. Divisional Manager,

        Oriental Insurance Company Limited,,

         At/P.O/Dist- Sambalpur.

2. Incharge Oriental Insurance Company Limited,,

          BC Rounak Plaza, Deogarh,

          P.O/Dist- Deogarh.                                   … Opposite Parties.

 

          For the Complainant    : -      Sri Sudhansu Ku. Amatya,Advocate.

          For the O.P-1 & 2         :-       Sri Ranjan Kumar Sahu,Advocate.

      

DATE OF HEARING: 14.08.2019, DATE OF ORDER: 19.08.2019.

Sri Dipak Kumar Mahapatra, President -    Brief facts of the case of the Complainant is that on dtd.28.01.2019 while he was returning from Kuchinda to Deogarh by his car bearing no- OD 28 5732, being driven by himself, near a place under Deogarh Police Station, a cow suddenly came and dashed with the Car for which the side door and mirror got damaged. The Complainant informed the matter in Deogarh Police station and the matter is entered in the station diary. He also intimated the matter to the O.Ps on the same day and shifted the damaged Car to the Maruti Showroom Sambalpur for necessary repair works. After completion of repair work the showroom intimated the O.Ps and issued an Invoice vide No-002/Br/18006098 on dtd.10.03.2019 to make the payment of Rs 45,901/- towards repair of the Car. But the O.Ps has not paid the amount to the Showroom for which the Car of the Complainant is not delivered to him (the Complainant). In the meantime the O.P-1 issued a letter through Regd. Post for submission of necessary documents for settlement of the claim failing which he will be compelled to repudiate the same. But according to the O.Ps the Car of the Complainant was damaged on dtd.28.01.2019 in Sambalpur but not in Deogarh. The O.P-1 though received one invoice from Maruti Showroom, Sambalpur in the name of the Complainant where the signature of the Complainant is necessary for further processing. In spite of several intimation the Complainant has not put his signature on the invoice and the process is stopped and ultimately the O.Ps has no other option but to repudiate the accident claim.

POINTS OF DETERMINATION:-

1. Whether the Complainant comes under the purview of Consumer Protection Act.1986?
2. Whether the O.Ps has committed any Deficiency in Service to the Complainant?    

From the above discussion and materials available on records we inferred that the Complainant is a consumer as he has purchased an insurance policy from the O.Ps for his Car. Here it is observed that the O.Ps has admitted the accident claim of the Insured and taken sufficient steps towards Settlement of the claim, hence the exact place of occurrence is purely immaterial. The O.P-1 has intimated the matter to the Complainant to put his signature on the invoice paper and requested to submit some requisites with him but due to some unexplained circumstances he neither became able to put his signature nor submitted the same. But the O.P-1 should not repudiate the claim basing on these silly matters. “According to the circular dated September 20th, 2011 IRDA/HLTH/MISC/CIR/216/09/2011 (Annexure-A) issued by INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY is as under:-

To: All life insurers and non-life insurers Regarding: Delay in claim intimation/documents submission with respect to

1. All life insurance contracts and
2. All Non-life individual and group insurance contracts- whereby-

The insurers’ decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such limitation clause does not work in isolation and is not absolute. One needs to see the merits and good spirit of the clause, without compromising on bad claims. Rejection of claims on purely technical grounds in a mechanical fashion will result in policy holders losing confidence in the insurance industry, giving rise to excessive litigation. The IRDA in its Circular advised that all insurers need to develop a sound mechanism of their own to handle such claims with utmost care and caution. It also advised that the Insurers shall not repudiate such claims unless and until the reasons of delay are specifically ascertained and recorded”.

Hence the O.Ps has to settle the claim of the Complainant/insured as per the guidelines provided by Insurance Regulatory and Development Authority (IRDA) and we order the O.Ps as under:-

ORDER

The Complaint petition is allowed. The Complainant is directed to make contact with the O.Ps and put his signature on the Invoice within 5 (Five) days of receiving this order. Further the O.Ps are directed not to take any parking charge against the car and to deliver the Car to the Complainant in purely repaired condition from 15 (fifteen) days of receiving this order failing which they shall be liable to pay Rs.200/- per day to the Complainant as fine till the actual date of delivery of the Car. No orders for Compensation towards mental agony, harassment and processing expenditure is allowed.

Order pronounced in the open Court today i.e, on 19^th day of August-2019 under my hand and seal of this Forum.

Office is directed to supply copies of the Order to the parties free of costs receiving acknowledgement of the delivery thereof.

                                           I agree,                                               I  agree,                           

 

MEMBER(W)                                     MEMBER                           PRESIDENT                 

     Dictated and Corrected

    by me.

              PRESIDENT