Orissa

Kalahandi

CC/119/2020

Romeo Ranjan Tripathy , aged about 27 years - Complainant(s)

Versus

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

A.K Padhi

16 Nov 2022

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KALAHANDI
NEAR TV CENTRE PADA, BHAWANIPATANA, KALAHANDI
ODISHA, PIN 766001
 
Complaint Case No. CC/119/2020
( Date of Filing : 01 Jul 2020 )
 
1. Romeo Ranjan Tripathy , aged about 27 years
S/O-: Ashok Kumar Tripathy , Resident of At-Nuapada PO/PS-Bhawanipatna,Dist-Kalahandi
...........Complainant(s)
Versus
1. Sr. Divisional Manager Oriental Insurance Co. Ltd.
Divisional Office , Basudev Bhawan, 1st Floor Infront of Govt. Girls High School, At/Po/Ps-Bolangir,Odisha
2. 2. S.R Branch Manager , Oriental Insurance Co. Ltd. Branch Office ,
Shivang complex, Near Dayanidhi Chowk , Bhawanipatna At/Po/Ps- Bhawanipatna, Dist-Kalahandi, Odisha,
3. Branch Office Head , Oriental Insurance Co.Ltd.
Branch Counter , Shop No.-04 Vetenary complex , Main Road, Kesinga At/Po/Ps-Kesinga , Dist-Kalahandi, Odisha, Pin-766002.
4. Branch Office Head , Oriental Insurance Co.Ltd.
Branch Counter , Shop No.-04 Vetenary complex , Main Road, Kesinga At/Po/Ps-Kesinga , Dist-Kalahandi, Odisha, Pin-766002
............Opp.Party(s)
 
BEFORE: 
 HON'BLE MR. Aswini Kumar Patra PRESIDENT
 HON'BLE MR. Sudhakar Senapothi MEMBER
 
PRESENT:A.K Padhi, Advocate for the Complainant 1
 Sri S.K Panda & Associate, Advocate for the Opp. Party 1
Dated : 16 Nov 2022
Final Order / Judgement
  1. Heard both the parties. Peruse the material available on record. We have our thoughtful consideration on the pleadings & submission of learned counsels of the parties.
  2. The facts of the case in brief are that, the complainant is the registered owner of Hyundi Grand 110 Magna vehicle bearing Reg. No-OD-08-E-9324. He had taken insurance policy for this vehicle from the Oriental Insurance Company Ltd. Branch Counter at Kesinga vide Policy No.346091/31/2018/246 valid from 21.12.2017 to 20.12.2018 paying required premium for the same. The vehicle met with an accident on dt.10.05.2018 near Nuapada, Bhawanipatna while the complainant was driving the said vehicle on the public road which caused damaged to the insured vehicle. The alleged vehicle was shifted for repairing  centre at Bhawanipatna .The complainant having valid Driving Licence bearing No-OR-08-20110052704 issued by the RTO Kalahandi authorize to drive MCWG & LMV valid till 05.08.2031 accordingly he immediately  made claim before the OP No.2 along with copy of all vehicular documents for claim of compensation under the said insurance policy against the damage sustained to the vehicle where upon  the Op No.2  registered the claim vide claim No.346000/31/2019/030016 . On 16.05.2018 the Opp.Parties appointed surveyor who visited the repairing centre at Bhawanipatna on 17.05.2018,inspected the damaged vehicle in presence of the complainant and instructed the complainant to repair damaged vehicle and as per the instruction of the Op No.2 the complainant repaired the vehicle by spending Rs.41,508/-.The original bill for cost of the repair was submitted to the Op No.2 for reimbursement.  After verification the Opp.Party No.2 send the claim file to the OP.No 1 for scrutiny of the documents submitted in support of the claim. The OP No. 1 repudiated the claim basing on the ground :-“ suppression of fact of claim in your earlier policy No-HAX/S8372990 OF Bharati AXA General Insurance for which 20% NCB       was allowed in our referred policy, which is clear cut violation of GR.27(No claim Bonus) of India Motor Tariff” and sent a letter dt.07.08.2018 to the complainant asking clarification for final decision of the Op No.1.which is received by the complainant on dt.13.08.2018. In reply to said repudiation the complainant requested the Op No.1 on 25.08.2018  to allow the claim for reimbursement but surprisingly the Ops have not intimated the complainant in spite of several requests for which the complainant suffered financial loss & mental agony . Hence, finding no other option the complainant has presented his grievance before this Commission alleging negligence & deficiency in service on the part of the Ops and prayed for an order directing  the Ops to pay the claim amount incurred for repair of vehicle  of  Rs.41,508/-, cost of Rs.10,000/-towards mental agony and Rs.5000/- towards cost of litigation. Hence, this complaint.
  3. Being notice, the Opposite Party appeared through their Counsel Sri S.K.Panda and files written version denying the petition allegations on all its material particulars, however insurance and alleged accident causing damage to the insured vehicle is not denied or disputed by the OPs. 
  4. The Opp. Party submitted that, on receipt of claim intimation from the complainant, the Op No.2 promptly registered the claim vide Claim No.346000/31/2019/030016 and appointed surveyor as per the norms of the policy but during the settlement of claim it came to the light that, the previous policy of the vehicle i.e. Car OD-08E/9324 was taken from Bharati Axa General Insurance vide Policy No. HAXR/S8372990 and during currency of that policy the complainant get his claim settled. As per norms during taking policy from this opposite party, the complainant has to disclosed  this fact and  in that case  no claim bonus of 20% is not be allowed to the complainant. The complainant by knowingly suppressed this fact while taking the policy from the opposite parties. It is further submitted that, as per norms the complainant is to disclose the material fact such as earlier claim in previous policy and the opposite party No .3 is not obliged to ask for the same as the insurance contract is of utmost good faith as such the opposite parties has rightly repudiated the claim of  the complainant .The complaint has no merits liable to dismissed with cost.
  5. The OP/insurer has not filed the copy of proposal form of the complainant or any other document to show that the complainant has suppressed any material fact being asked by the insurer. The O.P/Insurer could not adduce evidence that terms & condition of the insurance policy is supplied  to the insured/complainant, so also failed to prove that as per term of the policy the insured /complainant is not entitle to get insurance benefit because of non disclosure of the fact that; under previous policy the complainant got  settled of his any claim., So also the insurer/OP failed to adduce cogent evidence that, the complainant ha suppressed any material fact  knowingly to avail “20% no claim bonus” while submitting the proposal form for this alleged insurance policy .
  6. It was the duty of the insurer to verify the policy submitted by the complainant at the initial stage. Under the Indian Motor Traffic Regulation  if a person claims “no claim benefit “ in the subsequent policy then the insurance company is duly required to verify the insurance policy on the basis of which “no claim benefit” has been claim within a period of thirty days. As such the ground of none discloser/concealment of settlement of the claim under previous policy for the repudiation of the claim are not tenable as they do not relate to any material information which would be of any consequence and effect the risk involve or claim made.
  7. Here, in this case insurance policy and accident causing loss to the insured vehicle is not disputed. It is also found that, O.P/Insurer has promptly registered the claim of the complainant, appointed surveyor and collected the surveyor report where the surveyor has assessed the net loss at Rs.31500/-. The surveyor has fully verified the material fact and arrived at his own calculation of loss, a copy of which is placed in the record is not disputed by the parties in this case.
  8. Law is well settled that the surveyor is an expert and its report stand on the footing of expert evidence. Relying  on the judgment of the Hon’ble Supreme Court passed in Sri Vankatesware Syndicate Vrs. Oriental Insurance Company Ltd.(2009)8 SCC 507 and Khatema Fibres Ltd. Vrs. New India Insurance Company Ltd.(2021) SCC  818 ,we are of the opinion that the final assessment report of loss submitted by the surveyor dt.17.02.2017 is to be given due importance.
  9. Hence, in the light of above said discussion and settled principle of law we are of the considered view  that the complainant is entitled for insurance benefit and the Opposite Parties have unilaterally rejected  the  claim of the complainant as such we are of the opinion that , the Ops are deficient in service.
  10. The  complainant in this case  is entitle for the loss as assessed by the surveyor i.e. Rs.31,500/- only and further he is entitle for the interest @ 9% per annum over the said amount since the date filling of this complaint i.e 01.07.2020 along with litigation expenses of Rs.10,000/-. Accordingly ,the Ops are directed to pay the said amount to the complainant within four weeks from the date of received of this order failing which the Ops are liable to pay 12% interest over the awarded amount till its realization.
  11. This consumer Complain is partly allowed in above terms against the ops on contest.
  12. The pending application if any is also stands disposed of accordingly.
  13. The complaint could not be decided within the prescribed period of time due to COVID -19 & in want of quorum of the Commission.

Dictated and corrected by me.                             

        

 President

            I agree

 

               Member                                   President

Pronounced in open the Commission today on this 16th day of November  2022 under the seal and signature of this Commission.

Free copy of this order be supply to the respective parties or they may download the same from the Confonet to treat the same as copy of the order receipt from this Commission.

Order accordingly.

            

                         Member                                     President    

 
 
[HON'BLE MR. Aswini Kumar Patra]
PRESIDENT
 
 
[HON'BLE MR. Sudhakar Senapothi]
MEMBER
 

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