::BEFORE THE DISTRICT CONSUMER DISPUTES  REDRESSAL COMMISSION AT BIDAR::

                                                             C.C. No.17/2023.

                                                                                                                              Date of filing: 14.03.2023.

                                                              Date of disposal: 29.11.2023.   

P R E S E N Ts:-    

                                (1) Shri. Mabu Saheb H.Chabbi,                                                                                                               B.Com.,LL.B.,(Spl.),

                                                                                                  President.,  

                                (2) Kum. Kavita,

                                                               M.A.,LL.B.,(Spl.),  

                                                                         Member.                             

COMPLAINANT/S                    1.   Zarappa S/o Malappa Bukigar,

                                                      Age: Major, Occ: Agriculture/Labour,
                                                       R/o Bagdal Village, Tq & Dist:Bidar-585226.

                                                         (By Sri.Sanjaykumar S.Patil.,

                                                    Sri.R.M.Patil & Sri.V.R.Patil Advocate.)      

                 V/s

OPPONENT/S                              1.  The Branch Manager,

                                                       National Insurance Company Ltd, 
                                                       Veerbhadreshwar Chambers,

                                                       Door No.8-10-135/1 & 1-A,

                                                       Opposite Nehru Stadium Bidar-585401

                                                      (By Sri.S.M.Shetkar., Advocate.)

                                                                                              ::  J U D G M E N T  ::

By. Sri. Mabu Saheb H.Chabbi,. President.

The complaint is filed by the complainant under section 35 of the Consumer Protection Act, 2019, against the opponent for the deficiency of service caused by not settling the insurance claim by the OP to the complainant, hence following judgment is passed. 

Brief facts of the complaint.

The brief facts of the complaint are as follows: -

2.         The Complainant’s son Mr.Ravindra is the registered owner of motor cycle bearing Regd.No. KA.25-X-6315, and said motor cycle has been insured with the OP vide policy No. 610403312010003526 valid from 05.01.2021 to Midnight 04.01.2022. Further the complainant had paid premium  towards the compulsory PA cover (owner driver) to the OP. On 13.10.2021 at 19.30hours at Bidar Chincholi Road near Bagdal Tanda Cross while complainant’s son proceeding in his Motor Cycle, one auto Riksha bearing its Reg No.KA 38/A-0770 came in a rash and negligent manner from back side and dashed to the motor cycle of the complainant’s son then he fallen on the road and sustained head injuries suddenly he has been shifted to the Government Hospital for first aid treatment and shifted him for further treatment at Osmaniaya Hospital Hyderabad, but he died on 20.10.2021 in the hospital.  As there was pandemic disease not permitted to do rites of deceased Ravindra for cremation.  The case was registered against Auto Riksha Driver for the offence punishable u/s 279,304(a) of IPC R/w Sec.181,187 and 196 of IMV Act and also against the complainant’s son for not having valid D.L. to ride his motor cycle.  The death intimation of complainant son given to the OP and submitted claim No.610403/31/22/98815509, but the Ops written a letter to the complainant to submit D.L. but the complainant did not traced the D.L. of his son as the hospital authorities under SOP were not permitted to take ATM Card, D.L, R.C., Yessesvini health Card, from the pocket of the deceased while taking treatment.  Therefore, the complainant is unable to get D.L. of his deceased son.  The complainant intimated the same to the OP and OP keep quite without settling the claim of the complainant and caused deficiency of service. 

Gist of Written Version.

3.         The OP appeared before this commission after due service of notice from this commission through his advocate and filed his written version and the gist of the written version of the OP is as below.    

The OP Company does not dispute that the Complainant’s son is the registered owner of motorcycle bearing Reg No.KA 38/A-0770, and it was insured with OP Company having compulsory PA cover for owner/rider of insured motorcycle.  But, the OP denied that, the son of the complainant Sri Ravindra is having valid D.L.  As on the date of accident the said Ravindra does not possess any D.L. and hence the complainant is not entitled for any claim under insurance policy.  The complainant intimated the fact of incident on 28.06.2022 after lapse of more than 08 months from the date of incident.  The complainant violated the basic condition of the policy.  The letter issued to the complainant to produce D.L. of his son within 07 days from the date of receipt of the letter issued by OP but the complainant has not produced any D.L. pertaining to his son.  As per SOP the hospital authorities were not permitted to remove ATM Card, R.C., yessasvini health card, and cash in the pocked while taking treatment or making inquest or PM at the hospital is false and denied by the OP.  As per the terms of the conditions of liability only policy for personal accident cover for owner – driver at serial No.2(c) the owner/driver holds an effective D.L., in accordance with the provisions of Rule 3 of M.V.Act.  In view these violations the complainant is not entitled for any relief from this Hon’ble Commission hence, prayed to dismiss the complaint. 

Evidence of complainant.

4.         The complainant himself examined as P.W.1 and another witness of one Sri. Rajkumar S/o Lalappa Methre, as P.W.2 by filing their respective evidence affidavit and complainant got marked Ex.P.1 to Ex.P.9 documents and those are as below.

1.   Ex.P.1-Copy of letter issued by OP to the complainant dt:12.08.2022.

2.   Ex.P.2- Copy of further statement given by Jaishree W/o Zareppa to  
           Bidar Rurla Police dt:15.11.2021.

3.   Ex.P.3- Copy of Crime details Form conducted by police.

4.   Ex.P.4-Copy of sketch prepaired by police.

5. Ex.P.5-Copy of inquest panchanama u/s 174 of CR PC in Crime No.63/2021 of P.S. Bagdal on dt:21.10.2021.
6. Ex.P.6- Copy of P.M.report.
7. Ex.P.7-Copy of charge sheet filed by Bagdal Police.
8. Ex.P.8- Copy of policy schedule.
9. Ex.P.9-Copy of premium paid receipt.

Evidence of OP.

5.         One Sri.Harish Guguloth, Branch Manager is examined as R.W.1 on behalf of OP by filing his evidence affidavit and got marked one document is Ex.R.1&Ex.R2 is as below. 

1.   Ex.R.1-Copy of policy schedule.

2.   Ex.R.2- Copy of Standard Form liability only policy. 

Points/Issues.

6.         Heard the argument advanced by both parties.  From the pleadings and documents produced by the parties, the points that, arose for the consideration are as below. 

1. Whether the complainant proves that, he is consumer to the OP and further proves the deficiency of service from the OP?  
2. Whether the complainant proves any entitlement of claim of insurance from the OP?
3. What order?   

7.         Our answers to the points raised above are as follows: -

1. In the negative.
2. In the negative.
3. As per the final order.

Points No.1 and 2.

8.         In order to decide the said issues, since the points/issues No.1 and 2 are having inter related subject matter and point No.1 and 2 are discussed together as follows. 

9.         The complainant and OP have filed their respective evidence affidavit as per P.W.1 and R.W.1.  The complainant examined one witness Sri. Rajkumar S/o Lalappa Methre, as P.W.2, and reiterated the facts of their respective pleadings in their evidence affidavit. The complainant got marked Ex.P.1 to Ex.P.09 documents to establish his case.  The OP has produced 02 documents on his side.  

10.       The case of the complainant is that his son Ravindra has purchased one Motor Cycle bearing its Reg.No.KA.25-X-6315 and he has purchased an insurance policy vide No.610403312010003526, having its validity from  05.01.2021 to midnight 04.01.2022.  The son of the complainant paid premium towards the compulsory P.A. covering the period of 05.01.2021 to 04.01.2022 (owner driver) to the OP.  The insured Sri. Ravindra son of complainant died  due to accident during Covid-19 pandemic disease.   The Bagdal Police Bidar registered a case in Cr.No.63/2021 for offence punishable u/s 279, 337 and 338, of IPC R/w 187 of IMV Act.  The complainant being the nominee of the policy was intimated the death information to the OP.  Further the complainant submitted claim Form with the required documents to the OP.  But the OP repudiated the claim of the complainant that, the deceased was not having any valid D.L. to ride his Motor Cycle which was insured with the OP. 

11.       To substantiate the case of the complainant the complainant has produced Ex.P.2 the further statement of w/o complainant before police in Cr.No.63/2021, Ex.P.3 the crime details Form, Ex.P.4 the spot sketch, Ex.P.5 inquest panchanama conducted by Bagdal Police, Ex.P.6 P.M. report pertaining to deceased Ravindra conducted by Osmaniya Hospital Hyderabad, Ex.P.7 The charge sheet filed u/s 173 Cr.P.C against one Mohammed Sami the Auto Driver and against the son of the complainant Sri.Ravindra for the offence punishable u/s 279, 304(a) of IPC R/w Sec.181, 187 196 of IMV Act.   The OP has not denied Ex.P.2 to Ex.P.7 documents of the complainant from which the complainant proved that, his Son Ravindra died in an accident as per Ex.P.2 to Ex.P.7.  The complainant produced Ex.P.8 the insurance policy schedule purchased by deceased Ravindra from OP company for personal accident claim coverage.  Ex.P.9 premium paid receipt issued by OP.  The OP is not disputed with regard to Ex.P.8 and Ex.P.9.  But the OP denied that, the deceased does not possess any valid D.L. to ride his two wheeler vehicle as on the date of accident.  The OP is also furnished Ex.R.1 the policy schedule and Ex.R.2 the terms and conditions of the policy, which are not disputed by the complainant in this case. 

12.       The OP has repudiated the claim of the complainant as per Ex.P.1 letter issued by OP to the complainant.  The complainant tried to prove his case contending that, the deceased Ravindra possessed D.L.  for his two wheeler Motor Cycle.  During the Covid-19 period when the deceased was admitted to the Hospital for his treatment to the injuries sustained due to accident the DL and other valuable documents were in his packet and the relatives were not allowed to see and cremate the dead body of Ravindra with rituals and hence, the body was cremated along with all the documents by the officials.  But, this contention cannot be accepted because the guidelines during Covid-19 period produced by the complainant which allows the hospital authority as well as relatives of the deceased to cremate the body, within the frame of Covid-19 guidelines,  even as per inquest panchanama conducted by the Policy as per Ex.P.5, no documents found from the deceased personals.  As per the records available in the case the said Ravindra, died on 20.10.2021, after 07 dyas of  Motor Cycle accident, when he was admitted in the Osmaniya Hospital Hyderabad, the documents which were alleged to be in his pocket could be traced either by hospital authority or by Police authority or by the relatives of the deceased.  Assuming for the discussion even the deceased had valid D.L., the complainant could get another copy of D.L. from the competent authority and produce the same before this commission for adjudication of this case.  But, the complainant did not try to get and produce the valid D.L. from the competent authority. 

13.       The OP contended that, riding of a Motor Cycle by the deceased without valid D.L. which violates GR 36 conditions of the policy and violates the provisions of IMV Act, hence the OP claim that the repudiation of the insurance claim is in accordance with law. 

14.       On going through the above discussion made by this commission, the deceased Ravindra, is not having particular category of D.L. to ride his motor cycle and hence, the claim of the insurance cannot be allowed to claim by the complainant in this case, though the complainant proved to be a consumer to the OP.  In view of the above discussion the complainant fails to prove his case for claiming the benefits under insurance policy purchased by his son Ravindra.  Accordingly, we answered point No.1 and 2 in the negative as against complainant and proceed to pass following.

                                                                                            ::ORDERS::

The complaint filed by the complainant U/sec 35 of consumer protection Act 2019 as against OP is hereby dismissed.  No order as to cost.             

            Intimate the parties accordingly.                         

 (Typed to our dictation then corrected, signed by us and then pronounced in the open Commission on this   29^th day of November-2023).

Documents produced by the complainant.

1. Ex.P.1-Copy of letter issued by OP to the complainant dt:12.08.2022.

2.   Ex.P.2- Copy of further statement given by Jaishree W/o Zareppa to 
           Bidar Rurla Police dt:15.11.2021.

3.   Ex.P.3- Copy of Crime details Form conducted by police.

4.   Ex.P.4-Copy of sketch prepaired by police.

5.   Ex.P.5-Copy of inquest panchanama u/s 174 of CR PC in Crime  
      No.63/2021 of P.S. Bagdal on dt:21.10.2021.

6. Ex.P.6- Copy of P.M.report.
7. Ex.P.7-Copy of charge sheet filed by Bagdal Police.
8. Ex.P.8- Copy of policy schedule.
9. Ex.P.9-Copy of premium paid receipt.

Document produced by the Opponent.

1. Ex.R.1-Copy of policy schedule.

2.   Ex.R.2- Copy of Standard Form liability only policy. 

Witness examined.

Complainant.

P.W.1- Zarappa S/o Malappa Bukigar,    (complainant). 

P.W.2- Sri. Rajkumar S/o Lalappa Methre

Opponent.

R.W.1- Sri.Harish Guguloth, Branch Manager.