Repudiation of insurance claim by the OP 1 has led the complainant to lodge this complaint for redressal u/s 12 of the C.P Act 1986.
The summation of the case is that the complainant while on a trip with the members of his family dated 08.06.2017 by his own motor vehicle BOLERO PLUS vide registration No.WB61/9066 met an accident on the same date on road near Islampur Police station at Uttar Dinajpur. The accident report was immediately intimated to the insurance company and the cost for repairing the damage of the vehicle amounting to Rs. 42 thousand was claimed accordingly. The accident case was reported with Islampur police station vide case No.571/2017 dated 08.06.2017 u/s 279/304 (A) IPC. But till date the claim has not been settled but rather the claim has been repudiated by the OP-1 vide their letter No.150704/Motor claim/2017dated 23.11.2017. The complainant has claimed the repairing cost amounting to Rs.42, 000/- (Forty two thousand) plus compensation Rs.10, 000/- (Ten thousand) plus litigation cost Rs. 5,000/- (Five thousand).
The OP-1 in the written version had admitted that the complainant is a policy holder of the Op and his vehicle No. WB 61/9066 which is covered under the policy met the accident on 08.06.2017. The damage has also been assessed by the surveyor of the OP amounting to Rs.15, 600/- (Fifteen thousand six hundred) but the Op has repudiated the claim of the complainant under rule 3 of Motor vehicle rules 1989 as the driver of the car who was then driving having driving license No. WB 61200600002458 is not a valid license for driving the LMV car of the complainant.
On argument the ld. Lawyer for the complainant had advocated that if the insurance claim is not valid, why assessment of damage has been made by the surveyor of the insurance company. He has also argued with documents that the driver Shri Parimal Chandra Barman who was then plying vehicle has valid driving license bearing No. WB 61200600002458 issued by the RTA Dakshin Dinajpur and it is valid up to 22.02.2018. So at the time of the accident the driver has the valid driving license.
The Ld. Lawyer for the OP argued on the point of validity of the driving license to ply vehicle for personal purpose. As per the documents submitted by the complainant the driver Sri Parimal Chandra Barman had the license for plying non transport vehicle i.e. Light Motor Vehicles such as car, jeep, small vans for personal purpose for the period from 19.01.2016 to 23.11.2015 but not for commercial transportation. The said driver had the license for transport vehicle from 23.02.2015 to 22.02.2018 for driving any LMV for commercial transportation and not valid for HMV.
Under the circumstances the Ld. Lawyer argued that the repudiation by the insurance company is not illegal. He stated more to this Forum that to make a survey of any accident vehicle immediately after the receipt of accident report does not confirm for payment of any accident claim.
Points for discussion:
- Whether the complainant is a consumer of the OP?
- Whether there is any deficiency in service in repudiating the insurance claim by the OP.
DECISION WITH REASONS
From the above discussion it is found that the OP had never denied the complainant as an insurance policy holder of his concern, so it is affirmed that the complainant is a consumer to the OP.
In respect of deficiency in service it has been observed that the complainant has failed to satisfy the condition of his claim as per rule of insurance and also motor vehicles Act 1989. It has also been proved by the document of Registration of car & driving license (kept in record) that the vehicle No.WB61/9066 is a personal vehicle of non transport character and also vehicle on road on 08.06.2017 was on a trip by the members of the family of the complainant; the vehicle was on a non commercial use properly. But the driver engaged by the complainant had not the proper driving license (kept in record) for driving non transport vehicle according to traffic rules and regulation in India (kept in record) on the date of accident. So we are of the opinion that repudiation of insurance claim made by the OP is not unlawful & there is no deficiency in service on the part of the OPs.
Hence, it is
O R D E R E D
The case is dismissed on contest without cost.
Let a plain copy of this order be furnished to the parties forthwith free of cost.
