The present complaint case has been filed under section 11 and 12 of Consumer Protection Act by the complainant Pushpalata Marandi against the above opposite parties for non- payment of insurance claim and damages caused by accident during insurance period from 21.11.16 to 20.11.17.
The complainant case in brief is that the complaint Pushpalata Marandi is the owner of Scorpio Jeep JH04H0240 which was insured for package of Rs 7,50,000 by the O.P, The Oriental Insurance Company Ltd. which was valid from 21.11.16 to 20.11.17.During the valid insured period the above vehicle involved in accident on 25.07.17, Dumka, Jamtara main road nearby village – Chorkata under P.S Jama of Dumka district for which an FIR was lodged on 24.07.17 and the information of the accident of the Jeep was also given to the Oriental Insurance company Ltd. and to all higher concerned officer for inspection and for the action. Under the provision and inspection of the Insurance certificate the surveyor cum inspect and instruct for repairing the jeep at repairing shop of Mahendra & Mahendra, the authorized dealer, Dudhani, Dumka.
The said dealer supplied bills and invoices which was submitted in the Branch Office of Dumka for settlement of the payment comprising of Rs 251,495 which was acknowledged by O.P and forwarded to the Regional Office Bhagalpur for sanction. After filing the claim the complainant has made repeated request, reminder and legal notice for the early payment but the O.P neither supplied claim nor responded the legal notice dated 20.06.18. And thus the cause of action arose to file this complaint for the settlement of the claim as asserted in reliefs. The copies of bills/ invoices reports related to the vehicle and the complaints of letter dated 07.11.17 as were directed already have been submitted and no further any question has been raised for any compliance. The Complainant claim following reliefs:-
- The payment of repairing cost comprising of Rs 2,51,495 plus Rs 69347.
- Interest at the rate of 12% per annum till the date of realization payable installment comprising
- Payment of Rs 30,000 and also Rs 30,000 for physical and mental harassment. The cost of litigation of Rs 5,000.
The opposite parties Oriental Insurance Company Ltd. has appeared and filed his written statement on 07.06.19 which was accepted by this forum on 11.07.19. The opposite parties in his written statement show cause admitted this fact that vehicle of the complainant was insured by his Company for the period effective from 21.11.16 to 20.11.17. It is also admitted fact that vehicle in question made an accident and in Para 11 of so cause it is clearly submitted that after receiving the information from the insurer about the accident of the vehicle in question the Oriental Insurance Company immediately deputed his surveyor Sri Sunil Kumar Singh to inspect the accidental vehicle and submit his detailed report to the company. Accordingly the surveyor, inspected the vehicle and submitted his report dated 14.09.17 in respect of the cause, nature, extent of loss/ damages, subject to the terms and conditions of Insurance Policy and not binding upon the liability of insurer. In this report the surveyor reported that the liability of the insurer company on total loss basis was Rs 318,000 and on cash loss basis was Rs 278,000. He also annexed the surveyor’s report as Annexure – A. It is further submitted that the damages and liability of the company appeared to be more than a lac as per norms the Company the Competent Authority deputed Bipin Kumar of Bhagalpur for the second opinion. When the surveyor inspected the vehicle he found that the vehicle had already been repaired at the M/s Himmatsinghka & Brothers, Dumka and as such the surveyor was unable to submit second opinion. The report is annexed as Annexure – B.
It is further stated that insurer should not have done this without the prior permission or consent of the Insurer. Under the above circumstances while this O.P the insurer was considering how to finalize and make payment, the complainant slapped the O.P with a pleader notice. And after that the O.P took due cognizance of the notice and with most sympathetic attitude asked the insured, the complainant to report the present condition of the accidental vehicle and submit bill with cash memos for changed parts and bills for repairing vehicle etc. vide its letter dated 09.08.2018 which is Annexure – C.
While the O.P company was considering the claim of the complainant, the complainant without waiting for the result filed this complaint case before this forum and thus by making this matter sub-judicial under the Consumer Protection Act handicapped the insurer in taking any decision or patience the claim or make payment. In Para 15 of his so cause the O.P further stated that as per conditions of the insured policy the claim of repairing cost of Rs 251,495 and Rs 69,347 is not payable in full to the insured as this inclusive the price of such items which are wither not payable nor payable with certain depreciation as per the age of the vehicles. The cost of rubber, fiber parts are not payable and if payable, payable with certain deductions. And further stated that the question of any payment by way of interest does not arise as the delay in finalizing the claim settlement has been caused by the deliberate actions of the Complainant and the question of loss suffered and physical and mental torture does not arise in this case. The vehicle was immediately repaired at her own will and was in running condition and is with the complainant herself and there is no scope of any sort of suffering in such a case and further stated that the complainant is not entitled to get any amount as Litigation also. And prayed that the case of the complainant to be dismissed with cost.
Whether the complainant is entitled for any relief or reliefs as claimed?
Finding
The complainant in support of his case filed the affidavit C.W. – 1 Igneas Kunnu Murmu, C.W. – 2 Pushpalata Marandi and apart from that he also filed documentary evidence which are :-
Exhibit 1 – Photocopy of Certificate of Registration of vehicle no.
JH04H0240.
Exhibit 2 – is the Insurance Certificate – Cum – Policy Schedule of
Cash policy which was of the vehicle JH04H0240 for the period of 21.11.16 to 20.11.17.
Exhibit 3 – is the photocopy of the written information given to the Jama P.S on 24.07.17 by Mr. Sohrab which was entered into the P.S concern as SDE No. 7/17 dated 24.07.17.
Exhibit 4 – Photocopy of the written information given by the Complainant Pushpalata Marandi to the O.P Branch Manager Oriental Insurance Company Limited dated 28.07.17.
Exhibit 5 – is the letter issued by Branch Manager Oriental Insurance Company, Dumka dated 09.08.18 to the informant regarding his claim.
Exhibit 6 – is the letter of the Complainant dated 13.08.18 addressed to the OP in which he has given details information and also the cash memo and bills.
Exhibit 7 –is a letter of the Complainant dated 15.05.18 written to Regional Manager Oriental Insurance Company, Patna, Bihar.
Exhibit 8 –is the letter issued by Oriental Insurance Company Limited, Dumka Branch to the Complainant dated 7/8.11.17
Exhibit 9 – is the information dated 25.06.18.
Exhibit 10 – Is the photocopy of legal notice dated 20.06.18.
The Opposite Parties The Oriental Insurance Company Limited simply filed his so cause and along with so cause he also filed Annexure – A 6 page which is the Surveyor’s report filed by Sunil Kumar Singh dated 14.09.17.
Annexure B is the Policy Surveyor report of Bipin Kumar Singh dated 25.06.18 and
Annexure C is the letter written by Oriental Insurance Company Limited, Dumka Branch to the Complainant dated 09.08.18.
Apart from that the Opposite Parties has not filed any other documentary or oral evidence in support of his defense.
CW1 Igneas Kunnu Murmu in his affidavit has fully supported the case of the Complainant in Para 2 he has stated that Complainant after purchasing the said vehicle got insurance from Oriental Insuarance Company limited, Dumka branch by Policy no. 332401/31/2068/2986 in which the maximum accidental amount was Rs 750,000. The said vehicle met with an accident on 24.07.17 during insurance period immedieately the FIR was laodged to the P.S concern on the same day and after that O.P was also informed. He also inquired the matter who is leveled after that a surveyor from the Insurance Company was als deputed. He came and met the inspected and after that the vehicle was given for repairing to Mahendras & Mahendras authorized dealer, Dudhani, Dumka for repairing. Repairing level charges Rs 69347 and spare parts no. 251495 total Rs 320842 was paid by the Complainant and the voucher and cash memo was also given to the OP Branch Manager. In spite of the paper works and legal notice given to the O.P but O.P intentionally did not paid the Compensation amount to the Complainant.
CW2 is the Pushpalata Marandi, she is none other than but the Complainant of this case. In her affidavit she fully supported her case and also corroborated the evidence given by CW1. During cross examination Para 12 she has clearly stated that on inspection of the surveyor she got repaired her vehicle from the Dumka Workshop.
Going through the documents filed on behalf of the Complainant and also Annexure A, B and C filed by the O.P it is admitted fact that the vehicle Registration No. JH04H0240 was insured by the OP for packaged of Rs 750,000 for the period 21.11.16 to 20.11.17. And it is also admitted fact that on 24.07.17 during the insured period the said vehicle was met with an accident near village Chorkata, Dumka Jama road under Jama P.S. Annexure – A which is the document of the opposite parties is the report of surveyor of Mr. Sunil Kumar Singh dated 14.09.17 in which this surveyor has given a detail report regarding the repairing of the said vehicle and also approximate value of the damages and value of parts and this surveyor has in his report clearly stated in Para 6.
Summary of Liability –
Table – I ON REPAIRING BASIS Rs 5,20,500.
Table – II ON TOTAL LOSS BASIS Rs 3,18,000.
Table – III ON CASH LOSS BASIS Rs 2,78,000.
But the OP Company again deputed another surveyor Bipin Kumar Singh of Bhagalpur for the second opinion which report is as Annexure and from perusal of Annexure – B it appears that when this surveyor went to inspect the said vehicle on 30.04.18 he found that vehicle was fully repaired and the OP has taken the plea that insured should not have been done without the prior or consent of the insurer under the above circumstances still this OP the insurer was considering however to finalize and make payment. The Complainant said the OP with a pleader notice. From the perusal of record it appears that first surveyor was deputed and who gave the report on 14.09.17 and second surveyor Bipin Kumar Singh was deputed who gave report on 25.06.18. Apparently about 9 months from filing the report of the first surveyor the second surveyor was deputed and CW2 has clearly stated in her statement that with the direction of first surveyor she got repaired her vehicle from the said authorized dealer. So far as notice is concerned it was given to the OP on 20.06.18. There are sufficient time given to the OP. He intentionally withheld the claim of the Complainant without any justification and reasonable cause.
From perusal of Exhibit 9 which is Para under Right to Information Act dated 25.06.18 in its 3rd page some information was given in which it is mentioned that disposal of the claim is still pending and in Para 2 it was also written that on the basis of the report of surveyor Sunil Kumar Singh dated 19.09.17 the Complainant has requested to dispose of his petition on the basis of Cash loss. And Annexure – A on page 6 in Table 3 on cash loss basis it was amount to Rs 278,000.
From perusal of WS and the documents filed on behalf of OP it is crystal clear that OP 8 has not repudiated the claim of the Complainant and the OP is only simply withholding the claim of the Complainant simply on the basis that he has already forwarded the claim to the Regional Office for payment. But still no payment was made saying this that the Complainant has filed this case before this commission. Apparently the Opposite Parties intentionally not paying the claim amount of the Complainant and harassing him without any just cause or without any justified reason.
From the aforesaid discussion and going through case record documents and evidence adduced on behalf of both the parties we come to the conclusion that OP has intentionally not paid the Insurance claim of the damages exceeded by accidents during the Insurance period 21.11.16 to 20.11.17 of the Complainant Jeep Scorpio JH04H0240 which was insured by opposite parties The Oriental Insurance Company Ltd. when the vehicle was made with an accident during the insurance period on 24.07.17.
It is therefore,
Order
The O.P is directed to pay principal amount of Rs 320,842 and compensation amounting to Rs 60,000 and cost of litigation of Rs 5,000 with interest@ 12% per annum from the date of filing the case till the realization of the money to the complainant.
Thus this case and the same is allowed on contest with cost.
This case accordingly disposes off.
