DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: BHADRAK : (ODISHA).
Consumer Complaint No. 86 of 2021.
Date of hearing : 28.11.2023.
Date of order : 19.12.2023.
Dated the 19th day of December 2023.
Mansoor Ali Khan, S/o:-Mehmood Khan,
Vill:-Charampa (Station Road) Po:- Charampa,
P.S:- Bhadrak (T), Dist:-Bhadrak. ………….. Complainant.
-:Versus:-
The Branch Manager,
The New India Assurance Co. Ltd.
Bhadrak Branch, At:- 2nd Floor, Biswal Complex
Mahatab Chhak, Near Sunita Furniture Samraipur,
Po/P.S:- Bhadrak (R), Dist:- Bhadrak-756181.
.…………Opposite party.
P R E S E N T S.
1. Sri Shiba Prasad Mohanty, President,
2. Smt. Madhusmita Swain, Member.
Counsels appeared for the parties.
Counsel for the Complainant:-Mozahed Akhtar Khan, Advocate & Associate,
Counsel for the Opp. Party : Pratyush Ranjan Sinha, Advocate.
J U D G M E N T.
SRI SHIBA PRASAD MOHANTY, PRESIDENT.
In the matter of an application filed by the complainant alleging deficiency of service & unfair trade practice against the Opposite Party under Consumer Protection Act, 2019.
The fact of the case is that, the complainant is the Owner of the Passenger Carrying Bus bearing Regd. No.OD-04-A-0589 and the said vehicle was insured to the O.P. on a payment of premium Rs.57,619/- for a validity period of 17.07.2019 to 16.07.2020. The vehicle met an accident at Bonth Chhak on 03.01.2020 by an offending truck AP-16-TH-1363 and as a result of the accident the vehicle sustained extensive damage. F.I.R. No.2/20 at Bhadrak Town P.S. was registered. The complainant has also intimated the O.P. Insurance Company in promptitude. After a spot survey was done by the Surveyor of O.P. Insurance Company, the vehicle was shifted to Biswakarma Body Builder for repair work. The complainant has spent Rs.3,02,600/- towards the repair cost.
The complainant has submitted the claim proposal along with other relevant original document for settlement of the insurance claim. But on 31.12.2020 the O.P. Insurance Company repudiated the claim for lack of document. The complainant was able to obtain the certified copy of the Charge-sheet only after the same was submitted by police before the court. The complainant filed certified copy of Charge-sheet, Newspaper cutting etc. at O.P’s office on 08.12.2021 but the O.P. Insurance Company refused to entertain the letter sent documents as they have closed the claim. The complainant serves the legal notice through his advocate on 13.12.2021 but the OP refused to settle the claim in his reply on 16.12.2021. The complainant has filed copy of the insurance policy dtd.17.07.2019 letter of O.Ps dtd.28.10.2020, 31.12.2020 and the repudiation letter dtd.16.12.2021, Bill of Biswakarma Bodybuilder, legal notice dtd.13.12.2021. The O.P. has deputed a surveyor to assess the loss & damage & he also filed the surveyor report along with his written version. In the said report the surveyor has admitted that he has verified the route permit & the place of accident has been mentioned as near Bonth over Bridge on N.H.-16. Complainant has also submitted the F.I.R. copy which clearly reveals that the accident spot is over bridge of Bonth Chhaka which is within Bhadrak. The complainant has also submitted the route permit having two sheets, i.e. permanent permit route time information & another sheet containing vehicle replacement order.
The O.P. was set ex-parte on 12.08.2022. But on 08.08.2023 the O.P. appeared trough advocate Sri P.R. Sinha but he has also failed to file any written version on subsequent dates. So the O.P. was precluded from filing any written version and the matter was taken up for hearing.
O.P. states that, this O.P. being informed by the complainant about the incident deputed their surveyor on 03.01.2020 for spot inspection & thereafter Mr. S.S. Mishra was deputed for conducting final survey on 14.01.2020 with a request to submit final report. On 16.12.2020 the damage loss was assessed at Rs.1,39,000/- by the final surveyor. Complainant was requested to transmit all the relevant papers specifically the police papers & the route permit of the alleged vehicle vide letter dtd.28.10.2020 & 21.12.2020. Admittedly on the date of occurrence the bus was going from Dhamnagar to Bhadrak. The complainant after receiving the letters as above did not respond & remained silent over the matter for long. However on 10.12.2021 the complainant transmitted only the police papers without route permit. The claim file had already been closed on 31.12.2020 & repudiation letter was sent by R.P. with A.D. to the insured-complainant on 01.01.2021 due to non-furnish of route permit. When the complainant made further query to know about the fate of his damage claim, this O.P. sent another letter dtd.16.12.2021 informing the complainant that his claim was repudiated & to that effect the letter of repudiation had already been sent to the complainant on 31.12.2020 by R.P. with A.D. Complainant was very much aware about the repudiation of his damage claim due to non-submission of valid route permit. The damaged was assessed by the surveyor at Rs.1,39,000/- within the reasonable time. The complainant deliberately did not furnish the route permit of his vehicle which otherwise speaks that the vehicle was playing without valid route permit which is a direct violation of police condition. The insurance company in absence of valid route permit is not liable to pay own damage claim. In the instant case the complainant being the owner did not supply the route permit of his vehicle which is the vital document for settlement of damage claim. Complainant has utterly failed to submit the required documents as sought for by this O.P. for settlement of the damage claim despite issuance of several letters.
Having heard the rival contentions and materials available in the record, this commission frames these following issues for fair adjudication of the consumer dispute:-
ISSUES.
- Whether the complainant is a consumer and the complaint has been filed with jurisdiction and within limitation?
- Whether the complainant was plying his vehicle beyond his route permit which is a breach of condition of the insurance policy?
- Whether the OP has caused deficiency in service by closing the claim after one year and thereafter by repudiating the insurance claim?
- What relief the complainant is entitled to?
The complainant is the Owner of the Passenger Carrying Bus bearing Regd. No.OD-04-A-0589 and the said vehicle was insured with the O.P. on payment of a consideration of premium Rs.57,619/- for a validity period of 17.07.2019 to 16.07.2020. The vehicle of complainant met an accident at Bonth Chhak on 03.01.2020 by an offending truck AP-16-TH-1363. So the complainant is a consumer and he has filed this instant complaint with jurisdiction and limitation. Issue No.1 is thus in favor of the complainant.
The case vehicle has a valid permit no. PP99/130706/G which allows it to ply from Ananadpur to Bhadrak 7 Back two R.T. Daily that means Bonth Chhaka is very much within the route of the case vehicle and the vehicle met an accident while plying on its designated route. There was no requirement of any special permit to ply in its designated route. So, the assertion of the OP that the complainant breached the condition of the policy by plying the vehicle in a different route than allowed. So, Issue No.2 is also answered in favour of the complainant.
The OP insurance Company has their IRDA direction to settle claims within one years for which they either settle the claim or close the claim. But it is fact which needs to be reiterated that the complainant can submit the certified copy of the final report only after police submits those. The complainant cannot have any control over the actions of the police. Further, the complainant is duty bound to intimate about the loss and claim compensation to the insurance company. It is not sine qua non that the complainant must submit the certified copy of the final report of the police case to get his legitimate claim. So, the OP Insurance company has committed deficiency in service by repudiating the claim on flimsy ground despite having the loss report of the Surveyor with them. Thus Issue No.3 is answered in favour of the complainant.
The complainant needs to be compensated for the loss caused to his vehicle as per the survey report of the surveyor deputed by the OP Insurance Company. Further the OP Insurance Company should pay compensation for putting the complainant into unnecessary inconvenience and harassment by repudiating the claim along with cost of the present litigation. Issue No.4 is also answered in favour of the complainant.
O R D E R.
In the result, the complaint be & same is allowed. The O.P. Insurance Company is directed to pay the complainant Rs. 1,39,000/- along with interest of 6% interest from the date of claim lodged along with compensation of Rs.20,000/- and cost of litigation of Rs.10,000/- to the complainant within 30 days from the date of order , failing which the OP shall be liable to pay the whole amount along with an interest of 6% till the actual date of payment.
This order is pronounced in the open Court on this the 19th day of December 2023 under my hand and seal of the Commission.
