Karnataka
Chitradurga
CC/14/2017
Smt.Suvarnamurthy W/o LateB.S.Chandrashekar Murthy - Complainant(s)
Versus
The Devisional Manager,National Insurance Company Ltd., - Opp.Party(s)
Sri.B.K.Govardhan
05 Aug 2017
ORDER
COMPLAINT FILED ON:07/02/2017
DISPOSED ON:05/08/2017
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHITRADURGA.
CC.NO: 14/2017
DATED: 5th AUGUST 2017
PRESENT: - SRI. T.N. SREENIVASAIAH : PRESIDENT B.A., LL.B.,
SRI.N. THIPPESWAMY : MEMBER
B.A., LL.B.,
……COMPLAINANT/S | 1. Smt. Suvarnamurthy W/o Late B.S. Chandrashakarmurthy, Age: 58 Years, R/o Suvarna Nilaya, IUDP 11th Cross, Sri Sai Layout, 4th Main, Chitradurga.
2. Sri. C. Sachin, S/o Late B.S. Chandrashakarmurthy, Age: 32 Years, R/o Suvarna Nilaya, IUDP 11th Cross, Sri Sai Layout, 4th Main, Chitradurga.
(Rep by Sri.B.K. Govardhan, Advocate) |
V/S | |
…..OPPOSITE PARTIES | 1. The Divisional Manager, National Insurance Company Limited, Divisional Office, II Floor, Shivanaradamuni Plaza, Opp: Dental College, NCC B Block, Davanagere-577004.
|
ORDER
SRI. T.N. SREENIVASAIAH: PRESIDENT
The above complaint has been filed by the complainant u/Sec.12 of the C.P. Act, 1986 for the relief to direct the OP to pay a sum of Rs.2,00,000/- for personal accident benefit claims along with interest at the rate of 12% p.a and such other expenses.
2. The brief facts of the case of the above complainants are that, complainants No.1 and 2 are the wife and son of deceased B.S. Chandrashekaramurthy respectively who died on 07.09.2015 in an accident took place in between Holalkere and Arehalli due to rash and negligent driving of the driver. Complainants are the class I heirs of the deceased B.S. Chandrashekaramurthy. It is further submitted that, the said deceased B.S. Chandrashekaramurthy was the proper owner of the vehicle bearing Reg. No.KA-16 M 9509. At the time of accident, the RC stands in the name of said deceased. It is further submitted that, the said Swift-dizire vehicle insured with the OP No.1 under policy bearing No.356101031156136712899. The OP Company has collected premium towards personal accident benefit claim. On 15.08.2015 the said deceased was travelling in his own car to reach Ramagiri village which is his native place for attending his personal work. After his completion of his work on the same day at about 4-30 PM he was returning to Chitradurga, due to rash and negligent manner of the driver the said vehicle fell down between Holalkere-Arehalli village and deceased also fell down from the said car and caused several injuries to his body like head, both hands, legs, ribs and other parts of the body. In spite of better treatment taken by him, he did not survive and died on 07.09.2015. After the death of said Chandrashekaramurthy, complainants approached the OP for settlement of personal accident claim. OP suggested the complainants to furnish relevant papers pertaining to the policy. The complainants furnished all the relevant documents pertaining to NATMAR Policy No.356101031156136712899 including the police papers and vehicle records to the OP for the purpose of settlement of claim. After receiving all the relevant documents instead of settling the matter, issued a letter dated 05.02.2016 to furnish DL of deceased Chandrashekaramurthy. It is further submitted that, at the time of accident, the driver of the said vehicle was having valid and effective DL to drive the vehicle but, failed to settle the claim. Therefore, complainants issued a legal notice through their counsel on 13.04.2016 but, the OP has not settle the claim. The cause action for the complaint arose when the above said policy was obtained by deceased Chandrashekaramurthy valid for the period from 30.04.2015 to midnight on 29.04.2016 and when the OP refused to settle the matter in the last week of December which is within the jurisdiction of this Forum. Therefore, the complainants respectfully prayed before this Forum to allow their complaint with cost.
3. On service of notice, OP appeared through Sri. B.M. Ravichandra, Advocate and filed version denying the allegations made in para-2 to 11 of the complaint. It is further stated that, the complainant has not approached this Forum with clean hand and the complaint is not maintainable either in law or on facts and the same is liable to be dismissed in limine. It is true that, the OP company has issued policy for the period from 30.04.2015 to 29.04.2016 in the name B.S. Chandrashekaramurthy to his Maruthi Swift Car bearing Reg. No.KA-16 M-9505 covering the risk of third party injury and death unlimited, PA to owner cum driver for an amount of Rs.2,00,000/- and third party property damage is limited as per the Act and the policy covers own damage portion of the insured vehicle to the extent of Rs.5,93,518/-, the IDV as per the terms and conditions of the policy and confirmation of 64 VB. It is further submitted that, the owner of the above said vehicle met with an accident on 15.08.2015 at about 3-45 PM near Arehalli village and the same has been intimated to OP on 17.02.2015 to the Branch Office. The OP has collected a premium of Rs.200/- towards personal accident benefit to owner cum driver for an amount of Rs.2,00,000/- only. As per the said Pa the owner should be on wheels at the time of accident and also he should possess a proper and valid DL to drive a specific class of vehicle and the said Sec.III i.e., personal accident benefits give scope to details of injury and scale of compensation as under:
Details of injury | Scale of compensation |
| 100% |
| 100% |
| 50% |
| 100% |
As per the above details if the owner has sustained such an injuries, then he is entitle as per the coverages granted in policy. In view of the above stated facts prayed for dismissal of the complaint.
4. Complainant No.2 has examined as PW-1 by filing affidavit evidence and the documents Ex.A-1 to A-10 were got marked. On behalf of OP, one Sri. Malatesh C. Haller, Assistant Manager, Divisional Office, Davanagere, has examined as DW-1 by filing the affidavit evidence and Ex.B-1 to B-11 documents have been got marked.
5. Arguments of both sides heard.
6. Now the points that arise for our consideration for decision of above complaints are that;
(1) Whether the complainants prove that the OPs have committed deficiency of service in settling the claim made by them and entitled for the reliefs as prayed for in the above complaint?
(2) What order?
7. Our findings on the above points are as follows:-
Point No.1:- Partly in Affirmative.
Point No.2:- As per final order.
REASONS
8. It is not in dispute that, the husband of complainant No.1 and father of complainant No.2 the deceased B.S. Chandrashekaramurthy was the proper owner of the Swift-dizire vehicle bearing Reg. No.KA-16 M 9509. At the time of accident, the RC stands in the name of said deceased. The said Swift-dizire vehicle insured with the OP No.1 under policy bearing No.356101031156136712899. The OP Company has collected premium towards personal accident benefit claim. On 15.08.2015 the said deceased was travelling in his own car to reach Ramagiri village which is his native place for attending his personal work. After the completion of his work on the same day at about 4-30 PM he was returning to Chitradurga, due to rash and negligent manner of the driver the said vehicle fell down between Holalkere-Arehalli village and deceased also fell down from the said car and caused several injuries to his body like head, both hands, legs, ribs and other parts of the body. In spite of better treatment taken by him, he did not survive and died on 07.09.2015. After the death of said Chandrashekaramurthy, complainants approached the OP for settlement of personal accident claim by furnishing all the relevant documents pertaining to NATMAR Policy No.356101031156136712899 including the police papers and vehicle records to the OP for the purpose of settlement of claim. After receiving all the relevant documents instead of settling the matter, issued a letter dated 05.02.2016 to furnish DL of deceased Chandrashekaramurthy. It is further submitted that, at the time of accident, the driver of the said vehicle was having valid and effective DL to drive the vehicle but, failed to settle the claim.
9. In support of their contention, the complainant No.2 has filed his affidavit evidence and reiterated the contents of complaint and relied on the documents like Charge sheet marked as Ex.A-1, Ex.A-2 is the FIR, complaint given by complainant No.2 marked as Ex.A-3, spot panchanama marked as Ex.A-4, vehicle seizer marked as Ex.A-5, Wound certificates marked as Ex.A-6 and 7, Motor vehicles accident report marked as Ex.A-8, Death Certificate of B.S. Chandrashekaramurthy marked as Ex.A-9 and legal notice dated 13.04.2016 marked as Ex. A-10.
10. On the other hand, it is argued by the OP that, the OP company has issued policy for the period from 30.04.2015 to 29.04.2016 in the name B.S. Chandrashekaramurthy, the deceased to his Maruthi Swift Car bearing Reg. No.KA-16 M-9505 covering the risk of third party injury and death unlimited, PA to owner cum driver for an amount of Rs.2,00,000/- and third party property damage is limited as per the Act and the policy covers own damage portion of the insured vehicle to the extent of Rs.5,93,518/-, the IDV as per the terms and conditions of the policy and confirmation of 64 VB. The owner of the above said vehicle met with an accident on 15.08.2015 at about 3-45 PM near Arehalli village and the same has been intimated to OP on 17.02.2015 to the Branch Office. The OP has collected a premium of Rs.200/- towards personal accident benefit to owner cum driver for an amount of Rs.2,00,000/- only. As per the said PA, the owner should be on wheels at the time of accident and also he should possess a proper and valid DL to drive a specific class of vehicle and the said Sec.III i.e., personal accident benefits give scope to details of injury and scale of compensation as stated supra.
11. As per the details, if the owner has sustained such an injuries, then he is entitle as per the coverages granted in policy. As per the records produced by the complainants, the injuries sustained by the complainant will not attract as per the condition, the OP insurance company is not liable to pay any PA claim and also to give medical bills. The complainants have intimated the death of policy holder on 20.01.2016 stating that, the policy holder was died on 07.09.2015. Complainant No.1 issued claim form on 02.12.2015 along with relevant documents and also medical certificate given by Dr. Sandeep of Sunitha Nursing Home, Chitradurga. After receiving all the papers, OP asked for DL of policy holder but, the complainants have not given any document regarding of DL of deceased B.S. Chandrashekaramurthy. The OP also issued legal notice on 05.02.2016 calling upon the OP No.1 to produce DL of said deceased but, she has not produced DL. Again on 25.02.2016 OP issued one more letter asking the complainant No.1 for production of DL of said deceased for verification of original DL and also intimated in the said letter if fails to produce the said document within 10 days, the OP will treat the matter as no claim and will close the matter. Therefore, on 16.03.2016, the OP has repudiated the claim as the complainant No.1 has not produced the DL of deceased B.S. Chandrashekaramurthy for verification. The deceased did not possess any DL to drive said class of vehicle on the date of accident, which is a violation of policy terms and conditions and MV Act. Due to the violation of the terms and condition of the policy, the OP has repudiated the claim of the complainant.
12. In support of its contention, the OP has filed affidavit evidence of one Sri. Malatesh C. Haller, Assistant Manager, has examined as DW-1 by filing the affidavit evidence and reiterated the contents of version and relied on the documents like certified copy of policy with terms and conditions marked as Ex.B-1, claim intimation dated 17.08.2015 marked as Ex.B-2, FIR marked as Ex.B-3, Charge Sheet marked as Ex.B-4, Death certificate marked as Ex.B-5, Death intimation by complainant No.2 on 20.01.2016 marked as Ex.B-6, Claim Form dated 02.12.2015 with medical certificate marked as Ex.B-7, Legal notice dated 05.02.2016 marked as Ex.B-8, acknowledgement marked as Ex.B-9, Legal Notice dated 25.02.2016 marked as Ex.B-10 and Repudiation letter dated 16.03.2016 marked as Ex.B-11.
In support of its contention, OP has relied on the following decisions:
1) 2011 CPR 63 (NC)
2) 2003 CCJ 516
3) 2009(3) 165 (NC)
4) 2011(4) CPR 208
13. The above said decisions are all not applicable to the case on hand. The facts and circumstances of each case are different to the present case on hand.
14. On hearing the rival contentions of both parties and on perusal of the documents including the affidavit and documentary evidence, it clearly made out that, the husband of complainant No.1 and father of complainant No.2 B.S. Chandrashekaramurthy insured his Swift-dizire vehicle with the OP No.1 under policy bearing No.356101031156136712899 by collecting premium towards personal accident benefit claim. On 15.08.2015 the said B.S. Chandrashekaramurthy was travelling in the said car to reach Ramagiri village which is his native place for attending his personal work. After completion of his work on the same day at about 4-30 PM he was returning to Chitradurga, due to rash and negligent manner of the driver the said vehicle fell down between Holalkere-Arehalli village and deceased also fell down from the said car and caused several injuries to his body. In spite of better treatment taken by him, he died on 07.09.2015. After the death of said Chandrashekaramurthy, complainants approached the OP for settlement of personal accident claim by furnishing all the relevant documents pertaining to NATMAR Policy No.356101031156136712899 including the police papers and vehicle records to the OP for the purpose of settlement of claim. After receiving all the relevant documents instead of settling the matter, issued a letter dated 05.02.2016 to furnish DL of deceased Chandrashekaramurthy. At the time of accident, the driver of the said vehicle was having valid and effective DL to drive the vehicle but, failed to settle the claim. The policy obtained by the complainant covers the personal accident benefit. The complainant approached the OP No.1 claiming compensation but, the OP No.1 drag on the matter on one or the other reason and finally the OPs have not ready to settle the claim of the complainant.
15. Admittedly, the complainant was the owner of said vehicle and it was duly insured with the OPs and the policy was in force as on the date of accident. According to the counsel for the OPs, the complainant has violated the terms and conditions of the insurance policy and so, OPs have rightly repudiated the claim and he is not entitled for any relief. In the policy itself it is mentioned that, "Any person including insured provided that a person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such a license, provided also that the person holding an effective learner's license may also drive the vehicle and such a person satisfies the requirements of Rule 3 of Central Motor Vehicle Rule, 1989". Moreover in the policy under the head limit of liability, it is mentioned that, limit of the amount of the company's liability under Sec.II-1(ii) in respect of anyone claim or series of claims arising out of one event: UPTO Rs.2,00,000/-. The contention taken by the OP that, the owner should also having DL when he was travelling in the vehicle at the time of accident, which is not correct. Therefore, we come to the conclusion that, there is a deficiency of service on the part of OPs/insurance Company. Accordingly, this Point No.1 is held as partly affirmative to the complainant.
15. Point No.2:- As discussed on the above point and for the reasons stated therein we pass the following:-
ORDER
The complaint filed by the complainant U/s 12 of C.P Act 1986 is partly allowed.
It is ordered that, the OP is hereby directed to pay a sum of Rs.2,00,000/- the sum assured under the above said policy to the complainants along with interest at the rate of 12% p.a from the date of filing of the complaint till realization.
It is further ordered that, the OP is hereby directed to pay Rs.25,000/- towards compensation and Rs.5,000/- towards costs of this proceeding.
It is further ordered that, the OP is hereby directed to comply the above order within 30 days from the date of this order.
(This order is made with the consent of Member after the correction of the draft on 05/08/2017 and it is pronounced in the open Court after our signatures)
MEMBER PRESIDENT
-:ANNEXURES:-
Witnesses examined on behalf of Complainant:
PW-1: Complainant by way of affidavit evidence.
Witnesses examined on behalf of OP:
DW-1: Sri. Malatesh C. Haller, Assistant Manager, Divisional Office, Davanagere of OP by way of affidavit evidence.
Documents marked on behalf of Complainants:
01 | Ex-A-1:- | Charge sheet |
02 | Ex-A-2:- | FIR |
03 | Ex-A-3:- | Complaint given by complainant No.2 |
04 | Ex-A-4:- | Spot Panchanama |
05 | Ex-A-5:- | Vehicle seizer |
06 | Ex-A-6 & 7:- | Wound certificates |
07 | Ex-A-8:- | Motor vehicles accident report |
08 | Ex.A-9:- | Death Certificate of B.S. Chandrashekarappa |
09 | Ex.A-10:- | Legal notice dated 13.04.2016 |
Documents marked on behalf of OP:
01 | Ex-B-1:- | Policy with terms and conditions |
02 | Ex-B-2:- | Claim intimation dated 17.08.2015 |
03 | Ex-B-3:- | FIR |
04 | Ex.B-4:- | Charge Sheet |
05 | Ex.B-5:- | Death certificate |
06 | Ex.B-6:- | Death intimation by complainant No.2 on 20.01.2016 |
07 | Ex.B-7:- | Claim Form dated 02.12.2015 with medical certificate |
08 | Ex.B-8:- | Legal notice dated 05.02.2016 |
09 | Ex.B-9:- | Acknowledgement |
10 | Ex.B-10:- | Legal Notice dated 25.02.2016 |
11 | Ex.B-11:- | Repudiation letter dated 16.03.2016 |
MEMBER PRESIDENT
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