This appeal is directed against the final order by Ld. D.C.D.R.F, Dakshin Dinajpur dated 14/06/2018 in connection with CC/9/2016. The instant case in a nutshell is that the appellant Aju Mondal has purchased a tractor bearing registration no. WB619620 on 30/10/2012 from M/s M&M Ltd., Malda. And the said vehicle was insured with a policy issued by the respondent Cholamandalam M/s General Insurance Company Ltd. The said vehicle met with an accident on 27/06/2015 and got damaged. The accident was informed to the I.C Ganagarampore on 30/06/2015. And the said vehicle was seized by the police for investigation. The vehicle was released subsequently from the custody of the police and the complainant/appellant Aju Mandol then took an estimation of damage from the Durga Machinery Mart which was the authorized servicing centre of the Mahindra and Mahindra Company. The loss was estimated at Rs. 4,00,7912 and the appellant raised a claim before the insurer on 05/08/2015 which was repudiated on 31/07/2015 on the ground of no effective driving license was there who was plying the vehicle as driver. At the point of admission stage Ld. Forum had dismissed the complaint on the ground that the driver had no valid driving license at the time of accident. The complainant/appellant then preferred an appeal against the order of Ld. D.C.D.R.F, Dakshin Dinajpur before the Hon’ble State Commission, Kolkata. The hon’ble State Commission, Kolkata after hearing the appeal on merit observed that the driving license of the driver was issued by the licensing authority on 28/06/2010 and it was valid up to 27/06/2016 while the accident was occurred on 27/06/2015 and for that reason Hon’ble State Commission, Kolkata Bench allowed the appeal and was pleased to set aside the order of Ld. Forum, and the Ld. Forum was asked to dispose of consumer complaint on merit after issuing proper notice to the Opposite parties. The opposite parties were issued notice. The insurance company Cholamandalam M/s General Insurance Company Ltd. had contested the consumer complaint by submitting the written version contended inter alia that the insurance company not duly informed about the alleged accident immediately after its occurrence. The OP insurance company was informed about the accident while the petitioner submitted a claim application for receiving compensation. The further case of the Ops is that the driver had no valid driving license at the point of time which was the breach of the terms and conditions of the insurance policy. The further case of the Opposite Parties is that the complainant side could not produce the material documents before the company and for that reason the company was not compelled to release the compensation as claimed by the complainant and there were no deficiency of service on the part of the insurance company. Ld. Forum had decided the case on merit after recording evidences on perusal of the annexure documents and came to a conclusion that the complainant raised the claim after six months from the date of incident and the claim of the complainant was rightly repudiated by the insurance company and consumer complaint was dismissed on the ground that the complainant could not provide proper documents in support of his claim.

            Being aggrieved with this order this appeal follows on the ground that the observation of Ld. Forum was full of error mis conceived one and liable to be set aside. The appeal was registered in 11/10/2018 and the respondents were issued notice. The respondent Cholamandalam M/s General Insurance Company Ltd. had contested the appeal by appointing the Ld. Advocate to conduct the case of the respondents. Appeal was heard in presence of Ld. Advocates of both sides.

D E C I S I O N S   W I T H   R E A S O N S

Having heard the Ld. Advocate of both sides and on perusal of the pleadings of both sides before the Ld. Forum this Commission found that the appellant/complainant was a valid consumer who purchased the policy certificate for his vehicle no. WB619620 and the accident was held within the existence of the policy period. The claim was repudiated on the ground that the driver had no valid driving license at the material point of time and claim was raised by the complainant after six months from the date of accident. Now the first point has already clarified by the Hon’ble State Commission where it was found that the driver was holding a valid driving license issued by the licensing authority at the material point of time and for that reason, the repudiation of the claim on the part of respondent no. 1 was found illegal one. The second point is to determine as to which date and when the complainant has raised the claim for compensation. We know very well that claim should be met immediately after the accident. The insurance company in their written version mentions that the claimant informed about the accident to the insurer when he submitted the claim application for receiving compensation. In written version, the respondent does not speak as on which date the company has received the claim application from the complainant. While the complainant in their consumer complaint in para 3 mentioned that the claim application was furnished before the insurance company on 05/08/2015. At the time of argument Ld. Advocate of the appellant invites the attention of the commission by mentioning annexure 19 which speaks that in response to the claim of compensation the respondent company issued a letter to the complainant on 06/07/2015 which covers the exact date of furnishing the compensation claim that is on 29/06/2015. The alleged accident took place on 27/06/2015. The matter was reported to the concerned P.S on 30/06/2015 and a regular case was recorded by police on 04/07/2015 Ld. Forum had enough ground to suspect as to why the police was informed after 4-5 days of the accident and why the accidental case was recorded by the concerned P.S on 04/07/2015. The complainant could not satisfy the Ld. Forum about in which date the claim application was submitted and for that reason the Ld. Forum had dismissed the complaint on the ground for not production of proper documents. The Ld. Advocate of the respondent at the time of argument mentioned that there are catena of judgements of Hon’ble National Commission and Apex Court that the news of accident should be reported to the insurance company immediately means within couple of hours since the time of accident. But, here in this case the complainant could not comply the terms and conditions of the policy as the accident was reported to the insurance company in a belated stage and for that reason the Ld. Forum had reasonable ground to disbelieve the case of the complainant.

            After accepting the views of Ld. Advocates of both sides and on perusal of the necessary documents, it has become crystal clear that prior to the report of the accident before the police the complainant has raised the claim before the insurance company for compensation.

            From the very documents produced by the respondent, the Commission has no hesitation to hold that within 48 hours the report of accident and claim of compensation was simultaneously lodged before the insurance company and for that reason the repudiation of claim on the part of the insurance company are found to be illegal one. Here the term “immediately” does not mean that within seconds or minutes the report of accident to be informed to the insurance company.

The claim application was registered on 29/06/2015. The claim was repudiated on 31/07/2015 on the ground (annexure 23) that the driver had no valid driving license. The damage was estimated by D M Mart Automotive (P) Ltd. erstwhile known as Durga Machinery Mart on 05/08/2015 that is after repudiation of the claim. The insurance company has got no estimation about the damage or loss sustained by the complainant arising to the instant accident by appointing any surveyor. No document has furnished before the Forum or before this Commission on the part of the Insurance company that the insurance company also took initiative to have a survey to ascertain or estimation of loss arising out of the said accident. At the time of argument Ld. Advocate of the respondent mentioned before this Commission that subsequently the insurance company has appointed a surveyor to met an estimation of cost for repairing of the vehicle. And they are ready to produce the same. So, our overall conclusion of the Commission is that in this case the order of the Ld. Forum under appeal found to be irregular and not authorized in law. 

The Ld. Forum has dismissed the complainant on the ground of not producing the vital documents and the claim applicant was furnished before the company after six months of the accident. While the insurance company has repudiated the claim for want of valid D.L of the driver.

So, it requires interference to prevent the mis courage of justice. Ld. Forum should rehear the case again by giving an opportunity of both sides to furnish any relevant documents in support of their case and after hearing the parties and after perusing all the material documents in this case Ld. Forum should pass a final verdict over the alleged consumer dispute within two months. Ld. Forum need not go to determine whether the compensation claim was lodged within a short span of time or not from the date of incident as because this Commission has already found that the compensation claim was lodged on 29/06/2015 that is within 48 hours since the time of accident. Ld. Forum shall have only to determine the actual estimation of damage sustained by the complainant arising to this accident and have to consult with the loss of estimation furnished by the complainant and also to the estimation by any surveyor appointed by the insurance company and thereafter determine the compensation amount and other relieves as prayed by the complainant which the Ld. Forum thinks it proper and fit. As a result the appeal succeeds.

Hence it is ordered: -

That the instant appeal be and the same is hereby allowed on contest without imposing any cost. The order of Ld. Forum dated 14/06/2018 in CC/9/2016 is hereby set aside. Ld. Forum is requested to adjudicate the dispute within two months in accordance with the observation of this Commission in this appeal case along with the decisions of Hon’ble State Commission, Kolkata Bench in reference to appeal no. A/519/2016 dated 28/11/2017. Let a copy of this order be supplied to the parties to this case free of cost and this final order of this Commission be communicated to the Ld. Forum immediately.