Orissa

Rayagada

CC/102/2016

Smt. Ulumpa Kasalya - Complainant(s)

Versus

The General Manager, Sriram General Insurance Ltd., - Opp.Party(s)

Self

16 Jan 2018

ORDER

DISTRICT   CONSUMER  DISPUTES REDRESSAL    FORUM, RAYAGADA,

STATE:  ODISHA.

C.C. Case  No. 102/ 2016.                                        Date.       16.     01   . 2018.

P R E S E N T .

Dr. Aswini  Kumar Mohapatra,                                                   President

Sri GadadharaSahu,                                                                        Member.

Smt.PadmalayaMishra,.                                                                                 Member

Smt.  Ulumpa Kasalya @Koushalya, W/O: Rabndra Koushalya @ Kasalya, Vill: Khataganta, Po:Narayanapur,     Dist.Rayagada, State:  Odisha.                                                                                                                                                                                  …….Complainant

Vrs.

1.The General Manager,  Shriram General Insurance Company  Ltd., E-8, RIICO Industrial Area Sitapura, Jaipur, Rajasthan- 302022.

 

2.The Manager,  Shriram General Insurance Company  Ltd., Po/Dist: Rayagada(Odisha).                                                                                            .…..Opp.Parties

Counsel for the parties:                                 

For the complainant: - Sri Krushna Chandra Bisoi, Advocate,

For the O.P.:-  Sri Pratap Chandra  Das, Advocate,  Rayagada.

                                                          J u d g e m e n t.

         

          The  present dispute arises out of the complaint petition filed by the above named complainant alleging deficiency in service  against  afore mentioned O.Ps for non payment of insurance amount a sum of  Rs.2,00,000/-. The brief facts of the case are summarized here  under.

          1.That the complainant is the nominee-wife of Rabindra Koushaalya @Kasalya (insured) person-deceased) owner of vehicle Regd. No. OD-A-18A 9493 Model –AUTOP,  availed   an insurance policy  under the O.Ps  in his life time.  The  O.Ps  had issued  an insurance policy in favour of Rabindra Koushalya @Kasalya. The  said policy is one comprehensive  policy, vide policy No. 100003/31/15/646951  coverage of the accident  to insured person.   The O.P. has mentioned in his policy  as well  as said  policy covered  under any  person    including  insured are entitled to get accidental compensation amount a sum of Rs. 2 lakhs.  The said policy  was valid and in force from 26.3.2015 o 25.3.2017 midnight. The policy holder husband of the complainant on Dt. 10.12.2015  while returning  to his  home from Kalyansinghpur by driving  his own above Auto near Kusumsila Chakka under Kalyansinghpur P.S.  met accident by one unidentified Haiba loaded truck and the offender truck  dashed the deceased consequent upon  the  deceased received sever bleeding  injuries on his head and vital organs  like brain and lungs and succumbed to the injuries at the spot.  Thereafter  the complainant and other co-villager informed to the police station   K.Singhpur on Dt. 10.12.2015 and the same registered a PS case No. 139, thereafter the  Police station K.Singhpursend the dead body to the  District Head Quarter Hospital,Rayagada for conduct  post morterm over the dead body vide reference case No.84 Dt. 12.12.2015. The complainant filed grievance-cum-advocate notice  on DT.23.1.2016 to the O.Ps through  her advocate for the payment of insured compensation amount of her deceased Husband Rabindra Koushalya, but  the O.Ps  paid  deaf ear. Hence this case. The complainant prays the forum direct the O.Ps to pay  death claim insurance amount a sum of Rs.2,00,000/- inter alia Rs.50,000/- towards  litigation charges and other  reliefs as the hon’ble  forum deems fit and proper for the best interest of justice.

          2.On being noticed the O.Ps filed  written version through their learned counsel and submitted that  complaint petition are not true.  The complainant is called upon to prove the same which are not admitted here under.   There are  latches on the part of the  complainant for  non submission of the document for settling the claim. The number of grounds have been raised in the written version by the O.Ps.   Hence the O.Ps prayed the forum to dismiss the complaint petition  for the best interest of justice.

The O.Ps appeared and filed their written version.  Heard arguments from the  learned counsel for  the  complainant  and O.Ps.    Perused the record, documents, written version  filed by the parties. 

The  parties     vehemently advanced arguments touching the points both on the facts  as well as on  law.

                                                FINDINGS.

3.On perusal of the record we observed  it is not disputed  that the complainant had  package  policy  bearing  No.10003/31/15/646951  valid  for the period from  26.3.2015 to  25.3.2016 mid night. Again it is not disputed that deceased Rabindra Kousalya  was the Registered owner of the Auto bearing  Regd  No. OD-18-A-9493.   Further  it is not disputed the policy covers the risk for the owner –cum-driver up to Rs.2,00,000/- PACKAGE POLICY.

The O.P. in  their written version para No.3 clearly mentioned that the complainant has not filed any documents before the O.Ps to know that she is the wife of the deceased Rabindra Kousalya.  During the course of hearing  the learned counsel for the complainant field  Legal notice  along  with  postal acknowledgement (in original) before the forum  which are marked as Exhibit  No.1 and  Exhibit No.2 .  The  O.P. contended that in the policy the name of the complainant does not finds place as nominee of deceased Rabaindra Kousalya. In support of this the complainant filed Voter I.D. (Xerox copies) where  deceased name Rabindra Kasalya  mentioned  as   husband  of the complainant  which is marked Annexure –I.  

The O.P. in their written version para-4  contended that O.Ps have no information that while   deceased was returning to house from K.Singhpur driving  his own vehicle on Dtg. 10.12.2015 his Auto meet met  accident with Truck and due to such  accident  deceased Rabindra Kousalaya sustained  bleeding injuries on his head and vital organs and died on the spot.  In support of this the complainant  has filed   F.I.R, Post mortem report,  Inquest report, Accident report from MVI, Death certificate of deceased which are marked as Annexure-3 to Annexure-7 .

In para-5  of the written version the O.P. contended that  after getting information regarding the death of deceased the  O.P.  in turn  on Dt.23.2.2016 requested the complainant to submit  the documents mention in the letter  for processing the claim which is marked as Annexure-8.     Hence the complainant be directed to submit all the documents to the O.Ps.  It is revealed that the complainant without submitting all  the documents  before the O.Ps  has filed  C.C. case  before the forum  on Dt. 18.3.2016.  

At  this stage this forum observed   the interest of justice  would met if  the O.P. received  all the documents filed by the complainant relating to the case from   the complainant  and be settled the matter and to pay the insured amount to the complainant with in 60 days.

The O.Ps in their written version  para  No. 10 contended that the case is not maintainable before the forum. Prior  to delve in to the merit  of the case on outset  we have to  consider whether the complaint petition  is maintainable   under C.P. Act ?  While answering  the issue  we would like to refer the citation. It is held and reported in  CPC- 1991, page -540 the  Hon’ble  Hariyana State  Commission held that when ever there is any delay or dilatoriness in finalizing  the insurance claim, the same would be tenta  mount to a  deficiency  in service and thus comes squarely within the  purview of Consumer Forum.  Once it is held that default or negligence in the  settlement of an insurance claim is a deficiency  in service then an arbitrary  or mischievous  rejection  of an insurance claim  would patently  be a default  within its larger  meaning. On principle , it would   seem  some what manifest that the mere repudiation of the insurance claim cannot itself operate  as a  jurisdiction bar for redressel forums under the Act.  This is further  made it clear  it is held and reported  in CPR-1991(2), page No.18  where in  the Hon’ble National Commission  clearly defines  the mere unilateral  rejection of an insured parties  claimed by the insurer does not  per  se  operate as jurisdictional bar to seek redressal before  the forums under the Act. Accordingly answered the issue.   The complaint  petition  is  maintainable  under the C.P. Act.

In view of the above discussion relating to the above case and  In Res-IPSA-Loquiture  as well as  in the light of the settled legal position  discussed  as above referring citations  which is Aliane Juris. Hence  we allow the above complaint petition  in part.

Hence  to  meet the  ends of justice, the following order is passed.                                                                                                           ORDER.

            In  resultant    the complaint petition is allowed  in  part  on  contest against  the O.Ps. 

4.The O.Ps  ordered  to receive all the documents  pertaining to  this case from the complainant and settled the matter at their level  inter alia  to pay the insured amount  a sum of Rs.2,00,000/- to the complainant with in time frame .  The complainant is directed to  submit all the documents pertaining to the above case  to the O.P. within 15 days.  Parties are left to bear their own cost.

The OPs     ordered to make compliance the aforesaid Order within  60 days from the  date of  receipt  of this order      failing which  an interest  @ Rs.9%  per annum  would  accrue on the above  amount . from  the date of  default   till  realization.

   Serve the copies of above order to the parties free of cost.

 

Dictated and corrected by me

Pronounced on this         16 ^th.   Day of     January  ,   2018.

 

Member.                                                             Member.                                                              President