Date of filing:- 19/05/2020.

Date of Order:-27/05/2024.

DISTRICT CONSUMER DISPUTE REDRESSAL COMMISSION

B A R G A R H (ODISHA).

Consumer Complaint No. 41 of  2020.

            Narasingh Dash, S/o Pitabas Dash, aged about 29(twenty nine) years, R/o. Village. Khandahatha, Po. Khandahatha, Ps. Bargarh Sada, Dist. Bargarh.

                                                                          .....          .....        .....             Complainant.

-: V e r s u s :-

            The Legal Manager, HDFC ERGO General Insurance Company Ltd., At 2^nd Floor, O.S.L.Tower-III, Badambadi, Cuttack, Odisha-753012.

                   .....            .....       .....    Opposite Party.

Counsel for the Parties:-

For the Complainant :- Sri M.Sahu, Advocate with associates.

For the Opposite Party  :-        Sri A.K.Dash, Advocate with associates.

                                                            -: P  R  E  S  E  N  T :-

Smt. Jigeesha Mishra               .....       .....       .....       .....       .....       P r e s i d e n t.

Smt. Anju Agrawal             .....            .....       .....       .....       .....       M e m b e r (W).

Dt.27/05/2024.                                 -: J   U  D   G  E  M  E  N  T:-

Presented by Smt. Anju Agrawal, Member(w):-   

1)         The case of the Complainant is that the Complainant the registered owner of a i20 car bearing Regd. No. OD-17-J-4004 and the said vehicle was insured with the Opposite Party/Company vide Policy No. 2311202525874700000 valid from Dt. 30-11-2018 to Dt. 29-11-2019. For the aforesaid policy the Opposite Party has received an amount of ₹ 750/-(Rupees seven hundred fifty)only for PA coverage of owner/driver up to ₹15,00,000/-(Rupees fifteen lakh)only. On 23^rd October 2019 at about 5.00 PM the vehicle of the Complainant met with an accident near Baijamunda Chowk and at the time of the accident one Gautam Dash was driving the vehicle having driving license duly issued by the competent authority vide No. OR-1720090031918. In the accident the Complainant sustained multiply injuries and was treated in Apollo Hospital, Bhubaneswar from Dt. 24-10-2019 to Dt. 06-11-2019 and has spend ₹ 5,00,000/-(Rupees five lakh)only for his treatment. The Complainant requested the officer of Opposite Party several times for payment of compensation but the Complainant has not received the same. The Complainant had served pleader notice on Dt. 17-02-2020 along with relevant documents for settlement but there was no response from Opposite Party. Hence the petition is filed by the Complainant for the deficiency in service by the Opposite Party praying that the Opposite Party be directed to settle the claim of the Complainant and a sum of  ₹7,00,000/-(Rupees seven lakh)only towards the medical expenses, pain and suffering and his loss of income as compensation.

2)         The case of the Opposite Party is that the Opposite Party has filed its version. The  Opposite Party has admitted that the vehicle of the Complainant bearing Regd. No. OD-17-J-4004 has been insured by the Opposite Party having validity from 30-11-2018 to 29-11-2019. It is further submitted by the Opposite Party after immediately after getting information about the accident of the insured vehicle on Dt.23-10-2019, the Opposite Party deputed a licensed Surveyor to survey the vehicle who ultimately after completion of the survey submitted his report before the Opposite Party and accordingly the Complainant was informed by the Opposite Party vide letter Dt.15-11-2019 and 25-11-2019 where in Complainant was asked to submit all relevant documents. In spite of the letter to the Complainant the Complainant did not take any step for submission of documents. Finally, having no option to continue the process of settlement and closed the same as “No Claim”. Although the claim was closed, on request of the Complainant and on receipt of his consent, his claim was eventually settled for an amount of ₹6,08,000/-(Rupees six lakh eight thousand)only. It is further submitted that on receipt of the pleader notice a reply to the same had been sent vide 4545510006440. As the claim has been settled there lies no deficiency in service on the part of the Opposite Party.

3)         After perusal of the complaint petition, version and documents filed by the parties and following issues are framed.

Issues

1. Whether the Opposite Party is deficient in its service ?    
2. Whether the Complainant is entitled to get relief ?

Issue No.1(one)

4)         It is an admitted fact by the Opposite Party that the Complainant vehicle bearing Regd. No. OD-17-J-4004 has been insured by the Opposite Party having validity from 30-11-2018 to 29-11-2019.  The Opposite Party further submitted that for need of various documents the process of settlement was closed as “No Claim” but in spite of closer letter Dt.25-11-2019 the Opposite Party has settled the claim as own damage claim and the claim has settled by the Opposite Party for an amount of ₹6,08,000/-(Rupees six lakh eight thousand)only. The Opposite Party has only reflected the annexures in the written version by no documents was filed regarding payment. It is the duty of Opposite Party to provide documentary evidence but the Opposite Party failed to prove regarding payment, the date on which payment on which made. When the policy is admitted, accident is admitted it is the duty of the Opposite Party to settle the claim. The Opposite Party is deficient in its service by non-settlement of claim during the valid period of insurance. The issue is answered accordingly.

Issue No.2(two)

5)         For deficiency in service of the Opposite Party the Complainant entitled to get relief. The issued answered accordingly.

            As per supra discussion,  the following order is passed.

                                                            O  R  D  E  R

6)         The complaint is allowed on contest against the Opposite Party. The Opposite Party is directed to settle the insurance claim with a sum of ₹6,08,000/-(Rupees six lakh eight thousand)only of the Complainant within 30(thirty) days of this Order. Further the Opposite Party is directed to pay ₹30,000/-(Rupees thirty thousand)only for deficiency in service and ₹10,000/-(Rupees ten thousand)only towards litigation expense to the Complainant. All the order to be complied within 30(thirty) days of this order, failing which, the entire awarded amount shall carry 12%(twelve percent) interest per annum till realization.

7)         Accordingly the order is pronounced in the open Commission to-day i.e.  Dt.27/05/2024 and the case is allowed against the Opposite Party and disposed off.

                                                                                             Typed to my dictation

                                                                                              and corrected by me.                                                                                                     

                                    I agree,                                              ( Smt. Anju Agrawal)

                                                                                                     M e m b e r(w).

                       (Smt. Jigeesha Mishra)

                              P r e s i d e n t.