DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KANDHAMAL, PHULBANI

C.C.NO. 31 OF 2022

                                                                                              Date of Filing  : 08.08.2022

                      Date of Order :  31.01.2023

Sri Prasant Kumar Panda,

S/o Late Gadadhar Panda,

At/PO- Amalapada, Phulbani,

PS-Phulbani Town,

District-Kandhamal                               …………………….. Complainant.

Versus.

1. The Manager (Claim),

SBI General Insurance Co. Ltd.

At 3^rd and 4^th Floor, Lotus IT Part Road No. 16,

Plot No. B-18, 19 Wangle Industrial Estates,

Thane (W) Thane-400604.

2.  The Branch Manager,

SBI General Insurance Co. Ltd.

At/PO-Sai Complex, Berhampur,

District- Ganjam                                   …………………….. Opp. Parties.

Present: Sri Purna Chandra Mishra    - President.

                             Sri Sudhakar Senapothi          - Member.

For the Complainant: Mr. Purna Chandra Tripathy Advocate

For OP No. 1 and 2  : Mr. V.V.Das, Advocate

JUDGEMENT

Mr. Purna Chandra Mishra, President

Complainant Prasanta Kumar Panda has filed this petition U/S 35 of C.P. Act 2019 alleging deficiency of service on the part of the O.Ps. for not settling his insurance claim and praying therein for direction to the OPs to settle the claim, a sum of Rs. 50,000/- towards mental agony and deficiency in service and a sum of Rs. 20,000/- towards litigation.

1. Brief fact leading to the case is that the complainant is the owner of one Mahendra Bolero pick-up van bearing registration No. OD07C2575 out of which he earns his livelihood by way of self employment. The vehicle was insured with the OP insurance company vide Policy No. 638818501which was valid from 17.05.2018 to 16.05.2019. During the force of the policy, the vehicle was stolen in the night of 18.02.2019. Next morning, as he did not trace out the vehicle in spite of his all efforts, he lodged an FIR in Phulbani Town PS vide PS case No. 0017 dt. 19.02.2019. The complainant also on the same day intimated the matter to OP No. 1 and 2 and after intimation, the claim was registered and the claim Number was MVO 77205 dt. 19.02.2019. on 18.04.2019, the complainant received a letter from OP No. 1 wherein he was instructed to furnish certain documents along with final report of Police. But, as the investigation was in progress, he could not submit the Final Form. The OP No.1 deputed one Surveyor namely Bikash Biswal who inspected the spot and received a document relating to the vehicle. Thereafter, the OP No.1 issued reminders and asked for the documents with Final Report and finally, on 24.05.2019, the OP No. 1 issued a claim closure letter on the ground of non-submission of the document.  The Final Report of the police was submitted on 10.09.2019 as FRT No Clue. After receiving the copy of Final Form, the complainant submitted the copy thereof along with further documents to OP No. 2. The OP No. 2 advised the complainant to make a fresh application along with the documents to reopen the claim file and assured him of quick settlement after obtaining the approval from his higher authority. In the meantime, 2-3 months passed and no action was initiated by the OPs and thereafter, the pandemic situation started from March 2020 and after the pandemic situation is over, in the month of November-2022, the complainant requested the OPs to submit a status report to him regarding the fact of the claim. As no reply was received from him, he issued a pleader notice on 05.07.2022 and even though, the notice was duly served, the OPs remained silent for which the complainant filed this case before the commission for the reliefs as discussed above.
2. After receipt of notice, the Opposite Parties appeared through their advocate and filed the written version. In their written version, the OPs admitted regarding the cover of policy on the date of occurrence and stated that the IDV of the vehicle is Rs. 253398/-. The claim was pending for non-submission of the documents viz. Police Final Report, copy of the FIR, original RC, vehicle history, original RTO intimation letter, original intimation letter to NCRB with RP AD Slip, letter of subrogation, letter of indemnity etc. several reminders were issued to the complainant on 18.04.2019. 08.05.2019 and 17.05.2019. In spite of repeated reminders, the complainant did not respond for which the claim was closed on 24.05.2019. The complainant was not entitled for an amount of Rs. 570000/- as compensation as they have processed the claim as per policy terms and conditions. Therefore, they pray for dismissal of case with cost.
3. The complainant in support of his case has filed the copy of the FIR dt. 19.02.2019, copy of the vehicle particulars, copies of the letter dt. 08.05.2019, 17.05.2019 and 24.05.2019 issued by OP No. 1 to the complainant. Copy of pleader notice dt. 05.07.2022, copy of postal receipt dt. 07.07.2022, copy of postal tracking report dt. 12.07.2022, copy of the policy in support of his case.
4. On the other hand, the opposite party has filed the copy of the policy scheduled, copy of the reminder letters and copy of the claim closure letter.
5. In view of the pleadings and counter pleadings of the parties, the only point to be examined is whether the OPs are justified in closing the claim of the complainant vide their letter dt. 24.05.2019?

It is pleaded in Para-6 of the complaint petition that the OP No.1 deputed Surveyor Shri Bikash Biswal who inspected the spot and received the documents relating to the vehicle from the complainant. This fact is not denial by the opposite party in his written statement. It is also seen from the Final Form submitted by Phulbani Town PS that the Final Form submitted on 10.09.2019. When Police had not completed the investigation and had not submitted the Final Report, it is not possible on the part of the complainant to produce the document before the opposite parties. It appears that the opposite parties in utter haste has closed the claim on 24.05.2019. So, non-submission of the Final Firm on or before 24.05.2019 was beyond the control of the complainant and he has patiently waited for the Final Form which was submitted on 10.09.2019. So in opinion, closure of the claim on 24.05.2019 by the Insurance Company is unjustified and is violative of the principles of natural justice.

6. As the opposite parties did not wait till the completion of the investigation by police and closed the claim, it amounts deficiency in service and the OPs are liable to pay the insurance claim and compensate the petitioner for the loss sustained by him and hence the order.

ORDER

                  The complaint petition is allowed on contest against the OPs. The OPs are made liable for causing deficiency in service and harassment to the complainant. The OPs are directed to pay a sum of Rs. 2,53,398/- (Rupees Two Lakh Fifty Three Thousand Three Hundred Ninety Eight) to the complainant with an interest @ 9% per annum from the date of  submission of Final Form by police i.e. 10.09.2019 till it is actually paid to the complainant. It is made clear that the complainant will provide the copy of any document that may be required by the OPs. The OPs are further directed to intimate the complainant which documents they require within a week from the date of receipt of the order and the complainant will comply with the requirements within 15 days from the date of receipt of such intimation from the OPs. The OPs shall not ask for any document which they have not required in their earlier letters. Parties to bear their own cost.

                                                    Computerized & corrected by me.

         I Agree

     MEMBER                                                             PRESIDENT

Pronounced in the open Commissioner today on this 31st day of January 2023 in the presence of the parties.      

     MEMBER                                                             PRESIDENT