The complainant is the registered owner of Maruti Van JH04E1561 which was insured by Opposite Parties under Private Car Package policy no. 332401/31/2017/3820 for the period from 24.01.17 to 23.01.18 covering the risk of Rs 750,000 and also driver owner up to Rs 2,00,000. But when the accident occured of the said vehicle on 07.05.17 and complainant claimed for medical expenses and also for repairing of the vehicle from O.P who denied the claim of the complainant. For that the complainant has instituted this case.
The complainant case in brief is that complainant got insured his vehicle JH04E1561 by the opposite parties under Private Car package policy no. 33201/31/2017/3820 for the period 24.01.17 to 23.01.18 covering risk for insured including driver up to Rs 7,50,000 for registered owner and driver Rs 2,00,000. The complainant is registered owner and also driver of the said vehicle. The said vehicle met with an accident on 07.05.17 when the complainant’s vehicle dashed with a tree to save the life of a dog near Sugabathan Bridge between Hansdiha to Pathargama road and the vehicle was also got damaged badly.
The complainant was taken to the hospital but local clinic or hospital did not accepted the patient, hence he was taken to the Steel City Clinics Research Centre, Jamshedpur on 08.05.17 and during the treatment he expanded about Rs 1,10,468 and also for the repairing of the vehicle he expanded Rs 1,47,269. It is further stated that information was given to the police by the complainant’s son Aman Choudhary and Poraiyahat police seized the vehicle and handed over to the son of complainant on 30.06.15 were the information was registered as S.D no. 16/17 dated 30.06.17 after that the vehicle was taken to Dumka in National Engineering works for repairing who submitted bill of 147269 dt. 15.07.17. The information regarding accident was also given to the O.P just after accident on 10.05.17 by the son of the complainant who issued claim form and after discharge from the the hospital from Jamshedpur he submitted claim form duly filled with all essential and required documents which was registered as claim no. 332401/31/2018/000024.
It is further submitted that the complainant waited for claim amount since 2017 but after lapse of 1 year there is no whisper from the side of the respondent to pay the claim amount. When the complainant submitted petition dt. 30.04.18 asking about present status of the aforesaid claim but the opposite parties said that the inquiries are being done which may take 3 to 4 months. After that complainant sent a pleader notice on 29.05.18.
The opposite parties by his letter dt. 22.11.17 asking from complainant the tax token and duly filled discharge vouchers by affixing revenue one rupee revenue stamp with bank account details discharge voucher was submitted earlier to the respondent. The complainant went to the opposite parties and asked to bring out discharged voucher. But the O.P said it was not necessary let the higher authority pass the claim first. As such the O.P has filed the policy terms and has created mental agony, physical harassment to the complainant. The complainant demand following reliefs :-
The Complainant claim following reliefs:-
- Principal expenses on medical and repairing of the vehicle Rs 257737.
- Compensation for mental harassment and agony Rs 50,000.
- Cost of litigation Rs 25,000.
The complainant further stated that cause of action arose on 23.01.17 when the complainant’s vehicle was insured on 07.05.17 when the vehicle was met with an accident and complainant sustained various injuries and vehicle got damaged, on 07.05.17 when the Poraiyahat Police satation seized the vehicle, on the informing the O.P about the accident who sent surveyor for inquiry and report and also arose on 11.05.17 when the complainant was discharged from hospital. And also on 29.05.18 when the pleaders notice was sent to the O.P. The complainant has prayed that the O.P be directed to pay the medical expenses as well as carry charges of total Rs 110,468 and repairing charges of the vehicle Rs 147,269 and also be directed to pay 50,000 as compensation and also further to be directed to pay Rs 25,000 as the cost of litigation with 12% interest on the principal amount.
The O.P appeared and filed his show cause on 29.08.19 stating there under that the petition of the complainant is wholly misconceived, illegal and not tenable in law. There is no valid cause of action of complaint to the complainant as the O.P has not been repudiated the claim of the complainant as yet. It is further submitted that there is no deficiency or latches whatsoever on the part of opposite parties. In fact the latches were on the part of the complainant himself. The insured accidental vehicle met with an accident on 07.05.17 and the complainant did not inform this O.P, the insurer, Oriental Insurance Co. immedieately. Moreover he lodged a sanha on Poraiyahat P.S on 30.06.17 vide S.D. no. 16/17. A copy of Sanha is annexed with as Annexure – A. When the O.P made some queries vide this letter dt. 08.01.18 regarding his discrepancies in Sanha the information given to this O.P. The query is still unanswered. Copy of this is annexed as Annexure – B. It is submitted fact in Para 7 by the O.P that the said vehicle JHo4E/1561 was insured by the O.P under Private Car Package policy Zone B vide Policy no. 332401/31/20173320 valid for the period from 24.01.17 to 23.01.18. It is further stated in Para 8 of the so cause at the stage when the insured claim was being looked into and papers were being scrutinized in the light of the terms and condition of insurance policy with a view to examine the claim and make payment it will be a wrong allegation to say that the insurer did not pay the medical expenses for injuries occurred in the accident of the vehicle. It is pertinent to mention here that the complainant did not claim demand for the expenses incurred on medical treatment in his claim petition. It is further admitted that the vehicle in question mentioned in the insurance policy cover the risk of insured with limit of liability u/s 111 in respect of anyone claim for series arising out of one event Rs 7,50,000 p.a. covered u/s 111 for Registered- Owner- Cum- Driver Rs 2,00,000. It is further stated that the complainant has filed this case and the claim is still not repudiated by this opposite parties and under basis of examination and question of arising cause of action does not arise. As the claim of the complainant has not been repudiated even now the complainant may file petition before the Learned Forum for settling the matter outside the court, the O.P will welcome this idea. And it is submitted that in the light of petition facts and circumstances and in the interest of justice the claim of the complainant is deserves to be dismissed with cost.
The main point for the determination in this case is whether the complainant is entitled to get any relief or reliefs as claimed?
Finding
The complainant in support of his case has filed his affidavit as witness as C.W. – 1Ajit Choudhary and as documentary evidence he has filed following documents which is as follows:-
Exhibit 1 – Motor Insurance Certificate Cum Policy Schedule.
Exhibit 2 – is the photocopy of information of accident / given to Poraiyahat P.S which was registered as S.D.E no. 16/17 dt. 30.06.18.
Exhibit 3 –is the photocopy of certificate of registration of vehicle no. JH04E1561.
Exhibit 4 – Photocopy of DL of Ajit Choudhary.
Exhibit 5 – is the total 10 sheets which is regarding the money receipts issued by Steel City Clinic and Research Centre, Jamshedpur.
Exhibit 6 – is the ambulance hire no. receipts dt. 05.08.17.
Exhibit 7 – is the letter dt. 22.11.17 issued by Oriental Insurance Company Ltd. to the complainant.
Exhibit 8 – is the photocopy of written letter by complainant dt. 30.04.18.
Exhibit 9 – is the legal notice of the complainant dt. 29.05.18.
Exhibit 10 – in 4 sheets is the estimate for accidental vehicle JH04E1561 issued by national Engineering Works amounting Rs 147,269.
Apart from that no other documents has been adduced by the complainant in support of his case. The opposite parties in support of his case have submitted following documents:-
- Annexure – A – The photocopy of written report of complainant dt. 30.06.17 which was registered as S.D.E no. 16/17 dt. 30.06.17.
- Annexure – B - is the letter dt. 08.01.2018 sent to the complainant by the O.P.
Apart from that the O.P has not filed any other written oral evidence.
The CW1 is none other but the complainant Ajit Choudhary himself. In his affidavit he has fully supported his case and stated that he was admitted after the accident to the hospital at Jamshedpur and expanded Rs 110,468 and also expanded in the repairing cost of the vehicle about Rs 147269. It is further stated that on the date of occurrence his son informed to the police station which was registered in P.S concern as SDE no. 16/17 dt. 30.06.17 and regarding accident his son informed to the opposite parties on 10.05.17 and also filled the claim forum by the complainant after discharge from the hospital. It is further stated that on 22.11.17 the opposite parties demanded tax token and discharge voucher on with revenue stamp and he submitted at once those documents of the O.P. He further stated that in the registration certificate it is mention that tax has already been deposited till 24.02.2026. He has also given pleader notice to the O.P but O.P did not pay anything. And during cross examination although in Para 20 this witness has stated that he has only claim for vehicle not for medical reimbursement. But in Para 21 he has clearly stated that he got treatment at Jamshedpur Steel City hospital. From the perusal of complaint petition at Para 7 it is apparently clear that the complainant has filed the required documents in this case including policy bond registration certificate and also medical expenses receipts along with repairing voucher of the vehicle concerned. It is of upheld of learned council of the opposite parties that complainant has not claimed medical expenses in his claim petition. But going through statement of CW1 and also the complaint petition in Para 3, 4 it is crystal clear that the complainant who is Owner- Cum – Driver assistance graves injury on the said accident occurred on 07.05.17 and there after he was taken to Jamshedpur for better treatment and admitted to the Steel City Clinic and Research Centre Jamshedpur. Exhibit 5 is the money receipts of both the cash memo and discharge slip which clearly indicates that the complainant was admitted to the said clinic on 08.05.17 and discharged from the said hospital on 11.05.17 and during that period he expanded about Rs 110,468 as medical expenses merely saying that complainant has not claimed medical claim merely on the basis of the statement of CW1 Para 20 is not proper and justifiable.
The complainant has also claimed repairing cost of the said vehicle amounting Rs 147,269. He also filed the estimated issue by National Engineering Works which is Exhibit 10, it is amounting Rs 147,269. The O.P in his so cause in Para 3 has clearly admitted this fact that he has not repudiated claim of the complainant as yet. He has simply inquired regarding some deficiency or latched on the part of the complainant. He further stated that the accident took place on 07.05.17 and the complainant did not inform this O.P the insurer, The Oriental Insurance Company immediately. Moreover he lodged a Sanha in Poraiyahat P.S on 30.06.17 which was registered as S.D.E no. 16/17 which is Annexure - A corresponding to the Exhibit 2. But this is admitted fact that vehicle was insured vide policy no. 332401/31/20173300 which was filed for the period from 24.01.17 to 23.01.18 and the said accident took place on 07.05.17. Apparently the accident took place within the insured period and it is also admitted fact that the complainant has not repudiated the claim of the complainant till today and when the opposite parties was looking into the papers of the complainant and in the light of terms and conditions of Insurance Policy with a view to examine the claim and to make the payment the complainant filed this case before this forum. It is further submitted that it is wrong to say that the insurer did not pay the medical expenses for injuries occurred in the accident of the vehicle. But it is mentioned here that the complainant did not claim/ damages for expenses incurred in the medical treatment of his claim petition. But going through the claim petition the allegation of the opposite parties in this regard is not correct as the complainant in the complaint petition in Para 3 and 4 categorically described about his injuries and also expenditure in the hospital and filed the bill and voucher which is Exhibit 5.
So far as deficiency or difference in Exhibit 1 and corresponding to Exhibit 2 the written report it is submitted on upheld of the complainant that he informed the P.S concerned regarding accident on the same day that is the date of accident on 07.05.17 but P.S concerned registered the same as S.D.E no. 16/17 dt. 30.06.17. As such there is no any fault on the upheld of the complainant in giving the information to the P.S concerned. It is also submitted by the complainant in Para (iv) on page 3 of the complaint petition that the information was given to the police station by complainant’s son Aman Choudhary on the same day and further stated that vehicle was taken to Dumka National Engineering Works for repairing who submitted bill on 17.05.17. And further stated that information of accident was given to the respondent which is after accident that is on 10.05.17 by the son of the complainant who issued claim form and after discharge from hospital Jamshedpur and submitted the claim form duly filed with all essential and required documents under the claim no.332401/31/2018/000024.
From going through the Exhibit 1/ Exhibit 2, I find there is no any vital discrepancy which indicates the occurrence.
It is admitted fact that the accident took place during insured period and the vehicle was insured by the O.P and the O.P has not still repudiated claim of the complainant and from going through Exhibit 1 which is Motor Insured Certificate Cum Policy Schedule Private car Package Zone B in which the claim arising out of one fund is Rs 756,000 and u/s 3 for registration Owner – Cum - Driver Rs 2,00,000. Here in this case the complainant who is driver cum owner of the vehicle has claimed medical expenses of Rs 110464 and also claim arising out of repairing cost of the vehicle of Rs 147269. Both the claims of the complainant is within purview of the package policy. Apparently the accident took on 07.05.17 and till today that is after lapse of about 5 years the complainant is suffering by the conduct of the opposite parties. And the complainant has filed the policy terms in giving proper service to the complainant and he has suffered from physical and mental agony for which the opposite party is responsible.
It is therefore,
Order
The opposite parties Oriental Insurance Company Ltd. court compound, Dumka district is here by directed to pay expenses regarding medical and repairing of the vehicle Rs 257737 and also compensation of Rs 50000 and cost of litigation Rs 25000 with 12% interest on the principal amount from the filing of the case till the payment.
Within the period of 1 month this case and the same is hereby disposed of on contest with cost.
Let the copy of this order be given to both the parties free of cost.
