Complaints filed on: 17-09-2022

                                                      Disposed on:05-06-2023

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, TUMAKURU

          DATED THIS THE 05^th DAY OF JUNE 2023

PRESENT

SMT.G.T.VIJAYALAKSHMI, B.Com., LLM., PRESIDENT

SRI.KUMARA.N, B.Sc. (Agri), LL.B., MBA., MEMBER

SMT.NIVEDITA RAVISH, B.A., L.L.B, LADY MEMBER

CC.No.137/2022

1.       Smt. Manjula .R W/o late Ravish .L

          Aged about 27 years.

2.       Kum.Sahana D/o L. Ravish

          Aged about 03 years, Minor

3.       Kum. Moulya D/o Ravish .L

          Aged about 01 year, Minor

4.       Smt. Manjamma W/o Lakshmaiah,

          Aged about 55 years,

5.       Sri. Lakshmaiah S/o Chikkathimmaiah,

          Aged about  60 years,

          All are residents of Bugudanahalli,

          Bellavi Hobli, Tumkur Taluk and Dist.

……….Complainant/s

(By Sri. B.S.Doreswamy, Adv.,)

V/s

The Manager,

HDFC Ergo General Insurance Co., Ltd.,

Office at HM Geneva House, Unit No.14,

No.108, 109, 110 & 111, 1^st Floor,

Cunningham Road, Bangalore-560 052.

……….Opposite Party

(By Sri. N.V.Naveen Kuamr, Adv.,)

:ORDER:

BY SMT.G.T.VIJAYALAKSHMI, PRESIDENT

This complaint has been filed by the complainant against the OP U/s 35 of the Consumer Protection Act 2019 with a prayer to direct the OP to pay the death benefit amount for owner/driver of the Isher Goods Vehicle bearing registration No.:KA-01-AB-9212 of Rs.15,00,000/- with interest along with damages of Rs.2,00,000/- and other incidental charges of Rs.1,00,000/- together with cost and other incidental charges as this Hon’ble Commission deems fit to grant. 

2.       The brief facts of the complaint are as under:-

The deceased husband of the complainant was the owner and driver of the Isher Goods Vehicle bearing registration No.KA-01-AB-9212 and the same was insured with OP/General Insurance company and the OP issued goods carrying comprehensive policy by collecting premium of Rs.32,938/- by fixing the IDV of the said vehicle at Rs.4,01,748.00 and thereafter issued the policy on 29.12.2020 and the same was valid till 28.12.2021 vide policy No.2315100710360801000 and as per the said policy, the OP has collected a premium of Rs.325/- for PA cover for owner/driver and the OP assured a sum of Rs.15,00,000/- for PA cover for owner/driver in case of the death in road accident.  It is further submitted that due to wrong full act of the driver/owner i.e. the husband of the complainant, the said vehicle met with an accident on 15.06.2021 at about 9.15 PM at Ballapura Bus Stop, Tumkur – Chelur Road and the husband of the complainant died on the said day while shift to Bangalore after taking first aid at Tumkur Hospital.  It is further submitted that the husband of the complainant was holding a valid driving license to drive the goods vehicle and the policy was valid at the time of accident.   Hence, the complainant requested the OP to pay the death claim of Rs.15,00,000/- as per the assurance and terms and conditions of the policy.  But the OP till today has not settled the claim.  Therefore, the complainant issued legal notice to the OP, but the OP remained silent.  Hence, the complaint.

3.       After receipt of notice, the OP appeared through counsel and filed the version contending that the complainant has suppressed various material facts and hence the complaint is liable to be dismissed.  The OP contended the complainant’s husband has taken a goods carrying comprehensive policy viz policy No.2315100710360801000 valid from 29.12.2020 to 28.12.2021 for the vehicle bearing No.KA:01-AB-9212 for IDV value at Rs.4,01,748/- and the insured vehicle is hypothecated with M/s Equitas Small Finance Limited and is bound by the hypothecation clause under the policy and the complainant has not impleaded it as the necessary party to the complaint and therefore liable to be dismissed for non-joinder of parties.  The policy is based on the statements and declaration provided in the proposal form by the proposer and is subject to receipt of the requisite premium.  It is further contended that they have settled the own damage of Rs.45,000/- in favour of complainant on 06.10.2021.  It is further contended that the complainant had not made any claim under the personal accident head and he entire process of claim is system generated and if a claim was registered a unique claim number would have got generated like motor own damage claim and hence the insured for the best reason known to her had not made claim under personal accident.  It is further contended that the claim should be made within 6 calendar months of such injury and hence there is a clear violation of terms and condition with respect to delay intimation.  The complaint is a pre-mature and is liable to be dismissed as the complainant has not made a claim under personal accident and hence there is no deficiency of service on the part of OP.  On these among other grounds, the OP prays to dismiss the complaint.  

4.       The complainant has filed his affidavit evidence and produced some copies of documents.  Sri. G.Suresh, Senior Manager, on behalf of OP has filed the affidavit evidence and the OP marked the documents at Ex.R1 & R2.

5.       We have heard the arguments of OP.  The complainant filed written arguments and submits that there is no oral argument on their side.  

6.       On perusal of pleadings, evidence and documents, the admitted facts between the parties are:

1. The complainant’s husband was the owner & driver of the Isher Goods vehicle bearing Reg.No.KA.01, AB-9212.

2. The deceased husband of the complainant had obtained general insurance policy No.2315100710360801000 from the OP. The policy was in force from 29-12-2020 to 28-12-2021

3. As per the said policy, the OP has collected a premium of Rs.325/- for PA cover for owner/driver in case of the death in road accident.

4. The vehicle in question was met with an accident on 15-6-2021 @ about 9:15 PM at Ballapura Bus Stop, Tumakuru-Chelur Road.

5. The husband of the complainant died on the same day while shifting to Bangalore after taking first aid at Tumakuru Hospital.

7.       The main allegation of the complainant is that, though the complainant husband is having valid insurance policy and the policy was in force at the time of accident, the OP has not settled the claim of the complainants (personal accident claim).

8.       On the contrary, the counsel for OP has taken contention that, they have settled the own damage at Rs.45,000/- in favour of complainant on 06-10-2021.  The OP further contended that the complainant had not made any claim under the personal accident claim and the claim should be made within 06 months of such incident/injury. Hence there is a clear violation of terms and conditions with respect to delay intimation and the complaint is pre mature. Therefore, there is no deficiency of service on the part of OP.

9.       On perusal of the documents produced by the complainants, it is seen that the complainants have not produced any documents to show that they have submitted the claim form to the OPs for settlement of PA claim.  Hence, considering the above facts & circumstances of the case, we are of the opinion that, it is just and proper to direct the complainants to approach the OP with proper documents along with claim form and the OP is directed to consider the complainants’ claim by condoning the delay if any. Accordingly, we proceed to pass the following:-

:O R D E R:

The Complaint filed by the complainants is disposed off with liberty to the complainants to approach the OP with proper documents along with claim form without delay.

Communicate the order to the parties at free of costs.