Before the District Consumer Disputes Redressal Commission, Rohtak.

                                                          Complaint No. : 434

                                                          Instituted on     : 12.09.2018 

                                                          Decided on       : 20.11.2023

Smt. Meena age 28 years, wd/o Kamal r/o H.No.1227. Ward no.11, Rainak Pura, Rothak, Mata Darwaja, Rohtak.

                                                                             ………..Complainant.

                                      Vs.

The New India Assurance Company Ltd. Near D-Park, Delhi Road,   RohtakThrough its Manager.

                                                                   …….Opposite party.

COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1988

BEFORE:  SH.NAGENDER SINGH KADIAN, PRESIDENT.

                   DR. TRIPTI PANNU, MEMBER.

Present:       Shri Ram Avtar, Advocate for the complainant. 

                   Dr. Deepak Bhardwaj, Advocate for the opposite party.

                                                ORDER

TRIPTI PANNU, MEMBER:

1.                Brief facts of the case, as per the complainant are that husband of complainant namely Kamal(since deceased)  had purchased a commercial vehicle package policy for his truck bearing registration no.HR-46-C-7456 from the opposite party vide policy no.35380031150100007887, IDV Rs.1550000/- for the period 13.11.2015 to 12.11.2016.  Compulsory PA premium for owner driver of Rs.100/- was also paid in the policy and according to this coverage as told by the company, the owner driver is also covered for an amount of Rs.200000/-.  It  is further submitted that on 09.05.2016 the insured while driving himself going towards Gorakhpur, stopped the vehicle and when coming out from the truck, all of a sudden, fell down on the earth and received injuries sustained on his head. His head started bleeding and severe pain and when he was taken to nearby hospital, he was died due to the injuries sustained by him. One Lalit s/o Ram Niwas who was present alongwith the husband of the complainant in the truck, gave information to the police, and rapat no.10 was got registered on 10.05.2016 and post mortem was conducted. Complainant came to know in the month of October 2016 that the alleged vehicle was insured and there is coverage of PA Owner Driver. Then on 17.10.2016 complainant gave a written application to the office of opposite party for the insurance coverage and submitted all the required documents. One investigator Sh. Kailash Sharma also conducted investigation regarding the claim  andalso collected the documents from the complainant. Complainant approached the insurance company and requested personally as well as telephonically so many times to get the claim but no proper reply was given by the insurance company to the complainant. The act of opposite party is illegal and amounts to deficiency in service. Hence this complaint and it is prayed that opposite party may kindly be directed to disburse the insurance claim of Rs.200000/- alongwith interest, compensation and litigation expenses to the complainant.

2.                After registration of complaint notice was issued to the opposite party. Opposite party in its reply has submitted that on receiving the information on 17.10.2016 regarding the claim for personal accident for the death of owner-cum-driver of truck no.HR-47C-7456 the answering respondent took immediate action and appointed investigator Sh. Kailash Sharma who submitted his investigation report dated 17.03.2017 and some facts were emerged that deceased Kamal s/o Manphool was died on 10.05.2016 due to the alleged accident occurred on 09.05.2016 but the I.V was not met with an accident on the day of alleged incident. In this case the policy is for P.A. coverage but the I.V. was not in motion and not met with an accident. Moreover there is a delay of more than 5 months in information/intimation to the insurance company whereas in such case the information must be given in a one calendar month.  As per terms and condition of  P.A. policy, the death of the deceased does not come under the purview of P.A. policy which was duly informed to the complainant. The claim of the complainant is not maintainable and the complainant is not entitled for any claim from the answering respondent.  All the other contents of the complaint were stated to be wrong and denied and opposite party prayed for dismissal of complaint with costs.

3.                Ld. Counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, Ex.CW2/A, documents Ex.C1 to Ex.C16 and closed his evidence on 17.09.2021. Ld. counsel for the opposite party tendered affidavit Ex.RW1/A and documents Ex.R1 to Ex.R3 and has closed his evidence on dated 10.03.2021.

4.                We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.

5.                We have perused the documents placed on record by both the parties. As per the post mortem report the deceased received head injury and this fact is mentioned in PMR Ex.C5. Moreover the matter has been investigated by the investigator of the insurance company and he placed on record his report as Ex.R3 and upon pageno.2 the cause of death is mentioned as “Antemortem head injury”. As per pleadings, the husband of complainant was driving the vehicle at the time of accident and he sustained injuries while coming out from his truck. This fact is also supported by Lalits/o Ram Niwas through his affidavit Ex.CW2/A, who was present in the insured truck at the time of accident.  Hence it is proved that the L.A. died due to the injuries sustained by him in the accident.  As per policy, he paid Rs.100/- as premium on account of PA premium for owner driver. As such complainant is entitled for the P.A. claim of Rs.200000/- under the policy. As per report of investigator  Ex.R3, Smt. Savitri Devi, Smt. Meena, Prem and Mayank Sharma are the L.Rs of deceased Kamal.

6.                In view of the facts and circumstances of the case, we hereby allow the complaint and direct the opposite party to pay Rs.200000/-(Rupees two lacs only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 12.09.2018 till its realization, to pay Rs.5000/-(Rupees five thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the L.Rs of deceased Kamal namely Smt. Savitri Devi mother of deceased, Smt. Meena Devi wife of deceased, Prem son of deceased and Mayank Sharma son of deceased in equal share within one month from the date of decision. It is made clear that the share of minor sons namely Prem and Mayank Sharma will be deposited in any nationalized bank in the form of FDRs till the date of attaining the age of majority and will be paid to them on attaining the age of majority.

7.                Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.

Announced in open court:

20.11.2023.

                                                          ........................................................

                                                          Nagender Singh Kadian, President

                                                          ..........................................

                                                          TriptiPannu, Member.