BY - SRI.SAURAV CHANDRA, MEMBER

1. Brief facts of the Complainant’s case are that the Opposite Parties are the Insurance Company from whom the Complainant purchased a Car Insurance Policy No.991491823110017191 with a Sum Assured of Rs.12,12,191.00 during the period 08.03.2018 (13:01 Hrs.) to 07.03.2019 (Midnight) against his Motor Car No.WB-32-AA-9612, Engine No.D4FBJM506278 and Chassis No. MALC841DLJM048896.

2. The said car of the Complainant made an accident by the driver Sri. Arup Pradhan, son of the Complainant who died on spot on 30.06.2018 in between 11:00 PM to 11:30 PM near Subranadighi on the way of Contai Road under Police Station: Contai, Dist. Purba Medinipur.

3. For that reason the Complainant informed about the incident to the Ops vide Claim No.3118166350 and also before the Contai Police Station vide Case No.241/2018, dated: 20.07.2018.

4. The Complainant states, the Ops vide a letter dated: 24.10.2018 repudiated the claim on the ground of driver of the vehicle at the time of accident was found in alcoholic condition.

5. The cause of action of this case arose on and from 24.10.2018 when the Ops repudiated the claim of the Complainant and offered for settlement.

The Complainant, therefore, prays for:-

1. To pay the Insurance claim of Rs.12,12,191.00 by the OPs.

2. To pay Compensation of Rs.90,000.00 towards mental agony          by the Ops.

3. To pay a Litigation Cost of Rs.9,000.00 to the Complainant for conducting the case.

6. Notices were duly served upon the Ops but, Ops preferred to see that the case be decided ex-parte against them.

7. Under the above circumstances, the Complainant has prayed for ex-parte order against the Ops.

8. Points for determination are:

1. Is the case maintainable in its present form and in law?
2. Is the Complainant entitled to the relief(s) as sought for?

9. Decision with reasons

1. Both the points I and II, being inter related to each other, are taken up together for discussion for sake of brevity and convenience.

2. We have carefully perused the Petition of the Complainant along with all papers and other documents.

10. Having regards had to the facts and circumstances of the case in the light of evidence, it is evident that there is no dispute that Complainant is a consumer having grievances against the OPs, as such prima facie it was observed in the admission stage, the case is maintainable in its present form and in law.

11. In the instance case, the Complainant submitted a List of Documents dated: 05.07.2019 containing the copy of Estimate for Full Body Damage, Post Mortem Report, Letter for Settlement by the Ops, Car Insurance Policy, First Information Report (FIR), Intimation Letter to the Contai Police Station, Final Report as True (FRT), Deceased Learner License, Driving License of the Assisting Driver and Certificate of Registration of the Vehicle.

12. From the above submitted documents, it is noticed from the 4^th Column 5^th Row of the Post Mortem Report by the Medical Officer, Contai S.D Hospital, Purba Medinipur under heading Stomach and its contents – “…..Fluid with sweet alcoholic odour.”

13. The above finding is against the Terms & Conditions of the Policy which is clearly enumerated as “Intoxicated Driving” is not covered in the policy.

14. The Final Report as True (FRT) submitted against Case No.238 of 2018, dated: 31.08.2018 u/s 279 and 304A of the Indian Penal Code, 1860 due to accused driver died on spot. Therefore, the Viscera Report after Chemical Examination has not submitted as yet and for which this Commission is not in a position to confirm about the alcoholic condition of the Driver.

15. We have also carefully observed the letter dated: 30.03.2019 issued by the Ops to the Complainant with an advice to proceed the damaged vehicle for repairs. Before that, the Ops tried to obtain a market value of the damaged vehicle but, couldn’t find
16. the same due to superdari as per the police report. Moreover, the vehicle is repairable and is not a fit case to be considered a total loss, the Ops offered the Complainant another option for a full and final settlement of the claim with a sum of Rs.5,00,000.00 (Rupees Five Lakh Only) on a cash loss basis without production of any post repaired vehicle for inspection or submitting the repair bill but, with a liberty for free disposal of the vehicle.

17. Under the above facts and circumstances as mentioned in Paragraph No.12 to 16, this Commission doesn’t find any disputes or unfair trade practice or elements of negligence but, gross deficiency in service by the Ops for not paying the settled amount or even processing the offered amount to the Complainant.

18. Therefore, the Complainant is not at all entitled to any relief other than the one time settlement amount of Rs.5,00,000.00 offered by the Ops. Hence, the claim for paying the full Insured amount of Rs.12,12,191.00 to the Complainant by the OPs is not tenable at all. Accordingly, no order for Compensation of Rs.90,000.00 towards mental agony and for paying Litigation Cost of Rs.9,000.00 to the Complainant for conducting the case shall be passed.

19. Both the points are decided accordingly.

3.  Thus, the complaint case succeeds in part.

Hence, it is

          O R D E R E D

That the CC-460 of 2019 be and the same is allowed in part exparte against the opposite parties.

The opposite parties 1 & 2, who are jointly and severally liable, are hereby directed to pay Rs.5,00,000/- to the Complainant within one month from the date of this order in default the said amount shall carry Simple Interest @10% p.a. from the date of this order till realization.

The Complainant will be at liberty to put the order into execution if required.

2.  Let a copy of this judgment be provided to the Complainant free of cost. The judgment be uploaded forthwith on the website of the Commission for the perusal of the parties.

File be consigned to record section along with a copy of this   judgment.