BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no.231 of 2018
Date of Institution: 17.9.2018
Date of Decision : 24.05.2019
- Manjit Kaur, aged 58 years, widow of late Shri Gurdeep Singh son of Shri Maan Singh,
- Amrik Singh aged 38 years,
- Jarnail Singh, aged 33 years,
- Nirvair Singh aged 31 years
- Hardayal Singh, aged 26 years
Sons of late Shri Gurdeep Singh son of Maan Singh, all residents of village Kariwala, Tehsil Rania, District Sirsa.
……Complainants.
Versus
United India Insurance Company Ltd., thrugh its Branch Manger, Branch Office at Main Bazar, Mammera Chowk, Ellenabad, District Sirsa.
...…Opposite party.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SH. R.L.AHUJA…………………………PRESIDENT
SH. ISSAM SINGH SAGWAL………… MEMBER
MRS. SUKHDEEP KAUR…………………MEMBER
Present: Sh. Amit Goyal, Advocate for complainant.
Sh. Sandeep Tank, Advocate for opposite parties.
.
ORDER
In brief, the case of the complainants is that deceased Shri Gurdeep Singh was an agriculturist by profession and he used to cultivate his own land with his labour and used to incur his entire income upon the welfare and uplift of the complainant. That Shri Gurdeep Singh was owner of a motor cycle bearing No. HR-44F/3949 which was got insured by him with opposite party vide insurance policy No.111985/31/13/02/00002678 for the period 28.3.2014 to 27.3.2015. He had also paid premium for owner and driver of the said vehicle who is covered to the extent of Rs.one lac. That on 13.6.2014, Gurdeep Singh alongwith his son Amrik Singh complainant no.2 who was driving the motor cycle and deceased Gurdeep Singh was pillion rider were going from their house towards Rania and when they reached near Namdhari Dharamshala, village Kariwala, then in the meantime two dogs suddenly appeared on the road and came in front of the motor cycle and Amrik Singh tried to avoid the striking of motor cycle with them, as a result of which motor cycle became unbalanced and both the occupants fell down on the rod. Gurdeep Singh suffered serious and grievous injuries on his person and was taken to Sarvodya hospital at Hisar where he remained under treatment for a period of 13 days and thereafter he was taken to Fortis Hospital at Mohali where he remained admitted from 27.6.2014 to 1.7.2014 but he could not be survived and ultimately succumbed to the injuries on 9.7.2014. Post mortem on the dead body of deceased was conducted at PGI Chandigarh on 9.7.2014. It is further averred that above incidence was also reported to the police of P.S. Rania and a rapat no.6 dated 29.6.2014 was registered. That thereafter the petitioners being legal heirs of deceased Gurdeep Singh filed a claim petition under Section 163-A of Motor vehicle Act which was dismissed but petitioners were given liberty to approach the insurance company to claim personal accident cover for owner-driver as provided in insurance policy. That thereafter, the petitioners approached the ops and made representation to consider their claim and provided all the details and documents to the ops for settlement of claim and the ops vide letter dated 9.7.2018 repudiated the claim of complainant on the ground that driver of vehicle was not holding a valid and effective driving licence to drive the vehicle of Sh. Gurdeep Singh which is illegal as Amrik Singh was/is holding a valid and effective driving licence. That the ops have committed gross deficiency in service towards the complainant and have harassed the complainants. Hence, this complaint.
3. Upon notice, opposite party appeared and filed written statement taking certain preliminary objections. It is submitted that the story relating to striking of motor cycle is imaginary and concocted and driver is severely at fault because while driving motor cycle on road, he was not vigilant about safety rule and as per assertions he has put life of the pillion in danger and in these circumstances, the wrongdoer wish to enjoy the benefits under the law. Further, Gurdeep Singh insured who was a pillion rider as per version of DDR, did not possess a valid and effective driving licence at the time of alleged accident and as such the answering op cannot be held liable for any deliberate violation of the terms and conditions of the insurance policy by the insured or his agent. It is further submitted that investigation conducted by op revealed that deceased was already suffering from liver disease of advance stage as per USG report and as such cause of death was opined by the PGI Chandigarh was cerebral damage in a case of HCV positive. Liver parenchyml disease was antemortem. HCV means Haptitis C virus and it can lead to liver cirrhosis. So,. Gurdeep Singh died due to disease but not due to accident. As per terms and condition of policy, company is liable for bodily injury/ death sustained by owner-driver of the vehicle caused by violent, accidental external and visible means. It is further submitted that date of alleged accident is shown as 13.6.2014 whereas rapat no.6 has been shown recorded on 29.6.2014 as such there is delay of sixteen days. It is further submitted that complaint is time barred and prayer dismissal of complaint made.
4. The parties then led their respective evidence by way of affidavits and documents. The complainants have produced affidavit of Amrik Singh Ex.CW1/A and documents Ex.C1 to Ex.C6. On the other hand, op produced affidavit Ex.RW1/A, and documents Ex.R1 to Ex.R3.
5. We have heard learned counsel for the parties and have perused the case file carefully.
6. It is an admitted fact on record that deceased Gurdeep Singh was owner of a motor cycle No.HR-44F/3949 which was insured with op for period 28.3.2014 to 27.3.2015. As per allegations in the complaint on 13.6.2014 Gurdeep Singh and his son Amrik Singh were going on motor cycle and the motor cycle was being driven by Amrik Singh whereas Gurdeep Singh was pillion rider and suddenly they met with an accident and Gurdeep Singh was taken to hospital and ultimately he died due to the injuries on 9.7.2014. Due intimation was given to the op regarding the accident of deceased Gurdeep Singh and a DDR was lodged with the police station Rania. Further there are allegations that deceased had paid premium for coverage of personal accident of owner cum driver amounting to Rs.50/-. Thereafter, the complainants who are allegedly legal heirs of deceased Gurdeep Singh filed a claim petition No.32 of 2015 before the MACT, Sirsa which was decided on 2.12.2017 with the observation that said claim petition is not maintainable and same was dismissed but, however, petitioners were granted liberty to approach the insurance company to claim personal accident cover for owner-driver, as provided in the insurance policy and the insurance company shall consider the claim of petitioners, as per law, subject to fulfillment of terms and conditions as mentioned in the policy. As per allegations of complainants, they lodged claim with the ops after order of MACT alongwith all the requisite documents, but however, the same was repudiated vide letter dated 9.7.2018 on the ground that on the day of accident driver of the aforesaid vehicle was not holding a valid and effective driving licence to drive this vehicle of Sh. Gurdeep Singh. The perusal of the evidence of complainant reveals that complainant has tendered into evidence Ex.C4 copy of driving licence of Gurdeep Singh, copy of insurance cover Ex.C5 and Ex.C6 photocopy of driving licence of Amrik Singh who was allegedly driving vehicle at the time of accident.
7. During the course of arguments, learned counsel for op has strongly contended that as per post mortem report of PGI, Chandigarh Ex.R2, the cause of death was massive UGI bleed with liver failure with bilateral frontal ICH, traumatic HCV positive, liver failure, ultrasound abdomen showed gross ascitis chronic liver prenchymal disease with portal hyper tension, which proves that deceased Gurdeep Singh did not die due to accidental injuries. On the other hand, learned counsel for complainants has strongly contended that this matter has already been taken up by MACT, Sirsa and it has been observed that complainants can approach the ops for own damage claim of the deceased Gurdeep Singh and in pursuance to that order of the MACT, Sirsa, the complainants have lodged claim with the op which was repudiated on the ground that driver of the vehicle was not holding a valid and effective driving licence to drive the insured vehicle despite the fact that complainant had produced copy of driving licence of Gurdeep Singh and Amrik Singh and repudiation is therefore, illegal and arbitrary. We find force in the contention of learned counsel for complainants as the repudiation letter Ex.C2 reveals that op has repudiated the claim of the complainants on the ground that driver of the vehicle was not holding a valid and effective driving licence to drive the insured vehicle. So, keeping in view the facts and circumstances of the present case, it will be in the fitness of things, if present complaint is partly allowed and the op is directed to re-examine the documents of the complainants and thereafter pass fresh order.
8. In view of the above, we partly allow the present complaint and direct the opposite party to reconsider and re-examine the documents including copies of driving licence of Gurdeep Singh and Amrik Singh and thereafter pass fresh order and to settle and pay the claim of the complainants, if the same is payable as per terms and conditions of the policy within a period of 30 days from the date of receipt of copy of this order. However, keeping in view the facts and circumstances, the parties are left to bear their own costs. A copy of this order be supplied to the parties as per rules. File be consigned to the record room.
Announced in open Forum. President,
Dated: 24.05.2019. District Consumer Disputes
Redressal Forum, Sirsa.
Member Member
DCDRF, Sirsa DCDRF, Sirsa
