Order dictated by:
(Sh.Anoop Sharma, Presiding Member)
The complainant has filed the present complaint under section 12 & 13 of the Consumer Protection Act on the allegations that the complainant is widow of deceased Manjit Singh who was the policy holder having No.2002013114P107902836 covering risk period 18.2.2014 till 17.2.2015 for his vehicle PB-08CH 9201 having insured value of Rs.4,75,000/-. The deceased husband of the complainant was the holder of the policy issued by the Opposite Party for his vehicle and by virtue of the same is entitled for the insurance of Rs.4,75,000/- and consequential benefits and accidental claim, the deceased husband of the complainant unfortunately, met with an accident on 15.7.2014 while driving the said vehicle. FIR to this effect was lodged and the said vehicle was totally damaged and Opposite Party was duly informed and who appointed the surveyor who surveyed the vehicle and thereafter, the crushed vehicle was in police custody till date. The claim was made to the Opposite Party for the payment of Rs.4,75,000/- alongwith consequential benefits and accidental claim of the insurance cover of the deceased and Opposite Party till the filing of the present complaint has neither repudiated nor made good the genuine claim of the complainant meaning thereby that the Opposite Party has not decided on the claim of the complainant. The aforesaid acts of the Opposite Party in not deciding the genuine claim of the complainant is an act of deficiency in service, Unfair Trade Practice , mal practice and is not sustainable in the eyes of law. Vide instant complaint, the complainant has sought the following reliefs.
a) Opposite Party may be directed to make the payment of the claim of Rs.4,75,000/- with consequential benefits alongwith accidental benefit alongwith interest @ 12% per annum thereon from the date of accident till realization.
b) op may be directed to pay compensation to the tune of Rs.20,000/- to the c.
c) Adequate Costs of the proceedings may also be granted in favour of the complainant.
Hence, this complaint.
2. Upon notice, Opposite Party appeared and contested the complaint by filing written statement and submitted that the present complaint is not maintainable as the same has been filed without any basis; that the matter in question is out of the purview and jurisdiction of this Forum as the complainant has not filed/ submitted/ registered her claim with any of the office of the Opposite Party, as such, no question of deciding the claim of the complainant arose at any stage. On merits, the Opposite Parties denied all the averments made in the complaint and specifically mentioned that the plea of the complainant is totally false as no such claim of the above said vehicle was ever registered with any of the office or branch of the Opposite Party insurance company. No such document of any kind such like copy of FIR or any information or letter is ever supplied to the Opposite Party by the complainant, thus no occasion for appointing any surveyor by the Opposite Party is ever arisen. It is further submitted that when no claim as alleged has ever been lodged regarding the said matter, then the question of deciding or repudiating the claim of the complainant does not arise at all. Further, no document is supplied with this complaint also by the complainant. Even the copy of FIR attached in the court fill is not legible and hence, there is no deficiency or Unfair Trade Practice on the part of the answering Opposite Party. Remaining facts mentioned in the complaint are also denied and a prayer for dismissal of the complaint with cost was made.
3. In his bid to prove the case, complainant tendered into evidence affidavit Ex.C-1 in support of the allegations made in the complaint and also produced copies of documents Ex.C2 to Ex.C4 and closed his evidence.
4. On the other hand, to rebut the evidence of the complainant, the Opposite Party tendered into evidence the affidavit of Sh.Surinder Singh, Divisional Manager Ex.OP1 and closed the evidence on behalf of the Opposite Party.
5. We have heard the ld.counsel for the parties and have carefully gone through the evidence on record.
6. Ld.counsel for the complainant has reiterated the averments made by the complainant in her complaint and submitted that the deceased husband of the complainant unfortunately, met with an accident on 15.7.2014 while driving the said vehicle. FIR to this effect was lodged and the said vehicle was totally damaged and Opposite Party was duly informed and who appointed the surveyor who surveyed the vehicle and thereafter, the crushed vehicle was in police custody till date. The claim was made to the Opposite Party for the payment of Rs.4,75,000/- alongwith consequential benefits and accidental claim of the insurance cover of the deceased and Opposite Party till the filing of the present complaint has neither repudiated nor made good the genuine claim of the complainant meaning thereby that the Opposite Party has not decided on the claim of the complainant. The aforesaid acts of the Opposite Party in not deciding the genuine claim of the complainant is an act of deficiency in service, Unfair Trade Practice , mal practice and is not sustainable in the eyes of law.
7. On the other hand, ld.counsel for the Opposite Party has repelled the aforesaid contention of the ld.counsel for the complainant on the ground that the matter in question is out of the purview and jurisdiction of this Forum as the complainant has not filed/ submitted/ registered her claim with any of the office of the Opposite Party, as such, no question of deciding the claim of the complainant arose at any stage. On merits, the Opposite Parties denied all the averments made in the complaint and specifically mentioned that the plea of the complainant is totally false as no such claim of the above said vehicle was ever registered with any of the office or branch of the Opposite Party insurance company. No such document of any kind such like copy of FIR or any information or letter is ever supplied to the Opposite Party by the complainant, thus no occasion for appointing any surveyor by the Opposite Party is ever arisen. It is further submitted that when no claim as alleged has ever been lodged regarding the said matter, then the question of deciding or repudiating the claim of the complainant does not arise at all. Further, no document is supplied with this complaint also by the complainant. Even the copy of FIR attached in the court fill is not legible and hence, there is no deficiency or Unfair Trade Practice on the part of the answering Opposite Party. Ld.counsel for the complainant has repelled the aforesaid contentions of the ld.counsel for the OP-Insurance Company on the ground that the requisite documents/ information have already been submitted to the Opposite Party, but the Opposite Party has till date not decided the genuine claim of the complainant nor repudiated the same. But however, the complainant has failed to prove on record on which date and what claim she has lodged with the Opposite Party. So we are of the considered opinion that the complaint filed by the complainant is pre mature.
8. In such circumstances, we direct the complainant to submit the claim alongwith relevant documents and to complete all other formalities with the Opposite Party within 30 days from the date of receipt of copy of this order and consequently, Opposite Party shall process and settle the claim of the complainant either way, positively within further 45 days as per IRDA guidelines from the date of receipt of documents from the complainant. The complaint is disposed of accordingly. However, the complainant is at liberty to file the fresh complaint after the final settlement of her claim, if she still not satisfy with the decision of the Opposite Party No order as to costs. Copies of this order be supplied to the parties free of cost and the file be consigned to record room after compliance. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Forum.
Announced in Open Forum
Dated: 01.03.2017.
