State Consumer Disputes Redressal Commission
Smt Mou Maparu vs The Manager on 29 April, 2014
State Consumer Disputes Redressal Commission
State Consumer Disputes Redressal
Commission
West Bengal
11A, MIRZA GHALIB STREET,
KOLKATA 700 087
S.C. CASE NO- FA/624/13
(Arisen out of Order Dt. 24/05/2013
in Case No. CC/13/2013 of District Consumer Disputes Redressal Forum,
Purba Midnapur )
DATE OF FILING :12.06.2013
DATE OF ORDER:29.04.2014
APPELLANT
: Smt. Mou Maparu
W/o Sri Biplab Maparu
Vill. Harop, P.O. Harop,
P.S. Bagnan, Dist. Howrah
At Present: Tarachand Street, Kolkata-73
RESPONDENTS : 1.
The Manager,
HDFC Ergo General Insurance Co. Ltd.,
1, Metro Towers,
10th Floor,
Hochiminth Sarani, Kolkata-71
2. The Manager,
Motor Claim Department,
HDFC Ergo General Insurance Co. Ltd.,
6th Floor, Leela Business
Park,
Andheri Kurta Road,
Andheri (East), Mumbai-400052.
BEFORE HONBLE MEMBER : Sri Debasis Bhattacharya.
HONBLE MEMBER : Sri Jagannath Bag.
FOR THE
APPELLANT : Mr.
Himanshu Sekhar Samanta, Ld. Advocate
FOR THE RESPONDENT : Mr.Debajit Dutta, , Ld. Advocate.
Sri Jagannath
Bag ,
Member
The present appeal is directed against the order dated 24.05.2013 of the Ld. Consumer Disputes Redressal Forum, Purba Medinipur, in Consumer Case No. 13/2011, whereby, the complaint was dismissed ex-parte against the OPs.
The complaint case, in brief, was as follows:
The Complainant being the registered owner of the vehicle No. WB-02S/7544 (Tata Sumo Victa) took an insurance policy from the OP and the said policy was valid from 05.05.2010 to 04.05.2011 (midnight). The vehicle met with an accident at Karipukuria under Marishda P.S., District-Purba Medinipur on 22.07.2010. The Marishda Police Station started a case bearing No. 83/2010 on 22.07.2010 under Section 279/337/338/304(A)/427, I.P.C. The Complainant got the damaged vehicle released by the Courts order dated 23.03.2011. The OPs were informed about the accident over phone immediately after the accident. As advised by the OPs, the damaged vehicle was sent to Mullick Service Centre Maitapukur J.B, Howrah, for carrying out necessary repairing works. After repairing, the Complainant took delivery of the vehicle from the said Service Centre after paying a sum of Rs.2,27,632/- and thereafter she sought for reimbursement of expenses from the Insurance Company vide letter dated 03.10.2011. However, the OP Insurance Company repudiated the said claim vide their letter dated 25.01.2012. The Complainant moved the Ld. Forum below with a prayer for direction to release the sum of Rs.2,27,632/- as repairing charges with interest @ 10% from 03.10.2011 till realization and compensation of Rs.50,000/-, apart from litigation cost of Rs.5,000/- from the OPs.
Ld. Forum below considered the materials on record and found that the Complainant, though required to notify the loss in respect of the vehicle immediately after occurrence of loss/accident, intimated about the accident after about 17months. The ground for delay in sending the requisite information was said to be the illness of the Complainant. No medical paper showing the gravity of the Complainants infirm state or the duration of the illness for which she could not give due intimation regarding the accident of the car to the Insurance Company was furnished. Ld. Forum below also observed that to facilitate repairing of the damaged vehicle it was extremely crucial that intimation should have been given to the Insurance Company without fail and they were required to be kept on board with every development from time to time. Ld. Forum below did not find any good reason on the part of the Complainant withholding the intimation about the accident. As a result, it was decided that the complaint be dismissed ex parte against the OPs.
Being aggrieved by and dissatisfied with the order of the Ld. Forum below, the Complainant-turned-Appellant has come up before this Commission with a prayer for direction to set aside the impugned order.
We have gone through the Memo. of Appeal together with the copy of the impugned order, the petition of complaint, examination-in-chief on affidavit by the Complainant and certain other documents including the medical prescriptions in respect of the Complainant, Smt. Mou Maparu, and the insurance policy in respect of the vehicle.
BNA has been filed by the OP/Respondent.
Ld. Advocates for both sides have been heard.
Ld. Advocate for the Complainant/Appellant submitted that the vehicle, which stood insured with the OP Insurance Company, actually met with an accident resulting in the death of the Driver and other 4 persons .The Complainant was bedridden with her illness for a pretty long time, as a result of which she could not intimate the Insurance Company about the accident. The merit of the case cannot be ignored only because that there was delay in furnishing the intimation about the accident to the Insurance Company. All necessary papers were furnished to the Insurance Company as asked for. The fact of repairing of the vehicle has been substantiated with the documents of payment to the garage/service centre. Further, a case has been registered by the Marishda Police Station, who inspected the spot and gave report about the accident, that caused death of the Driver and other 04 persons, moving in the vehicle at the time of accident. Such accidental claim should have been entertained by the Insurance Company as covered by the Insurance Policy. The order passed by the Ld. Forum below is illegal and deserves to be set aside.
Ld. Advocate appearing for the Respondent Insurance Company submitted that there was serious lapse on the part of the Complainant in sending intimation about the accident which is said to be of grave nature. The Insurance Company for the sake of proper investigation would have engaged a Surveyor for spot visit and such enquiry would help determine the extent of loss and damage to the vehicle and also would help assessment of the loss/damage. As per policy condition No.1, notification of loss has to be made immediately on occurrence of any accident, but the accident was reported after a long gap of time and no purpose would be served by sending a Surveyor after passage of so long a period, as loss or damage of the vehicle could not be ascertained from the spot itself. The repudiation of the claim of the Complainant has been rightly made in terms of the policy. Citing certain case references, as reported in III (2003) CPJ 77 (NC), it was argued that there was a clear violation of policy condition. Further, the vehicle was repaired prior to the lodging of claim with the Insurance Company. The Respondent did not get any opportunity to appoint licensed independent Surveyor to assess the loss, which is also a clear violation of terms and conditions of the policy. The plea taken by the Complainant that she informed about the accident to the Insurance Company over telephone does not stand substantiated in so far as it has been admitted clearly that the failure on the part of the Complainant to intimate about the accident was because of the illness of the Complainant. The insurance policy between Insurer and Insured represents a contract between the parties. Since the Insurer undertakes to compensate the loss suffered by the Insured on account of risks covered by the insurance policy, the terms of the agreement had to be strictly construed to determine the extent of liability of the Insurer. The Insured cannot claim anything more than what is covered by the Insurance Policy. That being so, the Insured has also to act strictly in accordance with the terms of the policy expressly set out therein. The Ld. Forum below has in a very reasoned manner dealt with the matter and the impugned order should be upheld by this Commission.
Decision with reasons.
There is no dispute about the fact that the vehicle of the Complainant stood insured when the accident took place involving the said vehicle. The Complainant was actually required to notify the accident to the Insurance Company for reimbursement of the claims as regards repairing of the damaged vehicle. It was incumbent upon the Complainant to keep the Insurance Company posted with the fact of accident forthwith. Failure on the part of the Complainant to intimate about the accident and resultant loss/damage of the vehicle is not doubt a negligence on her part. The plea taken by her that because of her prolonged illness she could not intimate about the accident is but a very intangible proposition to go by. We are not inclined to hold that the Complainant was so incapacitated or rendered so much invalid that would restrain her from sending the intimation to the Insurance Company though as per policy condition notice should have been given in writing to the Company immediately upon occurrence of the accidental loss or damage.
We find that the Ld. District Forum has dealt with the matter in a reasoned manner and arrived at a right decision with all care about the facts on record and evidence as made available to them. We find no reason to interfere with the order of the Ld. Forum below.
Hence, ORDERED that the appeal be and the same is dismissed on contest. The impugned order stands confirmed. There shall be no order as to costs.
Sd/ Sd/ MEMBER MEMBER