State Consumer Disputes Redressal Commission
National Insurance Co.Ltd. vs Pawan Kumar on 19 July, 2023
Daily Order STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA First Appeal No.165 of 2018 Date of Institution: 07.02.2018 Date of Order: 19.07.2023 National Insurance CompanyLimited, SCO No.155-156, Commercial Urban Estate-1, Near Telephone Exchange, Hisar, Distt. Hisar, through its Divisional Manager, through authorized Signatory, at Regional Office SCO 332-334, Sector 34 A Chandigarh. .....Appellant Versus Pawan Kumar aged 25 years, S/o Sh.Mange Ram, R/o Near Ram Dev Mandir Village and Post Office Talwa, Tehsil and Distt. Hisar. .....Respondent CORAM: S.P.Sood, Judicial Member
Present:- Mr.S.S.Sidhu, Advocate for theappellant. Mr.Amit Singla, Advocate for the respondent. ORDER S P SOOD, JUDICIAL MEMBER:
The present appeal No.165 of 2018 has been filed against the impugned order dated 18.12.2017 of the District Consumer Disputes Redressal Commission, Hisar (In short "District Commission") in complaint case No.394 of 2016, which was allowed.
2. The brief facts put forth in that complaint goes like that he was owner of a Tata Ace bearing registration No.HR-39C/3813,which he got insured from the opposite party (OP). The insurance was valid from 09.03.2014 to 08.03.2015 having IDV value of Rs.2,89,170/-. The complainant has paid the premium of Rs.13,232/-. The vehicle was used by the complainant to earn livelihood for himself and his family members. Unfortunately, on 24.01.2015 at about 8.00 a.m., the said vehicle met with an accident. Intimation about this incident was given to the opposite party. FIR No.10 dated 24.01.2015 was also got registered at Police Station Kolayat, Distt Bikaner under Sections 279/337/304A IPC. Surveyor was appointed, who assessed the loss to the tune of Rs.2,01,500/-. Instead of settling the claim, the OP illegally repudiated the claim vide letter dated 20.06.2016. Faced with this situation, a legal notice was issued to the OP through counsel on 05.11.2016, but, to no avail. Thus there was deficiency in service on the part of the OP, hence the complaint.
3. Upon notice, OP appeared and filed reply submitting that the claimant intimated about the incident after a delay of six days. The complainant has violated the terms and conditions of the insurance company. It was admitted that the vehicle was insured with the insurance company. No such assurance was given by the officials of the respondent to pay any amount. The claim of the complainant was rightly repudiated due to violation of policy conditions. The OP was not liable to pay the insured value of Rs.2,89,170/- to the complainant.Thus there was no deficiency in service on the part of the OP and prayed for dismissal of the complaint.
4. After hearing both the parties, the learned District Commission, Hisarhas allowed the complaint vide order dated 18.12.2017. Relevant portion of the judgement is reproduced as under:-
"Resultantly, this complaint is hereby allowed, with a direction to respondent to pay Rs.2,01,500/- to complainant (as per surveyor report Ex.) with interest @ 9% per annum from the date of institution of this complaint i.e. 21.12.2016 till payment. Complainant is also hereby awarded compensation of Rs.5000/- for his harassment and mental agony and Rs.1000/- as litigation expenses etc. against the respondent."
5. Feeling aggrieved therefrom, opposite party-appellant has preferred this appeal.
6. These argumentswere advanced by Sh.S.S.Sidhu, learned counsel for the appellant as well as Sh.Amit Singla, learned counsel for the respondent.With their kind assistance entire records including that of the District Commission led on behalf of the parties has also been properly perused and examined.
7. As per the matrix of the facts, it is true that during the subsistence of the insurance policy, the vehicle was damaged in the accident. It is also true that FIR was also got registered on the same day. The sole reason for the appellant was that since complainant has intimated the insurance company about this mishap after six days from the date of accident and its driver did not have valid driving licenceas such there was clear cut violation of the terms and conditions of the insurance company and thus complainant was not entitled for the claim amount as prayed for.However the factual position was otherwise.After intimation, the surveyor Mr. Sanjay Soniwas appointed, who conducted spot survey and during spot survey, the complainant has disclosed to the surveyor that name of the driver of insured vehicle was Satyawan S/o Surender" and the complainant also signed the spot survey papers. The surveyor submitted his report on 15.02.2015 with remarks that "as per submitted papers, insured driver Mr.Satyawan have license for MCWG & LMV only, doesn't have valid license to drive the vehicle in question, for which insured has clearly been communicated." Perusal of the file shows that the complainant applied for final survey on 23.06.2015 after a delay of approximately five months from the date of spot survey, wherein the complainant disclosed that name of insured driver as Kuldeep Singh S/o Pala Singh" instead of Satyawan. As per the second surveyor report, the complainant suffered a loss of Rs.2,01,500/-. However the second surveyor also mentioned that insured had distorted the facts of incident and showing the different driver as Mr.Satyawan S/o Sh.Surinder might not be having the valid driving licence and he opined that thorough investigation should be carried out before the settling the claim.
8. Well if we look into facts of the whole incident of mishap we find as to how several persons all from Village Noli Kala, Distt. Hisarincluding one Deepak aged 15 years and one Satyawan decided to visit Ramdevra on foot as pilgrimage and have thus engaged a vehicle to carry their luggage. So keeping in view the nature of use the insured vehicle was chosen for this task as the owner of this vehicle was also a participating member of this entourage. This journey started on 16.01.2015. This is how when this group had reached at village Nokhda, Distt Bikaner their own engaged vehicle with their luggage while overtaking then was hit by some vehicle coming from the opposite side and as a result its driver Kuldeep Singh S/o Pala Singh lost his control and hit into two members of this group namely Sh.Deepak and Satyawan who were walking in front of other associates and after knocking them of finally dashed into road side trees and ditches. As a result of this impact both Deepak and Satyawan suffered injuries and Sh.Deepak succumbed to the same at the spot itself and Satyawan was badly injured. After this occurrence, one Budha Ram got registered an FIR against the driver of this vehicle itself i.e. Kuldeep Singh. During investigation statements of several other persons including that of the complainant were also recorded by police and virtually all of them named Kuldeep Singh to be the driver of this vehicle. It was just at one occasion when complainant was found to have wrote his signature at the end of a so called detail report alleged to have been prepared by one Sh.SanjaySoni surveyor who was deputed by OP company wherein the said author has mentioned that the driver of this insured vehicle was Satyawan. Whether the complainant was read over and explained about the contents of this report or not by said Sh.Soni is not clear as the same has not been clarified even. Except at this place, in all other documents prepared by the police or by other subsequent investigators so appointed by OP company it has been consistently coming on record that the insured vehicle was driven by Kuldeep Singh and Satyawan was injured when the same hit into him while walking with Deepak who died away at the spot itself. Even the local police after completing its investigation challaned Kuldeep Singh only u/s 279,337,338,304-A of IPC. Statement of this injured Satyawanand even that of driver Kuldeep Singh were also recorded by investigator to seek clarification in this regard.
9. In view of the above, the second surveyor report clearly shows that thorough investigation may be carried out before settling the claim. Since the second surveyor has declared loss of Rs.2,01,500/- in his report. It is the duty of the insurance company to pay the amount after thorough investigation, but, no such thorough investigation report has been produced on record by the appellant. The complainant has not violated the terms and conditions of the insurance policy. Learned District Commission rightly allowed the claim of the complainant.
10. Resultantly, the contentions raised on behalf of the present appellant stands rejected as rendered no assistance and found to be untenable and the order passed by the learned District Commission does not suffer from any illegality or perversity and is well reasoned and accordingly stands maintained for all intents and purposes.Hence, appeal stands dismissed on merits.
11. The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the complainant-respondent-Pawan Kumaragainst proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.
12. Applications pending, if any stand disposed of in terms of the aforesaid judgment.
13. A copy of this judgment be provided to all the parties free of cost as mandated by the Consumer Protection Act, 1986/2019. The judgment be uploaded forthwith on the website of the commission for the perusal of the parties.
14. File be consigned to record room.
Date of order (S. P. Sood) 19.07.2023 Judicial Member S.K (Pvt. Secy.) S.K (Pvt. Secy.)