State Consumer Disputes Redressal Commission
The Bajaj Allianz General Insurance Co ... vs Vinod Laxmikant Kasture And Three on 30 December, 2025
STATE CONSUMER DISPUTES REDRESSAL COMMISSION
CIRCUIT BENCH NAGPUR
FIRST APPEAL NO. SC/CB2/27/RBT/A/56/2019
The Bajaj Allianz General Insurance Co Ltd through its Manager
PRESENT ADDRESS - Kute Marg Mumbai Naka near Hotel Sandip Nasik Tq and Distt
Nasik,MAHARASHTRA.
.......Appellant(s)
Versus
Vinod Laxmikant Kasture and three
PRESENT ADDRESS - age 54 yrs occ service r/o Keshav Nagar Nandura rd Khamgaon Tq
Khamgaon,MAHARASHTRA.
BRANCH MANAGER MANRAJ MOTORS PVT LTD AUTHORIZED DEALER OF MARUTI
PRESENT ADDRESS - AJANTA RD JALGAON TQ JALGAONNAGPUR,MAHARASHTRA.
BRANCH MANAGER MANRAJ MOTORS PVT LTD
PRESENT ADDRESS - NEAR RELIANCE PETROL PUMP NANDUR RD KHAMGAON TQ
KHAMGAONNAGPUR,MAHARASHTRA.
.......Respondent(s)
BEFORE:
HON'BLE MRS. KALYANI KAPSE , PRESIDING MEMBER
HON'BLE MS. SHAILA D. WANDHARE , MEMBER
FOR THE APPELLANT:
NONE
FOR THE RESPONDENT:
ADV. LANDE FOR THE RESPONDENT NO. 1. ADV. SHAHAKAR FOR THE
RESPONDENT NOS. 2&3
DATED: 30/12/2025
ORDER
(Delivered on 30/12/2025) PER MS. S.D. WANDHARE , HON'BLE MEMBER.
1. The appellant namely Bajaj Allianz General Insurance Co. Ltd through its Manager, has preferred the present appeal under Section 15 of the Consumer Protection Act 1986 challenging the order passed on 30/07/2018 in Consumer Complaint No.CC/98/2014 (hereinafter it is referred to in short as "impugned order") of the learned District Consumer Disputes Redressal Forum, Buldhana (hereinafter it is referred to in short as "learned District Forum") by which the complaint filed by respondent No.1 /org. complainant came to be allowed. .
The parties of the appeal are hereinafter referred to by their original nomenclature as complainant and opposite parties respectively for better appreciation.
2. The facts that emerge from the original complaint are that the complainant had purchased a Maruti Ritz vehicle bearing No.MH-28-V-5170 on 19/12/2012 for Rs.6,63,000/- from Opposite Party (O.P.) No.2. Said vehicle was covered under a comprehensive insurance policy bearing No.0G-13-2002-1801-00003866 of Rs.5,33,880/- issued by O.P. No.1 after payment of premium of Rs.16803/- for the period from 19/12/2012 to 18/12/2013. On 05/05/2013, while the complainant was travelling from Nagpur, the vehicle met with a serious accident at Jamthi Phata on National Highway No.6, resulting in total loss of the vehicle, death of one co- passenger and injuries to the complainant and others. The complainant was treated at Ozone Hospital, Akola and the accident was informed to O.Ps. Nos.1 to 3. As per instructions of O.P. No.1, the damaged vehicle was deposited with O.P. No.2 and all necessary documents were submitted for processing the insurance claim. Despite the complainant's cooperation and his acquittal in the criminal case arising out of the accident, O.P. No.1 repudiated the insurance claim on 26/03/2014 on the ground of absence of a valid driving licence. The complainant alleging it deficiency in service and unfair trade practice on the part of O.P. and filed the complaint seeking insurance amount with interest, compensation for physical and mental suffering, medical expenses and litigation costs.
3. The Opposite Parties (O.P.) No.1 Insurance Company resisted the claim before the learned District Forum and denied all the allegations made against them by the complainant. They contended that the accident of the insured vehicle occurred on 05/05/2013, but the complainant has intimated the claim only on 25/11/2013 after an inordinate and unexplained delay of 240 days in clear violation of Term No.1 of the insurance policy which mandates immediate intimation of the accident. It also contended that on receipt of delayed intimation, they appointed a surveyor who assessed the loss at Rs.5,58,610/- which exceeded the declared value of the vehicle, i.e., Rs.5,33,880/-. It further submitted that despite repeated letters, the complainant failed to furnish essential documents including the learner's driving licence and other relevant papers. The complainant also made contradictory and false statements regarding the persons travelling in the vehicle at the time of the accident and deliberately suppressed the copy of the F.I.R. to mislead the Insurance Company. In view of these breaches and discrepancies, the claim was rightly repudiated on 26/03/2014. They denied their deficiency in service and unfair trade practice on their part. Therefore, they prayed to dismiss the complaint with costs.
4. The O.P.Nos.2 and 3 were appeared before the learned District Forum after due service of notice. However, they failed to submit their written version in stipulated period. Consequently, by order dated 19/03/2015 passed by learned District Forum, proceeded the complaint against without their written versions.
5. After considering the evidence of the parties and their documents filed in support thereof, learned District Forum by order dated 30/07/2018 allowed the Consumer Complaint No.CC/98/2014 directing the O.P.No.1 to pay Rs.5,33,880/- to the complainant for the accident of the Maruti Ritz vehicle No. MH-28-V-5170 along with interest at the rate of 8% per annum and also to pay Rs.5,000/- as compensation and Rs.2,000/- as expenses of the complaint. Being aggrieved by the impugned order of the learned District Forum, the present appeal is preferred by the appellant vide Section 15 of the Consumer Protection Act 1986. The grounds of appeal raised are that the impugned order dated 30/07/2018 passed by the learned District Forum is illegal, erroneous and unjust. The learned District Forum failed to properly appreciate the facts, documents and written statement on record. The delay in intimation of the alleged accident was wrongly condoned that contrary to IRDA guidelines. The findings regarding the driving licence, presence of a valid licence holder and police investigation are incorrect and unsupported by evidence. The learned District Forum wrongly held deficiency of service against the appellant. So also, the direction to pay compensation, interest and costs is without lawful justification. Therefore, the impugned order is liable to be quashed and set aside.
6. It is noted that the appellant/original O.P. No.1 and respondent Nos.2 and 3/original O.P. Nos.2 and 3 failed to file written notes of arguments, whereas respondent No.1/original complainant has filed the same. The learned Advocate for the appellant has remained absent for a considerable period, despite repeated opportunities and last chances granted as per order dated, 03/12/2024 and 29/07/2025. Since, neither the appellant nor his Advocate appeared to advance arguments. Accordingly, the learned Advocate Lande for respondent No.1/original complainant and learned Advocate Shahakar of respondent Nos.2 and 3 were heard. Considering the long pendency of this old appeal and the mandate of the Consumer Protection Act, 1986 for expeditious disposal, the matter is taken up for final disposal on merits. We have therefore perused the records and the proceedings of the matter.
7. On the rival contention of the parties available on record, the following points arise for our determination and we have recorded our findings against each of them as follows;
Sr.No. Points Findings
1. Whether the impugned order dated ... In the Negative.
30/07/2018 passed by the learned District
Forum in Consumer Complaint
No.CC/98/2014 suffers from any infirmity or
illegality and needs any interference and is
also liable to quash and set aside?
2. What Order? ... As per final
order.
REASONS
AS TO POINT NOS.1 AND 2:
8. In this matter, the complainant purchased the Maruti Ritz vehicle bearing No.MH-28-V-5170 on 19/12/2012 for Rs.6,63,000/- from O.P.No.2. Said vehicle was covered under a comprehensive insurance policy issued by O.P. No.1 for the period from 19/12/2012 to 18/12/2013. It is an undisputed fact that the accident occurred on 05/05/2013 on National Highway No.6. It is also not in dispute that the accident resulted in total loss of the vehicle. One co-passenger died and the complainant sustained injuries. The occurrence of the accident is not disputed by the Insurance Company. The surveyor appointed by O.P. No.1 assessed the loss at Rs.5,58,610/- which is more than the insured declared value of the vehicle. Thus, the factum of total loss stands established. It is seen that the O.P. No.1 Insurance Company repudiated the claim mainly on two grounds, namely delay in intimation and absence of a valid driving licence.
9. So far as the alleged delay in intimation of the accident dated 05/05/2013 is concerned, the complainant met with a serious accident, suffered injuries and was hospitalized. The record shows that the complainant alleged to be informed the Opposite Parties about the accident through his relatives and also deposited the damaged vehicle on 04/06/2013 with O.P. No.2 as per instructions of O.P. No.2. That fact was not denied by O.P. No.2 despite appearance in the proceedings. Hence, the contention of inordinate delay raised by O.P. No.1 is not acceptable. Even otherwise, delay by itself is not fatal unless prejudice is proved. The O.P.No.1 Insurance Company failed to establish that any prejudice was caused to the assessment of the claim due to such delay. Even assuming some delay, the claim cannot be rejected mechanically on technical grounds. An immediate intimation is desirable, but strict application of this condition must be balanced with fairness and the consumer-friendly object of the Consumer Protection Act, 1986. The delay caused by reasonable and unavoidable circumstances, particularly when the accident is undisputed and the claim is otherwise genuine, cannot defeat the substantive rights of the insured. It is well settled that technical breaches like delay should not override justice.
10. Another ground of rejection of the claim was the alleged absence of a valid driving licence, said to be contrary to the terms of the insurance policy. The burden to prove a wilful and fundamental breach of policy conditions squarely lies upon the insurer. In the present case, the accident occurred on 05/05/2013. The copies of driving licences of Vinod L. Kasture and Sudhakar D. Junghare are produced on record at page No.56 of the memo of appeal. The licence of Vinod L. Kasture was valid up to 29/08/2015 and covered MCWG and LMV categories and was effective on the date of accident. Similarly, the licence of Sudhakar D. Junghare was valid up to 07/01/2015 and authorised him to drive LMV-TR. Thus, on the date of accident, a duly licensed person was available to drive the vehicle. The O.P.No.1 Insurance Company has failed to establish that there was no valid licence. So, mere allegation of licence violation, without cogent proof and without nexus to the cause of accident, is insufficient to repudiate the claim. Therefore, the rejection of the claim on the ground of absence of a valid driving licence is unjust, unreasonable and unsustainable in law. It is also material to note that a criminal case bearing SCC No.975 of 2013 was registered against the complainant under Sections 279, 337, 338 and 304A of the Indian Penal Code, 1860 and Section 184 of the Motor Vehicles Act. The police investigation did not conclusively establish breach of policy conditions as the complainant was acquitted from all the said offences by judgment dated 25/03/2014, which is placed on record at page Nos.57 to 60 attached with the memo of appeal. The acquittal clearly shows that rash or negligent driving was not proved.
11. We have carefully examined the findings recorded by the learned District Forum which are challenged in the present appeal. On reappreciation of the material on record, we find that the learned District Forum rightly held that the delay in intimation of the accident was reasonably explained. This finding is neither perverse nor contrary to law. So, regarding the driving licence, O.P.No.1 contended that the complainant did not possess a valid licence at the time of the accident. However, the valid driving licences of Vinod L. Kasture and Sudhkar D. Junghare were in force at the relevant time as seen from the documents on record. As such, O.P. No.1 has failed to discharge this burden. Moreover, the complainant was acquitted in the criminal case arising out of the accident, which further demonstrates the absence of any deliberate or material breach. Therefore, the rejection of the insurance claim on the grounds of delay in intimation of the accident and non-possession of a valid licence was unjustified. The act of O.P. No.1 in denying the claim amounts to deficiency in service under Section 2(1)(g) read with Section 2(1)(o) of the Consumer Protection Act, 1986. It also constitutes an unfair trade practice under Section 2(1)(r) of the Consumer Protection Act, 1986.
12. In view of the matter, we have no hesitation in holding that the complainant was entitled to have his genuine insurance claim duly honoured by O.P. No.1. The failure of the O.P. No.1 to settle the claim amounts makes it clear deficiency in service and an unfair trade practice. Therefore, the impugned order of the learned District Forum suffers from no infirmity and no illegality that needs interference. So, the impugned order of learned District Forum directing the O.P.No.1 to pay an amount of Rs.5,33,880/- with interest at rate of 8% per annum to the complainant is just one. The compensation of Rs.5000/- and litigation cost of Rs.2000/- is also seem proper as the complainant suffered mental agony and inconvenience due to the delay. Consequently, we answered point no.1 in the negative and in answer to point no.2, we pass the following order.
ORDER
i. This appeal is hereby dismissed.
ii. The order of the learned District Consumer Disputes Redressal Forum,
Buldhana in Consumer Complaint No.CC/98/2014 passed on 30/07/2018 is hereby confirmed.
iii. A copy of the order be furnished to the parties free of cost.
..................J KALYANI KAPSE PRESIDING MEMBER ..................J SHAILA D. WANDHARE MEMBER