S. Loganathan,

s/o Subbaiyya @ Subbarayan,

Sadayampalayam, Kailasapuram,

Punnam Post, Aravakurichi TK,

Karur Dist. … Complainant



-versus-



The Manager,

ICICI Lombard Motor Insurance,

United Arcade, 3rd Floor, Annamalai Nagar,

Karur Byepass road, Thillai Nagar,

Tiruchirappalli 620 018. … Opposite Party





This complaint coming on this day for final hearing before us in the presence of Thiru R.G. Shivasaravanan, Counsel for complainant and Thiru R. Muthamilchetty, Counsel for opposite party and both parties are absent for several hearings and this Forum passed the following:

ORDER

1. The complaint is for directing the opposite party to pay 1,00,000/- towards insurance amount, to pay Rs.25,000/- towards compensation for loss and damages and to pay costs of this complaint to the complainant.



2. Both parties absent for several hearings though this Hon’ble Forum strictly warn both the parties to present before it. But both complainant and opposite party not turned up. Hence, the complaint is dismissed for default without costs.

Varinder Chand Head Constable s/o Ram Chand r/o Quarter No. 13, Police Colony, Banga Tehsil and Distt. Nawanshahr.

….Complainant.



Versus



1 ICICI Lombard General Insurance Company Ltd, through its Manager/ concerned officials, Kunal Towers, Unit No. 1-5, 3rd Floor, 88 The Mall , Ludhiana Tehsil and Distt. Ludhiana.

2 ICICI Lombard General Insurance Company Ltd, through its Manager/ concerned officials, ICICI Bank, Tower, Bandra Kurla Complex, Mumbai 400051

3 Senior Superintendent of Police Office, Nawanshahr through its Accounts Officer/ Concerned Official, SSP Office, Nawanshahr. ….Respondents




Varinder Chand (hereinafter called as complainant) has filed this complaint against ICICI Lombard General Insurance Company Ltd, through its Manager/ concerned officials, Kunal Towers, Unit No. 1-5, 3rd Floor, 88 The Mall , Ludhiana Tehsil and Distt. Ludhiana, ICICI Lombard General Insurance Company Ltd, through its Manager/ concerned officials, ICICI Bank, Tower, Bandra Kurla Complex, Mumbai 400051 and Senior Superintendent of Police Office, Nawanshahr through its Accounts Officer/ Concerned Official, SSP Office, Nawanshahr (hereinafter called as Ops No. 1, 2 and 3 respectively) for issuance of a direction to the Ops to pay the insurance claim as per the policy along with interest in addition to compensation to the tune of Rs. 20,000/- for mental and physical agony, as well as Rs. 5,000/- as litigation cost.



2. The brief admitted facts of this complaint are that the complainant was employed in the Punjab Police and was posted as Head Constable. He had obtained ‘Group Insurance Policy’ bearing no. 4005/0008737 from Op no. 1 through Op no.3. On 30-03-2008, the complainant had met with motor vehicle accident regarding which FIR no. 61 dated 01-04-2008 was got registered U/s 279/337/338/427IPC at PS Mahalpur, District Hoshiparpur. He had suffered multiple injuries and remained admitted in CMC hospital Ludhiana and his right lower leg had been amputated. His permanent physical disability was assessed as 75 percent by Civil Surgeon, Nawanshahr. The complainant claims to have approached the Op a number of times for payment of insurance claim amount of Rs 1 lac but the Ops had been putting him off on one pretext or the other leading to mental as well as physical agony to the complainant. Hence this complainant.



3. The Ops no. 1 & 2 in their written version have challenged, the maintainability of the complaint on the ground that they had no branch office at Nawanshahr and as such this Forum had no territorial jurisdiction to entertain and try this complaint. Further that the complaint was premature as the claim of the complainant had yet not been repudiated and was pending for want of supplying of documents by the complainant. On merits the issuance of insurance policy as well as lodging of the claim was not disputed. It was contended that the complainant despite demand by these Ops had not supplied the driving license or the details of the same and in the absence of these documents the claim of the complainant could not be finalized. It was denied that there was any deficiency on the part of these Ops. A prayer for dismissal of the complaint was accordingly made.



4. Op No.3 in its written version did not dispute the fact about the employment of the complainant under it as well as obtaining of his group insurance by this Op. A prayer for dismissal of the complaint was accordingly made.



5. Both the parties have placed on record their respective evidence in the shape of affidavits and other documents.





6. We have considered the oral submissions advanced by the learned counsel for the parties and carefully scrutinized the evidence on record.



7. From the written version filed by the Ops no.1 & 2 it is evident that the claim of the complainant had yet not been repudiated and it was still pending with these Ops for want of certain documents to be supplied by the complainant. The Ops have placed on record, Ex R-7 letter dated18-09-2008 and Ex R-9 letter dated 20-08-2009, vide which the complainant was requested to supply his driving license as well as other documents for finalization of the claim. Admittedly the complainant has not complied with the requirement of Ops no 1 and 2. In such circumstances it can be safely held that the claim of the complainant being yet pending, the complaint is premature and as such is not legally maintainable.

8. In view of the aforesaid facts, the complaint is dismissed. The complainant may submit the required documents to Ops no.1 and 2 for finalization of his claim and if necessity arises, may avail the remedy in accordance with the law.

09 The copies of this order be sent to the parties as per rules.



10. File be consigned to the record room.

Varinder Chand Head Constable s/o Ram Chand r/o Quarter No. 13, Police Colony, Banga Tehsil and Distt. Nawanshahr.

….Complainant.



Versus



1 ICICI Lombard General Insurance Company Ltd, through its Manager/ concerned officials, Kunal Towers, Unit No. 1-5, 3rd Floor, 88 The Mall , Ludhiana Tehsil and Distt. Ludhiana.

2 ICICI Lombard General Insurance Company Ltd, through its Manager/ concerned officials, ICICI Bank, Tower, Bandra Kurla Complex, Mumbai 400051

3 The Nawanshahr Centeral Co-operatrive Bank Ltd Evening Branch, Banga through its Manager, Main Road Banga Tehsil & Distt. Nawanshahr. ….Respondents





Varinder Chand (hereinafter called as complainant) has filed this complaint against ICICI Lombard General Insurance Company Ltd, through its Manager/ concerned officials, Kunal Towers, Unit No. 1-5, 3rd Floor, 88 The Mall , Ludhiana Tehsil and Distt. Ludhiana, ICICI Lombard General Insurance Company Ltd, through its Manager/ concerned officials, ICICI Bank, Tower, Bandra Kurla Complex, Mumbai 400051 and The Nawanshahr Centeral Co-operatrive Bank Ltd Evening Branch, Banga through its Manager, Main Road Banga Tehsil & Distt. Nawanshahr. (hereinafter called as Ops No. 1, 2 and 3 respectively) for issuance of a direction to the Ops to pay the insurance claim as per the policy along with interest in addition to compensation to the tune of Rs. 20,000/- for mental and physical agony, as well as Rs. 5,000/- as litigation cost.



2. The brief admitted facts of this complaint are that the complainant was employed in the Punjab Police and was posted as Head Constable. He had obtained ‘Group Insurance Policy’ bearing no. 4012/0001071 from Op no. 1 through Op no.3. On 30-03-2008, the complainant had met with motor vehicle accident regarding which FIR no. 61 dated 01-04-2008 was got registered U/s 279/337/338/427IPC at PS Mahalpur, District Hoshiparpur. He had suffered multiple injuries and remained admitted in CMC hospital Ludhiana and his right lower leg had been amputated. His permanent physical disability was assessed as 75 percent by Civil Surgeon, Nawanshahr. The complainant claims to have approached the Op a number of times for payment of insurance claim amount of Rs 1 lac but the Ops had been putting him off on one pretext or the other leading to mental as well as physical agony to the complainant. Hence this complainant.



3. The Ops no. 1 & 2 in their written version have challenged, the maintainability of the complaint on the ground that they had no branch office at Nawanshahr and as such this Forum had no territorial jurisdiction to entertain and try this complaint. Further that the complaint was premature as the claim of the complainant had yet not been repudiated and was pending for want of supplying of documents by the complainant. On merits the issuance of insurance policy as well as lodging of the claim was not disputed. It was contended that the complainant despite demand by these Ops had not supplied the driving license or the details of the same and in the absence of these documents the claim of the complainant could not be finalized. It was denied that there was any deficiency on the part of these Ops. A prayer for dismissal of the complaint was accordingly made.



4. Op No.3 did not dispute the insurance of the complainant through Ops No. 1&2 under “Sehkari Bank Bima Yojna” as a safeguard to protect the loan advanced to the complainant by the Ops. The information supplied by complainant to this Op was stated to have been duly sent to Ops No. 1&2. A prayer for dismissal of the complaint was accordingly made.



5. Both the parties have placed on record their respective evidence in the shape of affidavits and other documents.





6. We have considered the oral submissions advanced by the learned counsel for the parties and carefully scrutinized the evidence on record.



7. From the written version filed by the Ops no.1 & 2 it is evident that the claim of the complainant had yet not been repudiated and it was still pending with these Ops for want of certain documents to be supplied by the complainant. The Ops have placed on record, Ex R-7 letter dated18-09-2008 and Ex R-9 letter dated 20-08-2009, vide which the complainant was requested to supply his driving license as well as other documents for finalization of the claim. Admittedly the complainant has not complied with the requirement of Ops no 1 and 2. In such circumstances it can be safely held that the claim of the complainant being yet pending, the complaint is premature and as such is not legally maintainable.

8. In view of the aforesaid facts, the complaint is dismissed. The complainant may submit the required documents to Ops no.1 and 2 for finalization of his claim and if necessity arises, may avail the remedy in accordance with the law.

09 The copies of this order be sent to the parties as per rules.



10. File be consigned to the record room.

Jasvir Singh son of Sh. Gurdial Singh, resident of village Sujjanpur, Tehsil Jagraon, District Ludhiana.



…..Complainant.

Versus



1- ICICI Lombard General Insurance Company Limited, Space No.1, 5th Surya Towers, 108, The Mall, Ludhiana, through its Manager.

2- ICICI Lombard General Insurance Company Limited, SCO 174-175, Ist Floor, Sector 9-C, Madhya Marg, Chandigarh, through its Manager.

3- ICICI Bank Towers Bandra Kurla Complex, Mumbai-400051 through its Chairman. …..Opposite party.







O R D E R






1- Complainant vide cover note no.52920806 dated 22.11.2007, got his Toyota Innova car bearing no.PB-10CA-0267, insured with opposite party. The vehicle on 13.7.2008, met with an accident in District Sonipat, Haryana qua which, DDR No.22 dated 14.7.2008 was registered in P.S. Rai, District Sonipat. Qua damage of the vehicle, claim was lodged with opposite party and submitted necessary proof, documents, vouchers, but despite it, opposite party vide letter dated 29.8.2008 repudiated the claim, on the ground that vehicle in question was used for hire and reward. By filing this complaint u/s 12 of the Consumer Protection Act, 1986, complainant claimed that repudiation is arbitrary, wrong, null and void, as he never used his vehicle for hire and reward. Therefore, claimed compensation of Rs.5 lacs being value of the vehicle, Rs.50,000/- as compensation for deficiency in service and Rs.10000/- litigation expenses.

2- Opposite parties no.1 & 2 in reply, admitted insuring vehicle of the complainant and lodging insurance claim qua damage, repudiating the same. But they pleaded that complainant had obtained insurance coverage of his car, as private car. Whereas, he was plying the same for commercial purpose. Hence, claim was rightfully repudiated. Further averred that on receipt of claim application, the same was investigated, by engaging an investigator, who after inquiry, reported that vehicle was being used for taxi purpose. Hence, complainant violated terms and conditions of the insurance policy. Therefore, claim not payable.

3- Opposite party no.3 did not contest the complaint and as such, is being proceeded exparte.

4- Contesting parties, in support of their respective claims, adduced evidence by way of affidavits and documents.

5- We heard ld. counsel for parties and minutely scanned entire material placed on file.

6- Certain admitted aspects need not be highlighted, to burden the record. Suffice to say that vehicle of the complainant, was insured vide cover note Ex.C2 from 22.12.2007 to 21.11.2008, with opposite party. After the vehicle was damaged in an accident, regarding which DDR no.22 dated 14.7.2008, was recorded in P.S. Rai (Ex.C1), complainant lodged damage claim with the opposite party. Opposite party vide repudiation letter Ex.C7 dated 29th August, 2008, intimated complainant that the vehicle was plied for hire and reward, which is exclusion as per policy terms and conditions. Therefore, claim not payable. This repudiation was done, on the strength of report Ex.R2 of Sh. Sachin Gulati, Investigator, engaged by the opposite party.

7- It is, as such, apparent that opposite party got strength, to repudiate claim of the complainant, on the basis of report Ex.R2 of investigator Sh. Sachin Gulati. But affidavit of Mr. Gulati is not filed, to prove the report. Neither any material or evidence has been brought on record, to sustain allegations of Mr. Gulati, contained in his report Ex.R2 that the vehicle, in violation of the policy, was used for hire and reward. The conclusion of Mr. Gulati was whimsical, un-supported with any evidence. As per his report, had inter-action with some people of village Sujjanpur, out of which, one was Mr. Jasvir Singh, who confirmed that insured Jasvir Singh was having three vehicles, which he had been using for commercial usage. He had been using those vehicles from taxi stand, Hansa, located at a distance of two kilometers from his village. Neither the report is accompanied with statement of such person named Jasvir Singh or any other co-villager of the complainant.

8- Further reported by investigator that he visited taxi stand, Hansa, contacted some drivers, but they refused to provide any clue regarding the insured vehicle of the complainant. He on the strength that vehicle had travelled 1,50,000 kms., concluded that it was impossible for an owner of a private vehicle, to run the same 7500 kms. per month. So, concluded that vehicle must have been used as taxi on hire and reward basis. Such was inferred by the investigator, without any proof.

9- In these circumstances, there is nothing on the record, to substantiate conclusion of opposite party that the vehicle though insured as private vehicle, in violation of the policy, was being operated and run on hire and reward basis. There being no proof on the same, so such conclusion appears to be apparently false and wrong.

10- As a result, opposite party would be liable, to honour the insurance policy and compensate the complainant, for the loss or damage suffered by his vehicle in the accident.

11- Opposite party had also engaged Sh. Suneet Jain, surveyor and loss assessor, who had submitted report Ex.R1. He vide that report, assessed net loss of Rs.87,300/- to the vehicle of the complainant. Be it stated that report of loss assessor, is a valuable document, help of which can be taken, to ascertain the damage suffered by the insured. Reference made to Prithvi Raj Vs Oriental Insurance Company Limited II (2005) CPJ-69(NC).

12- As a result, it is proved that insured vehicle of the complainant, in an accident, suffered damage to the tune of Rs.87,300/-. Hence, by not paying the claim, opposite party would be guilty of not rendering proper services to its own consumer. Therefore, we allow this complaint and accordingly, direct opposite party to pay damage claim of Rs.87,300/- under the policy to the complainant, with interest @ 9% p.a. from the date of complaint till payment. For thrusting this litigation on complainant, they are ordered to pay compensation and litigation costs jointly assessed at Rs.4000/-. Order be complied within 30 days of receipt of copy of order, which be provided to the parties free of charge. File be completed and consigned to record room.

Satinder Singh Sobti Prop. M/s.Isher Singh Sobti & Sons Filling Station Ladhowal NH-I,Ludhiana.

….Complainant.

Versus



1- The ICICI Lombard General Insurance Company Limited, 3rd Floor, Kunal Tower 88, The Mall, Ludhiana-141001 Tel.0161-4649120/22, Fax. 0161-4649121 (through Manager).

2- ICICI Lombard General Insurance Company, Correspondence Address (Head Office) Zenith House, Keshav Rao Khade Marg, Opp. Race Course, Mahalakshmi, Mumbai-400034.

….Opposite parties.
O R D E R


1- Complainant being owner of a filling station in the name and style of “M/s.Isher Singh Sobti & Sons, Ladhowal”, Ludhiana, got his petrol station insured vide policy No. 4017/0003372 from the Ops. He consequently, got insured all kinds of losses, such as:

1. (a) Whole cash

(b) Burglary

(c) Cash in hand

(d) Cash in transit

(e) Safe.

2. Fire

3. Earthquake

4. Personal accident and

5. Terrorism.



So, consequently, got insured petrol station for Rs.4200000/-. The policy was provided to him after four months ie. in Nov,2006 after his repeated requests. During continuace of insurance policy, burglary was committed on 02.06.2007 qua which FIR was lodged, there was total loss of Rs.41912/- cash and Rs.5000/- due to damage to cash counter and the same being its costs. Claim lodged, which was declined as ‘no claim’ vide letter dated 11.10.2007. Hence assailed it to be deficiency in service on the part of Ops, filed this complaint under section 12 of the consumer Protection Act, 1986 to compensate his loss with interest and costs.

2. In reply admitted obtaining insurance coverage qua his petrol station by the complainant, and lodging theft claim under the policy. But averred that the claim was entertained, processed and investigated. M/s. Cunningham Lindsey International Private Limited, was appointed investigator to investigate the factum of burglary of cash of Rs.41912/- allegedly stolen from filling station cash counter. But no claim for the cost of the counter was ever lodged. After investigation, investigator submitted report on 3.08.2007 and after scrutinizing the record and documents, the claim was rightly, legally repudiated vide letter dated 06.08.2007. Because the policy only covered ‘cash in safe only’. So, whereas alleged cash was taken from the wooden cash counter which was not covered in the policy. Because cash in the counter cannot be treated as ‘cash in safe’. Therefore, there is no negligence or deficiency in service on their part.

3. Both the parties led their respective evidence. Complainant in person and counsel for Ops heard.

4. In the instant case, only dispute to settle the matter corner around interpretations of terms and conditions of insurance policy. Complainant has placed on record mark A & B of the Insurance Cover. Whereas, Ops have also placed the insurance cover Ex.R1 and terms and conditions of the policy Ex.R2. Henceforth, we would refer only documents Ex.R1 and Ex.R2, pertaining to insurance of petrol pump of the complainant. As per cover of Insurance Ex.R1, the risk stand covered under the insurance policy as under:

a) Fire

b) Cash in Safe

c) Cash in Transit

d) Personal Accident

e) Earthquake

f) Fire and Earthquake and

g) Terrorism Cover



5. So, under the policy ‘Cash in safe’ (emphasis laid) and cash in transit to the tune of Rs.4 lac each was insured under the policy. Consequently, question is whether alleged theft of the cash took place from the safe or not. Because plea of the OP is that no theft of cash had taken place from safe, it was committted from cash counter of petrol station, so loss from the counter was not covered under the policy.

6. Circumstances under which theft occured and the place of theft found mentioned in letter Annexure ‘C; dated 24.07.2007 of the complainant, to the claim department of Ops. It was under the letter that he lodged insurance claim. This letter contains admission of the complaint as under;

“(c) Cash in transit

Burglars had taken away the cash counter which was placed in locked room. Ultimately that cash had to shift either to main safe or to Bank directly. Main safe keys are always kept safe custody are not available with sale man. That is why whole day sale was saved and only few hours cash after 10 PM was lost.

Safe pouring is not done rupee by rupee or after every minute; but after some collection or sometime (specially during night hours) cash is dropped in safe. So the stolen cash was transit cash and was also kept in safe custody”.



7) So, while alleging claim under the policy complainant clearly stated that the cash was kept in counter placed in the locked room. Cash from the counter was to be shifted either to main safe or to bank directly. Keys of main safe were kept in safe counter and not given to the salesman. So it means that there was a safe in the petrol pump for keeping cash. But the sales cash was not kept in that safe. Rather it was kept in cash counter. There was no insurance coverage taken by the complainant for any amount retained or kept in cash counter of the petrol pump. Ex.R2 in part-3 titled “Cash in safe” contitute terms and conditions. Under such terms insurance company was mainly liable in respect of loss of money by burglary and/or attempted burglary and or valuables contained in a domestic safe or vault which is protected by appropriate security measures with lock and key. Whereas in the instant case the money was stolen from the cash counter and not from safe. Therefore it is apperent that there is no insurance coverage to cash of the complainanat, kept in cash counter.

8. In similar circumstances like this, Hon’ble National Commission in National Insurance Company Vs. Ram Kumar Aggarwal of 2002(3) CLT page 395 (NC) has held that where money is kept in the drawer of the almirah, as against stipulation in the policy to be kept in a strong room, the claim would not be covered under the policy. Similarly, in the instant case, cash was not kept in the cash chest, but in the counter and there was no insurance coverage for the cash counter.

9. In view of these aspects we are of the opinion that OP1 justified in rejecting the claim of the complainant vide communication Annexure ‘E’ dated 06.08.2007. Hence there is no negligence on the part of Ops nor there is any deficiency in service.Therefore, finding no merits in the complaint, the same is dismissed. In peculiar circumstances of the case, parties are left to bear own costs. Copy of order be made available to the parties free of charge. File be consigned to record room.

Harjinder Kaur aged 47 years wife of Sh. Avtar Singh, resident of Kothe Sobha Singh, Ludhiana Road, Ward No.1, VPO Raikot, District Ludhiana.

…..Complainant.

Versus





1- Med Save Global Health Care Company Group, Med Save Health Care Limited, (Regd. and Corporate Office), F-701-A, Ladey Sarai, Behind Gold Ground Delhi, through its Managing Director.

2- Med Save Global Health Care Company Group, Med Save Health Care Limited, Branch Office: SCO-121,22, Ist Floor, Sector 34-A, Chandigarh, through its Director.

3- Sanjivni Health Care Scheme, C/o Med Save Health Care Limited, (Regd. and Corporate Office), F-701-A, Ladey Sarai, Behind Gold Ground Delhi, through its Managing Director.

4- The Raikot Cooperative Agricultural Service Society Limited, through its Secretary (Concerned with Sanjivni Health Care Scheme/Sanjivni Trust) Raikot, District Ludhiana.

5- Deep Hospital, 481, Model Town, Ludhiana, through its Proprietor Baldip Singh.

6- Registrar Deputy Chairman, Cooperative Societies, Punjab, Chandigarh.

7- ICICI Lombard General Insurance Company Limited, Feroze Gandhi Market, Ludhiana.

8- ICICI Lombard General Insurance Company Limited, Mumbai.

…..Opposite parties.





O R D E R


1- Case of the complainant in this complaint u/s 12 of the Consumer Protection Act, 1986, is that her husband Sh. Avtar Singh being member of Raikot Cooperative Agricultural Society(opposite party no.4), had account no.5/707 with them. Being member of the society, having account, her husband alongwith family members, was covered under Sanjivni Health Care Scheme of opposite parties no.1 to 3. Under that scheme, members of the society and their family were automatically covered under Sanjivni Health Care Scheme and thereunder, complainant was fully covered under the health scheme. Complainant suffered ailment, got admitted in Deep Hospital (Opposite party no.5), who intimated that they were on list of panel hospitals of Sanjivni Health Care Scheme. She was operated and spent Rs.95,800/- for treatment which was payable by opposite party no.1 to 4 under the Sanjivni Health Care Scheme. Pre-authorization form for such purpose, was also filled. But it was not done and compelled to pay bill of hospital. Opposite party no.5, as such, were deficient in taking payment from her, despite the fact that was entitled for free treatment. Claiming it to be deficiency in service on part of opposite parties, sought payment of Rs.1 lac amount spent on treatment and given to opposite party no.5 hospital and also Rs.1 lac compensation for harassment and torture.



2- Sanjivni Trust opposite party no.3, in reply claimed that complaint is not maintainable, is based on false and frivolous allegations and does not disclose any cause of action against them. Averred that Sanjivni Trust is a confirming party to agreement signed between Med Save Health Care(Opposite party no.2), to operate and implement the scheme. Scheme has been out-sourced and the insurance company (ICICI Lombard General Ins. Co. Ltd.) is responsible for payment of claim to the beneficiaries. So, Sanjivni Trust can not be made responsible for any deficiency in service. Their role is confined to ensure obtaining minimum rate of premium to be paid by the beneficiaries to the insurance company. The same was ensured by the Sanjivni Trust. So, they are not negligent in rendering services.

3- Opposite party no.4- The Raikot Cooperative Agricultural Service Society Limited, in separate reply, also took objection qua maintainability, mis-joinder of parties. They averred that Punjab Govt. through department of Cooperative Societies, launched a scheme “Sanjivni Health Care Scheme”, for welfare of the members of the cooperative societies and their dependants. Under the scheme, members of the society and their family, were made eligible to become part of the scheme, by paying nominal amount. The insurance coverage qua treatment in various recognized hospitals, under the scheme, is to be provided by ICICI Lombard Insurance Company (opposite parties no.7 & 8). So, insurance company is liable, to reimburse expenses, if any, incurred by the complainant. There is no deficiency in service on their part. It is admitted that husband of complainant, is member of the society and insured under the scheme. Rest of the allegations is denied.

4- Opposite parties no.7 & 8-ICICI Lombard General Insurance Co. Ltd. pleaded in reply that claim with them, was never lodged, so complaint deserves dismissal, being not maintainable. There is no deficiency in service on their part. Further pleaded that as per record, they were intimated by Med Save Company opposite party no.1 that Deep Nursing Home (opposite party no.5) approached them qua providing cashless facilities for treatment of the complainant. Opposite party no.1 denied vide letter dated 4.5.2006 such cashless facility for treatment, on the ground that liability of the insurance company was not determinable at present. Opposite party no.1 rejected the claim, as hospital of opposite party no.5 was not on Sanjivni Network of hospitals, because hospital had not been provided with rate list. So, cashless facility was not provided to the complainant. Opposite party no.5 was intimated by opposite party that complainant may submit hospitalization papers for reimbursement and claim would be settled after investigation. Complainant till date has not lodged any claim. Only claim was lodged by Deep Nursing Home, opposite party no.5, which was rejected vide letter dated 4.5.2006. So, averred that there is no deficiency in service on their part.

5- Opposite parties no.1, 2 & 5 did not contest the complaint and are being proceeded exparte.

6- Contesting parties, in support of their respective claims, adduced evidence by way of affidavits and documents.

7- We have heard ld. counsel for parties and scanned the entire material placed on the file minutely.

8- Proved and admitted aspects of the case are that Punjab Govt. through Secretary, Cooperative Societies, launched Sanjivni Health Care Scheme, for welfare of the members of the cooperative societies, and their dependants. Members of the society, who opted for the scheme, were required to pay nominal amount, to get health insurance coverage. Job to implement Sanjivni Health Care Scheme was entrusted to Med Save Global Health Care Co. and they got insurance coverage for such members of the society and their dependants, from ICICI Lombard General Insurance Company Limited. Under the scheme, not only members of the society, but their dependents covered under the scheme, were also entitled to get cashless treatment in empanelled hospitals, recognized by Med Save Health Care Company.

9- It is in backdrop of aforesaid admitted aspects argued on behalf of opposite parties no.7 & 8 that no negligence is attributed to them by the complainant, who never lodged any claim for reimbursement and that Deep Hospital was not recognized hospital, for taking treatment and as a result, deficiency if any, is on part of Deep Hospital, who falsely represented to the complainant that they were on the penal recognized list of the hospitals of opposite party no.1.

10- We may state that husband of the complainant was issued by opposite party no.1, card no.86011000003559A qua account no.265-5075/707, valid from 14.1.2006, copy of which is Ex.C11. He being member of the society and covered in Med Save Health Care Scheme, his wife Smt. Harjinder Kaur automatically got obtained insurance coverage vide card Ex.C12 dated 14.1.1006 bearing card no.860110000 03559C, Code Account No.265.

11- The next question is whether Deep Hospital opposite party no.5, where she took treatment, was penalled hospital of opposite party no.1. Ex.C13 list of penalled hospitals, recognized by opposite party no.1, at serial no.104, contains name of Deep Nursing home. So, it means it was penalled and recognized hospital, empowering cardholder of Med Save Health Care Scheme, to get cashless treatment. In order to take such cashless treatment after getting admitted in Deep Nursing Home, complainant filled authorization form Ex.C9 and that request of the complainant for cashless treatment was faxed by Deep Nursing Home to opposite party no.1. Opposite party no.1 consequently, vide its communication Ex.C20 dated 4.5.2006, intimated Deep Nursing Home, as under:-

“This is with reference to the request form for cashless hospitalization received by us for the treatment of the above mentioned patient at your hospital. He/she is admitted on 26.4.2006 under the able supervision of Dr. Dr. Vyom Bhargava.



The liability of the insurance company under this policy is not determinable at present from the details provided to us regarding the history of the insurance and disease.



Rejected as the hospital is not on Sanjivni Network of hospitals as the hospital had not provided with the rate list.



Hence, cashless facility can not be extended in this case. The hospital is requested to collect the expenses from the insured person. However, the insured person may submit the hospitalization papers for reimbursement and the claim will be settled after investigation and gathering more information, if found admissible, as per policy terms and conditions.



This is issued with the approval of competent authority”.







12- So, from this communication, appears that opposite party no.1, in view of the intimation furnished by opposite party no.5, was not in a position to determine liability of the insurance company under the policy. Further, it was conveyed that claim rejected, as Deep Hospital was not in Sanjivni Network of hospitals, as it had not been provided with rate list. At this stage, we may intrude to say that as far as list of penalled and recognized hospitals, circulated by opposite party no.1, is concerned, in that list, Deep Nursing Home was mentioned at serial no.104. Therefore, it does not now lies in the mouth of opposite party no.1, to say that Deep Nursing Home was not recognized for cashless treatment, as they had not been provided the rate list. If it was so, they should not have penalled and recognized that hospital. For such act or deficiency on their part, complainant can not be made to suffer.

13- Also, it was intimated by opposite party no.1 to opposite party no.5 under the said communication Ex.C20 that insured may submit hospitalization papers for reimbursement which would be settled after investigation. We have no proof with us whether it was ever conveyed by opposite party no.5 to the complainant.

14- Though complainant alongwith complaint, has placed on record, discharge summary Ex.C5 alongwith invoices qua purchase of medicines, receipts of laboratory charges etc. Ex.C7 to Ex.C8 of opposite party no.5 hospital.

15- Opposite parties no.7 & 8 could not decide the claim, as it was never lodged with them. Though opposite party no.1 intimated opposite party no.5, regarding such requirement, to decide claim of the complainant. It appears in these circumstances that herein, not only opposite party no.5, but also opposite party no.1 faultered in doing their duty, which caused immense sufferance to the complainant.

15- In aforesaid circumstances, we accordingly allow this complaint and pass the following directions to opposite parties no.1 to 3 & 5:-

(i) Complainant shall lodge claim of reimbursement with opposite party no.1 to 3, supported with necessary vouchers, documents, medical records, who shall then forward claim of the complainant, for settlement to ICICI Lombard General Insurance Co. Ltd. opposite parties no.7 & 8 and they shall settle claim of the complainant within 60 days of receipt of claim papers from the complainant.

(ii) Complainant would also be entitled for compensation, as was entitled for cashless treatment from Deep Nursing Home, which was recognized hospital of opposite party no.1, but they wrongly denied cashless treatment, forcing complainant, to pay the amount of treatment to the hospital and for such deficiency in service on their part, by not allowing cashless treatment to the complainant, opposite party no.1 & 2 ordered to be pay compensation of Rs.5000/- to the complainant. Similarly, opposite party no.5 failed to convey to the complainant, lodging reimbursement claim with the opposite party, as was communicated to them by opposite party no.1, in their letter Ex.C20, by not intimating the complainant qua it, they would also be guilty of not rendering proper services to its own consumer. For such default, they are also ordered to pay Rs.5000/- to the complainant. Opposite parties no.1, 2 & 5 also ordered to pay litigation costs of Rs.1000/- each to the complainant.

Order be complied within 30 days of receipt of copy of this order which be provided to the parties free of charge. File be consigned to record room.

Karnail Singh son of Sh. Surjit Singh, resident of 1087/4, St. No.2, Kalsian Street, Himmatpura, Ludhiana.

(Complainant)

Vs.



1. ICICI Lombard Motor Insurance Co. Ltd. The Mall, Ludhiana through its Branch Manager.



2. ICICI Lombard Motor Insurance Co. Ltd. Zenith House, Keshave Rao Khande marg, mahalakshmi, Mumbai-34 through itsMD/GM.



3. ICICI Lombard Motor Insurance Co. Ltd. Patiala 133 006, through its Branch Manager.

(Opposite parities)






O R D E R



1. Complainant being owner of Mohindra Scorpio car (registration no. PB-10BR-0562) got it insured with opposite party vide policy no. 3001/52011864/00/000, valid from 8.6.2007 to 7.6.2008. The said vehicle was parked by the complainant on 1.11.2007 at 7.30 p.m. in front of his house after locking the same. During night, it was stolen, qua which FIR no.113/2.11.2007 was lodged, but the vehicle could not be traced. Intimation to opposite party was also given. But they failed to settle the same despite repeated visits by the complainant and providing them all the documents and information. Non settlement of claim caused mental tension, pain, agony and harassment to the complainant. Hence, served legal notice dated 6.5.08 on the opposite party, but they failed to clear the claim. Such act on the part of opposite party is claimed amounting to deficiency in service and sought value of the insured vehicle Rs.5,60,770/-from the opposite party and Rs.1,00,000/- compensation.

2. Opposite party in reply admitted insuring vehicle of the complainant. But claimed that complainant obtained insurance policy as a private car, but was using it as a taxi for commercial purpose. Premium for commercial vehicle is more than the private vehicle. Hence, the complaint is not maintainable and deserves dismissal. He was using the vehicle as a taxi, which aspect was admitted by the complainant in writing. There was no deficiency in service. Vide letter dated 4.2.2008; complainant had admitted using insured vehicle for hire and reward. Therefore, it was not covered under the terms and conditions of the policy. They were not deficient or negligent in rendering the services to the complainant.

3. Parties led their evidence by way of affidavit and documents in support of their respective contentions.

4. We have heard the arguments addressed by the ld. counsel for the parties and have gone through the file and scanned the documents and other material on record.

5. The sole question which requires determination is whether the insured private vehicle was being used for commercial purpose by the complainant by operating as a taxi, so, as empowering the opposite party to repudiate the claim? Because, it is not in dispute that the vehicle of the complainant was insured with the opposite party and during currency of the insurance policy had lodged claim of theft of the vehicle by giving copy of the DDR Ex.C.4, FIR Ex.C.5 and RC Ex.C2.


The claim so lodged was entertained by the opposite party who got it investigated through investigator Third Eye, Jalandhar. The investigator vide his report Ex.R.1 dated 5.12.2007 had found allegations of theft of the vehicle to be correct. But reported that the vehicle was being used as a taxi for commercial purpose. Regarding it, he had recorded statement Ex.R.2 of the complainant. In that statement, complainant himself had admitted also operating the vehicle as a taxi. It claimed that it was stolen while parked outside his house.

6. Aforesaid admission of the complainant contained in his statement Ex.R.2 and report of the investigator, the opposite party repudiated the claim vide repudiation letter Ex.R.3 dated 4.2.2008, on the ground that the insured vehicle was being used for hire and reward/transportation of goods, which is not covered under the terms and conditions of the policy.

7. In these circumstances on behalf of the complainant, it was argued that there is no proof or evidence that actually the vehicle was being used as a taxi in violation of the policy. Because no person or Incharge of the taxi stand in support of this has been examined. No doubt, there is no other evidence regarding it except report of the investigator, coupled with statement of the complainant recorded by him. This statement contains admission of the complainant. Admission being best evidence requires no other proof. Therefore, we have no reason to disbelieve that the complainant was using this private car as a taxi. Under the policy, vehicle could have been used for no other purpose such as hire and reward or carriage of goods when the complainant had obtained the insurance policy of his vehicle for private use.

8. No doubt, complainant had given statement to investigator of the opposite party that had been using his vehicle for hire and reward. But at the time of alleged loss, the vehicle was parked outside house of the complainant. There appears no nexus between theft and use of the vehicle. As at the time of theft it was not being used as a taxi. Therefore, such would not be fundamental breach of the policy, so as to empower opposite party to repudiate the contract in entirety.

9. In case titled as National Insurance Company vs. Nitin Khandewal,2008 (IV), Law Herald (Supreme Court), page 1507, Hon’ble Supreme Court has held that where a private vehicle was used as a taxi and it was found stolen, insurance company would be liable to settle the claim at 75% of the insured amount as on non standard basis.

10. In view of this law, this complaint is allowed and consequently, opposite party directed to settle insurance claim of Rs. 5,60,770/- on non standard basis by paying 75% of the insurance amount to the complainant with 9% interest per annum from the date of complaint till payment, subject to providing letter of subrogation within one month of the receipt of copy of this order by the complainant. If the complainant fails to do so, then opposite party shall not be liable to pay interest amount thereon. Complainant shall also execute the documents for transfer of ownership of the vehicle in favour of the opposite party. Same be also done within one month of the receipt of copy of the order, which be made available to the parties free of costs. File be completed and consigned to record.

Chinnapareddy Venkayamma,

W/o Late Anji Reddy,

Dondapadu village,

Narasaraopet Mandal,

Guntur district. …Complainant

And

1. Secretary,

The Jonnalagadda Primary Agricultural Co-op. Society,

Jonnalagadda,

Narasaraopet Mandal,

Guntur district.

2. The General Manager,

The Guntur District Co-OP Central Bank Limited,

2/13 Brodipet, Guntur.

3. The Area Manager,

ICICI Lombard General Insurance

Company Limited,

Usman Plaza,

Banjara Hills, Hyderabad. …opposite parties






O R D E R





The case of the complainant in brief is as follows:

The complainant is resident of Dondapadu village, Narasaraopet Mandal, Guntur district. Her husband by name Chinnapareddy Anji Reddy S/o Rami Reddy died due to snake bite on 24-02-07, while he was working in the agricultural fields.

The complainant’s husband while he was alive was a member of 1st opposite party i.e., the Jonnalagadda Primary Agricultural Co-op. Society with general number 2060. During his lifetime he had availed crop loan from the 1st opposite party under ‘Kisan Credit Card system’. The 2nd opposite party to which the 1st opposite party is affiliated has introduced coverage of insurance facility to all the members of 1st opposite party, who availed loan under ‘Kisan Credit Card system’. The insurance coverage was extended to the members of 1st opposite party under the scheme of Janatha Personal Accident Policy introduced by the 3rd opposite party i.e., ICCI Lombard General Insurance Company Limited. The husband of the complainant who has availed loan from the 1st opposite party vide loan No.120KCC was covered by the Janatha Personal Accident Policy with the 3rd opposite party under policy No.4012/0000981. The period of coverage of insurance risk under the policy was from 24-04-06 to 23-04-07.


The 2nd opposite party has obtained a blanket coverage policy from the 3rd opposite party under the said policy. The sum assured for the risk coverage is Rs.50,000/- for each member. Therefore, the 3rd opposite party is under the obligation to extend benefits of the insurance coverage in the event of accident/eventuality to the member. The husband of the complainant died due to snake bite during the period of insurance coverage.

The complainant informed to the 3rd opposite party by telegram dated 01-03-07 about the death of her husband. Subsequently the complainant submitted the claim form with all requisite particulars like FIR, Post Mortem Certificate and death certificate to the 3rd opposite party seeking settlement of the claim under the insurance coverage through the 1st and 2nd opposite parties with positive recommendations.

The 3rd opposite party i.e., the ICCI Lombard General Insurance Company Limited received the claim with all documents mentioned above and processed, but repudiated the same on the ground that the claim is not submitted within 30 days of death. There is no dispute with regard to the death of the claimant’s husband and coverage and validity of the policy and also sum assured. The complainant got issued regal notice to the 3rd opposite party requesting for settlement of the claim, but no reply was received. The 3rd opposite party willfully repudiated the claim that the process of the claim started within the period of 30 days on intimation of death through telegram dated 1-3-07. The repudiation is arbitrary and against the law.


There is no voluntary lapse on the part of the complainant. The delay in submission of claim is not fatal. The insurance company shall not take meaningless technicalities with negative approach while settling the genuine claims of the farmers. It has committed breach of trust and deficiency of service. Hence, the complaint.

The 1st opposite party filed its version in the following manner along with its affidavit through its secretary. It has submitted that the husband of the complainant namely Chinnapareddy Anji Reddy died in an accident on 24-2-07 due to snake bite that he was a member of the The Jonnalagadda Primary Agricultural Co-op. Society,

with general membership No.2060 and he was sanctioned agricultural loan under ‘Kisan Credit Card system’. The liability against the same loan is still substituting. According to it the personal accident benefit coverage insurance scheme introduced by the 3rd opposite party through 2nd opposite party also covers the deceased husband. It has also submitted consolidated list of the society showing membership and the total premium amount paid to the 3rd opposite party by the 2nd opposite party and the insurance policy No.4012/0000981, dated 24-4-06 etc. It is also claimed that it has forwarded the claim form to the 3rd opposite party within the time as such the insurance company is under obligation to settle the same. There is no deficiency of service on the part of the 1st opposite party.

The 2nd opposite party filed a memo adopting the version filed by the 1st opposite party.

The 3rd opposite party filed its version in the following manner: It has denied all the allegations made in the complaint in formal way in paras 1 and 2.

It is submitted that the 2nd opposite party entered into an agreement with 3rd opposite party and decided to introduce a scheme to provide insurance coverage to persons having account with the 1st opposite party under “Janatha Personal Accident Insurance Policy” and the said policy is for a period of one year.

As per the said agreement, intimation of accidents giving rise to claims shall be given within 90 days and claim form should be submitted within 180 days from the date of accident, while sending the intimation, bankers should confirm whether the period is covered by the policy conditions or not. The entire list of account holders insured during that month along with the aggrieved account holders passbooks should be submitted to this opposite party. The opposite party submits that the deceased died due to snake bite as per the version of the complainant and the police referred some samples of viscera for analysis to A.P. Forensic Science Laboratory for opinion.


The report received from A.P. Forensic Science Laboratory shows that no chemical poison is found as such the deceased not died due to snake bite. If at all he died due to snake bite the chemical analysis must show poison in his body. Therefore, it shows that the deceased died due to some other reason best known to the complainant for claiming compensation from this opposite party. Therefore, the claim is liable to be dismissed.

Further there is no deficiency of service on the part of this opposite party, since a letter dated 3-7-07 was issued to the 2nd opposite party informing that the claim has been repudiated as claim documents were received on 3-11-07. As per the terms and conditions of the policy and MOU the claim is not liable to be paid as it violates the terms of agreement. The claim should be intimated within 3 months from the expiry of the policy but the claim along with documents were received on 3-11-07 beyond the period of 3 months, as this opposite party lost the opportunity to investigate into the matter as to the cause of the death of the deceased. Therefore, prayed to dismiss the complaint.

The complainant has filed an affidavit and so also the opposite parties in respect of their claim. The complainant relied upon the documents Exs.A-1 to A-10. Opposite parties 1 and 2 have relied upon Exs.B-1 to B-4 and OP3 relied upon Ex.B-5.

Now the points for determination are that,

1. Whether there is deficiency of service on the part of the 3rd opposite party in not settling the claim of the complainant?

2. Whether the complainant is entitled for the amount as claimed for?

3. To what relief?



POINTS 1 to 3:- As seen from the pleading of the parties and the evidence on record there is no dispute that late Chinnapareddy Anji Reddy the husband of the complainant herein was a member of the Jonnalagadda Primary Agricultural Co-op. Society (OP1) and availed agricultural loan under ‘Kisan Credit Card system’, and the loan is still subsisting. By virtue of mutual agreement and understanding in between the 2nd opposite party and the ICCI Lombard General Insurance Company Limited, the scheme under Janatha Personal Accident Policy was introduced covering the risks of the members of all Primary Agricultural Societies in Guntur district who have availed the loan while assuring a sum of Rs.50,000/- for each member.


The name of late Chinnapareddy Anji Reddy is noted at serial No.211 vide membership No.2060 as per Ex.B-1 the list of members of 1st opposite party. As per Ex.B2 Jonnalagadda Primary Agricultural Co-op. Society is also covered under Narasaraopet branch which shows number of members, member share, PACS share, DCCB share and APCOB share etc. It also shows that the insurance premium payable for the year 2006-2007. The GDCC Bank, Tenali vide its office, Narasaraopet branch, shows payment of premium amount by the Jonnalagadda Primary Agricultural Co-op. Society (OP2) branch vide Ex.B-3. Ex.B-4 is the copy of Janatha Personal Accident Policy issued by 3rd opposite party.

As seen from the repudiation letter vide Ex.A-6 dated 3-11-07 issued by the 3rd opposite party, it has received the claim documents of Chinnapareddy Anji Reddy of the Jonnalagadda Primary Agricultural Co-op. Society under the policy “The Guntur District Co-Op Central Bank Limited”. The claim has been repudiated on the following ground. They have received the claim documents on 3-11-07. As per the policy terms and conditions the claim should be intimated with in three months from the expiry of the policy. The same is in violation of MOU, and ICCI Lombard General Insurance Company Limited, shall not have any liability in respect of captioned subject matter. Thus on this count the claim is not payable.

Whereas the version of the 3rd opposite party mention two grounds for repudiation viz., that poison is not found in the sample sent for chemical analysis as such the death is not due to snake bite but due to some other reason and claim is submitted belatedly beyond the period prescribed.

Except for the above no other ground is urged before the Forum for dismissal of the complaint. Though the 1st ground urged in the version is not found in the repudiation letter vide Ex.A-6, we deal with the same since the learned counsel for the OP3 laid much emphasis on this ground also. As seen from the contents of Ex.A-1 the telegram dated 01-03-07 is addressed to the Area Manager, G.S.G. ICCI Lombard General Insurance Company Limited, Banjara Hills, Hyderabad. The death intimation of the deceased is given as due to snake bite at Dondapadu village. The FIR lodged with the police Narasaraopet also shows that the deceased had a snake bite in the fields near by his home on 24-2-07 at about 7.30 pm and died thereafter. The inquest conducted on the dead body of the deceased in the presence of blood relations and other panchayatdars also shows the cause of death. There is bite mark on the left lower leg with blood stains.


The body of the deceased was sent for post mortem examination to the Medical officer area hospital, Narasaraopet. Accordingly, the autopsy was conducted while preserving viscera which was sent to A.P. Forensic Science Laboratory, Hyderabad on receipt of report from the A.P. Forensic Science Laboratory, Hyderabad the medical officer has given final report as “Dessiminated Intravascular Coagulation” as a result of poisonous snake bite. Basing on such report the case was also closed by the concerned police which is evident from Ex.A-10.

The learned counsel for the OP3 relied upon chemical analysis report of the viscera. The samples sent for analysis are that stomach and piece of intestine in brownish turbid liquid. A report has been sent stating that no chemical poison was found in them. Basing on this report it is vehemently contended that the deceased not died due to snake bite. It is pertinent to note that in all snake bite cases the cause of death may not occur due to poisonous substance but due to various reasons such as shock, cardiac arrest etc.


The chemical report is not the conclusive proof to decide the nature of the death of the deceased in this case. There is abundance evidence on record such as FIR, Inquest, Post mortem report which clearly established that the deceased died due to snake bite. Therefore, the chemical analysis report cannot outweigh the above record.

The other ground is that of the delay in submission of claim form along with the requisite documents. The complainant and as well as the counsels appearing for the 1st and 2nd opposite parties very much contend that within 5 days i.e., on 1-3-07 the death of the deceased was informed by way of telegram vide Ex.A-1 and this amounts to beginning of the process. The learned counsel for the OP3 contends that the address shown in the telegram is not proper and it should have been addressed to the Legal Manager of the 3rd opposite party.


Whereas the complainant and opposite parties 1 and 2 contend that the telegram is addressed as provided in their repudiation letter as such they have correctly followed the procedure. The policy issued by the 3rd opposite party is in force from 24-4-06 to 23-4-07. The repudiation letter speaks that the claim form along with the documents was received on 3-11-07 much beyond the period of expiry of 3 months period of the policy. Therefore, as per the terms of agreement and MOU, they are not liable to pay the sum assured.

Now the question is that whether the repudiation of the claim on the part of the 3rd opposite party on the ground of delay is lawful and justified. The learned counsel for the complainant contends that absolutely there is no voluntary lapse on their part and the repudiation of the claim has no meaning because of this technicality and it is not proper approach on the part of the insurance company. The similar contention is also put forth by the learned counsel for the opposite parties 1 and 2 supporting the cause of complainant. In this regard they also rely upon the decision reported in,

2007 (2) CPR 200 Chattisgarh State Commission in the case of Smt Ramayanvati vs Senior Divisional Manager, The Oriental Insurance Company Limited discussed the facts of the case and held as below,

“The respondent 1 insurer herein in the instant case had covered risk of employees of SECL in event of accidental death under Janatha Policy and complainant’s husband was also one of them. On death of complainant’s husband in a road accident, complainant preferred a claim. Claim was repudiated by insurance company on the ground that the claim was filed after three years of her husband’s death while as per terms of policy, claim ought to have been filed within 15 days after occurrence. However complaint was dismissed by District Forum.

Present appeal has been filed against said order of District Forum.

Findings of the Commission: It is held that as per specific averment of complainant she was an illiterate tribal woman and never knew about existence of policy and had not received any information about it and that she preferred claim with respondent 1 through employee respondent 2 SECL. There was no reason to disbelieve averments of complainant. Complainant was unaware of existence of policy and she made no delay in preferring claim, as soon as she came to know about existence of policy. Again, no reason as to why complainant would not have preferred claim earlier, had she known about existence of policy, since complainant preferred complaint without undue delay. Hence repudiation of claim solely based on the ground of delay in intimation by complainant held not proper. Appeal allowed”.



Further they relied upon IV (2004) CPJ 363 between United India Insurance Company Limited vs. Najibullah Ansari and another,

In this case the insured animal died on 24-12-1998. Intimation to company made late on 30-12-1998, as complainant out of station. The death intimated by his relative. The Commission held that the delay is not fatal to claim and the complaint was rightly allowed.

As against the above said decision the learned counsel for the 3rd opposite party relied upon 2008 (2) CPR 132 (NC) Sasanka Mohapatra vs. New India Assurance Company Limited. The facts of the case are that the complainant has availed Janatha Personal Accident Policy, met with an accident and suffered from disability. The claim petition was filed by the father of the complainant. The District Forum ordered compensation. The State Commission set aside the order of the District Forum thereafter revision is preferred before the National Commission. On considering the facts of the case the National Commission observed that where claim under Janatha Personal Accident Policy was inordinately delayed, it was rightly repudiated by insurance company.

On thorough examination of the facts of this case and further having regard to the principles evolved in all the above case law we are of the view that the death intimation of the deceased has been timely given to the insurance company and thereafter the process has began in forwarding the claim. The insurance company also sent the claim form and as per the directions of opposite parties 1 and 2 the complainant made endeavor to obtain copies of FIR, Inquest report, Post mortem report and death certificate of the deceased. Certainly this process would take sometime as all these documents got to be obtained from different authorities.


Thus we observe that there is no inordinate delay in submitting the documents along with claim form. The complainant is being a villager and her husband who was a farmer being covered by the scheme of the policy on his obtaining agricultural loan. The complainant is not expected to be having direct knowledge of the same, within a period of 4 or 5 days she has intimated about the death of her husband with the help of OPs 1 and 2 and began the process in forwarding the same to OP3.


Therefore, the complainant cannot be found fault for such delay. In the backdrop of these case facts we feel it that there is no justification on the part of insurance company in repudiating the claim. This amounts to deficiency of service on their part. The complainant is entitled to the sum assured i.e., a sum of Rs.50,000/- under the policy along with interest @9% p.a., from the date of complaint till the date of realisation. We are also of the view that the complainant is entitled for suitable compensation as she suffered mental agony, pain and suffering in not settling the claim by the 3rd opposite party. On this count we award a sum of Rs.3,000/- towards compensation and legal expenses and Rs.1,000/-.

In the result, the complaint is allowed in part interms as indicated below:

1. The insurance company i.e., the 3rd opposite party is hereby directed to pay the sum assured i.e., Rs.50,000/- under the policy along with interest @9% p.a., from the date of complaint till the date of realization.

2. Further, it is directed to pay a sum of Rs.3,000/- (Rupees three thousand only) towards compensation and Rs.1000/- towards costs of litigation.



3. The claim against opposite parties 1 and 2 is hereby dismissed.

4. The aforesaid amounts shall be paid within a period of six weeks from the date of receipt of the copy of the order, failing which the amounts ordered in item No.2 shall carry interest @9% p.a.

R. Hanuman Naik,

S/o. Balaji Naik,

R/o. Srinivasaraopet,

Guntur. …Complainant

And

The Branch Manager,

ICICI Lombard General Insurance Co., Ltd.,

Dr.No.39-1-82/A, 6th Floor,

Anjaneya Gold House,

M.G.Road, Labbipet,

Vijayawada – 10. …Opposite party






O R D E R



Per Sri M.V.L. Radhakrishna Murhty, Member:- This complaint is filed U/S 12 of Consumer Protection Act, 1986 praying to direct the opposite parties to pay an amount of Rs.1,00,000/- with interest @12% p.a, from the date of accident i.e, on 17-09-06 till realisation together with compensation and costs.

The averments of the complaint in brief are as follows:

The father of the complainant namely R. Balaji Naik is the owner of TVS Star City Motor Cycle bearing No. AP7AJ 7804 and the same was insured with the opposite party under the policy No.3005/50184511/001000, dated 19-08-06 which was valid from 08-08-06 to 07-08-07. Under the said policy the opposite party agreed to cover the risk of 3rd party, personal accident cover for the owner and driver of the said motor cycle to an extent of Rs.1,00,000/- and other liabilities.

While so, on 17-09-06 the father of the complainant entrusted the above motor cycle to the complainant for going to Vijayawada. When the complainant was on his way to Vijayawada on the above motor cycle it met with an accident near Prakasam Barage at about 9.30 am on 17-09-06, due to hit by an Appy Auto which came in a rash and negligent manner. The said accident was registered as a crime in F.I.R.No.243/07 U/S.338 I.P.C by Tadepalli PS of Guntur district.

On account of the accident, the complainant suffered with multiple injuries to his right leg and his knee cap was removed and complainant is totally and permanently disabled. For the above injuries the said complainant was treated at G.G.H, Vijayawada, G.G.H, Guntur and at Dr. Lakshmanaswamy, Guntur and also at Ahmedabad.

The complainant and his father after completing necessary and immediate treatment to complainant approached the opposite party to pay Rs.1,00,000/- which is due to them under the risk of personal accident cover of the above policy issued by the opposite party. As the opposite party is dodging the matter, the complainant and his father also got issued a legal notice dated 03-09-07 to the opposite party. But inspite of that there is no response from the opposite party. The complainant also filed P.L.C.636/07 before Nyaya Seva Sadan, Guntur for their intervention, but in vain. Hence, the complaint.

The opposite party filed its version which is in brief is as follows,

The motor cycle bearing No. AP7AJ 7804 was insured with this company under policy No.3005/50184511/001000, dated 19-08-06 and the period of insurance commenced from 08-08-06 to 07-08-07 and the insured name is Balaji Naik S/o Kotaiah and the type of policy is two wheelers package policy and the insured paid a premium of Rs.893/- covering the risk of basic 3rd party liability, personal accident coverage for owner-driver only.

As per Sec.3 of two wheeler’s package policy of this insurance company, the liability of personal accident covers only to the owner-driver of the registered owner of the vehicle insured. The complainant is the son of the registered owner who is driving the vehicle at the time of accident and in such cases, additional premium has to be paid by the owner at the time of insuring the vehicle as per IMT 18 (Indian Motor Tariff) and in this case the owner has not paid additional premium to under take to pay compensation to any unnamed hirer/driver/any unnamed pillion passenger on the scale provided for bodily injuries caused by violent, accidental on the vehicle insured with this company.

The policy is taken by the owner of the vehicle, the personal accident coverage is only to the owner-driver of the vehicle but not to the 3rd party or unnamed persons. So, the question of liability of RS.1,00,000/- does not arise as there is no coverage. No extra premium paid by the complainant’s father. Hence, the complaint may be dismissed.

The complainant filed affidavit in support of his claim. The opposite party also field affidavit in support of its version.

On behalf of complainant Exs.A-1 to A-7 are marked and on behalf of opposite party Ex.B-1 is marked.

Now the points for determination are that,

1. Whether there is any deficiency of service on the part of the opposite party?

2. To what relief the complainant is entitled?

POINTS 1 AND 2:- It is the case of the complainant that his father is the owner of TVS motor cycle bearing No. AP7AJ 7804. Ex.A-1 is the insurance cover note of the vehicle of his father and that he has insured the vehicle under Ex.A2 and paid premium of Rs.893/-. On 17-09-06 his father entrusted the motor cycle to the complainant for going to Vijayawada and when he was on the way to Vijayawada on the above motor cycle, it met with accident near prakasam barrage due to hit by an Appy Auto which came in a rash and negligent manner, and in that accident he received multiple injuries to his right leg and his knee cap was removed and he was totally and permanently disabled.


The said accident was registered as Cr.No.243/07 under Sec.338 IPC in Tadepalli PS of Guntur district. The complainant and his father approached the opposite party to pay Rs.1,00,000/- under risk of personal accident cover of the above policy issued by the opposite party. Subsequently, the complainant and his father also got issued a legal notice dated 03-09-07 to the opposite party but there is no response from the opposite party.


The case of the opposite party is that the motor cycle was insured with their company in the name of Balaji Naik S/o Kotaiah who is the father of the complainant and the type of policy is two wheeler package policy and that the insured paid a sum of Rs.893/- covering the risk of basic 3rd party liability, personal accident coverage for owner-driver only. As per Sec.3 of two wheeler’s package policy the insurance company is liable for personal accident of owner-driver of the vehicle. The policy covers only to the owner-driver of the registered owner of the vehicle insured. The complainant is the son of the registered owner who was driving the vehicle at the time of accident and in such cases additional premium has to be paid by the owner at the time of insuring the vehicle.


In this case the additional premium as required, is not paid by the father of the complainant at the time of insuring the vehicle. Hence, the complainant who is the son of the insured is not covered under the personal accident. Hence, the opposite party is not liable to pay any compensation to the complainant. Hence, we are of the opinion that there is no deficiency of service on the part of the opposite party. Accordingly this issue is answered.

In the result, the complaint is dismissed. Each party shall bear their own costs.

Chettepu Padmavathi, W/o Late Lakshmi Reddy,

aged about 40 years, Hindu, Cultivation,

Resident of Jangalapalli village of Peddamudium Mandal,

Kadapa District. ….. Complainant.



Vs.



1) The General Manager, ICICI Lombard General Finance

Osmana Plaza, 6-3-352/1 3rd and 4th floor, road No. 1,

Banjara Hills, Hyderabad – 500 034.

2) The General Manager, Kadapa District Co-operative Central Bank Ltd.,

R.S. Road, Kadapa.

3) The Secretary, PACS, Peddamudium

Primary Agriculture Co-operative Society Ltd.,

Peddamudium Village and Mandal, Kadapa District. ….. Respondents.





This complaint coming on this day for final hearing on 10-8-2009 in the presence of Sri J. Ravi, Advocate for complainant and Sri D. Nageswara Raju, Advocate for R2 and R1 & R3 called absent and set exparte and upon perusing the material papers on record, the Forum made the following:-


O R D E R


1. Complaint filed under section 12 of the Consumer Protection Act 1986.



2. The brief facts of the complaint is as follows:- The husband of the complainant namely Cheittepu Lakshmi Reddy was a member in R3 society. He availed a loan of Rs. 26,400/- under debt No. 190 and also Rs. 16,000/- under debt No. 191 from R3 for purchasing a motor and pipe line under debt Nos. 191 & 192. He became a Member in Janata Personal Accident Scheme of R1 and paid premium to R1 through R2 & R3. The sum assured was Rs. 50,000/- under policy No. JPA/0006004. Under the conditions of the policy in case of death R1 should pay Rs. 50,000/- to the nominee.


The complainant was nominee of her husband Lakshmi Reddy. The complainant’s husband Lakhsmi Reddy died around 7.30 p.m on 22-2-2007 at Kanalapalli Matta of Gospadu mandalam, Kurnool District due to Motor Accident. After the death the complainant searched the papers in the house and found the policy of her husband with R1 company. On 15-5-2007 the complainant informed to R3 for processing the claim. The R3 inturn informed the same to R2 and R2 secured necessary documents from the complainant and forwarded to R1 on 5-6-2007. On 19-7-2007 the R1 informed the R2 to send Motor Accident Claims Tribunal papers and police final report within 30 days. A case was registered against one Ramasubbaiah, driver of mini lorry bearing No. Ap 21 U : 4320 under Cr. No. 24/2007. Thus there was no final report of the police.


They were not relevant to process the claim. The complainant however, submitted motor accident claims tribunal papers to the respondent within time and the same were sent to R1 through other respondents. After receiving the documents the R1 repudiated the claim on 18-8-2007 on the ground that the required documents were not submitted within time. It was sent to R2, who informed the same to the complainant. Even after receiving the repudiation letter the complainant approached the respondents to settle the claim. But they have not done so. Thus the complaint was filed for Rs. 50,000/- sum assured along with Rs. 50,000/- towards mental agony and Rs. 1,000/- towards costs.



3. Notices were served to all the respondents 1 to 3 and R2 and R3 appeared in person on the first notice day i.e. 15-5-2009 and took time to file their counter. Time was granted for filing their counter of all three respondents. R2 alone filed a counter on 7-7-2009. Since no counter was filed and no representation was made for R1 and R3 and they were called absent and set exparte on 7-7-2009.



4. The counter of R2 in brief is as follows. The respondent admitted that the deceased Lakshmi Reddy was a member of R3 society and availed a loan under debt No. 191 & 192 and was a member in the Janata Personal Accidental Scheme of R1 and paid premium to R1 through R2 and R3 and the sum assured was Rs. 50,000/- and it should be paid in case of death of policy holder. The complainant had to prove that she was legally wedded wife of Lakshmi Reddy and nominee of Lakshmi Reddy. Lakshmi Reddy died in a Motor Accident on 22-2-2007 and same was informed by the complainant to R3 on 15-5-2007. Under the terms and conditions of the policy the claimant had to inform the death of the policy holder within a month from the date of death.


But the complainant informed the death of her husband after three months. The respondent received the proposals from R3 on 18-5-2007 and submitted to R1 along with all relevant documents. There was no negligence on the part of the respondent. The family member certificate filed by the complainant showed that the deceased had two daughters and one son. They were necessary and proper parties. They were not impleaded. There was no cause of action and limitation. Thus the complaint may be dismissed with costs.



5. On the basis of the above pleadings the following points are settled for determination.

i. Whether there is any negligence and deficiency of service on the part of the respondents?

ii. Whether the complainant is entitled to the relief as prayed for?

iii. To what relief?



6. On behalf of the complainant Ex. A1 to A12 were marked and on behalf of the respondent No. 2 Ex. B1 to B3 were marked.



7. Point No. 1 & 2 It was not a dispute that the deceased C. Lakshmi Reddy was a member of R3 cooperative society and availed a loan of Rs. 26,400/- under debt No. 190 and Rs. 16,000/- under debt No. 191 for purchasing of Motor and pipe line and became a member in Janata Personal Accident scheme of R1 and paid premium to R1 through R2 and R3 and the sum assured was Rs. 50,000/- and the assured sum should be paid in case of death of the policy holder to the nominee. Similarly it was not a dispute that C. Lakshmi Reddy died in a Motor Accident around 7.30 p.m on 22-2-2007 and the same was informed by the complainant on 15-5-2007 to R3, who inturn informed to R2 and R2 received proposals of the claim from R3 on 18-5-2007 and submitted to R1 along with all relevant documents submitted by the complainant. So the R3 received the documents and submitted to R2, who inturn submitted to R1 insurance company to settle the claim. Thus there was no liability on the part of R2 and R3. The assured sum of Rs. 50,000/- should be paid by the R1 company.



7. The complainant filed Ex. A1 a Xerox copy of list of policy holders in R3 society in which the name of the deceased C. Lakshmi Reddy was shown under Sl.No. 5 with policy No. JPA/0006004. Ex. A2 was a Xerox copy of family member certificate issued by Tahsildar, Peddamudium on 16-4-2007. The Tahsildar, Peddamudium issued family member certificate after due enquiry. Therefore, the complainant was the wife of the deceased in view of Ex. A2. Ex. A3 was Xerox copy of passbook issued by R3 in favour of deceased. Ex. A4 was Xerox copy FIR in Cr. No. 24/2007 of Gospadu police station, Kurnool District that the deceased died due to Motor accident on 22-2-2007. Ex. A5 was Xerox copy of inquest report. Ex. A6 was Xerox copy of post mortem certificate. Ex. A7 was Xerox copy of letter addressed by the complainant to R3 informed the death of her husband. Ex. A8 was Xerox copy of letter from R3 to R2 to settle the claim. Ex. A9 was letter addressed by R2 to R1 to release the claim of the complainant.

Ex. A10 was Xerox copy of claim application submitted by the complainant to R1. Ex. A11 was copy of repudiation letter from R1 that the complainant failed to submit police final report and Motor accident claims tribunal papers. Ex. A12 was another letter from R1 to R2 that the Motor accident claims tribunal papers was not submitted and hence, the claim was closed. The R2 filed Ex. B1 letter addressed by R2 to R1. Ex. B1 and Ex. A9 were one and same. Ex. B2 was letter from the complainant to R3 regarding death of her husband and the loan availed by her husband. Ex. B2 and Ex. A7 were one and same. Ex. B3 was letter from R3 to R2. Ex. B3 and Ex. A8 were one and same.



8. As per complaint and Ex. A3 the deceased availed loan of Rs. 26,400/- on one occasion and Rs. 16,000/- on another occasion totaling Rs. 42,400/- from R3 society. There was no proof from the complainant that the deceased discharged the entire debt to R3. The R3 also did not file any paper regarding debt dues of the deceased. Therefore, the complainant is liable to pay the debt of her deceased husband to R3 from out of the assured sum of Rs. 50,000/-. Thus the R1 had to pay Rs. 50,000/- by way of cheque to R3, who inturn deduct all the debt dues of the deceased C. Lakshmi Reddy and pay the balance if any by way of cheque to the complainant. Thus there is deficiency of service on the part of R1 for not settling the claim of the complainant.



9. Point No. 3 In the result, the complaint is allowed, directing the R1 to pay Rs. 50,000/- (Rupees fifty thousand only) to R3 by way of cheque, who in turn deduct the debt amount of Rs. 42,400/- (Rupees forty two thousand four hundred only) of the deceased and pay the balance if any to the complainant without interest by way of cheque. The R1 is directed to pay Rs. 4,000/- (Rupees four thousand only) towards mental agony and Rs. 1,000/- (Rupees one thousand only) towards costs to the complainant, payable within 45 days from the date of receipt of the order. The case against R2 & R3 is dismissed without costs.

Smt. S. Salamma, W/o Late Sudhakar Reddy,

aged about 30 years, R/a D.No. 6/47,

Bodisanivandlapalli Colony, Nooliveedu Village,

Galiveedu Mandal, Kadapa District. ….. Complainant.



Vs.



1) The Nooliveedu Primary Agricultural Co-operative Society,

Rep. by its Secretary, Nooliveedu, Galiveedu Mandal,

Kadapa Distrct.

2) The Kadapa District Co-operative Central bank Ltd.,

Rep. by its General Manager, R.S. Road, Kadapa.

3) ICICI Lombard General Insurance Co. Ltd., Rep. by its

Branch Manager, Osman Plaza, 6-3-352/1, 3rd and 4th floor,

Road No. 1, Banjara Hills, Hyderabad – 500 034. ….. Respondents.








O R D E R







1. Complaint filed under section 12 of the Consumer Protection Act 1986.



2. The brief facts of the complaint is as follows:- The husband of the complainant namely Samala Sudhakar Reddy, was a member of R1 society with membership No. 2298 and R1 issued a Kisan Credit card to the said Sudhakar Reddy. He paid his share capital membership amount and insurance amount to R1. The R1 and R2 sanctioned a loan of Rs. 4,500/- on 31-8-2007 to the husband of the complainant under G.No. 2298, STC Kcc loan No. 103 and S.No. 266. The R1 and R2 took Group Janatha Personal Accident Policy from R3 deducting amount from loan account of the policy holders including S. Sudhakar Reddy. The R3 issued Group Janatha Personal Accident Policy. As per terms and conditions the R3 was liable to pay Rs. 50,000/- to the nominee of the policy holder in case of his accidental death.



3. On 15-10-2007 around 8.00 p.m Sudhakar Reddy died due to electric shock at his house. It was brought to the notice of Galiveedu police station, who registered a case in Cr. No. 89/2007 under section 174 of Cr.P.C. The post mortem was conducted and panchanama was prepared. The complainant was nominee of her deceased husband and approached R1 and R2 to settle the claim under Group Janatha Personal Accident Policy. The R1 and R2 forwarded the claim of the complainant with necessary documents to R3, who sent a letter dt. 17-4-2008 to the complainant requesting to submit a letter from Electricity Department.


The complainant obtained a certificate from the Electricity Department dt. 16-6-2008 that her husband died due to electric shock and forwarded the letter to R3 through R1 and R2. The R2 and R3 informed the complainant that the claim was closed for noncompliance of required document i.e. Panchanama prepared by Electricity Board. The complainant submitted all the documents including the certificate from Electricity Board that her husband died due to electric shock. The R3 failed to consider and settle the claim. Thus the complaint was filed for Rs. 50,000/- with interest @ 24% p.a. from the date of policy i.e. 15-10-2007 till the date of realization and Rs. 30,000/- towards mental agony and Rs. 2,000/- towards costs.



4. Notices were served to R1 to R3 and they failed to represent the case and file any counter. Therefore, they were called absent and set exparte on 12-8-2009.



5. On the basis of the above pleadings the following points are settled for determination.

i. Whether there is any negligence and deficiency of service on the part of the respondents?

ii. Whether the complainant is entitled to the relief as prayed for?

iii. To what relief?



6. On behalf of the complainant Ex. A1 to A12 were marked.



7. Point No. 1 & 2 The complainant’s husband by name Samala Sudhakar Reddy was a member of R1 Co-operative Society with membership No. 2298 and he was given Kisan Credit Card also. Ex. A1 was Xerox copy of passbook issued by R1 society. Sudhkar Reddy availed a loan of Rs. 4,500/- on 31-8-2007 from R1 and R2 under G.No. 2298, STC K.C.C loan No. 103 and Sl.No. 266. Ex. A2 was Xerox copy of receipt issued by R2 paid to R1 for the loan availed by Sudhkar Reddy for Rs. 3,590/-. Under Ex. A3 interest was also collected. Thus Sudkhar Reddy paid the share amount Rs. 4,735/- to R1 society. While so Sudhkar Reddy died on 15-10-2007 around 8.00 p.m at his house due to electric shock. The Xerox copy of death certificate was Ex. A4.


It was reported to Galiveedu police station, who registered a case under section 174 of Cr.P.C in Cr. No. 89/2007, dt. 16-10-2007. the Xerox copy of FIR was Ex. A5. Ex. A6 was Xerox copy of post mortem certificate. Ex. A7 was Xerox copy of inquest report over the dead body of Sudhakar Reddy. Ex. A8 was Xerox copy of proceedings of Mandal Executive Magistrate, Galiveedu that the case was dropped as the deceased died due to Electrocution in view of the post mortem report issued by Community Health Center, Rayachoty. Ex. A9 was Xerox copy of letter from R1 to R2 to settle the claim of the complainant. Ex. A10 was Xerox copy of letter from R2 to R3 to release the claim amount of Rs. 50,000/-.


Ex. A11 was Xerox copy of certificate issued by Electricity Department that Sudhakar Reddy died due to electric shock on 15-10-2007. Ex. A12 was Xerox copy of repudiation letter issued by R3 to R2 that the Electricity Board panchanama was not submitted. Panchanama was not prepared by the Electricity Board or Electricity Department. It should be prepared by the concerned police after the death was reported. So non submission of panchanama from Electricity Department was not at all a ground to repudiate the claim of the complainant. Thus there is deficiency of service on the part of R3. The R1 and R2 have submitted all papers to R3. But R3 had not settled the claim and simply repudiated. Thus the points are answered accordingly.

8. Point No. 3 In the result, the complaint is allowed, directing the R3 to pay Rs. 50,000/- (Rupees fifty thousand only) without interest to the complainant and also pay Rs. 4,000/- (Rupees four thousand only) towards mental agony and Rs. 1,000/- (Rupees one thousand only) towards costs, within 45 days from the date of receipt of the order. The case against R1 and R2 is dismissed without costs.

Hari Singh son of Mehta Ram, resident of VPO Sidhpur, Tehsil Dharamshala, District Kangra (HP)

Complainant

Versus



ICICI Lombard, General Insurance Company Limited, ICICI Bank Towers, Bandra Kurla Complex, Mumbai 400051, through its Regional Manager.



Opposite party













ORDER/



The brief facts , as alleged, in the complaint, are that the complainant Sh. Hari Singh, had purchased one cow for earning his livelihood, and for his self employment, and had got it insured with the opposite party, for a sum of Rs.10000/-, vide Insurance Policy No.4057/0000098, valid with effect from 17.1.2008 upto 16.1.2011. It is alleged that ear tag No.0060259 was fixed on this insured cow, by the opposite party. However, this cow, had died on 5.3.2008, due to injuries. The post mortem of this cow, was also got done. The matter about the death of this cow, was also reported to the Pradhan of the Gram Panchayat-Sidhpur, who had issued a certificate dated 14.5.08. The complainant had lodged his claim with the opposite party, and had submitted all the required documents with them, but they vide their letter dated 10.10.2008, had repudiated his claim, on the ground that the death of the insured cow had occurred, due to mis-management of Farm and Stable.

It is alleged that the opposite party had repudiated his claim on vague and arbitrary reasons, and they have been deficient, in rendering the proper services to him, due to which, he has suffered mental agony, harassment, and financial loss. So, he has claimed the relief of Rs.10000/-( the value of the insured cow), alongwith interest @ 9% per annum, till it’s final payment, and has also claimed compensation to the tune of Rs.15,000/-, for his mental agony, and harassment, and has also claimed litigation charges to the tune of Rs.5,000/-.

2. The opposite party has contested this complaint, by filing their reply on 8.4.2009, in which they have contended that the complaint is not maintainable in the present form. Neither the complainant has got any cause of action, nor has got any locus standi to file this complaint. They have contended that the insured cow had died due to the negligence and mis-management, on behalf of the complainant. So, he is not entitled to any claim.

They have contended that the cow was suffering from the injuries, for the last 20 days, but the complainant had not provided any treatment/medicine to the cow, and ultimately, the cow had died on 5.3.2008, due to the negligence on the part of the complainant. They have contended that this cause of death, is not covered in the Insurance Policy. They have also contended that the complainant has suppressed the material facts from this Forum, and has not come with clean hands. They have further contended that since the complainant has got no cause of action, so the present complaint deserves dismissal.

3. We have considered the arguments of the learned counsel for the parties, and have also carefully gone through the case file, facts and evidence on the record.

4. Ex.CW-1, is the affidavit of the complainant Sh. Hari Singh. Annexure C-3, is the photo copy of the certificate dated 14.5.08, issued by the Pradhan of the Gram Panchayat-Sidhpur. Annexure C-10, is the photo copy of the Post Mortem Report, dated 13.5.08, issued by the Veterinary Doctor Sh.Gaurav Mahajan. Annexure C-9, is the photo copy of the death certificate, issued by the Veterinary Doctor, and Annexure C-4 is the photo copy of the claim form submitted by the complainant Sh. Hari Singh with the opposite party.

5. On the other hand, Ex.OPW-1 is the affidavit of Sh. Ravinder Dhull, Legal Manager of the opposite party.

6. The insurance and the death of the cow, is admitted by both the parties. The identity of the cow is also not in dispute, as ear tag bearing No.0060259, fixed by the opposite party, at the time of insurance of the cow, was found in the ear of the cow, at the time of it’s death/post mortem.

7. The only contention of the opposite party is that there was mis-management and negligence on the part of the complainant, for the medical treatment of the insured cow. Except the affidavit of Sh.Ravinder Dhull, no other solid, cogent, convincing, and reliable proof/evidence has been led by the opposite party to show that how there was any negligence, or mis-management on the part of the complainant, in giving proper medical treatment to the insured cow, in it’s ailment. We are satisfied that the complainant being the owner of the insured cow, must have medically given proper medical treatment to his cow.


The contentions of the complainant that the cow had died; due to injuries, is corroborated by the post mortem report. So, we feel satisfied that the claim of the complainant was repudiated by the opposite party, without any solid/justified reasons. So, we hold that the complainant is entitled to get Rs.10000/-(the value of the insured cow), alongwith interest @ 9% per annum, from the date of complaint, till it’s final payment. We also feel satisfied that due to deficiency in service on the part of the opposite party, the complainant has also suffered mental agony and harassment. So, we assess Rs.1500/-, as compensation, for his mental agony and harassment. We also assess Rs.1000/-, as litigation costs.

8. No other point has been argued or urged before us.

9. In view of the discussion made hereinabove, the complaint is partly allowed. We order to the opposite party to pay Rs.10000/- (the value of the insured cow), to the complainant alongwith interest @ 9% per annum, from the date of complaint, till it’s realization. We also direct the opposite party to pay compensation to the complainant to the tune of Rs.1500/-, for his mental agony and harassment, and litigation costs to the tune of Rs.1000/-, which will be paid by the opposite party, within 30 days, after the receipt of copy of this order. The copy of this order be sent to the parties, free of costs, by post, and the file after it’s due completion be consigned to the record-room.

Smt. Jatamba Devi wife of Mehar Chand, VPO Fatehpur, Post Office Sidhpur, Tehsil Dharamshala, District Kangra-HP



Complainant

Versus



ICICI Lombard, General Insurance Company Limited, SCO Sector 40-B, Chandigarh, UT through its Regional Manager

Opposite party








ORDER/



The brief facts of this complaint, as alleged, are that the complainant Smt. Jagtamba Devi, had purchased one cow for her self employment, and earning her livelihood, and had got it insured with the opposite party, for a sum of Rs.10000/-, vide Insurance Policy No.4057/0000098, valid with effect from 22.2.2008 upto 21.2.2011. It is alleged that ear tag No.0135325 was put on this insured cow, by the opposite party. However, this cow had died on 25.8.2008, due to fall in a Kuhal. The post mortem of this cow, was also got done. The matter about the death of this cow, was also reported to the Pradhan of the Gram Panchayat Sidhpur, who had issued a certificate dated 25.5.08 in this respect. The complainant had lodged her claim with the opposite party, and had submitted all the required documents with them, but they vide their letter dated 12.8.2008, had repudiated her claim, on the ground that the death of the insured cow had occurred, due to mis-management of Farm or Stable.


It is alleged that the opposite party had repudiated her claim on vague and arbitrary reasons, and they have been deficient, in rendering the services to her, due to which, she has suffered mental agony, harassment, and financial loss. So, she has claimed the relief of Rs.10000/-( the value of the insured cow), alongwith interest @ 9% per annum, till it’s final payment, and she has also claimed compensation to the tune of Rs.10000/-, for her mental harassment, and has also claimed litigation charges to the tune of Rs.5000/-..

2. The opposite party has contested this complaint, by filing their reply on 7.4.2009, in which they have contended that the complaint is not maintainable in the present form. Neither the complainant has got any cause of action, nor has any locus standi to file this complaint. They have contended that as per the documents furnished by the complainant, the cow had died due to fall in the Canal, and the death of the insured cow had occurred due to the negligence and mis-management, on behalf of the complainant. So, she is not entitled to any claim, and the complainant was informed by them vide their letter No.MUM/CS/103 dated 12.8.2008, regarding the non-settlement of her claim.

They have also contended that the complainant has suppressed the material facts from this Forum, and has not come with clean hands, so the present complaint deserves dismissal, with costs.

3. We have considered the arguments of the learned counsel for the parties, and have also carefully gone through the case file, facts and evidence on the record.

4. Ex.CW-1, is the affidavit of the complainant Smt. Jagtamba Devi. Annexure C-1, is letter dated 12.8.2008 issued by the opposite party, whereby the claim of the complainant was rejected. Annexure C-2, is the photo copy of the Certificate dated 25.5.08 issued by the Pradhan of the Gram Panchayat, Sidhpur, in which the Pradhan had certified that the insured cow bearing ear Tag No.0135325 of the complainant had died, due to fall in a Kuhal(canal). Annexure C-3, is the photo copy of the certificate of Insurance dated 22.2.08. Annexure C-4, is the photo copy of the post mortem report dated 25.5.08, in which the Veterinary Doctor Sh.Gaurav Mahajan, has opined that the insured cow had died due to asphyxia caused by drowning in the canal.

5. On the other hand, Ex.OPW-1 is the affidavit of Sh. Ravinder Dhull, Legal Manager of the opposite party.

6. The insurance and the death of the cow, is admitted by both the parties. The identity of the cow is also not in dispute, as ear tag bearing No. 0135325 fixed by the opposite party, at the time of insurance of the cow, was duly found in the ear of the cow, at the time of it’s death/post mortem.

7. The only contention of the opposite party is that there was mis-management and negligence on the part of the complainant in handling of the insured cow. Except the solitary affidavit of Sh. Ravinder Dhull, no other proof/evidence has been led by the opposite party to show that how there was any negligence, or mis-management on the part of the complainant, in handling the insured cow. We are satisfied that the complainant being the owner of the insured cow, must have properly handled this cow. The contentions of the complainant that the cow had fallen in the canal and had died, are also corroborated by the post mortem report. So, we feel satisfied that the claim of the complainant was repudiated by the opposite party, without any solid/justified reasons. So, we hold that the complainant is entitled to get Rs.10000/-(the value of the insured cow), alongwith interest @ 9% per annum, from the date of complaint, till it’s final payment. We also feel satisfied that due to deficiency in service on the part of the opposite party, the complainant had also suffered mental agony and harassment. So, we assess Rs.1500/-, as compensation, for her mental agony and harassment. We also assess Rs.1000/-, as litigation costs.

8. No other point has been argued or urged before us.

9. In view of the discussion made hereinabove, the complaint is partly allowed. We order the opposite party to pay Rs.10000/- (the value of the insured cow), to the complainant alongwith interest @ 9% per annum, from the date of complaint, till its realization. We also direct the opposite party to pay compensation to the complainant to the tune of Rs.1500/-, for her mental agony and harassment, and litigation costs to the tune of Rs.1000/-, which will be paid by the opposite party, within 30 days, after the receipt of copy of this order. The copy of this order be sent to the parties, free of costs, by post, and the file after it’s due completion be consigned to the record-room.

Prem Sukh Saini son of Sh. Ram Dayal Saini resident of village Bhour, Post Office Kanaid, Tehsil Sunder nagar, District Mandi, H.P.

…Complainant





V/S



1. The Branch Manager , ICICI Lombard General Insurance Company Ltd Chaman Complex Mandi, H.P.

2. The Manager , ICICI Lombard General Insurance Co Ltd SCO 174-175 Ist Floor Sector 9 –C Madhya Marg Chandigarh.

..Opposite parties.







ORDER.

This order shall dispose of a complaint under Section 12 of the Consumer Protection Act, 1986

( hereinafter referred to as the “Act”) instituted by the complainant against the opposite parties . The complainant averred that he is registered owner of Truck No. HP-65-0764 financed by Kotak Mohindra Bank Ltd Ludhiana . The vehicle was insured with the opposite parties which was valid with effect from 12-10-2007 to 11-10-2008 in the sum of Rs.5,74,035/- . The complainant averred that the driver of said vehicle was Sh. Hans Raj son of Sh.Sher Singh .


The vehicle had gone to Leh for delivering the goods . On 2-11-2007, on return journey ,the vehicle met with accident at place Tangan Gala Top which is 90 kilometres from Sarchu towards Leh due to locking of steering and it went out of road and fell about 600 feet down below the road. The vehicle was totally damaged and lying at the spot of accident. The complainant further averred that intimation of the accident was given to the police and daily diary report was recorded . The complainant further averred that the copy of the rapat was supplied to the opposite parties alongwith application on 17-11-.2007 and that relevant documents and information was supplied to the opposite parties for finalization of the insurance claim of the said truck, but no action was taken by the opposite parties .


The complainant further averred that the place of accident of insured truck of the complainant is snow bound area and earlier it was not possible for the surveyors of the opposite parties to inspect the truck but since the snow had melted much earlier in May 2008 the surveyor could reach the spot and inspect the vehicle . The complainant alleged that the opposite parties were requested time and again to finalize the full and final damage claim of the vehicle and also served them with legal notice dated 19-6-2008 but no action was taken which act on the part of the opposite parties is clear cut case of deficiency in service . The complainant has filed copies of registration certificate, driving license , daily diary report , intimation letter of accident dated 17-11-2007,postal receipt, notices and acknowledgements slip alongwith the complaint.


The complainant further alleged that he had to pay interest on the loan and he had suffered ,mental tension , torture and agony due to non settlement of the claim and had claimed a sum of Rs.50,000/- as compensation. With these allegations the complainant had sought direction to the opposite parties , to pay an amount of Rs.5,74,035/- as full and final settlement of the claim on total loss basis with interest at the rate of 12% per annum from the date of accident till payment , to pay Rs.50,000/- as compensation. Apart from this , cost of the complaint has also been claimed.

2. The opposite party had filed reply . Preliminary objections have been raised that there is no deficiency in service on the part of the opposite parties, that the complaint is not maintainable , that the alleged accident had never occurred, that the complainant intimated the opposite parties about the alleged accident when all the roads were blocked because of heavy snowfall and even D.D. report was got entered when all the roads were blocked and it had been admitted by the complainant that no survey could be conducted in these days because of snow fall , that the surveyor of the opposite party proceeded to the place disclosed as place of accident by the complainant and it was told that the accident had taken place ahead of Sarchu while going towards Leh but surveyor did not find the vehicle at the above place and on asking the complainant , new place of accident was disclosed ahead of Sarchu towards Leh to Tanglungla but did not provide any documents in support of the alleged accident , ,that the complainant is guilty of suppression of material facts , that the complainant has flouted the principle of law of equity, and played fraud upon the opposite parties with intention to extract money from them, that the complainant was plying the vehicle against the provisions of the M.V. Act and without valid documents i.e. route permit and fitness certificate , that the complaint is estopped to file the present complaint by his own act and conduct.


On merits . it has been admitted that the vehicle involved in the alleged accident was insured with the opposite parties and complainant is the registered owner of the vehicle . It has been averred that the complainant had informed the police vide DD report recorded by the police but the complainant had mentioned a different place of accident in DD report.


The opposite parties have denied that relevant documents have been supplied to them. It has further been denied that no application was given to them on 17-11-2008. It has further been stated that the place mentioned by the complainant as place of occurrence is a snow bound area and it is not possible for any one to approach this place during the month of November . The opposite parties had submitted that the complainant has given information regarding the accident which has never occurred . The opposite parties have denied any deficiency in service and had stated that the claim was rightly repudiated. The complaint had been sought to be dismissed.

3. The complainant had filed rejoinder reiterating the contents of the complainant and controverting those as made in the reply.

4. We have heard the ld. counsel for the parties and have carefully gone through the record. It is admitted case of the opposite parties that the vehicle in question was insured with it for the period with effect from 12-10-2007 to 11-10-2008. It has also been admitted by the opposite parties that the complainant is the registered owner of the vehicle in question.


The claim of the complainant has been denied on the ground that the accident as alleged by the complainant had never occurred and the complainant had manipulated and mis-represented the facts and played fraud upon the opposite parties to extract money from them. Further case of the opposite parties is that the complainant was plying the vehicle against the provisions of the Motor Vehicles Act and without valid documents i.e. route permit , fitness certificate etc and in this respect the opposite parties had relied upon the report of Surveyor dated 18-8-2008 Annexure R-2 who in his report has mentioned that the route permit of the vehicle in question was not endorsed for the State of J& K as accident had taken place in the jurisdiction of J & K State.



5 Now the controversy to be decided by this Forum is as to whether the accident as alleged by the complainant had never occurred and whether the complainant had played fraud upon the opposite parties . The onus was upon the opposite parties to prove that no accident as alleged by the complainant had ever occurred and the complainant had played fraud upon them.


However, no satisfactory evidence has been led by the opposite parties to prove that the complainant had played fraud upon them, in order to extract money. As per the opposite parties, the complainant intimated about the alleged accident when all the roads were blocked due to heavy snow fall and no survey could be conducted in those days because of heavy snow fall and after opening of the road in the end of May,2008, the opposite parties appointed surveyor for inspection of the vehicle and when the Surveyor proceeded to the place of accident as disclosed by the complainant, the Surveyor did not find the vehicle at the place ahead of Sarchu while going towards Leh.


Thereafter the Surveyor wrote letters to the complainant to tell him about the place of accident and to provide the vehicle’s documents , then the complainant disclosed a new place of accident and changed the site of accident ahead of Sarchu towards Leh to Tanglungla. According to the opposite parties, the complainant sent a representative alongwith the surveyor and he took the surveyor where the vehicle was lying and it was found that all the parts were removed from the vehicle. However, in our opinion, the mentioning of the aforesaid facts by the opposite parties is not sufficient to prove that no accident had taken place.


The perusal of the record reveals that the information about the accident was given to the police and in this respect daily diary report has been entered in Police Station Keylong which has been reported by the driver of the vehicle in question. Sh. Hans Raj driver had also filed affidavit dated 19-2-2009 wherein he has deposed that while returning from Leh the truck met with an accident at a place Tangan Gala top which is 90 kilometres from Sarchu towards Leh due to locking of steering and it went out of road and fell about 600 feet down below the road .


It has further been deposed in the affidavit that thereafter the deponent and conductor Sh. Manoj Kumar took shelter with the Shepherd nearby the place of accident and remained there till 7-11-2007, when they reached at Keylong on 8-11-2007 after getting lift in the truck at night , then reported the matter to the Police at Police Station Keylong regarding the accident. He further deposed that he had accompanied the surveyor and showed him the place of accident on 15-8-2008 and all the relevant documents were provided to the surveyor by the owner of the truck in question in his presence.


The Surveyor in his report Annexure R-2 had also stated that the accident took place on 2-11-2007 at 3 PM at Tanglungla . The opposite parties had failed to produce any evidence to the contrary that no accident took place and the complainant had manipulated and misrepresented the facts and played fraud in order to extort money from them. Therefore, from the perusal of the daily diary report as well as the affidavit of the driver coupled with surveyor report it has become clear that the truck in question met with an accident 2-11-2007 at 3 PM at Tanglungla.



6 The opposite parties had denied the claim of the complainant on the ground that the vehicle was being plied against the provisions of the Motor Vehicles Act in violation of the route permit . According to the opposite parties the vehicle was being plied in the jurisdiction of J & K State whereas route permit issued by the Regional Transport Authority, Mandi authorized him to ply the vehicle within the Area of Himachal Pradesh. The class of the vehicle in question is H.G.V as per the copy of the registration certificate adduced in evidence by the complainant himself .


The route permit dated 1-6-2005 adduced by the opposite parties in evidence shows that it was issued by Regional Transport Authority, Mandi and was valid from 1-6-2005 to 31-5-2010 . The vehicle has a valid registration certificate. Copy of route permit shows that it was issued by Regional Transport Officer , Mandi with respect to the vehicle in question for plying the same only within the area of Himachal Pradesh. The vehicle met with an accident ahead of Sarchu towards Leh in the State of J& K . Therefore , it has become clear that at the time of the accident, the vehicle was being plied outside the State of Himachal Pradesh in violation of the route permit.

7 Now the question which arises for determination by this Forum is as to whether the opposite parties are justified in repudiating the claim of the complainant only on the ground of violation of the route permit. It is not the case of the opposite parties that the complainant was plying the vehicle without any permit at all . The case of the opposite parties is that the insured was not having the route permit to ply the vehicle in the area of J& K . It is pertinent to mention here that there is nothing on record to suggest that the plying of the vehicle on a route other than the scheduled route had in any manner contributed to the accident. As per the record available , the accident had occurred due to locking of steering system. It has not been established by the opposite parties that the violation of the route permit had any nexus with the cause of the accident . Moreover , it cannot be said that such breach is a fundamental breach and that the owner should in all events , be denied indemnification.


In our opinion , the breach was not so fundamental in nature so as to put an end to the contract of insurance. In a case titled R.K.College vs Ramesh Chand and others AIR 2007 ( NOC) 1924 Rajasthan , offending vehicle was found on nationalized route not covered under permit , however, it had been held by the Hon’ble Court that the insurer cannot be exonerated of its liability as it might be a case of violation of condition of permit but it cannot be said that by such fact alone there occurred a breach of insurance policy condition. In the facts and circumstances of the present case also , in our opinion the breach regarding violation of the route permit was not so fundamental breach empowering the opposite party to defeat the claim of the complainant. In nut shell, the opposite party had been deficient in providing service to the complainant in repudiating the claim of the complainant.

8 Now the next question which arises for consideration before this Forum is as to what amount the complainant is entitled on account of loss suffered by him due to accident of the vehicle. The complainant in his complaint had clamed Rs.5,74,035 /- on total loss basis . On the other hand the opposite party has produced in evidence Motor ( Final ) Surveyor report dated 18-8-2008 of Sh. Mohinder K Sharma which is annexure R-2.


As per the report of surveyor the captioned vehicle was examined by him carefully and it was observed that all parts have been removed off the vehicle, only damaged load body, cabin and chassis frame were lying at spot of accident along with front axel beam. Aforesaid fact has not been denied by the complainant by leading any evidence to the contrary. Sh. Mohinder K Sharma in his final survey report Annexure R-2 had assessed the liability on net of salvage basis at Rs.3,49,035/-. The opposite parties had also adduced in evidence affidavit of Sh.Mohinder K Sharma in support of his report . The complainant had not adduced any satisfactory evidence contrary to the report of Surveyor. Moreover the report of Surveyor is an important document and it cannot be brushed aside without sufficient reasons.


The Hon’ble National Consumer Disputes Redressal Commission in United India Insurance company vs Jadhav Kiran Store , III (2005)CPJ-79(NC) has held that the Surveyor report is an important document and it should not be shunned without sufficient reasons. Therefore, in the absence of any satisfactory evidence to the contrary , we accept the report of Surveyor Annexure R-2 and in view of the same , we hold that the loss suffered by the complainant with respect to the damage caused to the vehicle on net of salvage basis is at Rs.3,49,035/-.

9 In the light of above discussion, the complaint is allowed and the opposite parties are directed to pay to the complainant Rs.3,49,035 /-. with interest at the rate of 9% p.a. from the date of filing of the complaint till realization . In addition to this the opposite parties shall also pay Rs.2000/- as costs of litigation .



10 Copy of this order be supplied to the parties free of cost as per Rules.



11 File, after due completion be consigned to the Record Room.

Shri Anwar Ahemad S/o Sh. Ameerdeen Ahemad,

Vill. Suraj Majra, PO: Baddi, Tehsil Nalagarh,

Distt. Solan (H.P.)



… Complainant

Versus



ICICI Lombard General Insurance Company Limited,

Quite Office No:10, Sector 40-B, Chandigarh,

Through its Branch Manager.

…Opposite Party.

O R D E R:




Sureshwar Thakur (District Judge) President:- The instant complaint has been filed by the complainant, by invoking the provisions of Section 12 of the Consumer Protection Act, 1986. The complainant, avers that he is registered owner of Tata Indica Car bearing registration No.HP-12B-6227, which came to be insured by him, with the OP-Company during the period, 29.12.2006 to 28.12.2007, for a sum of Rs.2.00 lacs. He further averred that, on, 23.10.2007, when his son was going from Baddi to Chandigarh, the aforesaid car, unfortunately, met with an accident, hence, suffered extensive loss. As usual, the matter, is stated to have been brought to the notice of the OP-Company, who instead of settling the claim, dilly-dallied, it, on, one pretext or the other. Hence, it is averred that there is apparent deficiency in service on the part of the OP-Company and accordingly relief to the extent as detailed in the relief clause be awarded in favour of the complainant.

2. The OP-Company, in its written version, to the complaint, raised preliminary objections vis-à-vis maintainability of the complaint, inasmuch, as, violation of the terms and conditions of the insurance policy and there being no deficiency in service. On merits, it is contended that since, the car was insured as a private car, but the complainant was using the same for commercial purpose against the terms and conditions of the insurance policy. Hence, it is, denied that, there was any deficiency in service on their part or that they have indulged in an unfair trade practice.

3. Thereafter, the parties adduced evidence, by way of affidavits, and, documents in support of their respective, contentions.

4. We have heard the learned counsel for the parties at length and have also thoroughly scanned the entire record of the case.

5. The vehicle of the complainant, met with an accident on, 23.10.2007, and a Rapat qua the said accident came to be lodged with the concerned Police Station. The OP-Company, has, repudiated the claim, as asserted by the complainant, merely on the strength of the report of Investigator, Annexure OP-1, the vehicle having been used for commercial purpose, at, the relevant time, when, it met with an accident.

6. However, the OP-Company, has not, adduced any proof qua the fact that the vehicle was being used for commercial purpose, when it met with an accident. No affidavit of the author of Annexure OP-1 has been brought on record, by the OP-Company, for us, to, hence, to concur with the same. They have also not placed on record the material, detailing the fact that the aforesaid car, was registered with any Taxi Union. Hence, for lack of said best evidence, it cannot be construed by any stretch of imagination, that the OP-Company has been able to prove its defence. Rather, when their exists on record the copy of registration certificate of the car, whose contents divulges the fact that the vehicle is registered as a private car, having registration No.HP-12B-6227 its existence also repulses the stand of the OP.


Moreover, when the complainant, has also placed on record, the affidavit of Anees Ahmed, who has in his affidavit, unequivocally, deposed that the car at the relevant time, when it met with an accident, was being used by his family when they were going to Chandigarh, hence, when their exists on record, such cogent and convincing evidence, obviously, its, existence further also belies the defence of the OP-Company that the vehicle was being used for commercial activities, though, it was insured as a private car. Hence, the non-settlement of the claim of the complainant, was arbitrary and without any justifiable cause.

7. Since, the OP-Company has not been able to bring home the guilt of the complainant, inasmuch, as, he having breached the terms and conditions of the insurance policy, now, the only point, which requires adjudication by us, is, the amount of indemnification payable by the OP-Company to the complainant. The complainant, in order to prove the quantum of loss, has depended upon the repair bill, issued by Joshi Auto Zone Pvt. Ltd., Chandigarh, in favour of the complainant, for a sum of Rs.1,03,400/-. The aforesaid repair bill, having remained un-repulsed, on behalf of the OP-Company, is, to be construed to be the only evidence available on record, in order to quantify the amount of indemnification.

8. Resultantly, we allow the complaint and direct the OP-Company as follows:-

i) That the OP-Company, shall indemnify the complainant, to the extent of Rs.1,03,400/-;



ii) That the aforesaid amount, shall carry interest at the rate of 9% per annum, with effect from the date of filing of the complaint, i.e. 23.02.2008, till actual payment of the aforesaid amount is made;



iii) That the OP-Company, shall also pay litigation cost of Rs.2500/-, to the complainant;



iv) That the OP-Company, shall comply with this order, within a period of forty five days, after the date of receipt of copy of this order;

9. The learned counsel for the parties undertook to collect the certified copy of this order from the office, free of cost, as per rules. The file after due completion, be consigned to record room.