BEFORE THE BANGALORE I ADDITIONAL DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SHANTHINAGAR BANGALORE -  27.

CONSUMER COMPLAINT NO.171/2022

DATED ON THIS THE 17^th  FEBRUARY-2023

Present:        1) Sri. B.Narayanappa

M.A., LL.B., - PRESIDENT  

                     2) Smt. Sharavathi. S.M,

                                               BA., LLB., MEMBER

ORDER’s Delivered by Smt. SHARAVATHI. S.M,

                                                               MEMBER

               ORDER

1. This is the Complaint filed by the Complainant against the Opposite party (herein referred to as OP) under section 35 of the Consumer Protection Act, 2019 for the deficiency of service in repudiating the insurance claim ofdeceased Hanumantharayappa C.K, who died in road accident, and for a sum of Rs.15,00000/-as accidental death claim along with interest at 24% per annum and Rs.20,00000/- as damages and cost of Rs.1,00,000/- and for such other reliefs , as the Hon,ble District Commission deems fit.

    

2. The brief facts of the Complaint are that; One Hanumantharayappa C.K was the husband of the complainant NO1 and father of complainants NO 2 to 5. He had obtained insurance with OP for a sum of Rs.15,00000/- towards accidental death and the insurance was covering for the period 13/06/2019 to midnight 12/06/2020 under Cholamandalam MS General Insurance policy and the deceased Hanumantharayappa C.K had paid Rs.1326/- being the one time insurance premium to cover the said period.

3. It is stated that her husband Hanumantharayappa C.K met with a road traffic accident on 29/01/2020 near Chikkanayakanahalli Village, Nelamangala, Doddaballapura Main road, near LG Gowdon, Hyadal. The accident was registered in the concerned jurisdictional police station and afterwards Sri Hanumantharayappa C.K shifted to Nelamanagala Govt. Hospital and taken first Aid treatment and Immediately shifted to Nimhans Hospital and further shifted to Victoria Hospital, Bangalore and on 06/02/2020 the said Hanumantharayappa C.K died due to accidental injuries. The same was intimated to the op and accident death claim was submitted. Op instead of settling the claim in respect of inordinate delay of 734 days. And did not settled the claim in spite of several request. The complainant no 1 being the wife of deceased is 62 years age and 3 daughters and 1 son after the demise of their deceased, they are extremely facing difficulties in life and that too the inaction of the OP in not settling the claim. Hence there is deficiency in service on the part of OP and prayed the Commission to allow the Complaint.

4. Upon the service of the notice OP appeared before the Commission through its advocate and not filed Version.

5. In order to prove the case, both parties filed their affidavit evidence and produced documents. arguments Heard. The following points arise for our consideration:-

1. Whether the complainants proved deficiency in service on the part of the Opposite party?

2. Whether the Complainant is entitled to the relief prayed for in the complaint?

           POINT NO 1: In the Affirmative.

           POINT NO 2: Partly in the affirmative

    for the following:

                                   REASONS

POINT NO 1:-

7. On perusing the Complaint, the documents, evidence filed by the respective parties, it becomes clear that, the husband of the Complainant no 1 obtained insurance policy from the OP. There is no dispute regarding issuing of the insurance as per EX-P1 in favour of the deceased Hanumantharayappa C.K and nominee name mentioned as Siddamma and the relationship is wife, benefit 100% as accidental death, Rs.15,00,000/-. It is not in dispute that in the accident that took place on 29/01/2020 on Nelamamgala-Doddaballapura road, the husband of the Complainant NO 1 Hanumantharayappa C.K. got sustained serious head and other injures and thereafter he was shifted to Nelamangala Govt. Hospital and taken first Aid treatement and immediately he was shifted to Nimhans Hospital Bangalore for further treatment and subsequently he was shifted to Victoria Hospital, Banagalorewhere he died on 06/02/2020 due to the injuries. The PM report, the Mahazar on the dead body, motor vehicles Accident report clearly reveals the same.

8. As per the averments made by the Complainants , OP has repudiated the claim based on the inordinate delay of 734 days. Under the policy OP has received the premium and has undertaken to indemnify the deceased, OP is bound to pay the amount as per the terms and conditions of the insurance policy.

9. It is specific contention of the OP that there is an inordinate delay of 730 days. Thus there has been undue delay of 730 days in intimating the claim. Which is violated the terms and conditions of the policy. That terms and conditions of the policy binding on the Insurer and Insured. The OP repudiated the claim according to the terms and conditions of the policy which provides that it is condition precedent for any claim to be made by the insured under the policy that written notice of claim must be given immediately upon the occurrence or commencement of any loss and in any event not later than 30 days of such occurrence or commencement. It is clearly shows that subsequently by the time the complainants attained to their knowledge about the existence of the policy bearing NO.3361/012/10693/000/00/ availed by the policy Holder the entire world was sucked into the trauma of the then on-going Covid 19 pandemic and there were interrupted services in all sectors and activities. As a result the complainants had difficulty in contacting the knowledgeable persons. As per the Hon’ble Supreme Court order dated 10/01/2022 Suo Motu W.P (C) NO 3/2020 the period from 15/03/2020 till 28/02/2022 shall stand excluded for the purposes of limitation as may be prescribed under any general or special laws in respect of all judicial proceedings. Hence, the OP being a humongous corporate entity has failed to take into consideration such facts has mechanically without any materials in support has given repudiating the claim. There is no applicability of limitation to accident matters and the dependents of the victim himself is eligible to the claim, which clearly shows the intention of OP in not indemnifying the claim of the complainants whereas, it was to dodge and protract the settlement of the claim. Hence we are of the opinion that there is deficiency in service and unfair trade practice on the part of OP and hence we answer POINT NO. 1 IN THE AFFIRMATIVE

POINT NO 2:-

10.  As pointed out above the deceased Hanumantharayappa C.K was issued Cholamandalam MS General Insurance policy for the period from13/06/2019 to 12/06/2020. He has been covered with an insurance amount of Rs.15,00000/- in respect of the accidental death. In view of this, OP is bound to pay the said amount to the complainants.

11. Further as per the insurance documents OP has undertaken to pay Rs.15,00000/- in respect of the accidental death. The documents clearly establishes that Hanumantharayappa C.K the husband of complainant NO 1 and father of complainants No 2to 5the deceased met with an accident in Nelamangala Doddaballapura Main road, near Gowdon, Hyadal, and later shifted to Nelamangala Govt, Hospital and shifted to Nimhans Hospital and subsequently he was shifted to Victoria Hospital, Bangalore on Victoria Hospital wherein he died due to the said accidental head injuries. In view of the insurance policy, complainants is entitled for Rs.15,00000/- being insured amount. act of OP in not taking any decision against claim and also not paying the said amount even though it has come to its knowledge the accidental injury and the death due to the said injuries amounts to deficiency in service which caused the senior citizen wife and not settled son and daughter’s lifeto undergo financial problems, mental agony and hardship for which we direct OP to pay a sum of Rs.50,000/- as damages and Rs.5,000/- towards litigation expenses besides directing the OP to pay an interest at 12% per annum on15,00000/- from the date of death of Hanumantharayappa C.K i.e., 06/02/2020 till payment of entire amount. in view of this we answer POINT NO. 2 PARTLY IN THE AFFIRMATIVE and pass the following:

                                 ORDER

              The Complaint is partly allowed with cost

2.  OP is hereby directed to pay a sum of Rs.15,00,000/- to the Complainant along with interest at 12% per annum from the date of death of Hanumantharayappa C.K i.e., on 06/02/2020 till payment of the entire amount.

3.  Further OP is also directed to pay Rs.50,000/- towards damages and Rs.5,000/- towards costs of the litigation expenses to the complainants.

4. OP is hereby directed to comply the above order within 30 days from the date of receipt of this order and submit the compliance report to this Commission within 15 days thereafter

5.  Send a copy of this order to both parties free of cost.                 

 (Dictated to the Stenographer transcribed, typed by him, corrected by us and then pronounced in open Commission on this the 17^th February 2023)

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