BEFORE THE PRESIDENT, DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR
C.C NO-121/2012
Present-Sri Dipak Kumar Mahapatra, President, Smt. Smita Tripathy,Member (W).
Jaylal Behera, aged about 48 years,
S/O- Late Bansidhar Sahu,
At-Ambira Nagar of Sambalpur,
P.O/P.S-Ainthapali,Dist-Sambalpur. …..Complainant
Vrs.
Oriental Insurance Co. Ltd.,
Division Office,
At- V.S.S Marg Sambalpur,
P.O/P.s-Aithapali,P.S-Town,Dist-Sambalpur. ………O.Ps
For the Complainant:-Sri S.K.Mahapatra, Advocate & Associates.
- For the O.P :- Sri B.K. Purohit, Advocate & Associates.
DATE OF HEARING : 15.03.2021, DATE OF ORDER : 13.04.2021
SRI DIPAK KUMAR MAHAPATRA,PRESIDENT:-Brief facts of the case is that the Complainant is the registered owner of a SANTRO Car bearing registration no-OR-15-H-3335 insured with the O.P i.e Oriental Insurance Co. Ltd. and was issued a comprehensive insurance policy vide No-345600/2011/1252. The Insurance was valid from dtd. 18.05.2010 to 17.05.2011 and the IDV was Rs.1,60,000/-. The above said vehicle met with an accident on dtd.25.02.2011, while proceeding to Bhubanesawar towards Sambalpur, near vill- Dakuamunda under Kishorenagar Police Station in the Dist. of Angul where the Complainant and his friend Tempo were the occupant inside the car driven by his driver Khoiru @ Kuna Seth, a truck bearing registration no- OR-15-A 3855 suddenly entered to the main road without prior indication, dashed the Car of the Complainant causing complete damage to the Car and death of the Car driver and the friend of the Complainant Tempo died at the spot. The Complainant sustained serious injuries on his body and undergone treatment in different hospitals. The Driving license and the purse were missing at the place of accident hence not seized by the police and certified copy of the same was not obtained. A case was registered at Kishorenagar Police station vide No-17 dtd. 25.02.2011. After being recovered from the accidental illness on dtd. 24.02.2012 the Complainant registered a OD Claim before the O.P but no surveyor was appointed and the loss was not assessed. As per sub section 2 of section 64U of insurance act the Complainant engaged one surveyor Er. B.K.Pujari who is a surveyor and loss assessor and investigator to assess the damage car of he complainant. The surveyor by the permission of police at Kishorenagar police station took 15 photographs of the damaged car and estimated the loss and submitted a report duly signed and sealed with a opinion that the car is not repairable i.e TOTAL LOSS. The Complainant paid Rs.4,000/- as professional fees. The Complainant then served an Advocate notice to the O.P for payment of Rs.1,60,000/- against the total loss as per the IDV along with Rs.4,000/- but the O.P has not settled the claim.
The O.P though admitted the avail of policy by the Complainant, he states that the a Private Car Package Policy of Insurance bearing no- No-345600/2011/1252 in favour of Jayalal Behera. The policy was issued to the Complainant against a Hyundai Santro Car was subject to certain terms and condition, exclusions of the policy. On dtd. 29.08.2012 the O.P received an intimation from the insured and the senior divisional manager of the insurance company perused the documents and found it genuine, sought permission from the Regional Manager Bhubaneswar to proceed in this case and deputing surveyor in this case. An intimation was given by the Regional Manager informing him regarding the deputation of surveyor Mr. H.P Singh for inspection of the vehicle along with a claim form. But the Claim form and the estimate was till yet not submitted by the Complainant. The O.P states that the Insured is not authorised to engage surveyor but as per Sec-64UM of the Insurance Act is only authorised to the Insurance Company to engage surveyor. The O.P denies that the Complainant is not entitled to get Rs.1,60,000/- as there was a total loss and Rs.4,000/- for Surveyor fees as the case is based on falsehood.
POINTS OF DETERMINATION:-
- Whether the Complainant is comes under the purview of Consumer Protection Act.2019?
- Whether the O.Ps has committed any Deficiency in Service to the Complainant?
From the above discussion and materials available on records we inferred that the Complainant comes under the purview of Consumers as he has purchased one SANTRO car and got it Insured from the O.P on payment of Consideration. Immediately after the information given by the Complainant as the O.P did not turn on send a surveyor to assess the loss, the Complainant compelled to engaged a surveyor for the same but the O.P denied to accept this as it was not according to their guidelines. But the O.P after being informed by the Insured belatedly after the specified time period, in course of their duty, has sought permission from the regional office and thereafter the O.P engaged surveyor for the assessment work. Again the dispute in this case is non submission of claim form by the Insured for settlement of Insurance claim even after several reminders. No evidence was placed by the Complainant/ Insured regarding the submission of claim forms, estimates and relevant documents with the O.P to settle the claim. Hence we order as under:-
ORDER
In these circumstances we are of the view that the present complaint deserves to be disposed of with the observations that the Complainant will submit the Claim Form along with Estimates and all the relevant documents with the Surveyor again and the Surveyor will examine the vehicle afresh and give a report by comparing the prices quoted by the complainant in the estimate submitted by him along with the claim application and the prices he will get from the authorised repairer. The O.P is directed to pay the amount that will become payable after the fresh assessment after submission of required documents by the Complainant shall also carry same rate of interest i.e. 7% per annum with effect from 19.12.2012 till the date of actual realization.
Order pronounced in the open Court today i.e, on 13th day of April 2021 under my hand and seal of this Commission.
Office is directed to supply copies of the Order to the parties free of costs receiving acknowledgement of the delivery thereof.
I agree,
-Sd/- -Sd/-
MEMBER(W) PRESIDENT
Dictated and Corrected
by me.
-Sd/-
PRESIDENT
