Haryana

Karnal

CC/652/2021

Smt. Seema - Complainant(s)

Versus

Iffco Tokio General Insurance Company Limited - Opp.Party(s)

Jasbir Singh

27 Sep 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No.652 of 2021

                                                        Date of instt 25.11.2021

                                                        Date of Decision:27.09.2024

 

1. Smt. Seema, aged 30 years, wife of late Shri Vikram Singh son of Shri Dalel Singh. (Aadhar no.4604 4202 7206).
2. Brian, aged 9 years (minor) son of late Shri Vikram Singh.
3. Ms.Muskan, aged 11 years, (minor) daughter of late Shri Vikram Singh minors through their mother Smt. Seema as natural guardian and next friend.
4. Beera Devi, aged 53 years, wife of Dalel Singh, all resident of house no.290, ward no.8-V, village Newal, tehsil and District Karnal.

 

                                                                        …….Complainants.

                                              Versus

 

Iffco Tokio General Insurance Company Limited, through its Branch Manager, Sector-12, Karnal. (Insurer of the motorcycle no.HR-05-BB-5228).

                                                                   …..Opposite Party.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

Before   Shri Jaswant Singh……President.

              Ms. Neeru Agarwal……Member

      Ms. Sarvjeet Kaur..…..Member

 

 Argued by: Shri  Jasbir Singh, counsel for the complainants.

                    Shri Naveen Khetarpal, counsel for the OP.

 

                     (Jaswant Singh, President)

ORDER:   

                

                The complainants have filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant no.1 is the widow of deceased Vikram Singh. The complainants no.2 and 3 are the minor son and daughter of deceased and complainant no.4 is the mother of the deceased respectively. The minors have filed the present complaint through their mother Smt. Seema as natural guardian and next friend.

2.             The husband of complainant no.1 was the owner of the motorcycle bearing registration no.HR-05-BB-5228. The said motorcycle was insured with the OP, vide policy no.1-18000XKO P400 MA827176, valid from 12.10.2019 to 11.10.2024. The policy was comprehensive. The complainants are the legal heirs of the deceased. The insurance company insured the owner-cum-driver of the vehicle for an amount of Rs.15,00,000/- as Compulsory Personal Accident (CPA) and for this purpose a sum of Rs.300/- has been charged by the insurance company from Vikram Singh (since deceased). On 19.06.2021, deceased life assured alongwith his cousin brother Sultan were going from village Newal to village Bara Gaon for some personal work on his motorcycle, which was being driven by him  in a proper, normal and moderate speed. When they reached near the Peer of village Newal on Bara Gaon Road, Karnal, the said motorcycle was hit by the offending tractor no.HR-05-AX-5384 by coming on wrong handside of the road, Vikram Singh died in the said accident. His post mortem was conducted in Civil Hospital, Karnal. In this regard a criminal case was registered against the driver of the offending tractor with the Police of Police Station Kunjpura, District Karnal vide FIR no.233 dated 20.06.2021 under section 279/304-A IPC. After the death of Vikram Singh, the complainant no.1 visited the office of OP and submitted the claim form and all other relevant documents as demanded by the official/s of the OP for the insured amount of Rs.15,00,000/-as per the insurance policy of the motorcycle. After checking all the documents, the officials of the OP assured the complainants that the insured amount will be made to the complainant as early as possible. After waiting long time, the complainant visited the office of OP and enquired about this matter from the OP but no satisfactory reply was given by the official of the OP and the matter was dragged unnecessarily and ultimately the OP refused to give any claim to the complainants. Due to this act and conduct of OP, complainants have suffered mental pain, agony and harassment. In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence, complainants filed the present complaint seeking direction to the OP to pay Rs.15,00,000/- as insured amount on account of death of insured Vikram Singh, to pay Rs.1,00,000/- on account of mental pain, agony and harassment and to pay Rs.20,000/- as litigation expenses.

 3.            On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability and concealment of true and material facts. On merits, it is pleaded that the claim is being sought under the CPA (Compulsory Personal Accident) cover under the motor insurance policy no.MA827176 issued against a brand new vehicle (Bajaj CT 100). The policy in question is a long term insurance policy issued for the period of 12.10.2019 to 11.10.2024 for Own Damage Cover as well as Third Party mandatory cover. The premium for CPA (Compulsory Personal Accidental) cover for owner/driver of the vehicle was charged for first year insurance period only i.e. for the period from 12.10.2019 to 11.10.2020. The accident was reportedly occurred on 19.06.2021 i.e. second year insurance period i.e. under policy period 12.10.2020 to 11.10.2021. The CPA premium was charged and paid only for the first year insurance period subject to renewal for subsequent policy periods by the insured himself. The insured has not renewed/extend the CPA cover for second year policy, hence at the time of accident there is no CPA cover was available covering the deceased person, so without a prejudice as to all other aspects of the claim, this claim was rejected out rightly and conveyed to the claimants, vide letter dated 17.09.2021. It is further pleaded that it is specifically mentioned in the policy that the personal accident cover to Owner-Driver is granted for one year from the date of inception of the policy. Insured need to renew it before expiry for continuation of the cover. As per circular issued by IRDAI, it is not mandatory for insured to go for long term CPA cover alongwith mandatory long term TP cover. The relevant abstract of IRDAI circular dated 09.10.018 is reproduced as under:-

“It has come to our notice that insurers are offering only long-term Compulsory Personal Accident (CPA) policy for new cars and new two wheelers alongwith long term TP policy. It is clarified that it is the choice of the owner driver to opt for a one year CPA cover or long term CPA cover and insurers should not compel owner drivers to go in for long term package policy or long term CPA cover. Hence, all insurers are hereby directed to ensure that they necessarily offer the choice of one year CPA cover to an owner driver.”

It is further pleaded that OP duly provide the CPA cover to the insured for first year policy and thereafter it was the duty of insured to renew the said cover by way of payment of premium prior to expiry of the cover, which was not clearly done in this case. The policy in question does not cover the personal accidental risk of the owner driver at the time of accident i.e. on 19.06.2021 as no premium for the same was paid by the insured, hence, the claim lodged by the complainants was rejected. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

4.             Parties then led their respective evidence.

5.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of FIR Ex.C1, copy of driving licence Ex.C2, copy of insurance policy Ex.C3, copy of RC Ex.C4 and closed the evidence on 18.05.2023 by suffering separate statement.

6.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Devendra Kumar, General Manager Ex.RW1/A, copy of insurance policy Ex.R1, copy of circular Ex.R2, copy of repudiation letter dated 17.09.2021 Ex.R3 and closed the evidence on 10.10.2023 by suffering separate statement.

7.             We have heard the learned for the parties and perused the case file carefully and also gone through the evidence led by the parties.

8.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that husband of complainant no.1 namely Vikram Singh got insured his motorcycle with the OP for the period of 12.10.2019 to 11.10.2024. A sum of Rs.3635/- was paid as premium including Rs.350/- for the Compulsory Personal Accident (CPA) claim of Rs.15,00,000/-. On 19.06.2021, Vikram Singh met with a roadside accident while driving the insured motorcycle and received multiple injuries and died due to said injuries. In this regard an FIR no.223 dated 20.06.2021, under section 279/304-A IPC was registered with police of Police Station Kunjpura, District Karnal. After the death of Vikram Singh, complainant approached the OP, submitted all the relevant documents and requested to pay the compulsory personal accident claim of Rs.15,00,000/- but OP did not pay the same and closed the claim of the complainant on the false and frivolous ground and lastly prayed for allowing the complaint.

9.             Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that the insurance policy in question was covering the CPA claim only for one year i.e. from 12.10.2019 to 11.10.2020. The husband of complainant no.1 died on 19.06.2021 in the roadside accident. On the date of accident the CPA was not covered. Thus, the claim of the complainant was rightly closed, vide letter dated 17.09.2021 and lastly prayed for dismissal of the complaint.

10.           We have duly considered the rival contentions of the parties.

11.           Admittedly, Vikram Singh (since deceased) was owner of motorcycle bearing registered no.HR-05-BB-5228. It is also admitted that the said motorcycle was insured with the OP. It is also admitted that husband of complainant no.1 died in roadside accident.

12.           The claim of the complainant has been closed by the OP, vide letter Ex.R3 dated 17.09.2021 on the ground, which are reproduced as under:-

“Upon verification of the claim documents submitted towards his claim, we would like to draw your attention as follows:

1. Personal Accident coverage on said policy was applicable for the period 12.10.2019 to 11.10.2020.
2. Whereas death of insured is reported to us on 19.06.2021, which is not covered in the said policy.

We bring to your kind notice; the policy wording which clearly state as follow:-

Based on your opinion, the personal accident cover to Owner-Driver is granted for one year from the date of inception of the policy. You need to renew it before expiry for continuation of the cover.

Therefore, we regret to inform you that we are unable to consider the said Personal Accident Claim and the said file is being closed as “No Claim.”

13.           The claim of the complainant has been closed on the abovesaid ground.

14.           Now, the moot question arises for consideration is that whether the deceased life assured was covered under the compulsory personal accident on the date of accident and the complainants are entitled for the compulsory personal accident claim of Rs.15,00,000/-.

15.           The best evidence to decide the said issue is insurance cover note Ex.C3/R1 dated 12.10.2019. Both the parties have relied upon the said cover note. On perusal of the said cover note, it reveals that the motorcycle was insured for the period from 12.10.2019 to 11.10.2024 for own damage cover as well as third party mandatory cover. The premium for CPA (Compulsory Personal Accident) cover for owner-driver of the vehicle was paid for the first year insurance period only i.e. for the period from 12.10.2019 to 11.10.2020. The accident took place on 19.06.2021 i.e. second year of insurance period. The insured had not renewed the CPA cover for the second year policy. Hence, as per the insurance policy the owner of the motorcycle i.e. Vikram Singh is not covered for compulsory personal accident claim on the date of accident.

16.           Moreover, as per circular Ex.R2 dated 09.10.2018 issued by IRDAI, it is not mandatory for insured to go for long term CPA cover alongwith mandatory long term TP cover. The relevant abstract of IRDAI circular dated 09.10.018 is reproduced as under:-

“It has come to our notice that insurers are offering only long-term Compulsory Personal Accident (CPA) policy for new cars and new two wheelers alongwith long term TP policy. It is clarified that it is the choice of the owner driver to opt for a one year CPA cover or long term CPA cover and insurers should not compel owner drivers to go in for long term package policy or long term CPA cover. Hence, all insurers are hereby directed to ensure that they necessarily offer the choice of one year CPA cover to an owner driver.”

 17.          Thus, in view of the above discussion, the present complaint is devoid of merit and deserves to be dismissed and the same is hereby dismissed. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced
Dated:27.09.2024

         President,

      District Consumer Disputes                           

      Redressal Commission, Karnal.

 

                   ( Neeru Agarwal)            (Sarvjeet Kaur)

                            Member                        Member