IMPORTANT POINTS
(1) Right to know settlement claim - The complainant was having a right at least to know about settlement of claim and if any amount is paid against settlement of his claim then at least an intimation ought to have been given.
(2) Non intimation - The insurance company committed deficiency in service and unfair trade practice in not intimating the complainant regarding settlement of claim.

ORDER

Gautam Chourdiya, President—The complainant has filed this complaint under Section 17 of the Consumer Protection Act 1986 (hereinafter called “the Act” for short) alleging deficiency in service and unfair trade practice on the part of the opposite party Insurance Company, seeking direction to the opposite party to pay the IDV Rs.29,70,974/- of the insured vehicle on total loss basis and thereby to pay the remaining amount Rs.20,70,974/- of the IDV after deducting Rs.9,00,000/- which was already paid to the financer of the vehicle. The said amount is sought to be paid along with interest @ 12% p.a. from the date of accident i.e. 21.02.2018. Rs.5,00,000/- as compensation for mental agony has also been sought along with cost of complaint.

2. Indisputably the complainant is the registered owner of vehicle bearing registration No.CG-07-BG-9537. The said vehicle was got insured from the opposite party insurance company under comprehensive motor vehicle insurance policy bearing No.3379/01761128/000/00 for the period between 23.06.2017 to 22.06.2018 and Insured Declared Value (IDV) Rs.29,70,974/-. The said vehicle met with road accident on 21.02.2018 and suffered severe damages due to head on collision with another truck.

3. As per case of the complainant at the time of accident, the vehicle was being driven by his son Mayank Sharma. Helper Trilok Tamrakar was also in the vehicle, who died on spot in the accident. FIR was lodged by the relative of the deceased. Later on a claim case before the Motor Accident Claims Tribunal (hereinafter called “MACT” for short) was also filed in which the driver Mayank Sharma, the complainant and the opposite party insurance company were made non-applicant. That claim case was settled in National Lok Adalat (hereinafter called “Lok Adalat” for short) and order Dt.13.07.2019 was passed in which the opposite party insurance company agreed to pay Rs.8,50,000/- to the applicants, copy of that order is filed as Annexure-C-4. In the meanwhile the incident was informed to the opposite party insurance company and claim form along with all necessary documents was submitted. On 04.09.2018, the insurance company wrote a letter to the complainant to the effect that as to why the claim should not be cancelled on the ground of driver implant/ No DL based on FIR and intimation sheet. The opposite party / insurance company sought certain documents within 5 days with regard to settlement of claim with a warning that if within the stipulated time demanded documents are not submitted the claim will be treated as “No. Claim.” The requisite documents were submitted again by the complainant, but his claim was treated as “No Claim”. When despite several requests no amount was paid, then legal notice dated 11.11.2019, Annexure-C-6, was sent by the complainant, which was neither replied nor claim amount was paid by the opposite party Insurance Company, hence the complaint is filed.

4. The complainant on the basis of Driver Certificate, Annexure-C-7, issued by the complainant, Supurdnama of vehicle, Annexure-C-8 and Police Investigation Report, Annexure-C-9 has contended in the complaint that his son Mayank Sharma was driving the vehicle at the time of incident. Copy of driving license of Mayank Sharma, Annexure-C-10, was given to the police as well as the insurance company, which was valid and effective on the date of accident.

5. It is further averred by the complainant that this fact was never challenged by the opposite party insurance company before the MACT in Claim Case No.35/2018, in fact the opposite party insurance company admitted that the vehicle was being driven by Mayank Sharma at the time of incident and upon finding no breach of insurance contract by the complainant, the claim case was settled by the insurance company before the Lok Adalat and paid Rs.8,50,000/- to the third party. As per averment of the complainant, this settlement in the claim case before Lok Adalat makes estoppel to the insurance compan