DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
SOUTH 24 – PARGANAS , AMANTRAN BAZAR, BARUIPUR,
KOLKATA-700 0144
C.C. CASE NO. __115_ _ OF ___2017
DATE OF FILING : 6.9.2017 DATE OF PASSING JUDGEMENT: 11.10.2018
Present : President : Ananta Kumar Kapri
Member(s) : Subrata Sarker
COMPLAINANT : Subrata Dutta, son of Kedar Nath Dutta of 121/2/3, D.H Road, Barisha, P.S Thakurpukur, Kolkata – 8.
O.P/O.Ps : 1. The Branch Manager, National Insurance Co. Limited. Amtala Branch, Murshed Market, D.H Road, Kannaya Nagar, Amtala, P.S Bishnupur, Dist. South 24-Parganas, Pin-743398.
2. The National Insurance Company Limited. Amtala Branch, Murshed Market, D.H Road, Kannaya Nagar, Amtala, P.S Bishnupur, Dist. South 24-Parganas, Pin-743398.
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J U D G M E N T
Sri Ananta Kumar Kapri, President
With the allegation of improper repudiation of complainant’s claim by the O.Ps, the complainant has filed the instant case under section 12 of the C.P Act, 1986, alleging deficiency in service on the part of the O.Ps.
The facts leading to the filing of the instant case by the complainant may be epitomized as follows.
Complainant got his vehicle bearing no.WB06D-6962 insured with the O.P Insurance Company under Policy no. 154601/31/16/6100001508, issued on 23.6.2015, which was valid from 23.6.2015 to 22.6.2016. On 18.7.2015, the vehicle met with an accident , as a result of which, it was damaged vehemently. On 29.9.2015, a claim was submitted by the complainant before the O.P-1 with necessary papers and documents for a sum of Rs.1,03,597/- which he spent to repair the damaged car. But, O.P-1 rejected the complainant’s claim vide his letter dated 19.7.2016, for non-production of final money receipt. Therefore, alleging deficiency in service for improper rejection of his claim by the O.ps, the complainant has filed the instant case ,praying for payment of Rs.1,03,597/-, compensation etc. Hence, this case.
Admitting the validity of the policy as well as the accident, the O.P nos. 1 and 2 have filed the written version of their statement, wherein it is contended inter alia that the complainant did not submit the money receipt issued by the garage where vehicle was repaired ,inspite of several reminders and, therefore, the claim of the complainant has been rejected by the O.Ps. It is further stated by the O.Ps that one licensed Independent Surveyor was appointed by them to assess the extent of the loss sustained by the vehicle and the said Surveyor submitted his report estimating loss at Rs.71000/- and against that assessment of the Surveyor, Rs.63000/- (approximately) was payable to the complainant by them. As the complainant has not been able to file the money receipts of the garage viz. Goutam Maruti Service, the claim petition has been properly rejected. There is no deficiency in service on their part and, therefore, the case should be dismissed in limini with cost.
Upon the averments of the parties, the following points are formulated for consideration.
POINT FOR DETERMINATION
- Are the O.Ps guilty of deficiency in service for repudiating the claim of the complainant?
- Is the complainant entitled to get relief or reliefs as prayed for ?
EVIDENCE OF THE PARTIES
Evidence on affidavit has been filed on behalf of both the parties and the same are kept in the record after consideration. Questionnaires, replies and BNAs filed by the parties are also kept in the record after consideration.
DECISION WITH REASONS
Point no.1 & 2 :
Ld. Lawyer appearing for the complainant has contended that necessary documents were filed before the Insurance Company and despite filing of such documents, the Insurance Company has rejected the claim of the complainant arbitrarily without taking into account those documents.
Ld. Lawyer appearing for the O.Ps has argued that the complainant was informed to file the original money receipt of the garage where the vehicle was repaired and he has not been able to file that money receipt within the prescribed period and, therefore, the claim has been rightly rejected.
Heard the submissions of Ld. Lawyers ,appearing for both the parties. Perused the materials on record. Considered all these.
It is fact that the vehicle of the complainant met with an accident on 18.7.2015 and that the vehicle was also considerably damaged in that accident. It is also fact that the complainant submitted claim petition before the O.Ps on 29.9.2015 with necessary papers and documents and thereby he claimed a sum of Rs.1,03,597/- ,which is alleged by him to have been spent towards the repair of the damaged car. The claim of the complainant has been repudiated on 19.7.2016 by O.P-1 and it has been repudiated on one ground only i.e the complainant has not produced the money receipt of the garage where the vehicle was repaired.
Let us see now, whether the money receipt of the garage is very much essential for settlement of a claim case by the O.Ps.
A similar point had come up for consideration by Hon’ble State Consumer Disputes Redressed Commission, West Bengal , reported in (2017) 2 WBLR (CPSC) 379, wherein it has been held that the terms and conditions of the policy do not make it necessary to subject cash memo as a condition precedent for settlement of claim and refusal to settle the claim for a long time on that ground is a deficiency in service.
Coming to the facts of the instant case, it is found that the Surveyor was appointed by the O.Ps on 8.8.2015 and he submitted report on 17.3.2016 i.e about 8 months after. A Surveyor is required to submit his report within 30 days of appointment. But in this case, it is found that a complete departure has been made by the Surveyor in so far as the compliance of Regulations of IRDA , 2017 is concerned vide Clause 15(5) thereof. Thereafter, it is incumbent upon the Insurance company to settle the claim within 30 days of the date of filing report by the Surveyor. This is provided also in Clause 15 of the aforesaid regulation. This regulation has not also been properly observed by the Insurance Company i.e O.P nos. 1 and 2.
In the instant case, Surveyor’s report has been filed on 17.3.2016. A notice was issued upon the complainant on 8.6.2016 whereby the complainant was asked to produce the garage money receipt. As he did not produce the same, his claim is rejected on 19.7.2016. So, it is seen that the O.Ps slept over the Surveyor’s report upto 8.6.2016 i.e for about 3 months. The claim has not been disposed of within 30days of receipt of the Surveyor’s report and this constitutes blatant disregard of the provision of the regulations by the O.Ps, which is treated as deficiency in service on the part of the O.Ps.
It has already been pointed out that the garage cash memo is not essential condition precedent for determination or settlement of an insurance claim. It is not fact that the complainant did not produce money receipt of the garage before the O.Ps. In his reply to question no.5 of O.P it is stated by him that he submitted the said receipt before the Surveyor of the O.Ps and also before the O.Ps . A copy of duplicate bill dated 3.8.2017 issued by “Goutam Maruti Service Station” has also been filed before this Forum and it is found therefrom that the complainant has paid Rs.30,000/- as service charge for opening, fitting, denting and painting of the vehicle. Goutam Maruti Service Station is a Service Centre of Maruti Company. “Auto Sales” is the authorized distributor for Maruti genuine parts. The damaged parts of the vehicle were replaced by new parts which were purchased from Auto Sales and the bills issued by Auto Sales have been produced before the Forum by the complainant. The Service Station i.e Goutam Maruti Service does never sell spare parts of the vehicle; its task is to repair the vehicle. Ld. Lawyer for the O.Ps submits that the complainant has failed to produce the money receipts from Goutam Maruti Service Station for the spare parts purchased for the vehicle. It is not possible for the complainant to produce such document ,because Goutam Maruti Service Station has not supplied the spare parts of the vehicle and it is Äuto Sales” which have supplied the parts of the vehicle. All these documents issued by “Äuto Sales” or by the Service Centre have not been challenged by the O.Ps. There is also no allegation raised by the O.Ps that these documents are forged and fictitious. In the circumstances, we find no difficulty whatsoever to rely upon these bills and relying upon these bills we proceed to determine the amount to which the complainant is actually entitled.
An investigation was conducted by the Surveyor appointed by the O.Ps and the report of the said Surveyor has also been filed. It is seen from the report of that Surveyor that total assessed liability was Rs.71,000/- including labour charge. There is no obstacle to rely upon the report of the Surveyor and we may safely act upon this report on our task to determine the amount of compensation to be available to the complainant. One thing which comes to light on a perusal of the report of the Surveyor is that Service charge which has been taken by Goutam Maruti Service Station has not been included in the estimate of the Surveyor . The complainant has paid Rs.30,000/- as service charge to the said Service Station and this charge should be included within the money to be indemnified to the complainant. If this service charge is included with the value as assessed by the Surveyor of the O.Ps, the amount stands at Rs.1,01,000/- and the complainant is found tobe reasonably entitled to this sum of Rs.1,01,000/-.
It is also found that the complainant has unnecessarily been driven to the threshold of this Forum by the O.Ps who have improperly rejected the claim of the complainant on flimsy ground and due to such improper rejection of the claim of the complainant, the complainant has certainly undergone tremendous physical and mental agony for which the O.Ps are required to compensate him.
In the consequence, the case succeeds.
Hence,
ORDERED
That the complaint case be and the same is decreed on contest against the O.Ps with a cost of Rs.10,000/- .
The O.Ps, who shall remain jointly and severally liable for payment to the complainant, are directed to pay Rs.1,01,000/- to the complainant towards his claim and also a sum of Rs.10,000/- as compensation for harassment and mental agony sustained by the complainant within a month of this order, failing which, the cost amount, decreetal claim amount and the amount of compensation will bear interest @6% p.a till full realization thereof.
Let a free copy of this order be given to the parties concerned at once.
President
I / We agree
Member
Dictated and corrected by me
President
T
