Order-22.
Date-09/11/2015.
In this complaint Complainant M/s. Bhanu Properties Ltd. by filing this complaint has submitted that complainant is the owner of a car of Mahindra Xylo being Chasis No. A2M29097, Engine No. BVA4M24625, Registration No.MP20CB2720 and the said car was purchased by the complainant on 10.02.2011 and it was insured as per the requirement under the law and in the year 2012 the complainant first time took the car insurance policy from the ops.But the car of the complainant is insured under the policy on payment of premium and from 2012 to 2013 and from 2013 to 2014 from Bharti Axa General Insurance Co. Ltd. and lastly on and from 13.01.2014 to 13.01.2015 and ops received the premium amount of Rs. 14,421/- and the op issued the car Insurance Policy being Policy No.OG-14-2401-1801-00049699 for Private Car Package Policy.
That all on a sudden the car of the complainant faced a road accident on 11.12.2013 by which the car of the complainant was badly damaged and accordingly complainant sent the car to the service centre for necessary repairing job and service centre estimate of the repairing cost amounting to Rs. 2,95,425/- and the complainant duly lodged the claim form to the op for reimbursement of the claim.So the op appointed the surveyor and op vide e-mail replied dated 28.03.2014 confirmed that the liability which may be subject change after completion of repairing job.
Thereafter complainant sent an e-mail dated 16.06.2014 to the ops stating the fact that the Bhopal Office of the op agreed to pay the claim of the repairing cost of the car as per the approval of the surveyor.Thereafter ops appointed another surveyor who did not refer to pay the claim against the cost of change of the complete body cell of the car and accordingly complainant requested to the ops to settle the Insurance claim of the complainant as early as possible and to that effect ops communicated their official co-ordination on 23.06.2014 but no effective result was received.
Subsequently ops made affirmative communications on 23.06.2014 with their officials for settlement of the claim of the complainant and copy of which was forwarded to the complainant and on the same date ops further asked to the complainant for some other papers and documents and complainant duly complied with the same and on 15.07.2014 complainant further sent the mail for communication to the ops for settlement of the Insurance claim of the complainant as early as possible.
Complainant further by e-mail dated 18.07.2014 demanded the copy of surveyor report from the op since the op failed and neglected to settle the car Insurance claim of the complainant nor the said surveyor called to the complainant and made any physical verification of the damaged car of the complainant and by e-mail dated 18.07,2014 complainant further intimated to the op for settlement of claim since as per the op who have appointed another surveyor who did not agree to pay the amount against repairing of the body of the car and finally op told to the complainant that they are unable to pay the insurance claim. Fact remains that op never made any letter communicating to the complainant and accordingly complainant demanded for the said letter but op failed to do the same.
Due to the non-settlement of the insurance claim of the complainant’s car, complainant was unable to complete the repairing job of the car and same is lying custody of the service centre and the service centre is about to claim the garage charges for prolonged period and complainant had to bear the same only due to unfair trade practice as adopted by the op and for the deficiency of service on the part of the ops and in the meantime complainant also compelled to pay expenses of huge amount of money against hiring of car from the private sector for daily use purpose as car rental till the month of November 2014.
As per stipulation under the law framed by the Hon’ble Supreme Court of India the period of time shall be 60 days for the purpose of settlement of the Insurance claim and the Insurance company is bound to settle the claim within the specified period of time but ops failed and neglected to settle the claim of the complainant for which complainant is entitled to get insurance claim for the expenses of repairing job of the car of the complainant for Rs. 2,95,425/- and complainant is entitled to get it along with interest and further compensation etc.
On the other hand op nos. 1 & 2 by filing written statement submitted that no doubt complainant’s vehicle was insured by virtue of insurance policy issued by ops’ company.But subject to compliance of terms and conditions of the contract of insurance during the alleged material point of time of accident.But as because the claim of the complainant is excessive and unreasonable for which such claim cannot be entertained by the ops.
It is specifically mentioned that complainant has tried to make out the case that final repairing of the vehicle after alleged accident is Rs. 2,95,425/- but no supporting documents have been filed by the complainant to prove such contention prior to filing of this complaintbefore the Ld. Forum.Beside that though along with the complaint the complainant has filed some so called bills issued by unauthorized garage under the name and style of Dharmandra Singh and the dates of those bills are during the period from February to November-2014 claiming those towards proof of hiring charges of car for the period during the said vehicle was lying unrepaired but none of those bills have been proved.Therefore no reliance placed upon the same.As per policy condition, there is no provision for payment of hiring charges of car and therefore such claim is not tenable.
Moreover from the bills submitted by the complainant issued by Bhusan Automobile Ltd. during the period from March 2015 and it is found that prior to filing of the complaint, complainant did not repair the said vehicle and therefore, there is no question of submitting the proof of repairing expenses to
It is specifically submitted that as per the statutory provision, surveyor was appointed to assess the loss and accordingly such surveyor submitted preliminary survey report by virtue of which the total loss was assessed to the tune of Rs. 1,23,345/-. Considering the compulsory excess and depreciation value of parts following terms and conditions of the policy of insurance. So, in the circumstances, ops’ liability to pay him Rs. 1,23,345/-. It is further submitted that the ops’ company requested the complainant to provide them the tax invoice as well as payment receipt for final settlement of the claim. Complainant has not provided copy of those two documents to op and so the claim of the complainant could not be finally settled. So, there was no deficiency on the part of the op.
It is specifically mentioned by the op to settle the claim of the complainant.But due to non-submission of the tax voice issued by the concerned garage against repairing of the said vehicle after alleged accident as well as the payment receipt, the claim of the complainant could not be finally settled and complainant also did not agree to settle the claim on the basis of loss assessed during preliminary survey.But complainant has filed only some photocopies of so called proof of repairing expenses which are not at all even authenticated at all.Thereafter complainant was directed to submit all the original proof of repairing expenses of the said vehicle after the alleged accident to the ops. Moreover complainant did not accept the said amount of Rs. 1,23,345/-.
Further ops submitted that only for non-submission of relevant documents, as requested by letter dated 28.11.2014 and also the several other letters dated 04.09.2014, 20.06.2014, 07.03.2014 and 28.11.2014, the claim of the complainant could not be finally settled by the ops.It is specifically submitted that consequential loss as mentioned by the complainant is not covered under the policy and as such complainant is not entitled to any other damages. So the entire complaint is vexatious and false and fabricated. Though ops have their no fault, negligence and deficiency on the part of the ops to settle the claim and claim could not be settled only by the complainant.
Decision with reasons
After comparative study of the complaint including the written version and also the documents, it is found that it is undisputed fact that complainant is a policy holder under the op in respect of the case vehicle being No.MP 20 CB 2720 and no doubt the said accident took place on 11.12.2013.Fact remains that complainant after accident reported the matter to the Insurance Aurthority and Insurance Authority engaged surveyor who submitted report.Thereafter complainant submitted claim form without any document and op asked the complainant to file final bill for repairing.But ops practically did not submit any bill of repairing showing payment of any money after repair.Not even after repairing the said vehicle it was reported to the ops for further verification by the surveyor.But initially after accident op appointed surveyor and considering and determining the loss op reported to the complainant that net assessed loss is Rs. 1,23,345/-.But complainant did not submit the final repairing bill to the ops which is proved beyond any manner of doubt.
Truth is that op did everything on receipt of the application for claim without any document, appointed surveyor, assessed net loss, reported the matter to the complainant.But complainant did not submit final repairing voucher and invoice to the op that is true.
It is mandatory provision of law as per policy terms and conditions,the assessment of loss against any accident in respect of any vehicle can only be paid subject to submit of the final receipt regarding repairing.But final receipt regarding repairing was not filed and final report of the repairing bill and use of the articles or parts by them must be filed but that has not been filed.
Truth is that complainant tried to receive the entire money without repairing the same which is proved from the fact.No document is produced by the complainant before this Forum that repairing is completed and Automobile companies or shop has issued such certificate to that effect.There is no such certificate of any repairing shop, nor to that effect that those parts are fixed after repairing and everything was corrected.So, it is clear that complainant did not comply the terms and conditions of the policy, did not file all the documents, not even has filed before this Forum that repairing shop owners certified that those articles were fixed and car is repaired.Whatever it may be it is found that from the surveyor report that date of registration of the said car is 14.01.2011, year of manufacturing is 2010, Model-Xylo of Mahindra and Mahindra and as per policy condition and also considering the age of the vehicle, it is found that on the date of accident, depreciation of the car shall be counted to the extent of 30 percent over the total claim and that was also assessed by the surveyor and surveyor’s reporthas not been challenged by the complainant and considering the entire fact and circumstances and also the activities of the complainant, we are confirmed that complainant tried to grab the entire amount by showing some receipts from different places of Bhopal without producing any certificate from any repairing shop that it was repaired and all those articles were placed and ops always agreed to pay net assessed amount of Rs. 1,23,345/-.But complainant was not willing to accept it for which he did not file any document in support of completion of repairing of the said vehicle the accident took place on 11.12.2013.
In view of the above findings, we find that after accidentwhen complainant has failed to complete the repairing, in that case, complainant is not entitled to get any amount more that net assessed Rs. 1,23,345/-.Truth is that complainant has not filed final receipt regarding final repairing of the vehicle and certificate to that effect that it has been properly repaired and released.But we find that for complainant’s ill conduct, ops is being harassed in such a manner.
So, in the above circumstances, even though we are confirmed that op has not complied the terms and conditions of the policy and has not filed all the documents as yet for which the settlement could not be properly finalized.But we are releasing that amount as final settlement amount of Rs. 1,23,345/- in favour of the complainant treating the claim of the complainant finally settled and op shall have no other liabilities to pay any further compensation.
In the result, the complaint succeeds in part without giving any further compensation, penalty etc. against the ops and also no cost.
Hence, it is
Ordered,
That the complaint be and the same is allowed on contest against the ops without any cost.
Ops is directed to pay of Rs. 1,23,345/- by issuing a cheque in favour of the complainant treating it as a final net assessed amount loss against the said policy by disposing of the final settlement of claim of the complainant treating it as final settlement made by this Forum in respect of this case and complainant is not entitled to get other relief as prayed for and accordingly this consumer dispute including the settlement of claim of the complainant is disposed of finally by awarding only this amount.
Ops are hereby directed to comply the order of this Forum within one month from the date of this order, failing which for non-compliance of the Forum’s order, ops shall be prosecuted u/s 25 read with 27 of C.P. Act 1986 for which further penalty and fine shall be imposed upon the ops.
