| Final Order / Judgement | ORDER 02.05.2024 MS. NIPUR CHANDNA, MEMBER - In brief facts of the present case are that the complainant is the consumer under section 2 (d) of the CP Act, 1986. It is stated that the complainant is owner of Ford Endeavour bearing Registration No. DL-4CAF1932 duly insured with the OP-1 to 3 vide policy no. OG-10-1003180100041148 for the period of 12.03.2010 to 11.03.2011.
- It is stated that the complainant met with an accident and after the accident the complainant pool his Ford Endeavour to the work shop of OP-4 on 22.10.2010 where after the inspection done by the supervisor of the OP-4 and thereafter the supervisor of OP-4 prepared the repair order of the vehicle in question and call the surveyor of the Insurance company OP-2. It is further stated that the OP-2 checked all the documents regarding the insurance policy, registration certificate, license and some other documents of the complainant and assured him that the vehicle in question will repair under the cash less scheme as soon as possible. It is further stated that surveyor of the OP-2 Insurance Company also given his consent on the estimated bill of the OP-4 for repairing the aforesaid Ford Endeavor under cashless scheme.
- It is stated that till 16.11.2010 the vehicle in question not repaired as the OP-4 always stated that the OP-2 has strictly refuse for the repairing of the car and when the complainant approached to the OP, the OP admitted that he has no objection for the repairing of the aforesaid car, but some time will be requied to take the approval from the OP-1 to 3 and avoided the matter on one pretext to another. It is further stated that due to negligence of OPs he suffer Rs. 5,000/- daily as a conveyance charges/expenses from 22.10.2010 to 14.12.2010. The complainant sent a legal notice to OPs on 16.11.2010. It is further stated that complainant found himself to be very helpless, he repaired his vehicle on the workshop of the OP-4 after giving him cash amount.
- It is stated that after sending the notice and taking of delivery of the vehicle in question the complainant on various occasion approached the OP-1 to 3 for the reimbursement of the expenses incurred for the repair of the vehicle in question of the complainant i.e. Rs. 1,45,371.00/- and also Rs. 5,000/- for per day expenses of the complainant, but all in vain. Being aggrieved by the conduct of all the OPs complainant approached this Commission for redressal of his grievance.
- Notice of the complaint was sent to all the OPs. OP-1 to 3 filed their joint written statement thereby denying any deficiency in service on their part. It is stated in their written statement that the complainant did not submit government approved photo ID proof and duly filled and signed claim form despite repeated reminders and letters as such having no other option OP-1 repudiated the claim of the complainant. It is further stated that on receipt of the intimation OP-1 appointed the surveyor to assess the loss in question and as per the surveyor report the loss was assessed to the tune of Rs. 83,934/- but as the complainant failed to complete the post claim formalities his claim was repudiated for non submission of the documents. It is further stated that the repudiation is justified as it is drafted within the four corners of the policy terms and conditions. It is further prayed that present complaint be dismissed with cost having no merits.
- OP-4 filed its written statement thereby denying any deficiency in service on its part. It is further stated that the insurance policy of the complainant is invalid on account of nonpayment of insurance premium and as such OP-4 refused to repair the vehicle on cashless basis. However, the vehicle of complainant was duly repaired on his direction subject to the payment of repairing bill in cash. It is further stated that no case of deficiency can be made out qua OP-4 as OP-4 cannot deliver the vehicle without getting the repairing expenses as the policy in question is invalid one and OP Insurance company has denied the cashless approval to the complainant.
- No rejoinder to the written statement of OPs filed by complainant. Complainant filed his evidence by way of affidavit wherein he has corroborated the contents of his complaint. He has placed on record copy of RC, cover note, repair order, copy of legal notice dated 16.11.2010, copy of repairing bills having the endorsement cash paid in support of his contention.
- Sh. Amit Wadhwa Asstt. Manager Legal filed evidence by way of affidavit on behalf of OP-1 to 3. Sh. A Mathews Executive Director of OP-4 filed his evidence by way of affidavit on behalf of OP-4. OP-4 has also placed on record the copy of preliminary survey report, final survey report in support of his contention.
- All the parties have filed their respective written arguments. We have heard the arguments advance at the bar by Ld. Counsel for complainant. Sh. Vishal Soni, counsel for OP-1 Sh. Rakesh kumar and counsel for OP-4 Sh. Dinesh Kumar and have perused the record.
- The sole question for our consideration is whether the claim of the complainant is rightly repudiated by OP-1 Ins. Co.
- We have carefully gone through the repudiation letters dated 7.01.2011, and 11.02.2011, the bare perusal of the aforesaid letter makes it clear that OP insurance Co. has admitted the policy in question , accident in question , as well as the loss to the complainant. The OP Insurance Co. has also appointed the surveyor to assess the loss arising out of the accident in question. If the complainant has not duly filled the claim form in respect to the loss in question, then OP-1 ins. Co. could neither accept the loss nor had appointed the surveyor to investigate and assess the loss in the accident, hence, we are of the considered view that the letter dated 07.01.2011 and 11.02.2011 are nothing but the lame excuses taken by the ins. Co. to escape itself from the liability, hence, in our view both the letters are unjustified.
- The complainant has prayed in the present complaint that direction be given to OP-1 to 3 to pay the bill of Rs. 1,45,371/- along with interest, whereas as per the surveyor report the net liability that can be fastened on OP-1 to 3 is to the tune of Rs. 83,934/-. Admittedly, surveyor, is independent person appointed by IRDA to investigate and assess the loss suffered by insured. The surveyor’s report certainly can be taken note as a piece of evidence until more reliable evidence is brought on record to rebut the contents of the surveyor’s report. In the present case, the complainant has not challenged the surveyor report and has not placed on record the documentary evidence rebutting the surveyor report in question. Hence, we have no other option but to rely upon the surveyor report for assessing the actual loss suffered by complainant in the alleged accident. (Reliance has been placed upon In PAALM EATABLE LTD. VS. UNITED INDIA INSURANCE CO. LTD. IV(2004) CPJ 22(NC)
- In view of the above discussion and the judgment cited above we are of the considered opinion that OP had arbitrarily rejected the claim of the complainant by taking lame excuses, hence, repudiation is unjustified. We therefore hold OP-1 guilty of deficiency in service and directed it as under:
- pay to the complainant a sum of Rs. 83,934/- along with interest @6% from the date of filing of complaint i.e. 20.11.2011 till realization.
- Pay to the complainant a sum of Rs.20,000/- toward compensation for pain and mental agony suffered by him which will include the cost of litigation.
- OP is directed to comply the order within 30 days from the date of receipt of this order failing which OP is liable to pay to the complainant interest @9% per annum from the date of non-compliance till realization.
- Copy of the order be given to the parties free of cost as per order dated 04.04.2022 of Hon’ble State Commission after receiving an application from the parties in the registry. The orders be uploaded on www.confonet.nic.in.
Announced in open Commission on 02.05.2024. SANJAY KUMAR NIPUR CHANDNA RAJESH PRESIDENT MEMBER MEMBER | |
