Date of Filing : 01.09.2017
Date of Disposal: 14.09.2022
DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION
THIRUVALLUR
BEFORE TMT. Dr.S.M. LATHA MAHESWARI, M.A.,M.L, Ph.D (Law) .…. PRESIDENT
THIRU.P.MURUGAN,M.COM.,ICWA(Inter), B.L., .....MEMBER-II
CC. No.42/2018
THIS WEDNESDAY, THE 14th DAY OF SEPTEMBER 2022
Mr.J.Gopinath, S/o.Janarthanan,
No.3/125, Gandhimedu,
Kakkalur Post,
Thiruvallur District – 602 003. ……Complainant.
//Vs//
The Manager,
Bajaj Alianz General Insurance Company Limited,
Old No.276 & 277, New No.497 & 498,
5th Floor, Poonamallee High Road,
Issana Kattima Complex,
Arumbakkam, Chennai -106. …..opposite party.
Counsel for the complainant : Mr.P.Balachandar, Advocate.
Counsel for the opposite parties 1 & 2 : Mrs.A.Latha Maheswari, Advocate.
This complaint is coming before us on various dates and finally on 05.09.2022 in the presence of Mr.P.Balachandar Advocate counsel for the complainant upon perusing the documents and evidences produced by both the parties this Commission delivered the following:
ORDER
PRONOUNCED BY THIRU.P.MURUGAN, MEMBER-II
This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act, 2019 alleging deficiency in not reimbursing the expenses to repair the complainant’s vehicle along with a prayer to direct the opposite party to reimburse the expenses to repair the vehicle in an authorized service centre amounting to Rs.59,564/-towards insurance claim and to pay a sum of Rs.35,000/- towards business loss incurred due to the delay in settling the insurance claim and to pay a sum of Rs.15,000/- towards compensation for the mental agony due to the deficiency in service on the part of the opposite party.
Sum and substance of the complaint:-
The complainant has bought a jeep of Mahandra & Mahandra make on 09.04.2015 and registered the vehicle on 10.09.2015 with RTO, Thiruvallur after certain modification on the driving system i.e. dual clutch and brake system since he wanted to use the vehicle as a driving trainer vehicle. The same modifications were mentioned in the registration certificate of the vehicle with registration No.TN-22-BP-0069, The Engine No.KKB4A39596, Chassis No.MAIXU2KKNB2A64121. The vehicle was insured with M/s.Bajaj Alianz General Insurance Company Limited. The complainant state that the insurance company was duly informed about the modification done on the vehicle driving system through the agent of the insurance company. Added is the papers of RC which does have the necessary endorsement on the alteration on the vehicle is submitted to the vehicle insurance company. The first insurance policy was taken in 2015 since it is mandatory for vehicle registration at RTO. Further renewal was done for the period from 25.02.2016 to 24.02.2017 vide policy No.OG16 152 1801 0000 2658. The policy was further renewed for the period of 25.02.2017 to 24.02.2018 vide policy No. OG 17 1521 1801 00001774. It is stated that no accident was reported all these years. But on 05.06.2017, the complainant’s vehicle got damaged by a lorry which was coming in the rear side and the doors and body of the complainant’s vehicle was smashed. The complainant has lodged an insurance claim recovery form on that day with the insurance company and the insurance company’s surveyor has also inspected the vehicle for the damages caused. Though the insurance company was duly informed of the accident, the company has sent a letter dated 16.06.2017 calling for clarification on the accident for which the complainant duly replied on 22.06.2017. But again on 27.06.2017, the insurance company has sent a letter stating that they are yet to receive any reply to their letter. Therefore for complainant has replied through his counsel vide letter dated 04.07.2017 on the facts of the case and to reimburse the expenses met to repair the vehicle by authorized vehicle service centre. The claim of the complainant was rejected by the insurance company as “NO CLAIM“ which made the complainant depressed. Therefore he has approached this commission on the grounds that the claim to reimburse the expenses by the insurance company was repudiated with“NO CLAIM“ clause the present complaint was filed for the following reliefs;
1) To reimburse the expenses to repair the vehicle in an authorized service centre amount to Rs.59,564/- towards insurance claim.
2)to compensate the business loss incurred due to the delay in settling the insurance claim amount to Rs.35,000/-
3) to pay a sum of Rs.15,000/- for the mental agony suffered though the claim was submitted on time and reply given by him/counsel not considered by the opposite party i.e. the insurance company.
4) To drop the unfair trade practice by the trader/vendor
5) To pay Rs.1000/- to each consumer who suffers in this way, in general by the commission.
Defence of the opposite party:-
The party on the other hand namely the insurance company has categorically denies that charges leveled by the complainant saying that the complaint is frivolous, vexatious and an abuse of Consumer Protection Act. The opposite party states that there is no deficiency of service or unfair trade practice on their part to involve the jurisdiction of this commission. The opposite party says that the insurance policy is a contract and both the parties are under obligation to obey/fulfill all the terms and conditions of the same in the strict sense of the words written therein. It is stated by the opposite party that it is well settled law that when the voluminous evidence and complicated questions are involved in the consumer complaint, the better course is to direct the complainant to approach the civil court to get the grievance resolved by leading cogent oral and documentary evidence. The opposite party put that the intimation about the accident was informed to the insurance company only after 36 days which is in violation of the policy condition. Thus, deprived, insurance company, an opportunity to ascertain the necessary facts related to the accident including loss, circumstances and quantum of loss required to decide the admissibility of claim and it is clear that the complainant has violated the terms and conditions of policy as per opposite party. The opposite party further explained about the section 17&18 of Indian Contract Act, in which the terms “Misrepresentation” and “Fraud”. It is further stated by the opposite party that the report of the insurance surveyor clearly indicates there are modification on the driving system other than the manufacturer model and it has not be endorsed in the policy and any additional fitment or change done in the vehicle has to be endorsed in the policy by paying an additional premium. Since the insurance policy is not binding on the claim, they argued to dismiss the case.
On the side of complainant proof affidavit was filed and documents Ex.A1 to Ex.A15 were marked on their side. On the side of opposite party proof affidavit was filed and documents Ex.B1 to Ex.B3 were marked.
Points for consideration:-
Whether the claim of the complainant is right?
Does the insurance company failed to keep up the commitment?
If so, to what relief the complainant is entitled?
Point No.1 to 3:-
On the side of the complainant following documents were filed in support of his allegations;
Family card of the complainant was marked as Ex.A1;
RC book was marked as Ex.A2;
Insurance policy for the vehicle from 25.02.2016 to 24.02.2017 was marked as Ex.A3;
Insurance policy for the vehicle from 25.02.2017 to 24.02.2018 was marked as Ex.A4;
Motor insurance claim form was marked as Ex.A5;
Photos of the vehicle with CD was marked as Ex.A6;
Receipts was marked as Ex.A7;
Notice issued by the opposite party to the complainant dated 06.06.2017 was marked as Ex.A8;
Reply from the complainant to the opposite party dated 22.06.2017 was marked as Ex.A9;
Track consignment for proof of delivery was marked as Ex.A10;
Notice issued by the opposite party dated 27.06.2017 was marked as Ex.A11;
Reply given by the complainant to the opposite party dated 04.07.2017 was marked as Ex.A12;
Track consignment for proof of delivery was marked as Ex.A13;
Acknowledgement card for proof of delivery was marked as Ex.A14;
Notice issued by the opposite party to the complainant dated 05.07.2017 was marked as Ex.A15;
On the side of opposite party the following documents were filed in support of their defence;
Policy copy was marked as Ex.B1;
Vehicle inspection report was marked as Ex.B2;
Surveyor report dated 14.06.2017 was marked as Ex.B3;
The complainant has purchased a Jeep manufactured by Mahendra & Mahendra on 09.04.2015 from one Mr.Karunakaran, Nehru Nagar, Chennai and registered the same vehicle with RTO, Thiruvallur with registration No.TN-22-BP-0069. The Engine No.KKB4A39596, Chassis No.MAIXU2KKNB2A64121. He states that certain changes in the vehicle clutch and brake system made to make it viable to run as a training vehicle for learners since the livelihood of the person depends on this vehicle. The change in the vehicle does have the endorsement of the registering authority namely RTO, Thiruvallur. The date of registration was done on 10.09.2015. Necessary insurance also done for the vehicle since it is mandatory for RTO registration. The complainant states that he has informed the insurance agent on the vehicle modification and the insurance company has issued a policy for the vehicle in reference OG-17-1521-1801-00001774. The policy was taken in 2015 and renewed for 2016-17, 2017-2018. On 05.06.2017 the complainant’s vehicle got damaged since a lorry coming in the rear side of the vehicle dashed on the right side of the vehicle. The doors and side portion of the complainant’s vehicle smashed and resulted in bad shape. The complainant had informed the insurance company about the accident and submitted claim form dated 05.06.2017 and a surveyor also inspected the vehicle. But the insurance company has called for details on the claim vide their letter dated 16.06.2017 which was replied on 22.06.2017. Again the insurance company has called for details on the claim vide letter dated 27.06.2017 for which the reply from the complainant though his Advocate sent to the insurance company as on 04.07.2017. But the claim of insurance was declined by the insurance company vide their letter dated 05.07.2017 stating “NO CLAIM”. Hence the complainant has preferred the case before this commission on the ground of material evidence that the vehicle’s damage due to accident and the policy for the vehicle is alive, the very purpose of the insurance company is to repudiate the claim on false ground. The complainant has repaired the vehicle in authorized service centre and claiming the money and other relief.
The opposite party in their version has stated that the details of the modification on the vehicle driving apparatus was not informed and not included in the policy, the incident of accident has not informed in time, and there is no deficiency of service or unfair trade practice on the part of the insurance company and the entire case is of other nature than consumer and the dispute complainant should approach Civil Court to settle the issue. The opposite party states that the report of the surveyor is only for the insurer and not for settling the claim.
It is evident that the complainant has insured the vehicle after the modification on clutch and brake system on dual basis which is duly endorsed by the Registering Authority and the insurance company does have the information on this modification which insured, since the RC book does have endorsement and scrutinized by the insurance company in which the insurance policy signed. Therefore, the statement of the opposite party that the contract is breached since the modification not informed stands dismissed. Also, the modification is on the clutch and brake dual system only and the accident is not due this technical change but a lorry smashed the vehicle on the side of the jeep which is proved by evidence of photo and insurance surveyor’s report. The material fact is that the insurance claim was submitted by the complainant on time while seeing the record (Ex.A5). The damaged vehicle was serviced in the authorized service centre of the manufacturer only and the claim is duly submitted to the insurance company. In general opinion, the insurance companies think twice before settling the claim. In this case, it is repudiated for filmsy reasons. In our opinion, the claim is in order and supported by materials evidences. The accident was reported to the insurance company on time, insurance surveyor has also inspected the vehicle, the policy is alive, and the accident not caused due to modification on the clutch and brake system. The very intention of the insurance company is to repudiate the claim by citing invalid reason. Their rejection as “NO CLAIM“ of the insurance claim not maintainable seeing all the evidences this commission finds the opposite party bind to oblige the claim by complainant.
In the result, the complaint is partly allowed directing the opposite party
a)to pay a sum of Rs.59,564/- (Rupees fifty nine thousand five hundred sixty four only) within six weeks from the date of receipt of copy of this order;
b) to pay a sum of Rs.10,000/- (Rupees ten thousand only) towards compensation for mental agony caused to the complainant;
c) to pay a sum of Rs.5,000/- (Rupees five thousand only) towards litigation expenses to the complainant.
d) Amount in clause (a) to be paid within six weeks from the date of receipt of copy of this order failing which an interest of 6% will be levied on the said amount from the date of complaint till realization.
Dictated by the Member-II to the steno-typist, transcribed and computerized by him, corrected by the Member-II and pronounced by us in the open Commission on this the 14th day of September 2022.
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MEMBER-II MEMBER-I PRESIDENT
List of document filed by the complainant:-
Ex.A1 ............... Family card of the complainant. Xerox
Ex.A2 ............... RC Book. Xerox
Ex.A3 .............. Copy of Insurance policy Xerox
Ex.A4 ............. Copy of insurance policy Xerox
Ex.A5 05.06.2017 Motor Insurance Claim Form. Xerox
Ex.A6 ............. Photos & CD original
Ex.A7 ............. Receipts. Xerox
Ex.A8 16.06.2017 Notice issued by the opposite party. Xerox
Ex.A9 22.06.2017 Reply given by the complainant to the opposite party. Xerox
Ex.A10 24.06.2017 Track consignment for proof of delivery. Xerox
Ex.A11 27.06.2017 Notice issued by the opposite party to the complainant. Xerox
Ex.A12 04.07.2017 Legal notice issued by the complainant to the opposite party. Xerox
Ex.A13 05.07.2017 Track consignment for proof of delivery Xerox
Ex.A14 ............... Acknowledgement card. Xerox
Ex.A15 .............. Notice issued by the opposite party to complainant. Xerox
List of documents filed by the opposite parties 1 & 2:-
Ex.B1 ……………. Policy Copy. Xerox
Ex.B2 ……………. Vehicle Inspection Report. Xerox
Ex.B3 14.06.2017 Surveyor’s Report. Xerox
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MEMBER-II MEMBER-I PRESIDENT
