::BEFORE THE DISTRICT CONSUMER DISPUTES  REDRESSAL COMMISSION AT BIDAR::

                                                           C.C. No.92/2023.

                                                                                                                          Date of filing: 02.11.2023.

                                                              Date of disposal:22.02.2024.

P R E S E N Ts:-    

                                (1) Shri. Mabu Saheb H.Chabbi,                                                                                                               B.Com.,LL.B.,(Spl.),

                                                                          President.,  

                                (2) Kum. Kavita,

                                                               M.A.,LL.B.,(Spl.),  

                                                                         Member.

COMPLAINANT/S                    1.    Sri.Kapil S/o gurubasappa Biradar,

                                                            Age:32 years,Occ:Business,

                                                            R/o Village Diggi,

                                                       Tq:Kamalnagar Dist:Bidar-585327.                                       

                                                  (By.Sri.Rajkumar K. and
                                                    Sri.Ramesh S.M. Advocate.)                        

V/s

OPPONENT/S                           1. Branch Manager,
                                                    Bajaj Allianz General Insurance
                                                    Company Ltd.,
                                                    Madiwale Arcade 1^st floor
                                                    Hasmi Manzi Club Road Belgaum
                                                    Karnataka-590001.                                                     

                                                     (By Sri.S.Wilson Advocate).
                                                                                                   

                                                                                        ::  J U D G M E N T  ::

By Shri. Mabu Saheb H.Chabbi, President.           

The complaint is filed by the complainant under section 35 of the Consumer Protection Act 2019, against the opponent for the deficiency of service caused by not settling the claim of the complainant based on the policy.  Hence, passed the following judgement.

Brief facts of the complaint.

The brief facts of the complaint are as follows: -

2.         The complainant is the owner of Maruti Car Suzuki Dzire ZX1+bearing Reg.No.KA38/M-7910 and insured with the OP Company under package policy No.OG-21-9910-1825-00068830, valid from 13.11.2020 to 12.11.2021 covering the risk of theft, own damage to the insure vehicle in the accident and 3^rd party risk.  On 17.04.2021 at 10pm the complainant along with his driver Omkar S/o Sangamesh were proceeding in the above insured vehicle to the house of relatives of complainant, the said Omkar S/o Sangamesh was driving the said car when they reached the land of one Papade near the village of Janwad the said Omkar suddenly applied breaks to the car.  Though it was in a normal speed the said car turned turtle and fell down on the road side ditch, due to the impact of the accident the entire car was damaged.  Complainant filed complaint before Janwad Police and registered case in Cr.No.30/2021 for the offense punishable u/s 279 of IPC.  Charge sheet was also been submitted by the police against the said Omkar the driver of the said car.  The said damaged car parked at Lahoti Showroom for repairs and estimated for Rs.6,65,551/- for the said repairs of the car.  The complainant paid cover premium of the policy to the tune of Rs.32,823/- and the policy is valid as on the date of accident the complainant is entitled for compensation from the OP of Rs.7,86,600/-.  The complainant approached the OP company to claim the above said amount as it was insured under the said policy but, the OP has repudiated the claim by mentioning the flimsy grounds and hence, the complainant filed this complaint against OP for claiming compensation.

Written Version of OP.

3.         The notice issued by this commission to the OP is served upon it and the OP appeared through its counsel before this commission and filed its W.V. and the gist of the W.V. is as below. 

            The OP has admitted the fact of purchase of insurance policy No.OG-21-9910-1825-00068830 by the insured complainant, which is valid from 13.11.2020 to 12.11.2021.  It is denied that, the complainant has not repaired the said car and still is keeping in Lahoti Show room for repairing some important parts of the car with the workshop at Bidar by spending more than Rs.6,65,551/- as estimated by the workshop.  It is true that, the premium of Rs.32,823/- is paid by the complainant but, the entitlement of compensation of Rs.7,86,600/- is denied.  Further it is denied by the OP that, repudiation of the claim was based on flimsy grounds.  After receiving the information about the accident the OP appointed the surveyor to assess the damages caused in the accident, the surveyor submitted the report of loss to the extent of Rs.5,10,000/-.  The OP has issued letters on 13.09.2021, 11.10.2021 and 04.11.2021 to the complainant to produce the required documents which is necessary for processing the claim of the complainant.  But, the complainant has not performed his part of contract by not providing any documents and it is in violation condition No.1 of the policy and hence the claim of the complainant was repudiated.  There is no deficiency caused by the OP towards the complainant hence, OP prayed to dismiss the compliant.            

Evidence of complainant.

4.         The complainant himself got examined as P.W.1 and got marked  documents Ex.P.1 to Ex.P.14 which are as follows,

1. Ex.P.1-Copy of FIR in Cr.No.30/2021 of Janwada Police.
2. Ex.P.2-Copy of complaint given by Kapil S/o Gurubasappa Biradar to the police on 18.04.2021.
3. Ex.P.3-Copy of crime details form.
4. Ex.P.4- Copy of M.V.report dt:19.04.2021.
5. Ex.P.5-Copy of charge sheet in Cr.No.30/2021 dt:18.04.2021.
6. Ex.p.6-Copy of letter issued by OP to the complainant dt:04.11.2021.
7. Ex.P.7-Service estimate report for Rs.6,65,651/-.
8. Ex.P.8-Copy of repudiation letter dt:07.12.2021.
9. Ex.P.9-Copy of bill for purchase of car issued by Lahoti Motors Pvt. Lmt. Dt:24.10.2020.
10. Ex.P.10-Copy of policy.
11. Ex.P.11-Copy of R.C.Card.
12. Ex.P.12- Copy of D.L. pertaining to Omkar S/o Sangmesh. 
13. Ex.P.13(a to d)-Copies of digital photos pertaining to car.
14. Ex.P.14-Copy of Aadhar Card of complainant.

Evidence of Opponent.

5.         One, Sri.Santosh Nirwani S/o Lingangouda, Deputy Manager has been examined as R.W.1 ad got marked 9 documents as per Ex.R.1 to Ex.R.9 on behalf of OP Company.

1.  Ex.R.1-Copy of transcript of proposal for private car policy.

2. Ex.R.2-Copy of provisional survey report for Rs.5,10,149/- dt:25.06.2021.
3. Ex.R.3(a to d)-Postal acknowledgment.
4. Ex.R.4 to 9-Copies of letters issued by OP to complainant.

Points/Issues.

6.         Learned counsels for the parties argued their respective case.  On perusal of pleadings, and documents of the parties, this commission raised the points for consideration as below;

1. Whether the complainant proves that, he is consumer to the OP and further proves the deficiency of service caused by the OP in not settling the claim of insurance to the complainant?  
2. Whether the complainant is entitled for any relief as sought in his complaint?

3. What orders? 

7.         Our answers to the points raised above are as follows: -

1. In the affirmative.
2. In the affirmative.
3. As per the final order.

Points No 1 and 2.

8.         In order to decide the complaint issues, this commission discussed points/issues No.1 and 2 together as each points are inter related to each other- as follows.

9.         In order to prove the case of the complainant the complainant has lead his evidence as P.W.1 by way of reiterating the facts of the complaint and got marked Ex.P.1 to Ex.P.14 documents on his behalf.  One Sri. Sri.Santosh Nirwani S/o Lingangouda, Deputy Manager of OP Company has been examined as R.W.1 by filing his evidence affidavit and reiterated the contents of his W.V. in its evidence affidavit and got marked 09 documents to prove the defence case.

10.       The case of the complainant is that, The complainant is the owner of Maruti Car Suzuki Dzire ZX1+bearing Reg.No.KA38/M-7910 and insured with the OP Company under package policy No.OG-21-9910-1825-00068830, valid from 13.11.2020 to 12.11.2021 covering the risk of theft, own damage to the insure vehicle in the accident and 3^rd party risk.  On 17.04.2021 at 10pm the complainant along with his driver Omkar S/o Sangamesh were proceeding in the above insured vehicle to the house of relatives of complainant, the said Omkar S/o Sangamesh was driving the said car when they reached the land of one Papade near the village of Janwad the said Omkar suddenly applied breaks to the car.  Though it was in a normal speed the said car turned turtle and fell down on the road side ditch, due to the impact of the accident the entire car was damaged.  Complainant filed complaint before Janwad Police and registered case in Cr.No.30/2021 for the offense punishable u/s 279 of IPC.  Charge sheet also been submitted by the police against the said Omkar the driver of the said car.  The said damaged car was then parked at Lahoti Showroom for repairs and estimated Rs.6,65,551/- for the said repairs of the car. 

11.       The complainant has produced Ex.P.1 and Ex.P.5 the copy of FIR and copy of charge sheet in Cr.30/2021 issued by Janwada police u/s 279 of IPC against Omkar S/o Sangamesh Chandeshware.  Ex.P.2 the copy of complaint given by the complainant to the Janwada Police against the said Omkar, Ex.P.3 the copy of Crime details Form and Ex.P.4 the copy of Motor vehicle accident report, which are not disputed by the OP.  Hence, the complainant has proved the fact of accident occurred on 17.04.2021 while driving the above said car by the said Omkar S/o Sangamesh. 

12.       The complainant has produced Ex.P.10 copy of insurance policy No.OG-21-9910-1825-00068830 in the name of the complainant, comprising the valid period of 13.11.2020 to 12.11.2021 for the IDV value of Rs.7,86,600/- for the vehicle bearing Chassis No.K12NN9052359-MA3CZFB3SLK711677.  The OP has not disputed the document Ex.P.10 insurance policy issued to the complainant.  The OP also produced Ex.R.1 the insurance policy pertaining to the complainant.  Hence, the complainant has proved that, he is consumer to the OP and the OP is considered as service provider to the complainant.

13.       The OP has repudiated the claim of the complainant as per Ex.P.8 by showing reasons that, the complainant has not submitted necessary documents required for processing the claim nor co-operated with the surveyor in conducting the final re-survey.  Several letters dt:13.09.2021, 11.10.2021 and 04.11.2021 were issued to the complainant but, the complainant did not produce the documents hence, the claim was repudiated by the OP.  On going through the contends of ex.P.8 repudiation letter the OP contended that, the complainant has not co-operated with the surveyor in conducting the final re-survey.  If it would be the case of OP then he would not have been given the survey report as per Ex.R.2 the provisional survey report.  As per Ex.R.2 provisional survey report the damages to the vehicle of the complainant assessed for Rs.5,10,149/-, the OP has issued letter to the complainant as per Ex.P.6 on 04.11.2021 stating that, the surveyor has assessed loss for Rs.5,10,000/- and requested the complainant to submit (a) the repair invoice as assessed in the survey report, (b) KYC documents, (c) provide vehicle for re-inspection with surveyor assessed parts, (d) signed discharged cum satisfaction voucher and (e) to provide the injury detail of the driver.  Further the OP contended that, he has issued several letters as per Ex.R.6 to Ex.R.9 to produce the said documents to the complainant and OP further contended that, he has produced Ex.R.3, 3(a)to(d) postal acknowledgments to show that, those exhibits Ex.R.6 to Ex.R.9 letters said to be served to the complainant but, on going through the signatures in the recipient column of postal acknowledgements the said signatures of alleged complainant were not tallied with the signatures of the complainant in Vakalathnama  and pleadings.  Hence, the documents which have been said to be served to the complainant as per Ex.R.3 (a) to (d) cannot be accepted as proper service to the complainant regarding Ex.R.6 to Ex.R.9 letters. 

14.       The complainant himself has produced Ex.P.6 the letter issued by the OP on 04.11.2021 requiring the complainant to produce the above said documents to the OP.  The OP has repudiated the claim of the complainant as per Ex.P.8 letter to the complainant dt:07.12.2021 and the reasons shown that, the complainant has not produced the required documents for processing the claim.  On going through the reasons assigned by the OP to repudiate the claim is not based with any basic conditions of the policy, the OP was not suppose to repudiate the claim as already the surveyor has submitted the report as per Ex.R.2.  By considering the availability and non-availability of the documents the surveyor assessed the loss of the complainant.  In view of the fact again demanding the documents from the complainant is not just and proper.  For the above said discussion we based the judgment of Hon’ble SCDRC Shillong Meghalaya, the Hon’ble Commission gave a proposition that, “C.P.Act 1986-Sec.(1)(g), 14(1)(d), 15-Insurnace-Burglary-surveyor appointment-refusal to assess loss on ground of non-submission of documents- deficiency in service-District allowed complaint-hence appeal- surveyor was not right in refusing to assess loss on ground that, respondent had not furnish documents-insured cannot be expected to furnish each and every document that, the insurer seeks ad nauseam according to its whim and fancy-insurer cannot reject claim in toto for mere non submission of a document or two-Assessment of loss by district Forum justly and fairly made-compensation awarded”. Another judgment of Hon’ble Supreme Court of India reported in 2022 live law (SC) 506 the ratio laid down by the Hon’ble Court that, “Insurance-insurance Comapnies refusing claim on flimsy grounds and/or technical grounds –while settling the claim, the insurance company should not be too technical and ask for the documents, which the insured is not in position to produced due to circumstances beyond his control”.   The above said two judgments are applicable to the facts of this case.  Hence, there is no violation of any condition by the complainant. 

15.       The complainant has produced Ex.P.7 the service estimate  report from the Lahoti Motors Pvt. Ltd. for Rs.6,65,651/-.  The complainant has produced Ex.P.9 in voice bill issued by Lahoti Motors Pvt. Ltd., for the purchase of the said car by the complainant on 24.10.2020 for Rs.8,12,400.12 paisa, But the IDV value of the said vehicle is Rs.7,86,600/- as per Ex.P.10 insurance policy as on the date of purchase of policy dt:13.11.2020.  By looking into the documents produced by the complainant no such documents produced before this commission regarding the bills and vouchers of actual repairs conducted to the above said car of the complainant.  However, the surveyor has given his report as per Ex.R.2 and letter as per Ex.P.6=Ex.R.5 stating that, the loss of the complainant was assessed at Rs.5,10,000/-.  In view these facts and circumstances the complainant is entitled for Rs.5,10,000/- compensation for the loss caused to his vehicle. 

16.       The complainant has produced Ex.P.13, Ex.P.13(a)(d) the photos pertaining to the damaged car No.KA.38/M/7910 which clearly shows that, the said vehicle was damaged.  The complainant produced Ex.P.11 the registration certificate card pertaining to the above said car which stood in the name of complainant and also produced Ex.P.12 the copy of  D.L. pertaining to Omkar S/o Sangamesh holding valid D.L., till 18.02.2035.  The police documents Ex.P.1 to Ex.P.5 also reveals that, the said driver Omkar was driving the above said vehicle as on the date of accident dt:17.04.2021.  As per Ex.P.1 and Ex.P.2 no such injuries are caused to the driver Omkar in the said accident and hence there is no question of producing document of injury certificate of said Omkar to the OP. 

17.       In view of the above discussion made by this commission we are of the considered opinion that, the complainant has proved his case against the OP for the deficiency of service caused to the complainant and accordingly answered the point No 1 and 2 in the affirmative in favour of complainant and proceed to pass the following order.

::ORDER::

        The complaint u/s 35 of CP Act 2019, filed by the complainant is hereby allowed in part along with costs and compensation.

            The OP is hereby directed to pay an amount of Rs.5,10,000/- (Rupees five-lakh ten-thousand only) based on Ex.P.10=Ex.R.1 insurance policy bearing No.OG-21-9910-1825-00068830, along with the interest at the rate of 9% p.a. from the date of repudiation letter Ex.P.8 dt:07.12.2021 till the realisation of entire amount along with compensation of Rs.10,000/- for sufferance and inconvenience caused to the complainant and Rs.5,000/- as litigation expense within 45 days from the date of this order to the complainant.

            Intimate the parties accordingly.                         

 (Typed to our dictation then corrected, signed by us and then pronounced in the open Commission on this 22^nd day of February-2024).

Documents produced by the complainant.

1. Ex.P.1-Copy of FIR in Cr.No.30/2021 of Janwada Police.
2. Ex.P.2-Copy of complaint given by Kapil S/o Gurubasappa Biradar to the police on 18.04.2021.
3. Ex.P.3-Copy of crime details form.
4. Ex.P.4- Copy of M.V.report dt:19.04.2021.
5. Ex.P.5-Copy of charge sheet in Cr.No.30/2021 dt:18.04.2021.
6. Ex.p.6-Copy of letter issued by OP to the complainant dt:04.11.2021.
7. Ex.P.7-Service estimate report for Rs.6,65,651/-.
8. Ex.P.8-Copy of repudiation letter dt:07.12.2021.
9. Ex.P.9-Copy of bill for purchase of car issued by Lahoti Motors Pvt. Lmt. Dt:24.10.2020.
10. Ex.P.10-Copy of policy.
11. Ex.P.11-Copy of R.C.Card.
12. Ex.P.12- Copy of D.L. pertaining to Omkar S/o Sangmesh.  
13. Ex.P.13(a to d)-Copies of digital photos pertaining to car.
14. Ex.P.14-Copy of Aadhar Card of complainant.

Document produced by the Opponent.

1. Ex.R.1-Copy of transcript of proposal for private car policy.
2. Ex.R.2-Copy of provisional survey report for Rs.5,10,149/- dt:25.06.2021.
3. Ex.R.3(a to d)-Postal acknowledgment.
4. Ex.R.4 to 9-Copies of letters issued by OP to complainant.

Witness examined.

Complainant.:-

P.W.1- Sri.Kapil S/o gurubasappa Biradar,                               (complainant).   

Opponent:- 

R.W.1- Sri.Santosh Nirwani S/o Lingangouda, Deputy Manager.