Kerala

Kollam

CC/07/153

K.Sobhanan, Thiruvathira Nivas, Kariyam - Complainant(s)

Versus

Branch Manager,The Oriental Insurance Company ltd. - Opp.Party(s)

S.Arun

30 Nov 2009

ORDER


C.D.R.F. KOLLAM : CIVIL STATION - 691013
CONSUMER DISPUTES REDRESSAL FORUM ::: KOLLAM
consumer case(CC) No. CC/07/153

K.Sobhanan, Thiruvathira Nivas, Kariyam
...........Appellant(s)

Vs.

Branch Manager,The Oriental Insurance Company ltd.
...........Respondent(s)


BEFORE:


Complainant(s)/Appellant(s):


OppositeParty/Respondent(s):


OppositeParty/Respondent(s):


OppositeParty/Respondent(s):




ORDER

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ADV. RAVI SUSHA, MEMBER.

 

            This is a complaint for getting the claim amount of Rs.27,041/-  and the loss estimate of the KSEB with 12%  interest and other reliefs

 

          The averments in the complaint can be briefly summarized as follows:

 

          The complainant is businessman and he owns a vehicle bearing Reg.No.KL-3D-6723.  The opp.party issued the insurance policy to the said vehicle for the period  11.9.04 to 10.9.2005  with policy No.MV/2749/2005.  On 30.6.2005 at about 11 pm the vehicle met with an accident at Pattithanam Kavala.   The vehicle skidded and hit on an Iron Electric post and caused damages to the post.  The accident has been intimated to the opp.party in  time and as per their direction the complainant filled up a form and submitted t them regarding the claim. The opp.party directed the complainant to pay the estimate amount to the KSEB and to produce the estimate, the receipt of the amount remitted and other relevant records.    That also has been complied by the complainant along with a letter dated 22.10.2005.  After receiving the above letter and documents the opp.party sent back a registered letter to the complainant along with the said documents stating that the claim is rejected because the complainant made the payment to the KSEB with out their consent and the matter was not intimated to them with loss estimate. All these facts the complainant sent a legal notice to the opp.party on 27.12.2006 but no reply has been received yet.  There is deficiency in service on the part of the opp.party.,  Hence the complaint.

 

          The opp.party filed aversion contending, interalia, that the complaint is not maintainable either in law or on facts.    The definition complaint, complainant, consumer dispute service as defined in Section 2[1] of the Consumer Protection Act do not cover the claim made out in the complaint.   The opp.party had issued a comprehensive Insurance policy to the complainant’s commercial vehicle Reg.No.KL-3D/6723 for a period from 11.9.2004 to 10.9.2005.  The Electricity Board is a 3rd party as far as this opp.party is concerned and any claim sustained to the Electricity Board that arised out of the use of the insured vehicle is matter to be adjudicated by the statutory provision of Motor Vehicles Act by the Motor Accident Claim Tribunal.   Section 165 and 166 of the MV Act 1988 is a special Act envisaged to adjudicate claims in respect of 3rd parties arising out of the use of the vehicle.  The complaint is not relating to any service hired or availed by the complainant why because the damage sustained by the Electricity Board has nothing to do with the service availed by the complainant by virtue of the Insurance Policy obtained from the opp.party   The complainant in this case have not obtained written consent or permission from this opp.party regarding the admission of liability and the settlement of claim he had with the Electricity Board.    As per condition No.2 of the policy no admission, offer, promise payment or indemnify shall be made or given by or on behalf of the insured without the written consent of the company. The complainant has not intimated the alleged occurrence of the incident before this opp.party at any point of time prior to the settlement made by him with KSEB.  The complainant/insured had deliberately violated the terms and conditions of the policy condition No.1 and 2 by not intimating the claim to the insurer and by not obtain ing the written consent from this opp.party before settling the claim with the KSEB.  The complainant has not made any attempt to comply with the policy condition before arriving a settlement with KSEB.   The complainant has willfully violated the mandatory conditions of the policy and as such this opp.party is not liable to indemnify the complainant due to the above breach of policy condition committed by him.  This opp.party was totally unaware of the alleged accident and also about the settlement of the claim till the receipt of the letter from the complainant dated 7.7.2005 which has been received by the opp.party on 11.7.2005..  There is no deficiency in service on the part of the opp.party.  Hence opp.party prays to dismiss the complaint with their costs.

 

Points that would arise for consideration are:

1.     Whether there is deficiency in service on the part of the opp.party

2.     Reliefs and costs.

 

For the complainant PW.1 is examined .  Exts.P1 to P3 are marked.

For the opp.parties DW.1 and 2 are examined.   Ext. D1 and D2 are marked

 

POINTS:

 

          Complainant filed this complaint to get claim amount which he has remitted as per the loss estimate of the Kerala State Electricity Board.   There is no dispute that the complainant has taken insurance policy to his vehicle KL-3D-6723 and thesaid vehicle skidded and hit on an Iron Electric Post and caused damages to the post.  Here the question to be decided is  whether  there is deficiency in service on the part of the opp.party.   According to the opp.party as per  policy conditions 1 and 2 ie. Notice shall be given in writing to the company immediately upon the occurrence of any accident and in the event of any claim, and no admission offer, promise payment or indemnity shall be made or given by or on behalf of the insured without the written consent of the company, the complainant is not entitled to get the claim amount.   Complainant’s definite case is that he has intimated the accident to the opp.party in time and as per the opp.party’s direction he has settled the claim with KSEB.  But the complainant did not produce any material to show that he has intimated in time and got sanction from the opp.party for settling the claim without producing any material, the mere averment is not sufficient.

 

          The complainant had violated the terms and conditions of the policy condition No.1 and 2 by not intimating the claim to the opp.p-0arty and by not obtaining the written consent from the opp.party before settling the claim with the KSEB.   According to opp.party due to the non-intimation of the claim by the complainant, The opp.party was deprived of the opportunity to assess the extent of damage sustained to the third party, by appointing a Licensed Insurance Surveyor and loss assessor.   From the available evidence we are of the opinion that as the complainant violated the condition No.1 and 2in Ext. D1, the opp.party is not liable to indemnify the complaint.  There is no deficiency in service on the part of the opp.party.

 

          In the result the complaint fails and the same is dismissed without cost.

 

            Dated this the 30th day of November, 2009.

 

                                                                                     

I N D E X

 

List of witnesses for the complainant

PW.1. – Sobhana

List of documents for the complainant

P1. – Payment receipt and loss estimate  of KSEB

P2. – Letter sent by opp.party to the complainant

P3. – Advocate notice with postal receipt and A/c. Card.

List of witnesses for the opp.party

DW.1. – R. Ashok kumar

List of documents for the opp.party

D1. – Certificate-cum-Policy Schedule

D2. – Letter sent by opp.party to the complainant dated 26.10.2005.