Shri B. Mukhopadhyay, President.   

This is an application u/s.12 of the C.P. Act, 1986.

             The present complainant in the present complaint has alleged that he holds a policy bearing No.OG-10-2401-1802-00025470 issued on 15-01-2010 Zone – A product two wheelers package policy vehicle IDV No.14382 premium of Rs.522/- damage of third party property Rs.1 lakh and he is registered owner of vehicle No.14382 having registration No.WB-O1U8052 which was burnt on 02-08-2010 and for which he immediately reported the matter to OP Insurance Company and as per OPs instruction it was sent to Auto Centre i.e. Ganapati Auto Centre, Bajaj Authorized Sales and Service Centre and on 09-08-2010 Auto Centre claimed a sum of Rs.67,207/- from the complainant.  Thereafter, complainant submitted claim of Rs.67,207/- to the OP on 10-08-2010 with a request to immediate release of the said amount for payment.  And, thereafter, the complainant repeatedly requested the OP to release the claim amount and to settle the same for releasing the vehicle from the Auto Centre custody.  The peculiar factor is that OP did not send any repudiation letter or did not respond against that even after repeated reminders though OPs are bound to release the compensation amount but for deficient and negligent manner of service the complainant has filed this compliant for redressal along with prayer for directing OP for releasing the claimed insurance amount and also compensation.

            On the contrary OP insurance company by filing written statement submitted that for the sake of this argument it is accepted that the vehicle was burnt due to fire and no doubt there is insurance policy but the liability of the OP is limited only up to the maximum limit of sum assured of the said policy as the present damage falls in the category of constructive total loss and in such cases the liability of the insurance company extends up to Rs.14,382/- less the compulsory deductable portion in the policy which is Rs.50/- only and it is further alleged that the said amount was duly offered to the complainant for the full and final settlement of the claim lodged by the complainant by letter on 24-08-2010 subject to production of some documents and also damaged part of the vehicle as salvaged but the complainant did not accept the same for which the matte could not be finally matured but OP Insurance Company is always willing to release the final settlement amount as per terms and condition of the insurance policy and there is no chance for releasing Rs.67,207/- what was required for the purpose of repairing the said vehicle.  It is further alleged practically the present price of the model of vehicle (Bazaz Boxer STD) is even less than the amount claimed by the complainant for repairing purpose of the vehicle when repairing cost of vehicle cannot be more than its market price in case of new one.  So in the circumstances there is no question of any deficiency on the part of the OP and for which the complaint should be dismissed and necessary order may be passed directing the OP to pay the settled amount what OPs are ready to pay always.

            Fact remains in the complaint complainant has filed paper for which both parties are relying upon and the entire materials on record the matter can be adjudicated on the basis of the materials as produced by the party upon which both the parties depend and invariably that is the insurance policy which is submitted by the complainant.

Decision with Reasons

Without discussing any further history of the entire fact when the matter has already been ventilated after squeezing the material fact of the complaint and the defence of the OP, we have considered and entered into the admitted document insurance policy which is no doubt an agreement in between the parties in this case and invariably an insurance policy is a document of an argument in between the parties and parties cannot go behind the terms and conditions as mentioned in the insurance policy and at the same time Forum has no legal jurisdiction to roam outside the circle created by the terms and condition of the insurance policy and for which the vital document of the insurance policy is considered for considering the present consumer dispute and the present complainant claimed for compensation to the extent of Rs.67,207/-. On applying our judicial mind in respect of the terms and condition of insurance policy it is found that the policy was filed by the complainant wherefrom it is found that total sum assured is Rs.14,382/- and it is specifically mentioned that in case of any damage of the vehicle complainant shall get the highest sum assured Rs.14,382/- and fact remains that OP Insurance Company already reported the complainant that they have settled the matter and they are willing to pay 14,382/- after compulsory deduction of Rs.50/- i.e. Rs.14,332/- and it is proved that the present OP already reported the matter to the complainant vide their letter dated 24-08-20910 but as because complainant did not accept it for which complainant appeared before this Court having no legal ground to file this compliant when sum assured of the insurance policy is Rs.14,382/-.  On appreciation of the entire defence story part, the letter dated 24-08-2010 issued by the OP in favour of the complainant we are convinced to hold that there was or is no deficiency and negligence on the part of the OP insurance company because OP insurance company awarded entire total sum assured after compulsory deduction of Rs.50/- and OP reported the matter to the complainant but complainant did not accept it.  In the light of the above observation we are convinced to hold that this complaint is a forceful application on the part of the complainant having its no material in the complaint and in reality there was no ground to file this complaint and another factor is that there was/is no cause of action also to file the present complaint but question is how the complaint was accepted by this Forum at the time of admission, reason is very clear because at the time of filing complaint complainant suppressed that letter what he received from the OP Company.  In the result, we are of view that the present complaint is not maintainable in the eye of law and fact remains there is no cause of action to file this case and another ground is that the case was filed suppressing the truth i.e. receipt of the final settlement letter dated 24-08-2010.  In the result, complaint fails

Hence,

Ordered

That the complaint be and the same is dismissed on contest without any cost against the OP but we are directing the OP to issue a cheque of Rs.14,332/- (Rupees Fourteen thousand three hundred thirty two only) at once in favour of the complainant along with bank interest @6%p.a. (at the rate of six per cent per annum) with effect from 25-08-2010 and till receipt of the cheque by the complainant when that amount was in the custody of the OP.

            OP is directed to comply this order and to show their moral value as insurance merchant.