Date of Filing : 22/01/2015
Order No. 22 dt. 09/01/2018
The case of the complainant in brief is that the complainant is an owner of a private car being no.WB 24K 0910. The complainant insured his vehicle with the o.p. insurance company. The complainant paid the total premium of Rs.7718/- for the period from 9.12.11 to 8.12.11. The complainant thereafter continued the policy and paid the premium as per the terms of the policy. In the month of Dec. 2013 the complainant’s vehicle met with an accident and the same was sent to o.p. no.4 for repair, assessment of damage and reimbursement from the insurance company regarding the expenses of the said damage. The o.p. nos.4 and 5 made assessment of the damage and as per the assessment sheet dt.5.12.13 the customer’s liability was fixed at approximately Rs.10,000/-. Thereafter as per the vehicle repair history card dt.7.1.14 o.p. nos.4 and 5 assessed the complainant’s liability to the tune of Rs.9146/-. The complainant sent a letter addressing to o.p. nos.4 and 5 on 3.1.14 asking as to when and in what mode he would get his vehicle after discharging is liability but in reply dt.3.2.14 o.p. nos.4 and 5 informed the complainant that they sent the final bill of Rs.35,001/- to the insurance company for final settlement and they informed that the cashless approval they received on 20.1.14 that an amount of Rs.15,489/-. The complainant became astonished and sent a letter to the insurance company to give proper and specific item wise break up of Rs.15,489/- i.e. the liability of o.p. no.1. Subsequently the complainant asked for refund of money of Rs.10,000/- which had been deducted from the gross liability of the complainant. The complainant in spite of giving such information no step was taken by o.p. for which the complainant filed this case praying for direction upon o.p. no.1 to pay the settled assured amount to the complainant to the tune of Rs.10,000/- as their liability and also prayed for compensation of Rs.3 lakhs and litigation cost of Rs.20,000/-.
The o.p. nos.1 and 2 contested this case by filing w/v and denied all the material allegations of the complaint. It was stated that the complainant had taken a Private Car Insurance Comprehensive Policy from o.p. no.1 for the period from 19.12.11 to 18.12.12 and also continued the said policy from 2013-2014. The said car met with an accident in the month of Dec. 2013 and the car was taken to the garage of o.p. no.3. After repairing of the said car o.p. no.3 sent a bill of Rs.35,001/- to o.p. no.1 and the insurance company after processing the bill sent a cashless approval for an amount of Rs.15,489/-. The o.p. no.1 by a letter informed the complainant that the deduction of voluntary excess or addition al excess from the gross liability while calculating approval of the said damaged car was made according to the terms and conditions of the policy and it was informed to the complainant by sending a calculation sheet showing item wise break up for the approved amount. The complainant is not entitled to get anything which is outside the purview of the terms and conditions of the policy and the demand of the complainant to credit in his favour the voluntary excess and additional excess cannot be entertained as it is the sheer violation of the terms and conditions of the policy. The o.p. nos.1 and 2 had no way liability for the repair and release of the car. There is negligence on the part of o.p. nos.1 and 2. On the basis of the said fact o.p. nos.1 and 2 prayed for dismissal of the case.
In spite of receipt of notices other o.ps. did not contest this case by filing w/v and as such, the case has proceeded ex parte against them.
On the basis of the pleadings of parties the following points are to be decided:
- Whether the complainant’s vehicle was insured in o.p. insurance company?
- Whether during the subsistence of the policy the vehicle met with an accident?
- Whether there was any deficiency in service on the part of o.ps.?
- Whether the complainant will be entitled to get the relief as prayed for?
Decision with reasons:
All the points are taken up together for the sake of brevity and avoidance of repetition of facts.
Ld. lawyer for the complainant argued that the complainant is an owner of a private car being no.WB 24K 0910. The complainant insured his vehicle with the o.p. insurance company. The complainant paid the total premium of Rs.7718/- for the period from 9.12.11 to 8.12.11. The complainant thereafter continued the policy and paid the premium as per the terms of the policy. In the month of Dec. 2013 the complainant’s vehicle met with an accident and the same was sent to o.p. no.4 for repair, assessment of damage and reimbursement from the insurance company regarding the expenses of the said damage. The o.p. nos.4 and 5 made assessment of the damage and as per the assessment sheet dt.5.12.13 the customer’s liability was fixed at approximately Rs.10,000/-. Thereafter as per the vehicle repair history card dt.7.1.14 o.p. nos.4 and 5 assessed the complainant’s liability to the tune of Rs.9146/-. The complainant sent a letter addressing to o.p. nos.4 and 5 on 3.1.14 asking as to when and in what mode he would get his vehicle after discharging is liability but in reply dt.3.2.14 o.p. nos.4 and 5 informed the complainant that they sent the final bill of Rs.35,001/- to the insurance company for final settlement and they informed that the cashless approval they received on 20.1.14 that an amount of Rs.15,489/-. The complainant became astonished and sent a letter to the insurance company to give proper and specific item wise break up of Rs.15,489/- i.e. the liability of o.p. no.1. Subsequently the complainant asked for refund of money of Rs.10,000/- which had been deducted from the gross liability of the complainant. The complainant in spite of giving such information no step was taken by o.p. for which the complainant filed this case praying for direction upon o.p. no.1 to pay the settled assured amount to the complainant to the tune of Rs.10,000/- as their liability and also prayed for compensation and litigation cost.
Ld. lawyer for the o.p. nos.1 and 2 argued that the complainant had taken a Private Car Insurance Comprehensive Policy from o.p. no.1 for the period from 19.12.11 to 18.12.12 and also continued the said policy from 2013-2014. The said car met with an accident in the month of Dec. 2013 and the car was taken to the garage of o.p. no.3. After repairing of the said car o.p. no.3 sent a bill of Rs.35,001/- to o.p. no.1 and the insurance company after processing the bill sent a cashless approval for an amount of Rs.15,489/-. The o.p. no.1 by a letter informed the complainant that the deduction of voluntary excess or addition al excess from the gross liability while calculating approval of the said damaged car was made according to the terms and conditions of the policy and it was informed to the complainant by sending a calculation sheet show item wise break up for the approved amount. The complainant is not entitled to get anything which is outside the purview of the terms and conditions of the policy and the demand of the complainant to credit in his favour the voluntary excess and additional excess cannot be entertained as it is the sheer violation of the terms and conditions of the policy. The o.p. nos.1 and 2 had no way liability for the repair and release of the car. There is no negligence on the part of o.p. nos.1 and 2. On the basis of the said fact o.p. nos.1 and 2 prayed for dismissal of the case.
Considering the submissions of the respective parties it is an admitted fact that the vehicle in question was insured with insurance company at the relevant point of time. It has been alleged by the complainant that the vehicle met with an accident in the month of Dec. 2013. After the accident the said vehicle was taken to the garage of o.p. no.3 for repair and assessment of damage and reimbursement for the same from the insurance company. After repair of the said vehicle o.p. no.3 sent a bill of Rs.35,001/- to o.p. no.1 and the insurance company after processing the bill sent a cashless approval for an amount of Rs.15,489/- to o.p. no.3. It appears from the record that the complainant by a letter dt.13.2.14 to o.p. no.1 asked for an item wise break up for the said approved amount of Rs.15,489/- and o.p. no.1 gave a reply to the same by a letter dt.21.2.14 sending a sheet along with the letter showing in detail the break up for the approved amount of Rs.15,489/-. The o.p. no.1 by another letter dt.29.3.14 informed the complainant that the deduction of voluntary excess or additional excess from the gross liability while calculating approval of the said damaged vehicle was made according to the terms and conditions of the policy and it has been clearly explained to the complainant by sending a calculation sheet showing item wise break up for the approved amount. On the basis of the facts and circumstances of the case it is worthwhile to mention here that the complainant was given the reply by o.p. no.1 before filing of this case and insurance company clarified the questions put by the complainant which was informed to the complainant regarding the calculation of the amount and the said calculation was made as per the terms and conditions of the policy being annex-A attached to the w/v filed by o.p. nos.1 and 2. Since there was no deficiency in service on the part of o.ps. therefore we hold that the complainant will not be entitled to get any relief as prayed for. Thus all the points are disposed of accordingly.
Hence, ordered,
That the CC No.35/2015 is dismissed on contest without cost against the o.p. nos.1 and 2 and dismissed ex parte without cost against other o.ps.
Supply certified copy of this order to the parties free of cost.
