THE KARNATAKA STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, BANGALORE. (ADDL. BENCH)
DATED THIS THE 8th DAY OF JULY, 2022
PRESENT
SRI RAVI SHANKAR – JUDICIAL MEMBER
SMT. SUNITA C.BAGEWADI - MEMBER
APPEAL NO. 469/2012
TATA AIG General Insurance
Company Ltd.,
#69, II Floor, JP & Devi Jambukeshwar Arcade,
Millers Road,
Bangalore-562 052
Having its Registered office at
Peninsula Corporate Park,
Nicholas Zpiramal Tower,
9th Floor, G K Marg,
Lower parel, Mumbai 400 013
……….Appellant/s.
(By Shri/Smt. S.P.Manjunath, Adv.,)
-Versus-
Gouse Ahmed, Proprietor ,
Emjay Engineering works,
No.36, Arekempanahalli,
Opp.9th Cross, Wilson Garden
But stop, Hosur road,
Bangalore-560 027
Respondent/s.
(By Shri/Smt.P.M.Vasudev and Co., Adv.)
:ORDER:
BY SRI.RAVI SHANKAR - JUDICIAL MEMBER
The respondent in Complaint No.1454/2011 preferred this appeal against the order passed by the III Additional District Consumer Forum, Bengaluru which directed to reconsider the claim of complainant and to pay own damage claim as per the terms and conditions of the policy within 30 days from the date of order along with cost of Rs.10,000-00.
2. Against which the appellant submits before this Commission that initially the complainant had obtained insurance policy from Bajaj Allianz General Insurance Co. Ltd for the period from 13-6-2009 to 12-6-2010 towards his vehicle Toyota Innova Car bearing No.KA-03-MS-2000. Subsequently on 13-6-2010 he paid premium of Rs.19,100-00 to this appellant company and obtained policy towards his vehicle. Such being the case the vehicle meet with an accident on 13-4-2011 and the same was intimated to the police on the same day and also informed this appellant company, due to accident the vehicle damaged and estimate was given to the tune of Rs.89,387-00. But this appellant has rejected the claim dated 27-4-2011. On the ground that the complainant has violated the policy condition no.8 and it was not fulfilled. Against which the complainant filed the complaint alleging deficiency of service and prays for settlement of the own damage claim.
3. After issuance of notice, the appellant/respondent appeared through his counsel and contended before the District Commission that the complainant has not informed with respect to the claim made from the previous policy towards own damage and at the time of taking this policy from this appellant has not disclosed the said claim and obtained no claim bonus. Hence he has obtained the policy by misrepresentation of facts, therefore repudiated the claim and submits there is no deficiency of service on their part.
4. After trial, the District Commission allowed the complaint and directed the Opposite Party to reconsider the claim, against which the appellant before this commission.
5. Heard from both sides.
6. On going through the certified copy of the order, memorandum of appeal and other documents produced before District Commission, there is no dispute that as on the date of accident the policy was valid, which obtained from Opposite Party Company and it is also not dispute that the complainant had previously obtained the policy towards his vehicle from the Bajaj Allianz Insurance Co. Ltd the only dispute raised by the Opposite Party to settle the claim is that the complainant has not given information with respect to the claim made in previous policy and by misrepresentation had obtained policy stating that he had obtained by claiming no claim bonus. Hence violated clause 8 of the policy and repudiated the claim.
7. We noticed here that after the information with respect of the accident this appellant has appointed IRDA approved surveyor to assess the loss after inspection, the said surveyor assessed the loss to the tune of Rs.35,531-00 even though the loss assessed by surveyor, they have repudiated the claim as the complainant made misrepresentation of the fact at the time of obtaining the policy hence submits no deficiency of service in spite of that the District Commission allowed the complaint and prays for dismissal of the complaint itself. We are of the opinion that mere not informing the claim made earlier to obtaining this insurance policy is not amounts any violation of terms of conditions of the policy. Of course, we agree the complainant had received 20% of the no claim bonus from this appellant but that will not coming the way for settlement of own damages. It is admitted fact that as on date of obtaining the policy the complainant has served previous policy which was issued by Bajaj Allianz General Insurance Co. Ltd. and it is mandate on the part appellant to notice whether the complainant had obtained no claim bonus or claim was made. In the absence of such, we cannot with hold the claim made for own damages of the vehicle is violation of conditions of the policy. The District Commission has rightly appreciated the evidence of both parties and the documents before the District Commission allowed the complaint. We found that there is deficiency of service on the part of the Opposite Party in not settling the claim of the complainant. Of course, they would have deducted 20% of amount which was provided under no claim bonus at the time of settlement own damage claim and It is noticed that, the surveyor had assessed the loss to the tune of Rs.35,531-00. Hence, the complainant is entitled to get an amount of Rs.35,531-00 as suggested in the survey report towards own damage claim and accordingly the order passed by the District Commission is hereby modified as under;
:ORDER:
The Opposite Party is directed to settle the claim to the tune of Rs.35,531-00 by deducting 20% of no claim bonus which was provided at the time of issue of policy to the complainant along with litigation expenses of Rs.10,000-00 and accordingly the appeal is disposed of.
The amount in deposit shall be transmitted to the District commission for needful action.
Send a copy of this order to both parties as well as Concerned District Commission.
Member. Judicial Member.
