O R D E R
By Dr.K.Radhakrishnan Nair , Member :
Complainant’s case is that his vehicle having the reg.No.KL-07-AY-6136 Accent 2005 model petrol met with an accident on 17/2/2013 at 2.30am at Mannuthy Bypass junction while coming from Ernakulam. The accident occurred in the wink of an eye by hitting a lorry ahead due to its sudden break. The vehicle was insured with the 1st OP. After accident the offending lorry went away without stopping. The damaged vehicle produced before the workshop on 18/2/13. Workshop name is K.T.C Hundai Puzhakkal. Claim intimation was given to the opposite party and a surveyor was deputed and assessed the loss. After a week repair was completed and returned the vehicle on 12/3/13. An amount of Rs.45,576/-was given to the repairer. On lodging the insurance claim opposite parties have informed that complainant is not entitled to get the claim. Complainant alleges that the above acts of the opposite parties tantamount to deficiency in service and are liable to compensate the complainant for financial loss and mental agony and they may be directed to settle the claim and also pay Rs.1,00,000/- towards compensation and costs as well.
2.Admitted the case, issued notice to opposite parties. Opposite parties have appeared before the Forum through counsel and filed version. As objected, opposite parties deny the alleged accident and resultant damage to the vehicle. As further stated, the pre inspection photographs have revealed that the complainant’s vehicle was having the same damages earlier. As such, those damage cannot be considered being pre-existing in nature. Complaint is filed with a malafide intention to grab money from the opposite parties. There is no deficiency in service on the part of opposite parties. Complaint may be dismissed with costs.
3. Then the case posted for evidence. The points for consideration are the following:
1)Is there any deficiency in service on the part of opposite parties?
2)If yes, what are the reliefs and costs ?
4.Both parties appeared before the Forum and filed proof affidavits, documents, argument notes and tendered oral evidence. Complainant produced four documents and marked as Exts.P1 to P4 and from the side of opposite parties five documents are produced and marked as Exts.R1 to R5. Ext.P1 – cash invoice for Rs.45,576/-, Ext.P2 – rejection letter dt. 19/3/2013, Ext.P3 – RC book,Ext.P4 – insurance policy. Ext.R1 – certificate of insurance cum policy schedule,Ext.R2 – motor insurance claim form, Ext.R3 pre inspection report dt. 7/2/2013, Ext.R4 – surveyor’s report, Ext.R5 – rejection letter. From the side of opposite party surveyors were examined. Their depositions are marked as RW1&RW2.
5.Appreciation of evidence : We have examined proof affidavits, documents submitted and marked by both parties, argument notes, deposition of RW1 and the points raised during the final hearing and are convinced that there is deficiency in service on the part of opposite parties. In the absence of cogent contra evidence establishing the pre inspection report by examining the surveyor who had pre inspected the vehicle and reported we are unable to give any weight to Ext.R4. Opposite parties could have taken more cautious steps attaching a separate sheet or annexure with policy certificate mentioning those items which are not considered while considering any future claim Since we are bound by the terms and conditions of the policy being the contract entered into between them must specify everything. In the instant case, the question of liability rather than the quantum of loss is the main enquiry in order to fix the aspect of deficiency in service.
6.Therefore the rejection of the claim is without any cogent or genuine grounds The deposition of RW1 could not throw much light on those aspect. On meticulously examining the complaint, statements and depositions we are convinced that complainant’s case is a valid one and its rejection amounts to deficiency in service.
7.Relief and Cost: We direct the opposite parties to settle the claim on nonstandard basis as per India Motor Tariff since we have found the liability on opposite parties. No compensation or costs are allowed. Compliance of the order must be made within 30 days from the receipt of a copy of this order. Complaint allowed partly.
Dictated to the Confidential Assistant, transcribed by her, corrected by me and pronounced in the open Commission this the 31st day of March 2021.
Sd/- Sd/- Sd/-
Sreeja.S Dr.K.Radhakrishnan Nair C.T.Sabu
Member Member President
Appendix
Complainant’s Exhibits
Ext.P1 – cash invoice for Rs.45,576/-, Ext.P2 – rejection letter dt. 19/3/2013, Ext.P3 – RC book,Ext.P4 – insurance policy
Opposite Party’s Exhibits
Ext.R1 – certificate of insurance cum policy schedule,Ext.R2 – motor insurance claim form, Ext.R3 pre inspection report dt. 7/2/2013, Ext.R4 – surveyor’s report, Ext.R5 – rejection letter
Opposite Party’s witnesses
RW1 – Jose N Mathew
RW2 - Raja.A
Id/-
Member
