The brief facts of the case is that the complainant is the owner of a car bearing registration No.OD-02AZ-1052. The complainant insured the said vehicle under Op1 which was valid from 10.02.2021, 00.01 hours to 09.02.2022 midnight. The said vehicle met with an accident on dtd.14.03.2021 at Sadha Chhaka with a truck. The said vehicle was damaged from the front side. The matter was informed to the Ops but Op1 rejected the claim of complainant on the ground that the complainant has submitted edited policy to obtain insurance coverage. But according to complainant there is no mistake done by the complainant. But Op1 and 2 have made mistake which caused deficiency in service. Op3 has granted receipt of Rs.1,51,758/- towards repair of vehicle. The Op insurance company declined to make payment. So the complainant prayed for payment of the claim amount Rs.1,51,758/- along with Rs.10,000/- for mental agony and Rs.5,000/- towards litigation cost.
The complainant relied on the following documents to prove his case:-
- RC Book of the vehicle bearing Regd. No. OD-02AZ-1052 (Photocopy)
- Insurance policy (Photocopy)
- Representation made by complainant to grievance officer, HDFC ERGO. (Photocopy)
- Rejection letter of Motor Accident claim C230020435718. (Photocopy)
- Receipt dtd. 30.04.2021 of Rs. 1,36,500/- and Rs.5,683/- issued by Kumar Automobiles. (Photocopy)
- Receipt dtd. 02.07.2021 of Rs. 6,000/- issued by Kumar Automobiles. (Photocopy)
- Photo copy of whats app message with Pradeep Tripathy Op2.
- Photo copy of Whatsup message of payment to Pradip Tripathy of Rs.17,300/-
- Previous policy copy for the year 2018-19 of Royal Sundaram General Insurance Co. Ltd.(Photocopy)
Under the above situation the complain case is admitted and notice issued to Ops. Op1 and 3 appeared and filed their written version but Op2 did not appear and not filed any written version so Op2 was set Ex-parte.
Op1 insurance company submitted in its written version that the present complain petition is not maintainable the Hon’ble commission has no jurisdiction and the case is barred by law of limitation. It is submitted by Op1 that after receiving the intimation of occurrence these Ops had appointed an independent IRDA surveyor to inspect and assess the loss. It was found that during the proposal of insurance the complainant had declared the previous insurance details as being policy vide No.MDBL6110 with the insurer being Royal Sundaram General Insurance Co. Ltd and policy being valid from 10.02.2020 to 09.02.2021. But insurance company said that this policy was not issued from insurance company, the complainant had submitted edited policy copy so benefits of own damage shall be forfeited. The loss assessor had assessed the loss to the tune of Rs.1,35,000/-. It is also submitted that the policy issued by CSC Centre and that the said Opposite party No.2 is an agent of the answering opposite party is totally false and baseless since the CSC centre is a government appointed body and works under the Government as a nodal agency. So the claim of complainant is totally false and fabricated.
Op3 filed their written version, it is submitted by the Op3 that the complainant came with said vehicle bearing Regd. No. OD02AZ 1052 Maruti Suzuki Dizaire for repairing work. On dtd.30.04.2021 the vehicle was fully repaired by Op3 and repairing amount was Rs.1,45,758/- out of which Rs.1,32,000/- was paid by the petitioner there is no deficiency of service in part of Op2 so the allegation against Op2 be dismissed.
On the above pleadings following issues are framed to decide the case:-
- Whether the case is maintainable?
- Whether any cause of action arises on this case?
- Whether Ops have made any deficiency of service?
- Whether the complainant is entitled to get any relief sought for?
FINDINGS
It is admitted fact that the said vehicle met with accident on dtd.14.03.2021.The complainant intimated the matter to authorized dealer and insurance company. The insurance company appointed an independent IRDA surveyor to inspect and assess the loss. The surveyor assed the loss to the tune of Rs.1,35,000/-. After proper verification of the claim application the present insurance company Op1 HDFC ERGO General Insurance Company Ltd. repudiated the claim on the ground that the complainant had mentioned the previous Policy No as MDBL6110 with the insurer being Royal Sundaram General Insurance Co. Ltd and policy being valid from 10.02.2020 to 09.02.2021. In the proposal from the agent Op2 filled up the proposal form after verifying necessary documents. It is also admitted fact that the previous Policy No was MOBL116149 as per the policy certificate issued by Royal Sundaram General Insurance Company but in policy certificate issued by HDFC ERGO the previous policy No. was MDBL6110. Here question arises HDFC ERGO Insurance company issued the policy certificate in the name of Pravat Kumar Biswal for his vehicle OD-02AZ-1052 without verifying previous policy documents and simply rejected the claim as the previous policy was an edited policy. In this situation the agent Op2 has not properly verified the documents and made proposal form to issue an insurance policy certificate by Op1. During the time of claim Op1 raised this question which has no basis and only to harass the complainant. Op3 Kumar Automobiles repaired the damaged vehicle and the repaired amount was estimated up to Rs.1,45,758/- and Op3 has not made any deficiency of service. Op1 Insurance Company has not file any documents to prove his case. So this commission feels that Op1 and Op2 have made deficiency of service to complainant for which the complainant was mentally harassed and knocked the door of this commission to get justice. This case is maintainable and the cause of action arose on the day of accident. The complainant is entitled to get the relief sought for.
ORDER
The complain petition filed by the complainant is allowed on contest. Op1 and 2 are jointly and severally liable to pay Rs.1,35,000/- as claim amount as per survey report and Rs.10,000/- for mental agony and Rs.5,000/- for litigation cost.
Op1 and 2 are further directed to pay the total amount Rs.1,35,000+ Rs.10,000+ Rs.5,000= Rs.1,50,000/- to complainant within 45 days of receipt of this order and if Ops are failed to comply the order it shall carry 9% interest per annum from the date of filing of this case till realization.
