Final Order / Judgement
(Dated : 29/04/ 2022)
Passed by Shri.Atul Alsi, Hon’ble President.
1. The complainant owns a four wheeler Hundai Creta Plus SUV Car bearing No.MH-31, FA-3700 which he got insured with the OP No.2 under Zero depreciation policy bearing No.3001/202644493/00/B00 for the period from 27/07/2020 to 26/07/2021. On 14/08/2020, while the complainant, alongwith his driver, was returning from Warora to Chandrapur by the said vehicle, one wild bore came in front of running vehicle due to which the complainant’s vehicle met with an accident and sustained extensive damage. However, in the accident, the complainant as well as his driver luckily survived due to airbags installed in the vehicle. The matter was immediately reported to Police Station, Bhadravati, Distt.Chandrapur who, in turn, registered Crime No.41/20 and the police also conducted spot panchanama of the accidented vehicle. The accrual of accident was also intimated to the OP No.2 Insurance company. Then the vehicle was brought for repairs by towing to the authorized workshop Ketan Hundai. The OP No.2 appointed surveyor who inspected the complainant’s vehicle. The complainant submitted all relevant documents to the surveyor. The complainant then filed his claim alongwith requisite documents with the OP Insurance Company, however, the OP repudiated the same vide their repudiation letter dated 10/12/2020 for the reason of misrepresentation of facts and change of vehicle. The complainant issued legal notice dated 28/12/2020 to the OP through his Advocate, but the OP did not comply the same, which resulted into filing of instant petition. The complainant has prayed for insurance claim amount of Rs.12,03,664/- under Zero% depreciation coverage alongwith interest @18% p.a. besides Rs.6500/ towards towing charges of vehicle, Rs.1 lac towards compensation for mental and physical torture and Rs.50,000/- towards cost of litigation.
2. After admission of the complaint, notices were served on OP Nos.1 & 2. On receipt of the notice, both the opposite parties appeared before the Commission through their counsel and filed their common reply to the complaint. They have admitted the insurance of the complainant’s vehicle, however, they denied all the adverse allegations levelled against them. They submitted that immediately after receiving the intimation about accrual of accident, they had appointed Mr. Modi as surveyor. Said surveyor, after conducting spot inspection, submitted his report that there is misrepresentation of facts and the accidented vehicle has been changed for claiming insurance benefits. Surveyor being an independent person, his report is binding on the Insurance company, and hence the OP insurance company rejected the insurance claim. That being so, there is no negligence or deficiency in service on their part and the complaint deserves to be dismissed.
3. The counsel for complainant argued that rejection of his insurance claim under Zero depreciation policy on the ground of misrepresentation of facts and change of vehicle, without attributing any evidence for the same, amounts to deficiency in service. Therefore the complainant is entitled for entire estimated repair charges of Rs.12,03,664/- besides other reliefs claimed.
4. The counsel for Ops argued that as per surveyor’s report, and considering the the manner and mode of accrual of accident, it does not support the story of accident put forth by the complainant. Therefore, rejection of his claim on the ground referred to above is justified and it does not constitute deficiency in service.
5. We have gone through the complaint, documents and the affidavit filed by the complainant so also the written version, affidavit and supporting documents filed by the OPs. After careful scrutiny of the documents filed on record and after hearing both the sides, we record our findings in respect of the allegation of deficiency in service, as follows..
REASONING
5. It is an admitted position that the Four wheeler Hundai Creta Plus SUV Car bearing No.MH-31, FA-3700 owned by the complainant was insured with the OPs under Zero depreciation policy bearing No.3001/202644493/00/B00 for the period from 27/07/2020 to 26/07/2021. Said vehicle met with an accident on 14/08/2020, while the complainant was returning from Warora to Chandrapur, with his driver, and sustained damage. However, in the accident, the complainant as well as his driver luckily survived due to airbags installed in the vehicle. The dispute arose when the OP insurance company repudiated the insurance claim on the ground of misrepresentation of facts and change of vehicle by the complainant to get the claim. For this, the OP has put reliance on the surveyor report of Mr.Modi. However, the OP Insurance company failed to support its contention by filing evidence on affidavit of Surveyor Mr.Modi on record. Therefore the contents of Surveyor’s report has not been proved by O.P. On the other hand, the Crime details form and the Spot Panchnama report supports the version of the accident as stated by the complainant. These documents are filed by the complainant on record at Exh.4/3 vide list of documents dated 22/2/2021. The accident is an unexpected untoward incident which can not be predicted nor its impact can be imagined. Even in ghastly mishaps involving extensive damages, people survive without sustaining a scar. So, adjudging bonafides of accrual of an accident on the basis of its impact, is an erroneous and futile endeavor. The allegation of change of vehicle and misrepresentation of facts by the complainant are not proved by the OP by adducing cogent evidence. Hence considering these facts, we have no hesitation in holding the virsion of the complainant about accrual of accident to be true. However, it is pertinent to note here that the complainant has filed only the estimate of repairs and not the bills of actual repairs. Considering this fact, we are inclined to grant the claim of the complainant on non standard basis i.e. 75% of the IDV value that is 9,50,000/- amounted tp Rs. 7,12,500/- under the policy, without granting any interest, compensation and cost of litigation. Hence we proceed to allow the petition partly, as per following order.
Final Order
- The complaint bearing No. CC/21/42 is partly allowed.
- OP Nos.1 & 2 shall jointly or severally pay 75% of IDV Value that Rs. 9,50,000/- of the policy amounted to Rs. 7,12,500/- to the complainant towards his insurance claim on non standard basis.
- Parties to bear their own costs.
(MRS. Kalpana Jangade(Kute) (MRS. Kirti Vaidya (Gadgil)] (MR. Atul D.Alsi)
HON'BLE MEMBER HON'BLE MEMBER HON'BLE PRESIDENT
