BEFORE THE DISTRICT CONSUMER

DISPUTES REDRESSAL FORUM, DHARWAD.

COMPLAINT NO.320/2015

Date: 23^rd day of May, 2017

P r e s e n t:

Smt.C.H.SamiunnisaAbrar, B.A., LLB   :  President

Sri.B.S.Keri, B.A., LLB (Spl)                  :   Member

Opposite Party      :-1.    ICICI Lombard General Insurance Co.

                                        Ltd., Branch Office, Bellad & Co.,

                                        II Floor, Gokul Road, Hubli-580030

                                        Rep. By its Branch Manager

                                        (Rep by Shri. N.C.Kolloori Adv.)

                                2.     Revankar Motors Pvt. Ltd., Maruti

                                        Suzuki Authority Dealer T.B. Road, Deshpande Nagar, Hubli-29 Rep. by its Manager

                                        (Exparte)

                                3.     RNS Motors Ltd., Authorised Dealers for Maruti Vehicles Unakal, Hubballi-25 rep by Gereral Manager

                                        (Rep by Shri. B.S.Hosakeri Adv.)

JUDGEMENT DELIVERED BY

SMT.C.H.SAMIUNNISA ABRAR, PRESIDENT:

The complainant has filed this Complaint against the Opposite Parties (herein after referred in short as OPs) u/s 12 of Consumer Protection Act, 1986 alleging deficiency in service against OPS.

2.    The brief fact of the case is that the Complainant hold a car swift D VD I.  The said vehicle bearing No. KA-25/Z-8068 the said car was insured with OP No.1 which was in forced from 11/2/2015 to 10/2/2015 and paid the premium of Rs.10,771/- policy bearing No.3001/MI-01849986/00/000.

3. On 25/4/2014 the complainant’s son Mr.Santosh while driving the car met with an accident while returning from Alnavar at Sharp Pink Curve where he lost the control suddenly an animal came in the middle of the road , as result the vehicle rolled over side of the road , but Mr.Santosh fortunately not got any major injurious . 

4. The said accident was reported to the Op No.1 and same was informed to the Alnavar Police. during the  communication to the OP , OP No.1 officials inform the complainants son that in case of no injuries to human being the complainant need not  go to the police without lodging the FIR the claim can be  filed.   After that the Alnavar police received a fine from the complainant’s son.  Thereafter immediately same has been informed to the OP No.2.  Op No.2 made arrangement for vehicle survey, as per the procedure the insurer has to carry out the necessary surveys through their authorized value and OP No.2 has assured that they on their own will take approval from Op No.1.

5.  Further complainant submits that the vehicle was insured under the cashless benefit policy scheme and complainant had submitted all the relevant documents and information to OP No1 for compensating the loss caused due to the accident.  Despite of fact that the policy is cashless policy, the complainant at the instance of Ops has paid the entire amount of Rs.3,50,315/- from her packet and a claim request submitted to Op No.1  .  Despite of the receipt of the claim application and documents Op did not communicate its decision after a long period a letter dtd. 24/9/2014 was issued stating that the claim was pending for want of document i.e., Clear Police Record mentioning correct date.   After clarification of the police again on 20/11/2014 Op issued a letter stating that claim is unprocessed as FIR has not been produced.   Thus OP No.1 expressed its inability to honor the claim.  The complainant filed the complaint against these OP in Complaint No.264/14 which has been withdrawn on 31/3/2015 with liberty to file the present complaint with same cause of action.    On 1/6/2015 the complainant has submitted the documents to Op No.1 company requesting to settle the claim.   But the request went in vain and OP not paid the claim amount. 

        6. Further the complainant submits that on 24/4/2014 the complainant has paid an amount for change of the name in insurance policy.  But Op No.2 had not forwarded the said letter.  Hence Op 1& 3 made deficiency in service, unfair trade practice.   

7. The predecessor on seat registered the complaint and notice was ordered as such Ops No.1 & 3 present, before the Forum and filed a respective Written Version on their behalf.  And OP No.2 remained absent.

Facts of Written Version of Op. No.1 & 3 as follows;

8. Both the admitted that the vehicle in question was insured with OP No.1 company and was inforce at the time of accident.  But the complainant has no insurable interest on the date of the accident.   And OP No.1 submitted that he had issued two reminder letters to submit proper documents to settle the claim.  On the other hand OP No.3 also submits that complainant has paid the amount to change the name of the complainant in insurance policy. But the complainant had not furnished any documents to proceed the claim process. Hence both the Ops prayed to dismiss the complaint. 

9.     In the background of the above said pleadings, the Complainant filed his affidavit and produced the documents. As follows.

10.   On the other hand, Op filed the Written Version and affidavit the following document produced the copy of the Insurance Policy on behalf of the OP.

11.   on perusal of above documents and arguments heard on both the sides, the points arises before us for adjudication are as follows:

1. Whether the Op made un-trade practice  

    and deficiency in service?

2. Whether the Op proves that the                         

    non process of claim is justifiable ?

3. Whether the Complainant is entitled for 

    relief?

 4. What Order?

Our Answer to the above Points are:

Point No.1–  Affirmative

Point No.2 –Negative

Point No.3;- Partly affirmative

Point No.4- As per the final order.

12.   On consideration of pleading, objection, evidence, documents and arguments of the parties, we answer the above points as under:

                                      REASONS

        13. Point No.1& 2: Since both the points are interlink and identical, hence we proceed both the points together. 

Complainant is the owner of a car bearing No. K.A.25/8068 insured from Op No.1 by paying premium of Rs.10,671/- .  The said vehicle met with an accident on 25/4/2014 and the vehicle rolled over side of the road but there were no injuries to the driver.  The accident was immediately reported to the OP No.1 (Insurance company) & Alnavar Police Station & said vehicle was shifted to OP No.2 who arranged a survey.

14. The complainant submitted the claim form and relevant   documents to the OP No.1 but OP No.1 kept the claim unprocessed stating that complainant had failed to produce a FIR. The said vehicle was repaired by the authorized service center of Maruthi Suzuki  (Revenkar Motors  Pvt. Ltd. (OP No.2) at the cost of Rs;3,50,315/- .  The OP No.1 had not made the payment despite the fact that it was cashless policy, so the complainant made the payment to OP No.2 & approached OP No.1 to make the payment.

15. The disputed fact in the case is that the Op had not processed the claim stating that ‘the claim is unprocessed   as FIR had not produced’’. On careful perusal of the documents on record we found that the vehicle was driven by the son of the complainant on 25/04/2014, while the accident occurred the matter was informed to the police. Hence there was no human injury or damage to the third party vehicle, the police had collected a fine of Rs.500/- for rash and negligent driving from the driver, the document No C-3 clears that. Hence there is no injury to any person, the police had not lodged a FIR.

16. The OP No.1 had not processed the claim only for the reason that FIR had not been produced. It is not mandatory that the claim like these cases where the FIR is not necessary and also how can an insured produced FIR. Whereas the police was not ready to register the FIR to prove an evidentiary document for the place, time and date of the accident, a fine receipt is more enough. It has been contended by learned counsel for OP No.1 that the complainant have no insurable interest.  Hence the policy had not been transferred in her name.  Here we have to look after that the nature of the transfer of the vehicle, the said vehicle was transferred in the name of complainant due to the death of the prior owner who was the husband of the complainant.   After the transfer of vehicle the complainant had paid the amount of Rs.56/- for the transfer of Insurance policy in her name, to Op No.3 who is an Agent of OP No.1.

17. The OP No.3 in his contention submitted that due to the non-production of relevant documents from the complainant the transfer application had not been processed, it is very hard to accept that OP No.3 had received the fee of Rs.56/- from the complainant for the transfer of Insurance Policy in the name of the complainant without relevant documents, how can a company blindly receive the amount (Document No C-16) clears that.

18. Moreover the prior owner of the vehicle had nominated his son Mr.Santosh who was driving the said vehicle at the time of accident.  Hence the Op No.1 cannot reject the claim file blindly stating that the file was un processed due to non-production of FIR, since we are in view that OP No.1 & 2 had made deficiency in service and un trade practice. Hence we answer point No.1 in affirmative and point No.2 in negative.

19. Point No.3:- In view of the above finding we are in a consideration that complainant is liable for claim of Rs.3,50,315/- along with interest.  Hence we answer point No.3 in partly affirmative. 

20. POINT No.4:  For the reasons and discussion made above and finding on the above points, we proceed to pass following: 

-: ORDER:-

1.  OP No.1 is directed to pay Rs.3,50,315/- (Rupees Three       

     lakh fifty thousand three hundred fifteen only)  to the

     complainant   along with interest at 6% from the date of

     filing of this complaint. 

        2. OP No.3 is directed to pay a compensation of Rs.10,000/-

            (Rupees ten thousand only) towards mental agony &          

            harassment & Rs;1,000/- towards litigation charges to the

            complaint within one month.

        3. Further Op No.1 is directed to pay the above claim amount  

            within 45 days , failing which Op is liable  to pay interest @

            9% p.a. till realization.

        4. Send the copies of this Order to the parties free of cost.