Date of Filing: 01/01/2016
Date of Order: 19/12/2017
ORDER
BY SRI.SYED ANSER KHALEEM, PRESIDENT
1. This is the complaint filed under section 12 of the C.P. Act 1986 alleging the deficiency in service against the opposite party (herein after referred as O.P) and prays for orders to direct the O.P to allow the complainant by awarding Rs.66,295/- towards claim made as per the insurance policy and to pay additional damage of Rs.25,000/- for causing mental agony and to grant such other relief that this Forum deems fit.
2. The facts in brief are that the complainant is the owner of the Toyota Etios Car bearing No.KA-02-AD-3839 and insured with O.P on 30.04.2015 by collecting premium amount of Rs.21,620/- from the complainant and the O.P issued insurance certificate vide policy No.P0016300022/4103/100064 for the period from 30.04.2015 to 29.04.2016. It is stated that the complainant had met with an accident on 26.11.2015 and the complainant registered the complaint with the jurisdictional police on the same day. Further states that the complainant left his car for repair at Ravindu Motors Pvt. Ltd., and also submitted his claim form with the O.P and the service center provided the estimate cost bill towards the claim made by the complainant. Further states that the O.P refused to honour the claim made by the complainant on flimsy ground of taking into consideration of earlier claim made by the complainant on policy issued by Reliance Insurance Company. Further states that the complainant did not get the benefits of the insurance policy and had to pay Rs.6000/- getting his insured car repaired and insurance certificate issued by the O.P for the period of one year. Further states that the O.P Company had verified all the antecedents and issued the said policy and are bound by the policy after collecting the premium from the complainant. Further states that the O.P even after issuing the policy did not notified any flaws against the complainant for more than seven months but after the complainant made a claim the O.P who are bound by the policy but issued a frivolous replay declined to honour the policy. Hence this complaint.
3. Upon issuance of the notice O.Ps entered appearance through its counsel and filed its version. It is contended that, complainant has not approached this Forum with clean hands and she has violated basis terms and conditions of the policy i.e. the fact of claim made by her with previous insurer i.e. Reliance General Insurance Co. Ltd. While obtaining the policy of insurance from the O.P on 30.4.2015, it is contended that complainant obtained no claim bonus of amounting to Rs. 2,263.61 at the time of obtaining the policy from the O.P and has not informed the O.P with regard to the previous claim made by her in the previous policy with the Reliance General Insurance Co. Ltd and got deduction of Rs.2,263.61, while obtaining the fresh policy from the O.P. the earlier policy is for the period from 30.4.2014 to 29.04.2015 in respect of her car bearing Reg. No. KA 02 AD 3839 and subsequently insured the said vehicle with the O.P and period of validity of insurance is from 30.04.2015 to 29.04.2016. It is contended that the complainant did not disclose the fact of the claim made by her with previous insurer and got obtained the benefit of no claim bonus. It is contended that when the complainant’s car met with an accident on 26.11.2015 and the claim was registered and processed by the O.P, while processing the claim the O.P came to know that the complainant avail 20% of no claim bonus in the policy obtained from the O.P against previous policy and based on the declaration given by the complainant the O.P provided 20% of no claim bonus and the complainant has taken claim in the previous policy with Reliance General Insurance Co. Ltd., and the complaint has suppressed the fact and it is breach of violation of condition No.8 of the Motor Insurance Policy. Further the O.P denied all the allegations made in the complaint and with the above grounds finally prays for dismissal of the complaint with cost.
4. In order to substantiate the case of the parties and both parties filed their affidavit evidence and we also heard the arguments.
5. On the basis of the pleadings of the parties, the following points will arise for our considerations are:-
(A) Whether the complainant has proved
deficiency in service on the part of the O.P?
(B) Whether the complainant is entitled to
the relief prayed for in the complaint?
(C) What order?
6. Our answers to the above points are:-
POINT (A) & (B): In the Negative.
POINT (C): As per the final order
for the following:
REASONS
POINT No. (A) & (B):-
7. On perusal of the rival pleadings of the parties it is not in dispute that the complainant had insured her car bearing Reg. No. KA 02 AD 3839 with the O.P and the period of the said policy commences from 30.04.2015 to 29.04.2016. It is also not in dispute that the complainant earlier insured her vehicle with the Reliance General insurance Co. Ltd., and had obtained the no claim bonus facility from the O.P while taking the fresh policy. It is also not in dispute that the complainant met with an accident and the complainant lodged the claim papers with the O.P and the O.P repudiated the claim on the ground of earlier claiming from the previous insurer and availed the benefit of no claim bonus.
8. The crux of the matter is to consider whether the O.P is justified in repudiating the claim made by the complainant.
9. On perusing the affidavit evidence filed by the complainant it discloses that complainant nowhere denied the taking the benefit of no claim bonus while taking the policy from the O.P. Further on perusing the Document produced by the O.P it is evident that complainant earlier insured her car with the Reliance General Insurance Co. Ltd. and the policy was in force from 30.04.2015 to 29.04.2016 and it clearly discloses that complainant availed the discount under own damage section i.e. No claim bonus 20% to an extent of Rs.2,063.61. It is worth to note that the policy in question issued as per the information given by the complainant alone and hence it is her duty to disclose all material facts to the O.P while obtaining the insurance. As we know that insurance is a contract based on the principle of uberrime-fidei i.e. utmost good faith and hence both parties to the insurance contract should act in an utmost good faith. On the basis of available evidence on record, complainant suppressed the fact of earlier insurance policy while insuring her car with the O.P and got obtained the benefit of no claim bonus it is as good as suppression of material facts. On perusal of the letter dated 15.12.2015 addressed to the complainant, it is clearly mentioned that the complainant has availed 20% of no claim bonus with the O.P at the time of renewal from Magma HDI General Insurance Co. Ltd. against previous policy of M/s. Reliance General Insurance co. Ltd., Hence the repudiation of the claim by the O.P is justifiable one. The O.P also relied on the reported decision of Hon’ble National Commission i.e. TATA AIG General Insurance Co. Ltd. Vs. Gulzari Singh in Revision Petition No.1255 /2009 decided on 26.02.2010 and on perusal of the above said decision, wherein, it is held that while giving the statement at the time of obtaining the policy found to be untrue and inaccurate and all the benefits under the policy will stand forfeited, it cannot be held that complainant would not be entitled to the benefit under policy. The ratio of the above decision is aptly applicable to the present case on hand. In the light of above discussion we reach to the conclusion that the complainant failed to prove deficiency in service on the part of the O.P. and hence she is entitled for the relief as sought in the complaint. Accordingly we answered these points in the Negative.
POINT (C):
10. On the basis of answering the points (A) and (B) and in the result, we proceed to pass the following:-
ORDER
- The complaint is hereby dismissed. No order as to cost.
- Send a copy of this order to both parties free of cost.
(Dictated to the Stenographer, transcribed and computerized by him, corrected and then pronounced by us in the Open Forum on this the 19th Day of December 2017)
MEMBER MEMBER PRESIDENT
*RAK
