:    J U D G M E N T    :

The brief fact of the case is that the complainant insured the vehicle being No.WB-51A/6601 (Sumo Gold) with the OP Insurance Company being policy No. 10004/31/13/053919 (package policy) covering the period from 26.02.2013 to 25.02.2014.  Unfortunately the said vehicle met with an accident on 15.12.2013 at about 09.00 pm on Basnia Road, P.S. Tehatta within the Dist. Nadia.  Information was given to the OPs / Insurance Company.  After accident, the said vehicle was repaired at T.C. Motors Pvt. Ltd. i.e., Tata Motors work shop at a cost of Rs. 2,43,036/-.  The complainant has claimed the said amount of Rs. 2,43,036/- but the OPs / Insurance Company informed that they would pay the said amount after getting the final bill but not before that.  T.C. Motors, the authorized service centre asked for amount from complainant for repairing works of the said vehicle & to that effect the complainant was bound to take loan from open market and paid the demand of T.C. Motors.  Thereafter the T.C. Motors delivered the vehicle to the complainant.  But the OPs / Insurance Company repudiated the claim of the complainant by letter dtd.11.06.2014 on the ground of non-supply of some documents from the end of complainant.  But the complainant stated that he submitted all required documents in the office of OPs / Insurance Company on earlier occasion. The O.P.s/ Insurance Company has tried to escape from their liability.  There is a clear gross negligence & deficiency in service on the part of OPs / Insurance Company.  Hence, the claim has brought by the complainant before the Forum for proper redressal.

            As per order No. 6 dtd.  05.08.15.  It is clear that written version has already been filed by OP / Insurance Company.  So it is revealed that the OP / Insurance Company contested their case by filing written version stating, inter alia, that the complainant provided false statement by way of mentioning the address of OP No. 2 i.e., at Krishnagar within the district of Nadia for the purpose of bringing territorial jurisdiction.  Therefore, the complaint itself is not maintainable.  The OPs also stated that they informed the complainant to submit particular documents like final bill, discharge voucher, Driving licence etc. but after repeated requests vide registered letter dtd.  24.01.2014, 27.02.2014, 25.03.2014, nothing was produced by the complainant.  An inspection was held.  The surveyor prepared a report and assessed lose of Rs. 1,27,627/- as per legal norms of the policy.  The complainant has failed to comply the terms & conditions of the said policy and as such the OP / Insurance Company closed the said file on 11.06.2014.  There is no negligence / deficiency in service on the part of the OPs / Insurance Company.  So the case is liable to be rejected with cost. Though there is no step on behalf of OP / Insurance Company on 10.12.2015, the case has been fixed for ex parte hearing. On 07.01.2016 heard the ld. counsel for complainant, but we have considered their written version filed by the OP / Insurance Company.

Now the Forum is to consider the following points:-

1. Whether the complainant is to be treated as consumer or not as per 

Consumer Protection Act 1986.

2. Whether the case is maintainable or not.
3. Whether there is any gross negligence or deficiency in service on the part of OP or not,
4. Whether the complainant is entitled to get any relief as prayed for.

            DECISION WITH REASONS

Point No. 1.

            It is admitted that the complainant, Sri Sandip Ghosh has obtained a package policy being No. 10004/31/13/053919 from the OPs / Insurance Company on 21.05.2013 covering the endorsement effective on and from 21.05.2013 to midnight  of 25.02.2014 after payment of necessary premium amount of Rs. 1803/- in the office of OPs / Insurance Company and to that effect the OPs / Insurance Company issued the said policy to the complainant.  So the OPs / Insurance Company both are service providers & the complainant is to be treated as consumer as per Consumer Protection Act, 1986. 

Point No. 2:

            The Branch office of OPs/Insurance Company, Shriram General Industrial Co. Ltd. is situated at Krishnagar, Nadia, which is within the local limit of jurisdiction of this Forum and furthermore that OP No. 1 informed “no claim” to the complainant with address of Birpur, Bethuadahari, Nadia by the letter dtd.  11.06.2014, wherein the cause of action partly arises in Dist. Nadia.  In view of above observation and as per Sec. 11 of Consumer Protection Act, 1986, the District Forum, Nadia has exclusive power to try the case.  So the case is maintainable in this present Forum.  

Point Nos. 3 & 4

At first now, we try to know the basic feature of the package policy in the eye of law.  This policy is also known as comprehensive policy.  The said policy covers all types of risks.  It also includes the risk of the property (i.e., the vehicle), risk of life of the insured as well as risk of body injury of the insured while the vehicle is running and lastly the third Party risks.  So from the above analysis it is clear that the comprehensive / package policy covers the following:-

1. Risk of property damage (damage of vehicle)
2. Risk of body injury.
3. Death risk
4. Third Party risk
5. Repairing charge
6. Medical expenses etc.

            But at the time of accident, the driver of the vehicle must bear valid driving licence, otherwise the insurance company is not liable to pay any compensation / loss / damage, which is called general exceptions.  Policy is admitted.  The  year of manufacture of the vehicle is 2013 and the said vehicle is new one covering the period of insurance on & term 26.02.2013 to 25.02.2014 in respect of registration of vehicle being No. WB /51A/6601, which is clearly revealed from policy certificate.  The registration is valid upto 03.03.2015 which is also clearly revealed from certificate of Registration.  We have perused the tax token regarding vehicle No. WB/51A/6601, wherein it is clear that road tax was paid on 05.12.2013 which would be expired on 05.03.2014  i.e., the said tax token was in force up to the said date i.e., 05.03.2014.

            Thereafter, we have perused tax invoice (not valid as a money receipt) issued by T.C. Motors Pvt. Ltd..  From the said document, it is clear that the vehicle being No. WB/51A/6601 has been repaired in the work Shop of T.C. Motors and for that purpose a bill amount of Rs. 2,43,036/- has been raised.  Complainant, Sandip Ghosh paid the following amounts in respect of vehicle service & to that effect T.C. Motors Pvt. Ltd. issued the receipts in favour of complainant.

            Though as per receipts, it is clear that the complainant paid Rs. 2,38,000/- regarding repairing charge, yet as per tax invoice, it is clear that all charge amounting to Rs. 2,43,036/- has already been paid for repairing charge of vehicle.

            Now, we have perused the driving licence bearing No. WB/5120040020343 which is an essential ingredients regarding valid claim of complainant.  After perusing the said DL it is clear that the licence is in force at the time of accident as it is valid for the period from 01.01.2004 to 16.01.2015.  It is also fact that the alleged vehicle met with an accident and to that effect Tehatta P.S. case No. 903/13 dtd.  16.12.13 has been started. From the said accident, the damage was caused and as per package policy, the OPs/Insurance Company is bound to pay the amount of repairing charges to the complainant as the insurance policy is an agreement between the parties which is based on the principle of Ube Rima Fide i.e. utmost good faith.

In this context it is pertinent to cite the observation of Hon’ble Apex Court in the casae of Bimal Krishna Bose Vs. United India Insurance Co. Ltd. and others, reported in III (2001) CPJ 10 (SC). The Hon'ble’ble Supreme Court had observed in the following manner :

1. That the Insurance Companies are “state” within the meaning of article 12 of the Constitution of India and they are expected to act fairly and reasonably.

2)That the Insurance Companies are required to satisfy the requirement of reasonableness and fairness while dealing with customer. They must not take any irrelevant and extraneous consideration while arriving to a decision. Arbitrariness should not appear in their actions or decisions.    

So from the above observation we have come into conclusion  that the case has a strong stand to believe the truth of the event.  The repudiation by letter dtd.11.06.2014 is baseless & has no basis at all causing gross negligence & deficiency in service on the part of O.Ps/Insurance Company.  The complainant is entitled to get Rs. 2,43,036/- from OPs/Insurance Company as  the said amount does not exceed the revised sum insured / IDV of vehicle of Rs. 6,25,000/-.  So the case succeeds.

            Hence,

Ordered,

                        That the case CC/2015/59 be and the same is allowed on contest against OPs/Insurance Company with cost of Rs. 2,000/-

                        That the OP / Insurance Company is directed to pay awarded amount of Rs. 2,43,036/- + cost of Rs. 2000/- i.e., 2,45,036/- to the complainant within 30 days from the date of judgment, in default, the interest @ 10% p.a. shall be charged upon the aforesaid amount till full realization.

            Let the copy of this order be supplied to the parties free of cost.