Per:  Akatha.H.D. 

JUDGMENT

            The Complainant has filed this complaint U/s 12 of the consumer protection Act 1986 against  the OP alleging deficiency of service in not settling the claim of the policy amount of Rs. 1,70,000/-. Hence prays for the relief to settle the Vehicle policy amount of Rs. 1, 70,000/- along with compensation of Rs. 50,000/- towards physical and mental agony and Rs. 50,000/- towards deficiency of service and Rs. 20,000/- towards the loss occurred to the complainant and Rs. 5,000/- towards miscellaneous and litigation expenses.

Brief averments of the complaint are:-

2)         That the complainant had purchased a lorry and was using it for earning his livelihood. The said vehicle was registered under No: KA27/A-1914. The vehicle was insured with a policy from the opponent. The details of the policy are policy No: 10003/31/ 15/177305. The commencement date of policy was on 20-07-2014 and had validity up to 19-07-2015. The sum assured of the insured vehicle is Rs. 99,952/- and it had premium of Rs. 16,671/-. The said vehicle met with an accident near Ron and the vehicle was damaged.

            The complainant further alleged that he informed the opponent about the accident and then the opponent sent their surveyor to examine the vehicle and after the surveyor examined the vehicle he got it repaired. The expenditure of the vehicle towards repair is Rs. 1, 70,000/- and the said amount was paid by the complainant and has obtained the receipts. The complainant further alleged  that  he did not received few of the receipts. The complainant has got repaired the said vehicle near Chitradurga with Zabi Body builders.

            The complainant further alleged that he informed about the repairs done and submitted the claim form along with the necessary documents.  On 19-9-2015 the opponent sent a letter to the complainant stating that towards the vehicle policy claim the OP will give only Rs. 17,000/- and asked them to sign the voucher. But the complainant did not agree to this.

            The complainant further alleged that the said vehicle was used by him for the purpose of earning his livelihood. But the opponent is telling that only Rs. 17,000/- will be given for claim amount is not justifiable. Hence the OP has committed unfair trade practice and deficiency of service.

            The complainant further averred that he had produced the photos of the vehicle damaged and also the bills of getting repaired the vehicle. The Opponent instead of giving full claim amount is saying that only Rs. 17,000/- will be given. Hence the Opponent has committed deficiency of service and hence filed this complainant praying for settling the vehicle policy claim amount of Rs. 17,000/-  along with Rs. 50,000/-  towards physical and mental agony and Rs. 50,000/- towards deficiency of service and Rs. 20,000/- towards the loss occurred to the complainant and Rs. 5,000/- towards miscellaneous and litigation expenses.      

3)         The forum after admitting the complaint, the notice was issued to the OP’s and the said notice was served upon him. The OP appeared through their counsel before the Forum and filed Vakalatnama and main objections to the complaint/Written Version and the said case was posted for the complainant evidence.

4)         The main objections/written version of the Opponent.

            That the OP submits that the complaint filed by the complainant against the respondents is false, frivolous and vexatious and far away from the truth and the same is not maintainable either in law or in facts. Hence, the same is fit to be dismissed.

That the OP further submits that the contents of Para No. 1 of the complaint are true and correct and hence, they are admitted.

That the OP further submits that the contents of Para No. 2 of the complaint are true and correct. It is true that, the complainant has purchased a lorry and the said vehicle has been used for his livelihood. It is further true that, the registration number is KA-27/A-1914 and same has been insured with respondent and the particulars of policy is policy No: 10003/31/15/177305 and validity of policy is from 20-07-2014 to 19-07-2015 and the insurance amount of Rs. 99,952/-/- and premium amount is Rs. 16,671/-.

That the OP further submits that, the contents of Para No. 3 of the complaint are false and baseless and hence, they are denied. It is false to state that, on 07-08-2015 the said vehicle has been subjected to accident near Ron and due to the said accident, the said vehicle damaged. Hence, the complainant is put to strict proof of the same.

That the OP further submits that, the contents of Para No. 4 of the complaint are false and baseless and hence, they are denied except the fact that, the respondent has sent surveyor to inspect the vehicle. It is false to state that, the complainant has informed this fact to the respondent. It is further false that, the complainant has spent Rs. 1,70,000/- and the said amount has been given by the complainant and has taken the receipts in that regard and it is further false that, he did not get some of the bills. It is further false to state that, the complainant got repaired his vehicle in Zabi Body Builders near Chitradurga. Hence, the complainant is put to strict proof of the same.

That the OP further submits that, the contents of Para No. 5 of the complainant are false and baseless and hence, they are denied. It is false to state that, the complainant has informed this matter to the respondent insurance branch and he has filled the claim form given by them and submitted the documents as asked by them. Later on the respondent on 19-09-2015 has issued a letter in favor of the complainant and they have stated that, they are giving only Rs. 17,000/- and asked to sign the voucher. It is further false that, for which the complainant did not agreed for the same. Hence, the complainant is put to strict proof of the same. Other contents of the Para No. 6 of the complaint are false and baseless and hence, they are denied.

That the OP further submits that, the contents of Para No. 7 of the complaint are false and baseless and hence, they are denied. As a matter of fact, this Hon’ble Forum has no jurisdiction to try this complaint.

True Facts of the Case:-

            That the OP further submits that, as per the version of the complaint, the alleged accident in question has occurred within the jurisdiction Ron Taluka which comes under the district of Gadag. Further the vehicle in question has been repaired in Chitradurga and the complainant has admitted for the same. Further the policy has been issued by the Jaipur branch of Rajasthan state. Hence, on all the above grounds, this Hon’ble Court has no jurisdiction to try this complaint. Hence, on this count also the complaint is fit to be dismissed

            That the OP further submits that, the complainant has not informed about the fact of accident, immediately after accident either to the concerned police authorities or to the respondent company. It is the mandatory of the complainant or owner of vehicle to inform about the fact of accident to the respondent within 24 hours of the accident. Further there are no criminal records to show that, the vehicle in question has subjected to accident. Hence, there is a doubt about the occurrence of the accident. Hence, on this count also, the complaint is to be dismissed with costs.

            That the OP further submits that there is a delay of 3 days in intimating the fact of accident to the respondent by the complainant. It is the mandatory duty of the complainant to inform about the fact of the accident to the respondent insurance company immediately after the accident. But, the complainant has not done so and he has informed this fact after 3 days of the accident. Hence, on this count also, the complaint is fit to be dismissed.

            That the OP further submits that, the complainant has not provided the insurance company surveyor to inspect the vehicle immediately after the accident and without providing opportunity; the complainant has started the repair work. Further, prior to the inspection by the respondent company surveyor, the parts of the vehicle have dismantled by the complainant. Hence, the complainant has violated the policy conditions. As per Section 1: Loss of or damage to the vehicle insured;

The insured my authorize the repair of the vehicle necessitated by damage for which the company may be liable under this policy provided that,

C) The insured shall give the company every assistance to see that, such repair is necessary and the charges are reasonable.

But, they said condition has been violated by the complainant. Hence, on this count also, the complaint is fit to be dismissed.

            That the OP further submits that, the bills produced by the complainant has no tin Number and the same are created only with a view to get the compensation and to garb money from the respondent insurance company. Hence, on this count also, the complaint is fit to be dismissed.

That the OP further submits that, the respondent company surveyor after making fully fledged survey has assessed the loss caused to the vehicle in question at Rs. 17,000/- and for the said amount, respondent company has issued the letter by stating that, they are ready to pay Rs. 17,0000/-. But, the complainant didn’t agree for the same. Hence, prays for the dismissal of the complaint with heavy cost.

5)         On the basis of the above pleadings, the following points that arise for our consideration are; 

POINTS

1)         Whether the complainant proves that there is deficiency of service in not settling the vehicle policy amount after the accident of the vehicle?

2)         Whether the complainant is entitled for any relief as sought for?

3)         What order?

6)         To prove the case of the complainant, the complainant himself examined as PW1 and has got marked documents as per Ex. A 1 to Ex. A 6 and closed their side evidence.  The OP himself examined as RW 1 and has got marked the documents as per Ex. B 1 to B 4 and closed their side of evidence and then posted for argument.

7)         Heard the arguments of the counsel and perused the records.

8)         Our findings on the above points are as under;

Point No. 1:  In the negative

Point No. 2:  In the negative

                  Point No.3:  As per final Order for the following

REASONS

9)         POINT No. 1 and 2:  As these issues are interconnected each other, hence they are taken together for common discussion to avoid repetition of facts, evidence, documents and arguments.

10)       On perusal of the pleadings, evidence coupled with the documents of respective parties on record, it is the case of the complainant alleging deficiency of service in not settling the claim of  vehicle policy claim amount of Rs. 1,70,000/-. There is also no dispute regarding that the policy had validity at the time of accident. There is also no dispute that the premium of the policy is not paid. The complainant approached the OP Company and claimed for the claim amount and submitted the claim form and necessary documents. But till today the OP Company has not settled the claim. Hence the complainant alleged deficiency of service. 

11)       To prove the case of the complainant, the PW1 has reiterated the complainant averments in his examination in chief and in support of his case he has produced the Insurance Bond of the vehicle and the said bond has been marked as Ex. A 4. Ex. A4 clearly reveals that this insurance policy was issued in the name of the complainant and the premium was paid and the said policy covered insurance from 20-07-215 and had validity up to midnight of 19-07-2016.

12)       As per Ex. A 1 the photos of the vehicle which was damaged, on perusal of the photos it is clear that vehicle was damaged and Ex. A 2 it is the claim discharge own satisfaction voucher where the OP Company has issued this letter to the complainant that Rs. 17,000/- will be given and Ex. A 3 is the claim cost confirmation further it is also admitted that the OP  had sent a letter to the complainant regarding to provide signed discharge voucher of Rs. 17,000/- and the same is marked as Ex.B2.

13)       Further, with respect to the vehicle accident the RW 1 has deposed as per their specific defense set up in their written version that the said vehicle has met with an accident near Ron and due to this accident, the said vehicle was damaged and to substantiate the same the complainant has produced 5 photos of the vehicle showing the damage which is marked as Ex. A 1. Further the complainant has not at all informed about the accident to the police authorities nor the OP Company. The complainant has not produced any of the documents to show that the vehicle was damaged in an accident. Further the document which have been relied by the complainant more specifically with respect to Ex. A 1 the photos of the damaged vehicle. Therefore, on perusal of the Ex. A 1 the photos. Where in only images of the vehicle can be seen, but whether the photos have been taken in an accident spot or no is not shown, this itself clearly goes to show that the clear picture of the accident spot is not shown in the complaint also. He has not produced any document to show that where the accident has occurred even in the interrogatories the complainant failed to answer the question No. 1 to 8 regarding the place of the accident further, he cannot say that the answering to those questions does not arises.   When he fails to depose with respect to the place of the accident, believing his the version with respect to the vehicle damage in the accident is not justifiable one. So also on perusal of the evidence of RW 1 he has submitted that the complainant has not provided the insurance company surveyor to inspect the vehicle immediately after the accident and without providing opportunity the complainant has started the  repair work. Further prior to the inspection by the respondent company surveyor the parts of the vehicle have been  dismantled by the complainant and the substantiate the same the opponent has produced the letter to the complainant stating that he has not given opportunity to inspect the vehicle immediately and started the repair work and the same is marked as Ex B-1. On perusal of Ex. B 1 it clearly shown that the complainant has violated the policy condition. The complainant has failed to answer the question No 10-13 regarding the intimation given to the OP Company for conducting the survey of the damaged vehicle. Therefore on perusal of Ex. B 1 which is a letter to the PW-1 that he has violated the policy condition for not giving an opportunity to survey the vehicle. Therefore it can be presumed that the complainant has not informed about the accident in time to the OP Company and has not given an opportunity to inspect the vehicle before getting repaired.

14)       Further PW 1 has a averred that the said vehicle was repaired in  Chitradurga by Zabi Body Builders and to substantiate the same the complainant has produced the bills and the said bills are marked as Ex. A 5 to Ex. A 6. On perusal of Ex. A 5 and Ex. A 6 it is the bill given by the Zabi Body Builders showing that the vehicle was repaired and it cost around to the tone of Rs. 1,94,700/-. The bill does not pertain Tin number or CST number in Ex. A 5 and as for as Ex. A 6 in the insurance report there is no specific mentioning of the tyre damaged looking to the bills produced by PW 1 the question of considering that the bills are original is not justifiable hence his version is not believable with respect to specific allegation that vehicle repair costs him with to the tone be of Rs. 1,70,000/-.

15)       The counsel for the complainant has relied upon the citation reported in IV (2009) CPJ 46 in Supreme Court of India, New India Assurance Complainant. Ltd. V/s Pradeep Kumar,

            Insurance Act, 1938 – Section 64UM(2) – Insurance – Assessment of loss – Pre-requisite for settlement of claim – Surveyor’s report not last and final word – It may be basis for settlement of claim but neither binding upon insurer nor insured – Complainant’s claim accepted by Consumer For a as duly supported by original vouchers, bills and receipts – No interference required in appeal.

            The facts and circumstances of the case in hand and the fact and circumstances of the said citations all together different. because with respect to the bills, the bills do not contain any tin number  or CST number.  The bills are written in a letter pad for which it cannot be treated as the valid bill for the repair of the vehicle. Therefore the present complainant filed by the complainant is no way helpful to him. Therefore the complainant fails to prove that the vehicle is damaged in an accident.

16)       Further during the course of arguments advanced by the counsel for the respondent they have much argued that the present complaint is also not maintainable because as per the complainant averment, the accident has taken place in Ron, repaired at Chitradurga and the policy is insured in Jaipur Rajasthan. Whereas on the perusal of Ex. B 3 that is the survey report accident, the surveyor has mentioned Khustagi Koppal in the Accident place. Therefore the contention taken by the respondent counsel that the suit is not maintainable is not justifiable one.

17)       On the contrary as per the oral evidence coupled with the documentary evidence the complainant failed to prove that the accident was occurred and the vehicle was damaged and the said fact has been clearly disclose in Ex. B 1, Ex. B 2 and Ex. B 3 which are the letters and Survey report and which have been already discussed supra.  However the OP Company as per Ex. B 2 the IRDA approved surveyor has sanctioned Rs. 17,000/- for the external damages of the vehicle. The claim amount sanctioned of Rs. 17,000/- is just and proper in accordance with. Hence, in the light of above observation the complainant failed to prove that deficiency of service on part of OP in not settling the claim of the vehicle policy. Hence, in the light of above observations we constrained to hold point No: 1 and 2 in the Negative.

18)       Point No: 3:- Hence in the result we proceed to pass the following;

ORDER

1. The complaint filed by the complainant is hereby dismissed.
2. No order as to cost.
3. Send the free copies of this order to both parties.

Dictated to the Stenographer, transcribed, typed by him, typescript, corrected by me and then pronounced in the Open Forum on 25^th day of July, 2016.

                                                ANNEXURE //

List of Documents Exhibited for the Complainant.

Ex. A 1            Vehicle Photo Copy                          

Ex. A 2            Claim Voucher                                 Date: 07-08-2015

Ex.  A 3           Claim Cost Confirmation                Date: 07-08-2015

Ex. A 4            Insurance Bond                                Date: 14-07-2015

Ex. A 5            Cash Bill                                            Date: 08-08-2015

Ex. A 6            Quotation                                          Date: 07-08-2015

List of Documents Exhibited for the OP

Ex. B 1            Communication letter                     Date: 03-10-2015

Ex. B 2            Communication letter                     Date: 19-09-2015

Ex. B 3            Survey Report                                         

Ex .B 4            Insurance Policy                                      

Witnesses examined for the Complainant / Respondent.