D.O.F:17/03/2016
D.O.O:05/05/2023
IN THE CONSUMER DISPUTES REDRESSAL COMMISSION, KASARAGOD
CC.101/2016
Dated this, the 5th day of May 2023
PRESENT:
SRI.KRISHNAN.K : PRESIDENT
SRI.RADHAKRISHNAN NAIR.M : MEMBER
SMT.BEENA.K.G : MEMBER
Mohammed Ismail, Adult
S/o Mohammed Iqbal,
R/at Shaima Manzil, : Complainant
P.O- Alampady via Vidyanagar,
Kasaragod- 671 123
(Adv. Shajid Kammadam)
And
HDFC ERGO General Insurance Company Limited,
2nd Floor, Chicago Plaza,
Near KSRTC Bus Stand, : Opposite Party
Rajaji Road, Cochin – 682 035,
Represented by its Manager
(Adv. S. Mammu)
ORDER
SRI.RADHAKRISHNAN NAIR.M : MEMBER
The complaint is filed under section 12 of the Consumer Protection Act, 1986( asamended )
The facts of the case in brief is that the complainant is the owner of VOKLSWAGEN car styled as polo, which was registered temporarily with No.KL 13W Temp4864.The vehicle was validly insured with the opposite party with policy for the period from 16.07.2015 to 17.08.2015.
The vehicle met with an accident, while taking for registration before the appropriate authority,which resulted in the damage of the vehicle to the tune of Rs.72,247/-.The factum of the accident was duly informed to the opposite party and registered a claim for own damage. Accordingly, the vehicle was entrusted with the dealer for repair. But the opposite party failed to act as envisaged in the insurance policy, for long, in spite of several requests.At last, the complainant received a claim rejection letter dated 06.11.2015, as per which the opposite party arbitrarily rejected the claim of the complainant on the ground of misrepresentation.The complainant has been put to great mental agony and hardships, besides the financial loss on account of the arbitrary denial of insurance benefits,which amounts to service deficiency on the part of the opposite party.
Hence this complaint is filed for a direction to the opposite party to allow the insurance claim of the complainant and to pay Rs.50,000/- as compensation and costs.The opposite party entered appearance through their respective counsel,who filed written Version.
As per the version of the opposite party the complaint is false frivolous, vexatious, and not maintainable at law. The opposite party admit that thevehicle No. KL 13W Temp4864 was validly insured with the opposite party with policy for the period from 15.07.2015 to 14.07.2016. The vehicle was registered in the name of the complainant for the period from 16.07.2015 to 17.08.2015. But contention that the factum of the accident was duly communicated to the opposite party etc. are false and hence denied. The opposite party submitted that the complainant deliberately not stated the date of alleged accident in the complaint. The complainant preferred the claim stating that the car met with an accident on 19.09.2015 at around 2 pm. But the temporary registration of the vehicle was expired on 17.08.2015. On verification of the security register at the garage of Phoenix Car Pvt. Ltd,it was found that the vehicle wasentered in to the workshop after accident on18.09.2015 at 5 pm. The repair order mentioned at the last visit history column of the vehicle that the last visit was on 07.09.2015 for repair of the damages like RH side damage, RH side body replace, RH bob door replace. These damages are similar to that mentioned in the repair order dated 19.09.2015. From this it is clear that the complainant had misrepresented regarding the date of accident, manner of accident and the damages sustained to the vehicles. Since there is misrepresentation regarding actual facts of accident and the opposite party has no other way but to deny the claim. The complainant did not intimate the opposite party immediately after the accident and the opposite party was prevented from ascertaining the real facts of the alleged accident. There is no deficiency of service on the part of opposite party. The complainant is not entitled to any relief and the complaint is liable to be dismissed.
One Mr. Yousuf,a relative of the complainant filed proof affidavit in Iieu of chief examination for and on behalf of the complainant, who was duly cross examined as PW1. The documents Ext.A1 and A2 are marked.Ext.A1 is the Private Car Package Policy, Ext.A2 is the Claim Rejection Letterdated 06.11.2015 issued by the Opposite Party.
From the side of opposite party, DW1 and 2 are examined. Dw1 is the manager of the Phoenix car India Ltd, Kannur, Dw2 is Smt. Sreeja, Insurance Investigator. The document produced by the opposite party as per the order in IA 207/ 2017 is marked as Ext.X1, which is the file related to the insurance agreement pertaining to the repudiation of claim registered by the complainant.Also documents Ext.B1 to B7 are marked from the file of Ext.X1. Ext.B1 is the Report prepared by the Insurance Investigator.Ext.B2 is a copy of invoice dated 10.10.2015cum-repair order issued by the Phoenix car India Ltd, Kannur, Ext.B3 is Private Car Package Policy,Ext.B4 is the Final Survey Report, Ext.B5 is a copy of the Temporary Registration Certificate of the VehicleKL13W-Temp.4864, Ext.B6 is the Claim Form submitted by the complainant, Ext.B7 is the claim Rejection Letterdated 06.11.2015.
Based on the pleadings and evidence of the rival parties in this case the following issues are framed for consideration.
1. Whether the complainant is entitled to get the insurance benefit for the damages sustained to his vehicle.
2. Whether there is any service deficiency or unfair trade practice on the part of the opposite party
3. If so what is the relief ?
For convenience, all the above issues are discussed together.
The specific case of the complainant is that the rejection of his claim for insurance benefit for the damages to his vehicle by the opposite party is arbitrary and amounts to service deficiency.The opposite party rejected the claim of the complainant on the ground of misrepresentation. The complainant has been put to great mental agony and hardships besides the financial loss on account of the arbitrary denial of insurance benefit, which amounts to service deficiency on the part of the opposite party.The vehicle was validly insured with the opposite party with policy for the period from 16.07.2015 to 17.08.2015.
The vehicle met with an accident, while taking for registration before the appropriate authority, which resulted in the damage of the vehicle to the tune of Rs.72,247/-. The factum of the accident was duly informed to the Opposite Party and registered a claim for own damage. Accordingly, the vehicle was entrusted the dealer for repair. But the opposite party failed to act as envisaged in the insurance policy, for long in spite of several requestsand finally rejected for the reason of “misrepresentation”.
The opposite party admit thatthe complainant preferred the claim stating that the car met with an accident on 19.09.2015 at around 2 pm. But the temporary registration of the vehicle was expired on 17.08.2015. On verification of the security register at the garage of Phoenix Car Pvt. Ltd, it was found that the vehicle was entered in to the workshop after accident on 18.09.2015 at 5 pm. The repair order mentioned at the last visit history column of the vehicle that the last visit was on 07.09.2015 for repair of the damages like RH side damage, RH side body replace, RH bob door replace. These damages are similar to that mentioned in the repair order dated 19.09.2015. From this it is clear that the complainant had misrepresented regarding the date of accident, manner of accident and the damages sustained to the vehicles. Since there is misrepresentation regarding actual facts of accident, the opposite party has no other way but to deny the claim. The complainant did not intimate the opposite party immediately after the accident, the opposite party was prevented from ascertaining the real facts of the alleged accident. There is no deficiency of service on the part of opposite party. The complainant is not entitled to any relief and the complaint is liable to be dismissed.
The claim of the complainant for the insurance benefit was rejected by the opposite party as per the Ext.A2 (Ext.B7) the claim Rejection Letter dated 06.11.2015. It shows that the claim was rejected for the reason misrepresentation of material facts regarding the said claim. The opposite party submit that the complainant did not furnish the exact facts but misrepresented. For that the opposite party examined witness DW1 and 2.
The opposite Party argue that even though the date of accident is 19.09.2015as per the Claim Form submitted by the complainant, the exact date of the accident is 07.09.2015 and that is evident from the Ext.B2 document, which is a copy of invoice dated 10.10.2015cum-repair order issued by the Phoenix car India Ltd. The DW1 would depose that the recital 7/9/15 seen in the Ext.B2 is to the indication that the vehicle was taken to the workshop on 07.09.2015.The repair order mentioned at the last visit history column of the vehicle that the last visit was on 07.09.2015 for repair of the damages like RH side damage, RH side body replace, RH bob door replace. These damages are similar to that mentioned in the repair order dated:19.09.2015.
The opposite party argues that from this it is clear that the complainant had misrepresented regarding the date of accident, manner of accident and the damages sustained to the vehicles. Since there is misrepresentation regarding actual facts of accident, the opposite party has no other way but to deny the claim.
Also the opposite party produced a ruling of the Honourable Supreme Court reported in 2021 (5) KLT 708 (SC), where in the apex court held that Consumer Protection Act 1986 -Motor Vehicles Act 1988, Section 39and 192-Vehicle driven/used without a valid registration, amount to a clear violation of sections 39 and 192 of the Motor Vehicles Act-This result in a fundamental breach of terms and conditions of the policy entitling the insurer to repudiate the policy.
The complainant did not produce the registration certificate of the vehicle to show that the vehicle had valid registration at the time of the accident.The opposite Party produced the entire file relating to Insurance Agreement pertaining to the repudiation of the claim of the complainant as per the order in IA 207/2017, which is marked as Ext.X1,The above file containsa copy of the Temporary Registration Certificate of the VehicleKL13W-Temp.4864, which is marked as theExt.B5.The above document shows that the vehicle has been registered temporarily under the provision of Section 43 of the Motor Vehicles Act 1988 for the period 16.07.2015 to 17.08.2015.
As per the Ext.B6 is the Claim Form submitted by the complainant, the date of accident is 19.09.2015. It means that the vehicle had no valid registration for the vehicle. Therefore in the light of the decision of the Apex Court reported in 2021 (5) KLT 708 (SC), the Vehicle has no valid registration on the relevant date of accident and the same was driven/used without a valid registration and that amount to a clear violation of sections 39 and 192 of the Motor Vehicles Act-This result in a fundamental breach of terms and conditions of the policy entitling the insurer to repudiate the policy.
The Section 43(2) of the Motor Vehicles Act would show that the temporary registration made under this section shall be valid only for a period not exceeding one month,and shall not be renewable.But it can be extended in some unforeseen circumstances beyond the control of the owner, on payment of prescribed fees. But the complainant has no case that the temporary registration of his vehicle has been extended further and the accident was occurred during that period.No document is produced by the complainant to that effect. There is no evidence to hold that the vehicle has valid registration at the date and time of the accident.Therefore it is clear that there is breach of terms and conditions of the policy entitling the insurer to repudiate the policy in this case.
Considering the facts and circumstances of the case this commission is of the view that the complainant is not entitled for the insurance benefit. The complainant could not prove any service deficiency or unfair trade practice on the part of the opposite party.
In the result the complaint is dismissed without cost.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Exhibits
A1: Private Car Package Policy
A2: Claim Rejection Letter
X1 Series
B1: Report prepared by Insurance Investigator
B2: Copy of invoice dated 10/10/2015
B3: Private Car Package
B4: Final Survey
B5: Copy of Temporary Registration Certificate
B6: Motor Insurance Claim form
B7: Claim Rejection Letter
Witness Cross examined
PW1 : Yousuf.K
DW1: Nishith.M.C
DW2: Sreeja
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Forwarded by Order
Ps/ Assistant Registrar
