The averments of the complainant is as follows:-
1. The complainant had purchased a Tata Nixon diesel model 2021 car numbered as KL-85-6158 from the first opposite party after making payment of Rs.14,69,355/-. The payment was made with assistance of a vehicle loan from SBI, Ramanattukara Branch. It is averred that vehicle insurance was also availed through the second opposite party and services of the vehicle was done properly. On 04/10/2021 at about 3 PM, the vehicle of the complainant had met with an accident at Pulikkal , Malappuram district. At the time of accident sister of the complainant, Dr. Shahalath was driving the vehicle. It is averred that accident was occurred while complainant and his family were travelling in the car. But no injuries were sustained to the passengers. At the same time, heavy damage was occurred to the vehicle in the accident. On 06/10/2021, the complainant had taken the vehicle to the first opposite party for repair work and on 18/10/2021 the complainant had handed over all records on the basis of directions of the first opposite party.
2. It is alleged in the complaint that insurance investigator named Melvin Thankachan misbehaved towards the complainant and used ugly words. It is also alleged that the above said Melvin threatened the complainant to block the claim.
3. On 22/11/2021, the third opposite party had directed the complainant to submit FIR, police report and valid driving license. Accordingly, the complainant submitted all records. It is averred that the vehicle was driven by sister of the complainant at the time of accident. The vehicle was collided with an alto car and same was driven by one Mr. Liyakath. But no case was registered by the police as Mr. Liyakath had declined to initiate legal action and statement of Mr. Liyakath was recorded by the police in that regard. But the opposite parties did not repair the vehicle. Even though messages were received from the insurer, that claim was approved and ‘claim was settled’ but no action was taken by them. Later the complainant had contacted the fifth opposite party for approval of the claim. But the insurer rejected the claim application and a letter was received in this regard. In claim rejection letter ,it was stated that the complainant had driven without valid license. It is pleaded by the complainant that no statement was given to the insurance investigator by admitting driving without valid license. The sixth opposite party also rejected the request of claim as done by the fifth opposite party. The opposite parties did not take any step to repair the damage and vehicle was kept in idle in the custody of the opposite parties for long time. The vehicle was purchased after availing a loan from the bank. Moreover the complainant has been dependent on the vehicle for his profession. The acts of the opposite parties caused financial loss, mental agony and physical strain. It is alleged that the opposite parties have committed deficiency in service towards the complainant. It is averred that the complainant had incurred expenses of Rs.3,01,996/- to repair the vehicle. So the complainant prayed for direction to the opposite parties to pay Rs. 15,00,000/- as compensation for the sufferings of mental agony , physical strain and financial loss due to deficiency in service. The complainant also claimed refund of Rs. 3,01,996/- from the opposite parties as the cost of the repair work and cost of the proceedings.
4. The complaint is admitted, there after notices were issued to the opposite parties. All the opposite parties have appeared and submitted their respective versions.
5. The first opposite party is the authorized dealer and service centre of M/s Tata Motors. It is contended that no allegation of deficiency in service was raised against the first opposite party and award of insurance claim is under the discretion of insurer. The first opposite party did not involve in the processing of claim. The first opposite party admitted the purchase of vehicle by the complainant. It is also admitted by the first opposite party that vehicle was met with a major accident and vehicle was entrusted for repair work on 06/10/2021. The surveyor of the insurer had inspected the vehicle and submitted claim report before the insurer. On 26/10/2021 the insurer issued a stop memo to the first opposite party and blocked repair work of the vehicle. So the first opposite party contacted the complainant and sought permission to carry out repair work at the cost of the complainant. But the complainant did not respond properly. So the first opposite party was compelled to keep the vehicle for a long time due to lack of consent from the complainant. The first opposite party is not supposed to repair the vehicle without an assurance of payment of cost either from the insurance company or from the complainant. There is deficiency in service from the side of the first opposite party, hence prayed for dismissal of the complaint.
6. The second opposite party has admitted that they had solicited the complainant to avail insurance coverage to his vehicle bearing No. KL 85 6158. The second opposite party is a composite insurance broker registered with IRDAI and engaged in the business of arranging insurance products for its clients from insurance companies. The complainant did not demand for any service from the second opposite party so far. Hence there is no deficiency in service from the side of the second opposite party. So the second opposite party is an un necessary party in the proceedings. There is no role to the second opposite party in the dispute arisen between the opposite party No.3 to 6 and the complainant. So the second opposite party stands for dismissal of the complaint.
7. The opposite parties 3 to 6 have jointly submitted written version. The opposite parties admitted issuance of insurance policy to the vehicle of the complainant as averred in the complaint. It is contended that the claim of the complainant was unwarranted and against the terms and conditions of policy. It is contended that the driver was implanted by the complainant to topple down terms and conditions of policy. It is further contended that at the time of accident complainant herself was driving the vehicle with a learner’s license (LLR) which was against the terms and conditions of policy. So the complainant had committed misrepresentation of facts which equated to fraud and more voluminous evidence is required to adjudicate the matter. Hence no jurisdiction is vested with the Commission. The complainant submitted the claim application on 25/10/2021 belatedly though accident was occurred on 04/10/2021. It is stated that a surveyor was appointed and report was submitted after assessing the actual loss. As per the report of the surveyor loss is assessed to the tune of Rs.2,26,707/-. It is also admitted that after verification of documents an investigator was appointed to conduct enquiry with regard to alleged accident. It was revealed in the inquiry that an alto car was involved in the accident and same was overturned. As per statement of the driver of Alto car, the complainant was driving the vehicle at the time of accident with learners license (LLR). But GD entry produced by the complainant shows the name of the driver as Mrs. Shalalath. So the opposite parties conducted further enquiry. It is contended that Mrs. Shahalath is the sister of the complainant, who was working as a doctor in Government Social Health Department at Palakkad. On verifications of attendance register, the sister of the complainant was on duty on the date of accident i.e on 04/10/2021. So it is contended by the opposite parties that it is not logically possible that the alleged driver Mrs. Shahalath could be on the wheels at that time in Malappuram. It is further contended that GD entry was given on 24/11/2021 and accident date was on 04/10/2021. So a considerable delay was occurred in reporting the matter. The opposite party contended that the complainant had been misrepresented facts before police authority or colluded with them. It is contended that insurance contract is based on principle of utmost good faith and the parties are bound to disclose truth and all material facts. Here, the complainant suppressed material facts and implanted her sister as the person on the wheel at the time of accident. So the opposite parties repudiated claim of the complainant. It is contended that the complainant was holding learners license (LLR) with some restrictions at the time of accident. So there is no deficiency in service from the side of the opposite parties and the complainant is not entitled for any relief as prayed in the complaint.
8. The complainant has filed an interim application numbered as 60/2023 to take possession of the vehicle from the custody of the first opposite party and repair the vehicle. The Commission allowed the application. Subsequently, the complainant has submitted another application numbered as IA 553/2023 to amend the complaint and same was also allowed by the Commission after hearing the parties.
9. The complainant and the opposite parties have submitted proof affidavits in lieu of evidence. The documents produced by the complainant is marked as Ext. A1 to Ext. A17. Ext. A1 document is the copy of registration certificate of the vehicle number KL 85 6158 owned by the complainant. Ext.A2 document is the copy of driving license of Mrs. Shahalath.M. Ext. A3 document is the copy of bundled private car insurance policy issued by the opposite parties 3 to 6 in favour of the complainant. Ext.A4 document is the copy of the job slip of the vehicle issued by the first opposite party at the time of delivery of damaged vehicle for repair work. Ext. 5 document is the copy of query letter dated 17/11/2021 issued by the opposite parties 3 to 6 for production of FIR / police report and valid DL of insured. Ext.A6 document is the copy of letter dated 25/11/2021 issued by the complainant to the third opposite party demanding to take step for repair work of the vehicle. Ext. A7 document is the copy of query letter dated 19/11/2021 issued by the opposite parties 3 to 6 demanding to produce documents pertaining to the claim of the complainant. Ext. A8 document is the copy of the letter dated 25/11/2021 issued by the complainant to the claim department of the opposite parties 3 to 6 demanding to release policy benefits. Ext. A9 document is the copy of letter dated 10/01/2022 issued by the opposite parties 3 to 6 to the complainant stating repudiation of claim. Ext.A10 document is the copy of certificate dated 24/11/2021 issued by the police.Ext. A11 document is the copy of letter dated 17/02/2021 issued by the first opposite party to the complainant. Ext. A12 document is the certificate dated 01/03/2023 issued by the Medical officer stating that sister of the complainant was availed casual leave on 04/10/2021. Ext.A13 document is the copy of statement made before police by the driver of Alto car involved in the accident. Ext.A14 document is the copy of print out of SMS from the opposite parties 3 to 6. Ext. A15 documents are 5 photographs of the vehicle taken while kept in the custody of the first opposite party. Ext.A16 document is the copy of bill showing the purchase of cover for the vehicle for its protection. Ext. A17 document is the copy of bill dated 26/07/2023 showing the expenses of Rs. 3,01,996/- incurred for repair work of the vehicle.
10. The documents of opposite parties 3 to 6 are marked as Ext. B1 to B5. Ext. B1 document is the insurance policy schedule issued to the complainant. Ext. B2 document is the copy of claim form submitted by the complainant.Ext.B3 document is the copy of survey report of the vehicle. Ext. B4 document is the copy of investigation report dated 27/11/2023 submitted by the investigator of the insurer. Ext. B5 document is the copy of repudiation letter.
11. Heard both sides in detail. Perused documents, affidavits along with notes of argument submitted by the parties in the proceeding.The Commission considered the following points to adjudicate the matter.
Whether the acts of the opposite parties are amounted to deficiency in service?
Relief and cost?
12. Point No. (i) and (ii)
The Commission is considering both points jointly as those are interconnected to each other. The grievance of the complainant is that her vehicle numbered as KL 85-6158 met with an road accident and damaged heavily, but the opposite parties did not take any steps to repair the vehicle under coverage of policy issued by the opposite parties. The complainant has alleged deficiency in service against the opposite parties. The Commission find that as per Ext.A1 document the complainant is the owner of the said vehicle and it remained as undisputed fact in this matter. The argument of the complainant is that she had availed a policy from the opposite parties 3 to 6 as per Ext.A3 document. The opposite parties admitted issuance of policy as stated in the complaint. It is pleaded in the complaint that on 04/10/2021 at about 3 PM the vehicle of the complainant collided with an Alto car in which the vehicle of the complainant was damaged heavily. At the time of accident the complainant and her family members were travelling in the car but fortunately nobody had sustained any serious injury except minor injury to a child. The specific argument of the complainant is that at the time of accident her sister named Mrs. Shahalath was driving the vehicle.The complainant argued that vehicle was purchased from the first opposite party and insurance was arranged by the second opposite party. The first and second opposite parties are also admitted the pleadings of the complainant in that regard. It is argued that on 06/10/2022 vehicle was taken to the service centre of the first opposite party and submitted all records required for insurance benefits. But the opposite parties including the insurer did not take any step to repair the damage to the vehicle. The complainant had submitted all required documents on the basis of Ext. A5 and A7 documents issued by the opposite parties 3 to 6. But they did not take any steps to repair damage of the vehicle. So the complainant was compelled to arrange repair work of the vehicle with her own money. The complainant argued that the opposite parties have committed deficiency in service causing financial loss mental agony and physical strain to her.
13. On the other hand ,the first and second opposite parties have argued that they are unnecessary parties in the proceedings as consumer dispute is related to re imbursement of expenses incurred for repair work under policy issued by the opposite parties 3 to 6. In the analysis of evidence it can be seen that there are no evidence available before the Commission against the first and second opposite parties to show deficiency in service on their part.
14. The opposite parties 3 to 6 admitted issuance of policy as pleaded by the complainant but at the same time the opposite parties argued that the repudiation of claim as per Ext. A9 document is valid and it was in accordance with terms of the policy. It is admitted by the opposite parties that they have received a claim application from the complainant as per Ext.B2 document. On the basis of Ext. B2 document, a surveyor was duly appointed and the surveyor submitted a report as per Ext. B3 document. The opposite parties argued that as per evidence collected by their investigator the complainant had implanted her sister Mrs. Shahalath as the driver of the vehicle at that particular time of accident. It is argued by the opposite parties that at the time of accident complainant was driving the vehicle with learner’s license, which was against the terms of the policy. It is argued by the opposite parties that driver was implanted to topple down the terms and conditions of the policy and thereby make unlawful gain. The opposite parties further argued that after conducting investigation, the investigator had submitted Ext.A4 document before the opposite parties. According to the opposite parties, at the time of accident Dr. Shahalath was on duty at Palakkad district and investigator confirmed it through verification of attendance register in that office. Moreover at the time of accident ‘L’ board was fixed on the vehicle indicating driver of the vehicle was a learner’s license holder. Moreover no FIR was registered by the police authority in connection with accident. So the complainant is not entitled for any benefits under the policy.
15. In the evaluation of evidence it can be seen that incident of road accident is admitted by the parties, but consumer dispute is revolved around contention of misrepresentation with regard to identity of the driver. There is no material on record to substantiate the contention of the opposite parties 3 to 6 that the complainant was driving the vehicle at the time of accident. The allegation of implantation of driver is baseless and without proof. The Commission find that the vehicle of the complainant was collided with an Alto car driven by one Mr. Liyakath. Ext.A13 document is the statement of Mr. Liyakath given before the police. As per Ext.A13 document, it can be seen that Mr. Liyakath was not interested to initiate a legal action against Mrs. Shahalath, who drove the vehicle of the complainant at the time of accident. So no FIR was registered. The contention of occurrence of delay in reporting the matter before police authority is not sustainable and cannot be reckoned. As per Ext.A13 document, it has come out in evidence that driver of the Alto car, which involved in the accident had sustained injury and he was under treatment. Moreover the complainant as well as her sister are practicing doctors and by considering the facts of the case, unreasonable delay was not occurred in the reporting the matter before police authority. In the examination of Ext.A10 document it can be seen that police department has been investigated the matter and confirmed that Dr. Sahalath M was driving the vehicle at particular point of time. More over the Commission also find that as per Ext. A12 document Dr. Shahalath was on casual leave on 04/10/2021 i.e. on the day of accident. Ext. A12 document is a certificate issued by Medical Officer, Community Health Centre, Ambalappara Palakkad Dist. Ext.A10 document is issued by Sub inspector of police, Kondotty police station. The opposite parties did not challenge the veracity of Ext. A10 and A12 documents. The Commission consider that evidence imparted through Ext. A10 and A12 documents are cogent and reliable. It is find that at the time of accident sister of complainant was the driver of the vehicle and she hold valid license as per Ext. A2 document. So repudiation of claim is against terms and conditions of policy and the acts of the opposite parties 3 to 6 are amounted to deficiency in service causing financial loss, mental agony and physical strain to the complainant. It has come out in evidence that the complainant has incurred expenses Rs.3,01,996/- to repair the damage of the vehicle. The complainant has produced Ext. A17 document in that regard. It can be seen that the repair work was conducted only after filing of the complaint before this Commission. As per Ext. B3 document, the surveyor has calculated the liability to the tune of 2,26,707/-. But Ext.B2 assessment report was made on 07/01/2022 and vehicle was entrusted with the first opposite party on 06/10/2021 for repair works. As per Ext. A 17 document repair work was completed on 26/07/2023. So the vehicle was kept in idle for a long time without repair work. In this juncture the Commission find that the opposite parties are liable to reimburse the expenses incurred as per Ext. A17 document to the complainant. Even though it is argued by the complainant that she was using the vehicle for her profession, but no evidence was brought before this Commission in that regard.
16. From the facts and circumstances of the case, it can be seen that acts of the opposite parties 3 to 6 caused mental agony and hardship to the complainant. Ext. A6 and Ext. A8 would show that the complainant had made persistent efforts to get repaired the damage of the vehicle under policy, but the opposite parties 3 to 6 were turned down negligently. So the Commission find that the opposite parties 3 to 6 are liable to pay compensation for their acts of deficiency in service. The Commission consider that Rs. 1,00,000/- is a reasonable amount to compensate the sufferings of the complainant . The opposite parties 3 to 6 are also liable to pay Rs. 15,000/- to the complainant as cost of the proceedings.
17. On the basis of the above discussions, the Commission allow the complaint in the following manner:-
The opposite parties 3 to 6 are directed to re imburse Rs. 3,01,996/- (Rupees three lakh one thousand nine hundred and ninety six only) to the complainant as the cost of repair work .
The opposite parties 3 to 6 are directed to pay Rs.1,00,000/- (Rupees one lakh only) to the complainant as compensation for the acts of deficiency in service.
The opposite parties 3 to 6 are directed to pay Rs. 15,000/- (Rupees fifteen thousand only) to the complainant as cost of the proceedings.
The opposite parties 3 to 6 shall comply this order within 30 days from the date of receipt of copy of this order otherwise entire amount shall carry interest at the rate of 9% per annum from the date of order till the date of realisation .
Dated this 28th day of June, 2024.
MOHANDASAN.K, PRESIDENT
PREETHI SIVARAMAN.C, MEMBER
MOHAMED ISMAYIL.C.V, MEMBER
APPENDIX
Witness examined on the side of the complainant: Nil
Documents marked on the side of the complainant: Ext.A1to A17
Ext.A1: Copy of registration certificate of the vehicle number KL 48 6158 owned by
the complainant.
Ext.A2: Copy of driving license of Mrs. Shahalath. M.
Ext A3: Copy of bundled private car insurance policy issued by the opposite parties 3
to 6 in favour of the complainant.
Ext A4: Copy of the job slip of the vehicle issued by the first opposite party at the time
of delivery of damaged vehicle for repair work.
Ext A5: Copy of query letter dated 17/11/2021 issued by the opposite parties 3 to 6 for
production of FIR / police report and valid DL of insured.
Ext.A6: Copy of letter dated 25/11/2021 issued by the complainant to the third
opposite party demanding to take step for repair work of the vehicle.
Ext.A7: Copy of query letter dated 19/11/2021 issued by the opposite parties 3 to 6
demanding of produce documents pertaining to the claim of the complainant.
Ext.A8: Copy of the letter dated 25/11/2021 issued by the complainant to the claim
department of the opposite parties 3 to 6 demanding to release policy benefits.
Ext.A9: Copy of letter dated 10/01/2022 issued by the opposite parties 3 to 6 to the
complainant stating cancellation of policy on the ground of misrepresentation
of facts and repudiation of claim.
Ext.A10: Copy of certificate dated 24/11/2021 issued by the police.
Ext.A11: Copy of letter dated 17/02/2021 issued by the first opposite party to the
complainant.
Ext.A12: Certificate dated 01/03/2023 issued by the Medical officer stating that sister
of the complainant was availed casual leave on 04/10/2021.
Ext.A13: Copy of statement made before police by the driver of Alto car involved in
the accident.
Ext.A14: Copy of print out of SMS from the opposite parties 3 to 6.
Ext.A15: 5 photographs of the vehicle while kept in the custody of the first opposite
party.
Ext.A16: Copy of bill showing the purchase of cover
Ext.A17: Copy of bill dated 26/07/2023 showing the expense of Rs. 3,01,996/-
incurred for repair work of the vehicle.
Witness examined on the side of the opposite party : DW1 and DW2
Documents marked on the side of the opposite party : Ext. B1 to B
Ext.B1: Insurance policy schedule issued to the complainant.
Ext.B2: Copy of claim form submitted by the complainant.
Ext.B3: Copy of survey report of the vehicle.
Ext.B4: Copy of investigation report dated 27/11/2023 submitted by the investigator
of the insurer.
Ext.B5: Copy of repudiation letter.
MOHANDASAN.K, PRESIDENT
PREETHI SIVARAMAN.C, MEMBER
MOHAMED ISMAYIL.C.V, MEMBER
