BEFORE THE CONSUMER DISPUTES REDRESSAL FORUM, ERNAKULAM.

Date of filing : 07/01/2011

Date of Order : 27/08/2011

Present :-

Shri. A. Rajesh, President.

Shri. Paul Gomez, Member.

Smt. C.K. Lekhamma, Member.

C.C. No. 11/2011

Between

 

And

O R D E R

C.K. Lekhamma, Member.

1. The facts of the complainant's case are as follows :

The complainant's light goods carriage bearing Reg. No. KL-7-T-181 was insured with the opposite party. On 18-04-2010, during a trip the vehicle lost control and hit on an electric post and a compound wall. The vehicle was damaged and the electric post was broken. Two claims were lodged before the opposite party. The surveyor appointed by the opposite party had assessed the compensation payable to the complainant with respect to the damage suffered to the vehicle to the tune of Rs. 55,690/- after deducting the depreciation etc. The complainant paid Rs. 4,700/- to the K.S.E. Board towards the damage caused to the electric post. Subsequently a discharge voucher for 2,644/- with respect to the electric post and Rs. 41,625/- with respect to the damage suffered to the vehicle were sent to the complainant. The complainant submitted the signed voucher by endorsing that the cheque received under protest. Since there was an entry of protest in the voucher, the opposite party refused to give the cheques for the offered amount. The act of the opposite party to deduct considerable amount from the assessed amount amounts to deficiency of service. The complainant, he is entitled to get Rs. 55,690/- as assessed by the surveyor appointed by the opposite party with respect to the damage caused to the vehicle and Rs. 4,700/- which he spent for the replacement of the K.S.E.B. post along with interest from the opposite party. Hence this complaint.

2. Version of the opposite party :

It is admitted that the complainant had insured his vehicle with the opposite party for the period from 29-05-2009 to 28-05-2010. The insured's declared value is Rs. 90,000/-. The complainant as per his claim form dated 20-04-2010, intimated that the said vehicle met with an accident at about 9 a.m. on 18-04-2010 at Vettikavala. But as on the date of such intimation, the complainant had removed the vehicle from the accident spot and hence no spot survey could be conducted. The complainant submitted an estimate for Rs. 1,87,450/- together with other required documents for his own damage claim before the opposite party. The opposite party deputed a surveyor in order to conduct the survey and to assess the loss. The surveyor assessed the loss at Rs. 55,690/- and then the complainant repaired the vehicle. Thereafter, the complainant submitted the final bills and the opposite party offered to settle his claim for Rs. 41,625/- strictly as per the terms and conditions in the policy by deducting the policy excess, the salvage value and also by deducting 25% there from on account of the reason that no spot survey could be conducted. The complainant had also filed yet another claim with regard to the damage caused to the electric post which arose from this accident. The opposite party also offered to settle that claim for Rs. 2,645/- strictly in terms of the conditions in the policy. The opposite party offered the claim vouchers towards full and final settlement of his claims, he refused to accept the same by demanding his full claim amount without any deduction. The complainant had no just cause or reason to refuse the claim amounts offered by the opposite party. The opposite party is still ready and willing to settle the complainant's claim in terms of the contract. In view of the above facts and circumstances, there is absolutely no deficiency of any service on the part of the opposite party.

3. The complainant and the opposite party represented through the counsel. Both sides did not adduce oral evidence. Exts. A1 and A2 series were marked on the side of the complainant. Ext. B1 was marked on the opposite party's side. The counsel for the complainant filed argument notes. Thereafter, we have heard both sides.

4. The points that emerge for our consideration are as follows :

1. Whether the complainant is entitled to get the entire insurance claim amount from the opposite party?

2. Costs, if any?

5. Point Nos. i. and ii. :- There is no dispute with regard to the policy. One of the main contentions in the version of the opposite party is that the accident was intimated by the complainant through the claim form dated 20-04-2010 only it is stated that the vehicle met with an accident on 18-04-2010. The spot inspection of the vehicle could not be conducted, since the vehicle was removed from the accident spot. The opposite party offered to settle the claim for Rs. 41,625/- by deducting the policy excess, the salvage value and by deducting 25% therefrom. Summary assessment as per Ext. A1 surveyors report is as follows :

“SUMMARY ASSESSMENT

a) Repairer's estimate

Labour charge claimed for Rs. 67450.00

Cost of parts claimed for Rs. 1,20,000.00

Total Rs. 1,87,450.00

b) Assessment

Labour Charges allowed Rs. 30,000.00

Cost of allowed parts less depreciation Rs. 28,690.00

Less policy deductible Rs. 500.00

Less salvage value Rs. 2,500.00

Total Rs. 55,690.00

Assessed amount to rounded to Rs. 55,690/-.”

As per the report, it can be seen that after deducting depreciation, policy excess and salvage value, the surveyor arrived at Rs. 55,690/-. In Ext. B1, it is stated that “25% will be deducted from Claim Amount in the absence of Spot Survey.” There is no evidence before us that the complainant had removed the vehicle from the accident spot before intimating the opposite party. The opposite party contended that the complainant intimated the accident only on 20-04-2010. But there is no evidence to substantiate that contention. Moreover, there is no evidence that somebody was appointed for spot inspection. We think that in the absence of contrary evidence against the complainant 25% deduction from the claim amount as per clause in Ext. B1 is not applicable in this case. Section 9 (3) and (5) of the Insurance Regulatory and Development Authority (Protection of Policy holders' Interests) Regulations, 2002 reads as follows :

“(3) If an insurer, on the receipt of a survey report, finds that it is incomplete in any respect, he shall require the surveyor under intimation to the insured, to furnish an additional report on certain specific issues as may be required by the insurer. Such a request may be made by the insurer within 15 days of the receipt of the original survey report;

(5) On receipt of the survey report or the additional survey report, as the case may be an insurer shall within a period of 30 days offer a settlement of the claim to the insured. If the insurer, for any reasons to be recorded in writing and communicated to the insured, decides to reject a claim under the policy, it shall do so within a period of 30 days from the receipt of the survey report or the additional survey report, as the case may be.”

6. In this case, there is no additional report was called for. If Ext. A1 report is incomplete, the opposite party ought to have called for an additional report. Therefore, we are of the view that there is no discrepancy in Ext. A1 report. Hence, we are of the opinion that the complainant is entitled to get the entire claim amount as per Ext. A1 report with regard to the vehicle concerned. Moreover, the opposite party did not comply with Section 9 (5) of the Regulations.

7.The claim with respect to the electric post, the complainant contended that he paid Rs. 4,700/- to the K.S.E. Board towards the damages caused. But there is no evidence before us to substantiate such contention the complainant. Therefore, we are of the view that the amount of Rs. 2,644/- arrived at by the opposite party with regard to the said claim is sufficient to meet the ends of justice.

7. Indisputably as per the order in I.A. No. 16/2011, the opposite party deposited the admitted insurance claim amount of Rs. 41,625/- towards the vehicle damage and Rs. 2,644/- towards the damage of the electric post in the Forum. The complainant received said amounts on 18-05-2011. Therefore, the opposite party is liable to pay to the complainant the remaining amount with regard to damage of the vehicle ie. after deducting the deposited amount as Rs. 41,625/- from the total amount of Rs. 55,690/- shown in Ext. A1 surveyor's report. In the facts and circumstances of the case, we are not ordering any litigation costs.

8. Accordingly, we partly allow the complaint and direct that, the opposite party shall pay to the complainant the remaining insurance claim amount of Rs. 14,065/- (Rupees fourteen thousand and sixty five only) as per Ext. A1 surveyor's report pertaining to the vehicle under dispute.

The order shall be complied with, within a period of one month from the date of receipt of a copy of this order, failing which the said amount shall carry interest @ 12% p.a. till realisation.

Pronounced in open Forum on this the 27^th day of August 2011.

Sd/- C.K. Lekhamma, Member.

Sd/- A. Rajesh,President.

Sd/- Paul Gomez, Member.

Forwarded/By order,

Senior Superintendent.

A P P E N D I X

Complainant's Exhibits :-

Opposite party's Exhibits :-

=========

Date of Despatch of this Order ::

By Post ::

By Hand ::