Date of Filing:19-01-2016  

                                                                                         Date of Order:06 -5-2019

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM – I, HYDERABAD

P r e s e n t­

HON’BLE Sri P.VIJENDER, B.Sc. L.L.B.  PRESIDENT.

HON’BLE Smt. D.NIRMALA, B.Com., LLB., MEMBER

Monday, the  6^th day of May, 2019

C.C.No.45 /2016

Between

Miss. Apoorva Kamath, D/o.P.D.Kamath,

Aged about 25 years, Occ : Pvt.Employee,

Resident of Flat No.410, Fourth floor,

H.No.3-6-484, Shettipally Apartments,

Street No.6, Himayath Nagar,

Hyderabad. T.S.

Rep. though her father Mr.P.D.Kamath                                        ……Complainant                                                                   

And

1. M/s. HDFC ERGO  General Insurance  Company Ltd.,

Rep. by it’s  Managing Director,

6^th floor, Leela Business Park,

Andheri-Kurla Road, Andheri (East),

Mumbai – 400059

2. M/s. HDFC ERGO  General Insurance  Company Ltd.,

Rep. by it’s  Regional  Manager,

3^rd floor, Road No.1, Skofia Bank   Building,

Opp: Vengalrao Park, Banjara Hills,

Hyderabad.T.S. – 500035

3. Mr.Srikant

The Regional Claims Manager,

M/s. HDFC ERGO  General Insurance  Company Ltd.,

Third floor,  #3-6-180/2, Kuchkulla House,

Himayath Nagar, Hyderabad, TS – 500029                                 ….Opposite Parties

Counsel for the complainant                      :  M/s.Nizami & Associates

Counsel for the opposite Parties                :  Mr. N.Srinath Rao

.                      

O R D E R

(By Sri P. Vijender, B.Sc., LL.B., President on behalf of the bench)

            This complaint has been  preferred under Section 12 of C.P. Act of 1986  against the  opposite  parties alleging deficiency of service and in consequence of it directions for full payment  of Rs.67,500/-  together with interest  at 18% P.A from the date of accident to the date of payment, a further sum of Rs.12,000/- which  amount spent by the complainant for hiring  cabs on account of non availability of his own car and compensation of Rs.1,50,000/- for  causing mental agony, harassment and hardship  on account  of  opposite parties deficiency of service and cost of this complaint. 

1. Complainant’s case  in brief is that  he got  insured his Toyota Innova  vehicle with  registration bearing No. AP31AP6566 with opposite party No.1   under comprehensive insurance policy No.2311200015294904000 valid from 10-07-2015 and was not renewed  for subsequent period.   While the  complainant  was  travelling   to Dwaraka Tirumala  from Hyderabad the said  vehicle  was met with an accident  on 6-06-2015 at about  11.30AM as the weather  at that time was not conducive and heavy damage was caused to the vehicle and same was reported  in the police station  within  whose jurisdiction   the place of  accident  comes and also to opposite party No.1 regional office and made a request  to initiate  the necessary  process  under the  policy  but the opposite party No.1 made the complainant  wait for two days at the place of  accident as no one came for inspection of the vehicle.  After repeated calls by the complainant to the surveyor as directed by opposite party No.3 the complainant took the vehicle to Hyderabad by towing by spending money. 

                There was gross negligence on the part of the opposite parties in discharging their duties and their designated surveyor  in the process of inspection of the vehicle  damage.  It also affected complainant’s business as he was made waiting for 5 days  for  surveyor appointed by the opposite parties.  After 5 days of the accident a surveyor by name Sandeep came to inspect the vehicle and asked the complainant to get it repaired in the local workshop.   Accordingly complainant got it repaired and asked the surveyor  as to the amount of the damage assessed and  learnt from his surveyor  that an amount of Rs.11,000/- was assessed towards damages as against the actual amount of Rs.55,900/- which is the lowest quotation  received.  Complainant contacted  Mr.Prabhakar Reddy  of the opposite parties   through the counsel  and said Mr.Prabhakar Reddy   reported that he is in Chennai    and will  settle the matter   after coming back. Thereafter complainant received a reminder by   message asking him to submit repair bill as per the surveyor’s assessment.  Complainant and her father contacted opposite party No.3 in person as well as on phone and she was informed to submit  all the bills and vouchers relating to the repairs of the vehicle  submitted.   When the copies of the same were submitted she received a final letter dated 19-08-2015 from the opposite parties stating that she defaulted by not submitted original repair bills  as per surveyor’s assessment. 

              The act  of the  surveyor Mr.Prabhakar Reddy   and his associate  of the opposite parties  in assessing damage is caused monetary loss  to her.  The employees of opposite party No.1 to 3 acted in  gross violation  of insurance conditions and other   provisions  of  laws.  The complainant  spent an amount of Rs.11,000/- for denting work, for bonnet Rs.4,500/-  for  painting work Rs.9,000/-    Rs.19,900/-  for spare parts,  Rs.4,500/- towards repair of AC unit and Rs.7,000/- towards towing   charges.  In addition to that she spent Rs.12,000/- for hiring the vehicle for  necessities  during the  time of repair of her vehicle.  The opposite parties failed to provide their services as assured at the time of  taking of policy.  Complainant got issued a legal notice on 31-8-2015 to opposite parties 1 to 3 and  copy of the same addressed to Insurance Ombudsman at Lakdi-ka-pul in Hyderabad but all her efforts resulted in futile.  The insurance  Ombudsman  refused to take any responsibility  and  endorsed that it was  a legal  issue.             

        The opposite parties have indulged in  unfair trade practice  and gross deficiency of service and failed  to comply  with the terms and conditions   of  policy issued by them. Hence the present complaint for the above stated reliefs. 

2. The common written version is filed for opposite parties 1 to 3  while admitting  issuance  of the  policy to the vehicle of the complainant  but denied the rest of the  complainant’s version.  The defense set out in the written version  is that the  complainant got  insured her  four wheeler  with opposite parties 1 to 3   and the period of the policy was  from  11-7-2014 to 10-7-2015 and said policy was subject to terms, conditions and limitations   thereof.  On 8-6-2015 complainant lodged a claim stating that  on 6-6-2015 while  the vehicle was  going on the  highway, a motor cycle came abruptly  in front of Ashok Layland auto and the driver of the her car applied sudden breaks, as a result vehicle  skidded and dashed, resulting  in damage.  Soon after  receiving  of the said claim   the opposite parties  appointed  Mr.V.Prabhakar Reddy a registered surveyor with license No.SLA 47304  to assess the extent of damage caused to the  vehicle.  The said surveyor  inspected  the vehicle and   he tried to contact the complainant    for details  but the complainant did not respond.  Hence the opposite parties  have addressed a letter  to complainant  on 8-7-2015 requesting  her  produce  original  repair bills within 4 days  from the date of receipt of  the letter for assessing  the claim.  It was further  informed in the said letter that if the complainant fails to submit the said bills  in a period of 4 days  they will consider that the complainant  no longer interested in claim.  But the complainant  did  not respond and left  with no option the opposite parties  have addressed another letter on 19-08-2015 informing   closure of the claim as  complainant did not respond  to the letters addressed to her. 

          As  per the  terms and conditions of  the policy   the insured should extend her cooperation at all times for processing the claim.  Though two letters were addressed to the complainant asking  her to submit original bills she did not submit the same did not extend  any cooperation to process the claim.  Complainant having failed to cooperate  for processing  the claim  to the opposite parties.  Having not submitted the required documents, the complainant try to blame them for not   settling  her claim. 

          The claim of the complainant  that she suffered in convenience on account of delay to inspect the vehicle by the surveyor and was constrained to  stay  at the place of accident  for two days  are all false.  The opposite parties have  never deputed  a person by name Mr. Sandeep for assessing the damage caused to the vehicle.  In the letters addressed to the complainant   it was specifically  mentioned that  if the complainant  fails to produce original bills within  a period of  4 days it will be presumed that  she no longer interested  in the claim and when the complainant has not complied with the request made in the letter addressed to her the opposite parties  closed the claim as no claim and communicated the same to the complainant by letter dated 19-08-2015. 

                The surveyor appointed by the opposite parties is a 3^rd party and will not have interest in either of the parties.  The assessment made by the independent surveyor is binding on both the parties.  The amount mentioned by the complainant for attending repairs is not   binding on opposite parties and same has no basis.  The complainant   has shown exorbitant amount by obtaining  receipts from various shops  in order to get  more compensation  therefore the same cannot be considered.  There is any amount of  suspicion with regard to  genuinely of the claim  submitted by the complainant.   The opposite parties   being a custodian of public funds cannot   settle the claim without      perusing the required documents.  The complainant having failed to submit original bills  and receipts  for attending repairs  to the  damaged vehicle  cannot allege either unfair trade practice or deficiency of service.  Hence the complaint deserves to be dismissed.  

            In the enquiry  the  complainant has  got filed her evidence affidavit which  is nothing but a replica of the complaint itself.  She has got exhibited ten (10) documents.    Similarly for the  Opposite Parties  evidence affidavit  of Sri  S.Sanjay Kumar  stated to be Manager –legal and that  of V.Prabhakar Reddy  are got  filed  the substance of his affidavit is also in line with the defense set out  in the written version.  Through him opposite parties have got exhibited six (6) documents.   Both sides  have filed written arguments

            On a consideration of material available on  record the following points have emerged for consideration .        

1. Whether complainant could prove that the opposite parties  have indulged  unfair trade practice  or caused  deficiency of service  while in responding to the complainant’s claim ?
2. Whether the complainant is  entitled for the amounts claimed in the complaint?
3. To what relief?

Point No.1:  Issuance of the policy to the complainant’s four wheeler and accident to the said vehicle during the subsistence of the policy are not in dispute.  Normally  whenever a vehicle insured with  the company is met with an accident  the insured  person shall communicate the same to the  insurer  apart from giving a report  to the police within whose jurisdiction    the accident  occurred.  It  is also usual practice  for the insurance  companies  to depute  a 3^rd  party licensed  surveyor  to inspect the damaged vehicle  at the place of accident.  It has been crystal clearly  stated by the  complainant   that  the vehicle met with an accident on 6-6-2015 while  she was travelling to Dwaraka Tirumala  from Hyderabad and soon after the accident she  intimated  to the opposite  parties  as insurer of the vehicle.  Ex.A2 is the  Xerox copy of the  Panchanama conducted to the  place of accident  by Khammam   Rural Police within whose jurisdiction   accident occurred.   Even according to the  written version  of the opposite parties  the claim was submitted by the complainant  on 8-6-2015 informing  about the involvement of the vehicle  in the accident on 6-6-2015.  According to the  opposite parties   soon after receipt of the claim  they have   appointed  one  Mr.Prabhakar Reddy  stated to be  licensed  surveyor   to inspect the vehicle  involved in the accident  and he assessed the  damage.   According  to the  affidavit  of the said Mr.Prabhakar Reddy.  On the instructions of the opposite parties   he conducted survey  in respect of the complainant’s vehicle     and assessed  the damage at Rs.12,470/- and submitted  his report  to opposite parties   on 7-09-2015. As already said the factum  of accident  involving  the complainant’s insured vehicle  on 6-6-2015 is not  disputed.  When the opposite parties   pleaded that complainant  submitted   on 8-6-2015 i..e, two days after the accident and they have immediately appointed  Mr.Prabhakar Reddy of licensed surveyor  to inspect  and assessed  damage  what made him to submit report after the inspecting  the vehicle  on 7-09-2015 i.e exactly three months after the accident is not stated.  It is specific case  of the complainant  that   she was asked by the  surveyor Mr.Sandeep to bring the vehicle  to Hyderabad  and accordingly she brought the vehicle  to  Hyderabad by  towing it  by spending an amount of Rs.7,000/-.  The evidence affidavit of the surveyor Mr.Prabhakar Reddy is conveniently silent not only as to the place of his inspection and assessment  of damage  by him   but also  date of it.  Either in  the evidence affidavit of Sanjay Kumar, Manager (legal) of opposite party No.1  office  and also in  the  written version there  is no mention of inspecting of the subject vehicle  by surveyor Mr.Prabhakar Reddy.  This fortifies the complainant’s version  that there was inordinate delay  on the part of  opposite parties   in getting  surveyed the subject   vehicle  for assessment  of damages caused in the accident. 

             The complainant  has specifically stated that  Mr.Prabhakar Reddy whom  the opposite parties   stated have been appointed as a surveyor to inspect  the damaged vehicle  for  assessment of  damage never examined  the subject vehicle.  It is further  stated by the complainant  that one Mr.Sandeep inspected it and  then asked her to get vehicle repaired with a local workshop.  Though the opposite parties   pleaded that they  never appointed a person by name Mr.Sandeep as surveyor  they did not deny the complainant’s version  that when she was asked to get the vehicle  repaired at local workshop.  As  already  said  the  evidence affidavit  of Mr.Prabhakar Reddy  claims to be licensed surveyor shows he submitted report of his  assessment  of damages to opposite parties   on 7-09-2015. Ex.B5 appears to be report of said  Mr.Prabhakar Reddy   but this document is a computer generated one not a handwritten.  Normally  damaged vehicle  would be inspected by the surveyor for assessment  of the damages  either  at the workshop or place of accident.   It  is not claim  that  surveyor  carried a  computer to    workshop  for preparing  an assessment.  So he  himself  must  have a manual rough  noting of his  inspection which  should have been filed along with his report but he did not do it.  The main defense of the opposite parties  is that the complainant failed  to furnish  the original bills and  receipts relating to the repairs attended in the local workshop hence the claim was closed as not interested.  Ex.B2 is said to  be  a letter from the opposite party No.2 in which  the complainant  was asked  for original  repair bills as per surveyor’s assessment.  It is nobody’s    case that  surveyor Mr.Prabhakar Reddy  furnished   copy of his report to the complainant before filing it with that the opposite parties.  Then how could  complainant get original  repair bills as per the assessment   of the surveyor  is not  explained.  Ex.B4  is  stated to be final letter from the opposite parties   to the complainant  and  this  is nothing but a replica to Ex.B2.  As already said  the report of the surveyor  Mr.Prabhakar Reddy in Ex.B5 is  dated 9-7-2015 so there was  no possibility  for the complainant  to have  a copy of this report as on the date  when she got repaired  the damaged vehicle.  The complainant  has filed  the copies of the bills  and receipts   which are dated  25-6-2015 i.e, about two months  prior to the  preparation of the final report by surveyor Mr.Prabhakar Redddy along with the  assessment  of damage made by him.  So virtually  it was impossible to complainant  to have   the  original bills to attending  repairs  as assessed by surveyor.  So it appears  just in order to deny the claim  of the complainant  the opposite parties   have ingeniously  took a plea that the complainant  failed to furnish the original  bills and receipts  relating to the attending of repairs for the vehicle. 

         As already said  the version of the  complainant is that she was asked to  get repair the vehicle  by the surveyor who inspected is in not denied.  As such the complainant’s version stands that she got repaired the vehicle as asked by the surveyor who inspected it much before filing of a final report by the Mr.Prabhakar Reddy with the opposite parties.  All these facts and circumstances have clinchingly established  not only unfair trade practice  but also deficiency of service on the part of the opposite parties.  Accordingly point is answered infavour of the complainant. 

Point No.2:  Since the complainant has successfully established her allegation of unfair trade practice and deficiency of service she is entitled for the amounts claimed in the complaint. 

Point No.3: In the result, the complaint is  allowed directing the  opposite  parties

1. To pay to  the complainant a sum of Rs.67,500/-  together with interest at 18% P.A from the date of submitting of the claim i.e, 8-6-2015 to the date of payment
2. Opposite parties  are further directed  to pay a sum of Rs.12,000/- to the complainant  towards expenses  incurred by her for hiring the vehicle for her use . 
3. Opposite parties  are further directed  to pay a sum of Rs. 50,000/- as compensation  for inconvenience and mental agony caused the complainant by  not settling the claim
4. Opposite parties  are further directed  to pay a sum of Rs. 10,000/- as costs of this complaint. 

Time for compliance : one month from the date of service  of this orders

                        Dictated to steno, transcribed and typed by her, pronounced  by us on this the  6^th   day of May , 2019

MEMBER                                                                                            PRESIDENT

APPENDIX OF EVIDENCE

Exs. filed on behalf of the Complainant:

Ex.A1- copy  of insurance policy

Ex.A2- copy of panchanama report dated 6-6-2015

Ex.A3- copy of   receipt towards vehicle towing charges dt.6-6-2015

Ex.A4- copy of purchase bill No.4222 dt.25-6-2015

Ex.A5- copy of purchase bill  dt.25-6-2015

Ex.A6- copy of the bill  dt.29-06-2015

Ex.A7- copy of final letter issued by the opposite  party dt.19-08-015

Ex.A8- office copy of the legal notice dt.31-08-2015

Ex.A9- copy of the letter send by the Ombudsman dt.07-09-2015

Ex.A10- copy of the I.D.proof of the complainant

Exs. filed on behalf of the Opposite parties

Ex.B1 policy terms and conditions

Ex.B2 letter dated 8-07-2015

Ex.B3 reminder letter dated 08-08-2015

Ex.B4 final letter dated 19-08-2015

Ex.B5 survey report dt.07-09-2015

Ex.B6 claim form

MEMBER                                                                                            PRESIDENT