Order No. 18 dt. 02/06/2017
The case of the complainant in brief is that the complainant purchased a vehicle on 20.12.11. The said vehicle was insured with o.p. insurance company and during the validity of the insurance policy an accident took place at Sitapur, Uttar Pradesh. The complainant lodged an FIR at Sitapur P.S. The complainant also informed the o.p. in respect of the said accident and o.p. appointed a surveyor to ascertain the loss upon enquiry and the surveyor submitted the report to o.p. The complainant thereafter by payment an amount of Rs.4000/- got the said vehicle to Howrah by Supercrane Service. The complainant as per the advice of o.p. handed over the vehicle to M/s Viswakarma Bodybuilders. Viswakarma Bodybuilders submitted a bill of Rs.1,85,000/- and the complainant paid the said amount. In order to make the said vehicle roadworthy the complainant handed over the said vehicle to Suman Motors and they charged Rs.3,74,535/-. The complainant paid the said amount. After repairing and making the vehicle worthy the complainant submitted a claim of Rs.5,61,745/- to o.p. but o.p. did not disburse the amount to the complainant. In view of the said fact the complainant filed this case praying for direction upon the o.p. to pay the sum of Rs.5,65,745/- and compensation of Rs.1 lakh and litigation cost of Rs.25,000/-.
The o.p. contested this case by filing w/v and denied all the material allegations of the complaint. It was stated that the complainant is not a consumer as per the provision of C.P. Act and the dispute involved is not a consumer dispute. The complainant was using he vehicle for commercial purpose. Hence the complaint is liable to be dismissed. It was further stated that the policy in question is an insurance policy for period 4.6.13 to 3.6.14, the sum assured was Rs.16,82,300/-. The complainant obtained the insurance policy by submitting forged documents. The complainant has submitted one policy copy issued by Bharti Axa General Insurance Co. Ltd. bearing policy no.FCV/10842165/61/03/K1621E for the period from 6.5.12 to 5.5.13. But during investigation by insurance company it is found that the particular vehicle was earlier insured with the said insurance company for the period from 28.3.12 to 27.3.13 bearing the same policy number. The policy copies and investigation report have been annexed with the w/v. As the policy was obtained by the complainant by misrepresentation and by submitting forged document the claim is not maintainable. The complainant has deliberately made false allegation against the o.p. to cover his own fault or latches of not taking proper care of the consignment and under the present terms and conditions of the policy and unnecessarily o.p. has been dragged investigation for which o.p. prayed for compensation and also prayed for dismissal of the case.
On the basis of the pleadings of parties the following points are to be decided:
- Whether the complainant had the policy at the relevant point of time.
- Whether the complainant suppressed the material fact and obtained the policy from o.p. in spite of existence of another policy in respect of the said vehicle from another insurance company.
- Whether there was any deficiency in service on the part of o.p.
- Whether the complainant will be entitled to get the relief as prayed for.
Decision with reasons:
All the points are taken up together for the sake of brevity and avoidance of repetition of facts.
Ld. lawyer for the complainant argued that the vehicle belonging to the complainant was insured with o.p. and during the existence of the said policy the vehicle of the complainant met with accident. Due to the said accident the vehicle was damaged and after giving proper information to o.p. the vehicle was brought from U.P. to Howrah and the said vehicle was repaired in a garage at Howrah. The complainant paid necessary charges. After repairing of the said vehicle it was noticed that the vehicle was not roadworthy for which the vehicle was again sent to another garage whereby the vehicle was repaired and the complainant the amount further. In such manner the complainant paid a total amount of Rs.5,61,745/- plus crane charge of Rs.4000/-. Ld. lawyer for the complainant emphasized that the complainant after repairing of the said vehicle and procuring of the documents submitted bill to o.p. praying for releasing of the fund in favour of the complainant but o.p. did not take any measure for which the complainant had to file this case praying for reliefs.
Ld. lawyer for the o.p. argued that the vehicle in question was insured with another insurance company at the relevant point of time and the complainant by suppressing the material fact obtained the policy from o.p. In order to substantiate the said fact o.p. filed the documents including the survey report. The o.p. made a investigation regarding the claim of the complainant and the report was submitted wherefrom it is evident that during investigation it was revealed that 20% NCV enjoy against the said policy which was issued on 28.3.12 valid upto 27.3.13. The investigation also obtained a policy copy which was annexed with the report wherefrom it is found that the complainant obtained the policy from Bharti Axa General Insurance Co. Ltd. and the period of policy as mentioned in the said policy was valid from 28.3.12 to midnight of 27.3.13 and the policy obtained by the complainant from o.p. was valid for the period from 4.6.13 to 3.6.14. But the policy supplied by the complainant showing validity from 6.5.12 to 5.5.13 was a fake policy. It is relevant to mention here that the complainant submitted one policy copy issued by Bharti Axa General Insurance Co. Ltd. being policy no.FCV/10842165/61/03/K1621E for the period from 6.5.12 to 5.5.13, but during investigation o.p. found that the particular vehicle was earlier insured with Bharti Axa General Insurance Co. Ltd. vide policy no. FCV/10842165/61/03/K1621E for the period from 28.3.12 to 27.3.13 bearing the same policy number. As the policy was obtained by misrepresentation and submitting forged documents the claim was not entertained by o.p. as per the terms and conditions of the policy. In order to fortify the said claim o.p. insurance company annexed the relevant documents with w/v.
Considering the submissions of the respective parties it is an admitted fact that the vehicle owned by the complainant had met with an accident on 5.6.13. The complainant in order to fortify the said fact filed some documents including the FIR lodged at the P.S. It is also undisputed fact that immediately after the said accident o.p. was informed by the complainant. From the materials on record it appears that in the said accident driver of the vehicle expired and the helper sustained severe injuries. The complainant after the said accident while the fact was informed to the insurance company and as per the advice of o.p. the vehicle was brought to Howrah and a repairing was made. Subsequently for making roadworthy of the said vehicle further repairing was made in another garage. The complainant incurred the expenses which he claimed of Rs.5,61,745/-. The insurance company after getting such information from the complainant appointed a surveyor and the surveyor examined the vehicle and assessed the damage sustained by the complainant and submitted a report whereby it was mentioned that the damage was found to the extent of Rs.3,74,535/-. The complainant submitted the bills along with reports of the said accident to o.p. and o.p. repudiated the claim on the ground that the complainant obtained the insurance policy by suppressing the material fact that he had another policy at the relevant point of time with Bharti Axa General Insurance Co. Ltd. On perusal of the documents it appears that the policy held by the complainant in respect of the said vehicle issued by Bharti Axa General Insurance Co. Ltd. for the period from 6.5.12 to 5.5.13 and 28.3.12 to 27.3.13. But the policy on which the complainant claimed the compensation relating to the policy for the period from 4.6.13 to 3.6.14. The complainant filed the copy of the said policy which has not been denied by o.p. From the facts and circumstances of the case we find that during the subsistence of the policy the accident took place. The complainant made claim to o.p. and no action was taken, subsequently after filing of the case and with the filing of the w/v the complainant came to know of the fact that due to suppression of the obtaining policy the repudiation was made. But on perusal of the documents we find that the claim made by o.p. is not correct in view of the fact that the policy on which the claim was made by the complainant was a subsequent policy and o.p. issued the said policy after accepting the premium. Merely because raising this point of suppression of material fact by fraudulent means the policy was obtained cannot be a ground for repudiation of the claim of the complainant. It is also found from the surveyor’s report that the extensive damage was caused to the said vehicle and for repairing of the said vehicle the assessment was made by the surveyor to the extent of Rs.3,74,535/-. Since the surveyor’s report has not been challenged by o.p. though the complainant challenged the said assessment made by the surveyor but the surveyor’s report cannot be rejected mere because of the complainant raised objection regarding the higher quantum of amount he had to spend for the purpose of repairing of the damage of the said vehicle. A bonafide insurance claim cannot be repudiated by the insurance company by raising unsubstantive allegation against the complainant that the policy was obtained by fraudulent means [2017(2) CPR 9 (NC)]. Since there was deficiency in service on the part of o.p. insurance company, therefore we hold that the complainant will be entitled to get the relief. Thus all the points are disposed of accordingly.
Hence, ordered,
That the CC No.486/2014 is allowed on contest with cost against the o.p. The o.p. is directed to pay to the complainant a sum of Rs.3,74,535/- (Rupees three lakhs seventy four thousand five hundred thirty five) only along with compensation of Rs.30,000/- (Rupees thirty thousand) only for harassment and mental agony and litigation cost of Rs.5000/- (Rupees five thousand) only within 30 days from the date of communication of this order, i.d. an interest @ 10% p.a. shall accrue over the entire sum due to the credit of the complainant till full realization.
Supply certified copy of this order to the parties free of cost.
