DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, PALAKKAD

Dated this the  13^th day of August, 2024

Present      :   Sri. Vinay Menon V., President

                    :   Smt. Vidya A., Member                        

                   :   Sri. Krishnankutty N.K., Member                                        Date of Filing:  18/10/2022    

                                      CC/195/2022

Ratheesh K.,

S/o. Radakrishnan,

Usha Nivas,  Chathanur Post,

Peringodu Via, Thirumittakode II Village,

Pattambi, Palakkad – 679 535                                                -           Complainant

(By Adv. Raghudas S.G.)

                                                                                                Vs

1. M/s. Shriram GIC Ltd.,

       E8, EPIP, Seethapura Industrial Area,

       Jaipur, Rajasthan- 302 022

              Rep. by Managing Director.

2. M/s. Shriram GIC Ltd.,

            Rep. by Managing Director

       E8, EPIP, Seethapura Industrial Area,

       Jaipur, Rajasthan- 302 022.          

3. M/s. Shriram GIC Ltd.,

       41/339, Azad Tower,

Amman Kovil Cross Road,

Ernakulam, Kochi – 682 035

       Rep.by Branch Manager.

4. Jacob Hancy,

       Agent, Shriram GIC Ltd.,

      Pulikal, 1/745/A,

Police Quarters Road,

Fort Kochi – 682 001

Ernakulam.

5. Vasudev @Vasudevan T.,

Insurance Portal Office,

             EP Tower, Riyas Complex,

M.G. Road, Mele Pattambi,

Pattambi Taluk, Palakkad – 679 303                                        -          Opposite parties

            (OPs 1 to 3 by Adv. K.K. Jaidip

               OPs 4 & 5 are exparte)

O R D E R

By Sri. Vinay Menon V., President

1. Quintessential pleadings necessary for judicial appreciation of facts is that the complainant is the owner of a vehicle which is insured under the OP company.  Complainant’s vehicle met with a minor accident. Subsequent to repairs carried out, complainant filed a claim for Rs.32,209/- but the said claim was repudiated on the ground that the complainant is enjoying no claim bonus in contravention of the policy. Therefore, the claim was closed. It is aggrieved by this closure that this complaint is filed for claim amount and compensation and other claims.
2. Opposite party filed version admitting the details as pleaded and submitted that the surveyor had prepared a survey report dated 30/5/2022 for Rs.21,735.67/-. But the surveyor also submitted that the complainant had not stated about the earlier accident and had illegally availed NCB and the policy was issued based on reduced premium. Since the complainant was enjoying the no claim bonus and benefits based on misrepresentation, claim file was closed.  Complaint is only liable to be dismissed.
3. Following issues were framed for consideration:

1. Whether the repudiation of complaint of the complainant is as per the terms and conditions of the policy?
2. Whether there is any deficiency in service or unfair trade practice on the part of the OPs?
3. Whether the complainant is entitled to any of the reliefs sought for?
4. Any other reliefs?

4.         (i)           Documentary evidence of complainant comprised of proof affidavit and Exhibits           

                          A1 to A7.    There was no objection in marking of the documents.

(ii)          OPs 1 to 3 filed proof affidavit and marked Exts.B1 to B7.

(iii)        (a)        Marking of all documents are objected to on the ground that they are photocopies. Since this Commission is not bound by Indian Evidence Act of BSA objection regarding exhibits being photocopies is overruled.

(b)        Marking of Ext.B1 is additionally objected to on the grounds that it is produced for the first time, that the complainant is not in receipt of Ext.B1 and that the complainant has no knowledge of Ext.B1.  The multi-pronged objection regarding Ext. B1 Commercial Vehicles Package Policy can be considered if and when the necessity arises.  

(c)        Marking of Ext.B2 is objected to on the ground it is not prepared either by the complainant or under his instructions or directions and is unaccompanied by Section 65B certification. Since execution of the proposal form itself is objected to by the complainant, a duty was cast upon the opposite party to prove that Ext. B2 was prepared in accordance with the instruction given by the complainant. Since the OP has failed to prove the validity or legal sanctity of Ext.B2, Ext.B2 is rejected. It will not be relied on for any purposes.

 Issue No.1

5.         Fact that the complainant’s vehicle met with an accident and had incurred expenses for repairing is not disputed. The only allegation is that the complainant had not disclosed the factum of earlier accident and claims from the earlier insurer.  

6.         Hence, crux of the dispute therefore lies in the answer to the question whether the complainant had illegally claimed for benefits or not?

7.         The primary document that would prove whether the complainant had claimed No Claim Bonus or not is the proposal form. OP had produced and marked the said proposal form as the Ext.B2 but the counsel for complainant had raised serious objection to marking of the same since, per complainant, it was not prepared by the complainant or under his instructions. The OPs also had not taken any steps to prove by cogent evidence that the said proposal form had been issued under the supervision of the complainant. Therefore Ext.B2 stands rejected, as already stated supra, and is not to be relied upon.

                        At the time of hearing, counsel for the complainant himself sought to rely on Ext.B2 to prove his case. But complainant cannot approbate and reprobate or blow hot and cold with regard to a document at the same time. The complainant therefore cannot rely on a document that he had staunchly objected to marking at the time of evidence and successfully got rejected.

8.         The next document in line to prove the contention of the OP is Ext.A2 certificate-cum- policy schedule. Ext.A2 clearly shows that the complainant had availed an NCB discount of 45%. Ext. A2 was marked undisputedly and hence reliance is placed in its contents.

9.         Thus, we find that the complainant had availed NCB willfully.

10.       The next question is whether the complainant had earlier claimed insurance. Ext. B5 is the surveyor’s report. Complainant has no case that the contents of the said report is falsified to deter the genuine claim of the complainant and had not objected to marking of the same with the same vehemency with which Ext. B2 was objected. Therefore, we presume that the vehicle had met with earlier accident and claims were raised as pleaded by the O.P.

11.       Thus, on an appreciation of the over-all evidence adduced by parties, we are of the opinion that the complainant has attempted to mislead and misguide the insurance company for availing the reduced premium by claiming NCB.  We hold that repudiation is based on the terms and conditions of the policy.

Issue No.2

12.       Counsel for complainant, at the time of hearing, relied on the statutory provisions contained in India Motor Tariff.   He argued that conduct of OP was violative of clause (f) of General Regulation 27 [G.R. 27] pertaining to No Claim Bonus. This clause clearly states that the insurer allowing NCB should write to the policy issuing office of the previous insurer by recorded delivery calling for confirmation of the entitlement and rate of NCB for the particular insured and the previous insurer shall be obliged to provide the information sought within 30 days of receipt of the letter of enquiry failing which the matter will be treated as a breach of Tariff on the part of the previous insurer. Failure of the insurer granting the NCB to write to the previous insurer within 21 days after granting the cover will also constitute a breach of the Tariff.   

13.       O.P. had not raised any reply to this argument. It is true that the OP had not made any enquiries likewise and the factum of earlier accidents came to light only upon the surveyor filing his report.  Insurance company has failed to comply with a statutory regulation and has breached the Tariff.

14.       Having failed to comply with a statutory requirement, we hold that there is deficiency in service on the part of OP.

            Issue No.3

15.       As already found in Issue No.1, the complainant’s claim was repudiated for raising a claim on a policy availed by non-disclosure of material facts.  Therefore, the reliefs sought for cannot be granted.

16.       But for failure to comply with statutory requirements, we are granting a compensation, yet in a reduced scale considering the contribution of the complainant.  

            Issue No.4

17.       Based on the discussions above, we allow the complaint in part holding as follows:

1.          Complainant is entitled to a compensation of Rs.15,000/-

2.         Complainant is entitled to a cost of Rs.5,000/-.

3.         OPs 1 to 3  shall comply with the aforesaid directives within 45 days of receipt of this order, failing which they shall pay Rs.500/- per month or part thereof as solatium from the date of this order till the date of full and final compliance of this order.

                        Pronounced in open court on this the 13^th  day of  August,  2024.  

                             Sd/-                                                                                                                             

                                                                                                                                                  Vinay Menon V

                                                                                   President

                                                                                         Sd/-

                          Vidya.A

                                              Member         

                               Sd/-

                Krishnankutty N.K.

                                                                                                                                                   Member    

APPENDIX

Exhibits marked on the side of the complainant

Ext.A1   - Copy of   certification of registration

Ext.A2  –  Copy  of certificate cum policy schedule    

Ext.A3  –  Printout  of GST bill dated 24/5/2022   

Ext.A4  –  Printout  of  invoice dated 25/5/2022

Ext.A5  –  Printout of bill dated 25/5/2022   

Ext.A6  –  Copy of repudiation letter dated 2/5/2022

Ext.A7  –  Copy of lawyers notice dated 5/7/2022 alongwith postal receipts & AD cards

 Exhibits marked on the side of the opposite party

Ext.B1   - Original commercial vehicles package policy wordings.

Ext.B2   - Copy of proposal form

Ext.B3   - Copy of certificate cum policy schedule

Ext.B4   - Copy of claim intimation slip

Ext.B5   - Printout of the surveyors file pertaining to complainants reply

Ext.B6   - Copy of repudiation letter

Ext.B7   - Copy of download details of vehicle.

 Court Exhibit:  Nil  

Third party documents:  Nil

 Witness examined on the side of the complainant:  Nil

Witness examined on the side of the opposite party:  Nil

Court Witness: Nil

NB : Parties are directed to take back all extra set of  documents submitted in the proceedings in accordance with Regulation 20(5) of the Consumer Protection (Consumer Commission Procedure) Regulations, 2020 failing which they will be weeded out.