DISTRICT CONSUMER DISPUTES REDRESSAL FORUM  PALAKKAD

Dated this the 10^th day of October 2018

Present   : Smt.Shiny.P.R. President

              : Smt.Suma.K.P. Member                           Date of filing:  01/10/2016

              : Sri.V.P.Anantha Narayanan, Member

CC/150/2016

K.C.Chandrasekharan,

S/o Kunjunni Nair,

K.C House, Cherumundasseri (PO),

Ambalappara, Ottapalam Taluk,

Palakkad District, Kerala State,

679 512.                                                                -  Complainant       

(By Advs.K.Jyothi Basu & K.Dhananjayan)

                                                            Vs

Company Limited, - Opposite parties

Head Office, Vishranthi Melaram Towers, No.2/319,

Rajiv Gandhi Salai (OMR), Karapakkam,

Chennai – 600 097.

(Rep.by its Managing Director/Manager/Authorised

2. M/s Royal Sundaram Alliance Insurance

Company Limited,

Head Office, Vishranthi Melaram Towers, No.2/319,

Rajiv Gandhi Salai (OMR), Karapakkam,

Chennai – 600 097.

(Rep.by its Managing Director/Manager/Authorised

Manapulikavu, Palakkad.

( Rep.by its Manager)

                                                          O R D E R

By Smt.Suma.K.P. Member

The complainant hear in is the owner of the vehicle bearing chasis No.MAJIXXMRJIDP03338 Engine No.DPO338 and which bears registration No.KL-51D-7725(Ford Figo Passenger Car).  Complainant is using the vehicle for his and his family’s personnel needs. While he was driving the said car on its way from Calicut to Palakkad on 16/1/2016 at 8 PM the vehicle has hit on a stone laid on the road side and has sustained damages to engine as well as other parts of the vehicle.  The accident occurred in Mannarkkad Town. 

          At the time of purchase of the vehicle and also on the date of the incident the vehicle was having and covered with an insurance policy issued by opposite party 1 and 2.  The policy bears No.FOP1095493, the name of the policy is private car package policy, the term and tenure of the policy is from 00 hours on 15/6/2015 to 14/6/2016 midnight.  As per the stipulations and conditions of the said insurance policy the complainant is legally entitled to get the full coverage of the policy.  Immediately after the accident, the complainant has telephonically informed to the opposite parties regarding the accident and the damage occurred to the vehicle of the complainant.  Then, in reply telephonic information given by the complainant, the opposite parties have asked the complainant to tow the vehicle by lifting the front side and thus by not causing any further damage to the vehicle and bring it to the 3^rd opposite party.  Thus the complainant has arranged a Kaja Mini Crane Services, Kunthipuzha, Mannarkkad to tow the vehicle by means of Crane on 16/1/2016 and brought it to the third opposite party at about 10 PM, for which a receipt of payment is issued to the complainant by the Manager of Crane service.  After that, the third opposite party has checked the damages and prepared and issued an estimate to the complainant for Rs.1,54,136/-.  After the thorough inspection of the vehicle the following damages were found and noticed in the car of the complainant, which as stated in the estimate details given to the complainant provided by the third opposite party.  The cost of repairing the damages caused to the above said vehicle has been estimated to the tune of Rs.1,54,136/- and other conditions stipulated in the estimate details.  Thereafter the complainant processed the claim of the damages caused to the vehicle through third opposite party from the opposite parties 1 and 2.  The claim of complainant has not been entertained and rejected on flimsy reason that there is engine components being in result of damages and stated that the claim cannot be entertained based on the condition No.4 of the insurance policy.  The rejection of insurance claim of complainant is informed to the complainant by 1^st opposite party by virtue of letter dated 2/3/2016.  The insurance to the vehicle coverage is denied by the 1^st and 2^nd opposite parties by the reason stating that condition No.4 of the insurance policy not comply with, which states as follows:

“in the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damages or loss and the vehicle be driven before the necessary repairs are affected any extension of the damage or further damage to the vehicle shall be entirely at the insurer’s on risk”.  Other reasons is repairs of the vehicle were carried out before inspection of the vehicle, thereby not giving an opportunity to inspect the vehicle in damaged condition.  On the above stated two reasons, the first and 2^nd opposite parties have denied the claim.  The complainant had paid Rs.1,54,136/- to the 3^rd opposite party, as the cost of the repair of the vehicle.  The reason for the denial of the claim shown in the letter dated 2/3/2016 is baseless and incorrect.  Even though the letter reveals to submit the original bills/ cash receipt to enable the 1^st and 2^nd opposite parties to proceed further in insurance claim, even after issuance of the bill and cash receipts by the 3^rd opposite party, the 1^st and 2^nd opposite parties have not considered the same and denied the claim of the complainant in this regard.  At last the complainant paid the entire amount for repairing the vehicle to the 3^rd opposite party.  He submits that the opposite parties 1 and 2 are liable to indemnify the loss caused the complainant as well as the vehicle.  The act of the opposite parties 1 and 2 is highly illegal, improper and to defeat the legitimate claim of insurance policy amount of the complainant.  Due to the act of 1st and 2^nd opposite parties the complainant had suffered heavy mental agony.  Hence the complainant approached this Forum for the redressal of his grievance and also claiming compensation of Rs.1 lakh for the mental agony suffered by him.

          Opposite parties entered appearance upon notice from the Forum and filed their version contending the following.

          Opposite party 1 and 2 states that the claim of the complainant was rightly repudiated after observing that the claim is resultant of aggravation damage which is beyond the scope of this policy.  Further the insured vehicle was dismantled before being inspected by these opposite parties.  Thus the claim was rightly repudiated.  Hence the present complaint is liable to be dismissed.  The complainant ought to have lodged a claim immediately as required under condition No.1 of the policy terms and conditions.  Further the insured vide the claim form narrated the accident as “the vehicle hit the bottom on gutter”.  It is also submitted that, on intimation of the claim these opposite parties appointed a licensed surveyor to assess the loss.  The surveyor had assessed impact damage based on the claim to the tune of Rs.5,613/-.  It is pertinent to note that the surveyor only assessed the damage with respect to the impact damage which he had expressly mention under “point 35-comments” section of the survey report.  The surveyor in his report specifically made an observation that, before the survey itself the vehicle was dismantled condition, and the impact damage is only to oil sump and oil strainer.  Moreover, he states that connecting rod’s main bearers were seized and there are scoring marks on crankshaft, based on the extend and nature of damage he concludes that the vehicle was driven after the accident.  The said observations of the surveyor confirms aggravation damage to the engine inner parts due to oil starvation.  It is also submitted that the complainant has not taken add-on cover “engine (aggravation) protection cover” for including the aggravation damage due to “leakage of lubricating oil slash woolent due to any accidental means” were lodging a claim in respect.  Since, the complainant had not opted for the said add-on coverage or paid any premium in this respect the scope of the policy is only limited to accidental external damage only.  It is submitted that the surveyor observed damage to engine’s inner parts which was due to oil starvation which is confirmed by the scoring marks on the engine main journel bearing a crank shaft.  Further, the oil circulation inside the engines stock due to the breakage of the strainer inside the same, this confirms that the vehicle was running to some distance after the impact which resulted in aggravation damage to engine.  Due to the above mentioned reasons the claim was rightly repudiated with respect to aggravation damage.  Further with respect to the impact damage the complainant was informed to submit the original bills to process the claim.  In the light of aforesaid contentions and submissions the complaint had to be dismissed. 

The 3^rd opposite party filed version stating that since no relief is claimed from them by the complainant they are unnecessary party to this proceedings.  The complainants vehicle was brought to the service centre of the 3^rd opposite party for repairing some damages sustained and accordingly the repair works carried out and the bill was also settled by the complainant. 

The complainant filed chief affidavit.  Ext.A1 to A4 was marked from the side of the complainant.  Opposite parties 1 and 2 filed affidavits and Ext.B1 to B4 was marked from the side of the opposite parties. 

Complainant filed application to reopen the evidence and also application to amend the complaint.  Amendments was allowed and opposite parties were asked to file additional version.  No additional version was filed by the opposite parties.  Complainant filed additional affidavit Ext. A4 to Ext.A10 was marked from the side of the complainant. 

Evidence was closed and matter was heard. 

The issue that arises for consideration before the Forum is :

1. Whether the complainant is entitled to get the relief as prayed for in the light of the insurance policy?
2. Whether there is in a deficiency of service from the part of opposite parties?
3. Relief and cost?

Issues 1,2 & 3

The opposite parties admitted that the vehicle of the complainant is having a comprehensive insurance policy issued by the opposite parties.  As insurance policy is admitted, the only contention taken by the opposite parties is that the complainant has not taken genuine care to prevent further damages and thus claim is repudiated as per clause 4 of the policy.  The opposite parties had also produced the surveyor report which shows damages.  Ext.A5 is the invoice receipt issued by 3^rd opposite party immediately after the accident dated.31.01.2017 which shows that the grant total amount for the repairs amounts to Rs.94,037/-.  But the document Ext.A5 is incomplete document and the page 3 of the document is missing.  Moreover the said document does not bear signature or seal. 

The surveyor of the opposite party had visited on 09.02.2016 alleging damage and vide his survey had assessed impact damage based on the claim to the tune of Rs.5,613/-.  Further the surveyor in his report had specifically made an observation that, before the survey itself the vehicle was dismantled condition  and the impact damage is only to oil sump and oil strainer.  It was also submitted that Hon’ble National Commission have held that the survey report is a valid document and it should be given due importance unless there are adequate reason to discard the same.  Our National Commission had also held that the surveyor’s report is an important document and the same cannot be brushed aside easily without valid justification only if there is cogent reason for rejecting the same it can be done so.  The report of the surveyor is to be given much more weightage than any other document. 

The documents produces by the complainant cannot be relied upon since most of them are photocopies and does not bear seal or signature.  Exts.A4 to A10 seems to be subsequent bills which shows battery fitting, A/C gas filling, washing etc… which is in no way connected to the incident. 

In the light of the above discussions we are of the view that the complainant has failed to prove the allegations stated in the complaint.  No contra evidence is produced from the part of the complainant to discard the surveyors report.  In the above circumstances the complaint is dismissed without cost. 

          Pronounced in the open court on this the 10^th October 2018.

              Sd/-    

                   Shiny.P.R

                   President 

                       Sd/-        

                   Suma.K.P

                    Member

              Sd/-     

    V.P.Anantha Narayanan

                   Member

Appendix

Exhibits marked on the side of complainant

Ext.A1          -  Photocopy of Private car package policy certificate cum policy schedule

Ext.A2          -  Photocopy of letter issued to the complainant showing denial claim of

             insurance dated.02.03.2016

Ext.A3          -  Photocopy of certificate of registration of the vehicle Ford Figo bearing

             Reg.No.KL 51 D 7725

Ext.A4          -  Original Cash Bill dated.16.01.16  issued by Kaja Mini Crain Service

             Goods Service to Complainant

Ext.A5          -  Original Bill dated.31.01.17 issued by PVS Ford limited to complainant

Ext.A6          -  Original Estimation details by PVS Ford to complainant dated.28.2.16

Ext.A7          -  Original bill dated. 05.05.17 issued by Auto clinic to complainant

Ext.A8          -  Original bill dated. 15.02.17 issued by Auto clinic to complainant

Ext.A9          -  Original bill dated. 19.04.17 issued by Auto clinic to complainant

Ext.A10- Original bill dated. 31.01.17 issued by PVS Ford limited to complainant

Exhibits marked on the side of Opposite parties

Ext.B1 -  Certified true copy of Private car package policy certificate cum policy

              Schedule

Ext.B2 -  Certified true copy of Motor Insurance claim form

Ext.B3 -  Survey Report of the vehicle

Ext.B4 -  Photocopy of letter issued by opposite party to the complainant

Witness examined on the side of complainant

Nil

Witness examined on the side of opposite parties

Nil

Cost

          Nil