STATE CONSUMER DISPUTES REDRESSAL COMMISSION OF TELANGANA :
At HYDERABAD
FA No. 1286 OF 2013
AGAINST
CC NO.1043/2011, DISTRICT FORUM II, HYDERABAD
Between :
- M/s. Bajaj Allianz General Insurance Co. Ltd
6-3-111/8, Street No. 18, Main road,
Fare East Plaza, 2nd Floor,
Himayat Nagar, Hyderabad – 500 029.
- M/s. Bajaj Allianz General Insurance Co. Ltd
GE Plaza, Air Port Road, Yerrawada,
Pune-411 006 ( India)
Rep. by its Managing Director .. Appellants/opposite parties
And
N. Srinivasa Rao, S/o N.Venkateswarlu,
Aged about 45 years, Indian,
Occ : Private Service,
R/o H.No. 11-41/1, Sahithinagar,
P & T Colony, Gaddiannaram,
Dilsukhnagar, Hyderabad .. Respondent/complainant
Counsel for the Appellants/opp. parties : Sri N. Mohan Krishna
Counsel for the Respondent/complainant : M/s. V. Gourisankara rao
Coram :
Honble Sri Justice B. N. Rao Nalla … President
And
Sri Patil Vithal Rao … Member
Thursday, the Fourteenth Day of September
Two Thousand Seventeen
Oral order : ( per Hon’ ble Sri Justice B.N.Rao Nalla, Hon’ble President )
***
1) This is an appeal filed under Section 15 of the Consumer Protection Act by the complainant to set aside the impugned order dated 15.05.2013 made in CC No 1043 of 2011 on the file of the District Forum II, Hyderabad and allow the appeal.
2) For the sake of convenience, the parties are described as arrayed in the complaint before the District Forum.
3) The case of the complainant, in brief, is that he insured his Martui Alto 2007 Model car bearing No. AP29BA4266 under Private Car Package Insurance policy bearing No. OG-12-1801-00012960 for the period commencing from 09.06.2011 to 08.06.2012 for Rs.2,10,000/- by paying Premium of Rs.3,982/- and on 26.07.2011, the said car met with an accident. The same was informed to the opposite parties, in turn, they appointed a surveyor, who, assessed the loss at Rs.36,000/-. On 11.08.2011 he paid Rs.35,726/- towards repair charges to M/s. RKS Motor Pvt. Ltd . The claim submitted by him on 18.08.2011 with all relevant documents was repudiated by the opposite party on the ground that the complainant breached the insurance contract, i.e, the complainant availed the 45% NCB ( No claim Bonus) inspite of availed a claim on the previous policy . Despite addressing three registered letters, the opposite parties did not furnish proposal form which discloses the correct information. The proposal form was filled by the agent of the opposite parties and simply he put his signature. The acts of the opposite parties amount to deficiency in service. Hence the complaint to direct the opposite party to pay Rs.35,726/- with interest@ 18% pa from 11.8.2011 till the date of realization, to pay compensation of Rs.10,000/- and costs of Rs.5,000/-.
4). The opposite party opposed the above complaint, while admitting issuance of the policy in question, contending that the copy of the policy schedule furnished by the complainant itself clearly discloses that he availed the benefit of NCB ( NO Claim Bonus) @ 45% by paying Rs.3,982/- instead of Rs.7,519/-. He did not furnish any particulars of his earlier claim in the complaint. He declared in the policy schedule that no claim has arisen in the previous policy and that if the declaration is found to be incorrect, all benefits under the policy in respect of Section 1 of the policy will stand forfeited. As per the said condition, no person should take the benefit of No Claim Bonus in case of raising the claim in the previous policy. The complainant availed a claim earlier in the previous policy and due to non-disclosure of the same, they granted 45% of NCB to him and the complainant paid the premium for the present policy after deduction of 45% of NCB amount. There is no denial by the complainant about the claim in the previous policy and also taking the benefit of NCB @ 45% in the present policy, the declaration as mentioned on the face of the policy disentitles him for all the benefits under the present policy. Hence they repudiated the claim in view of the above declaration and suppression of the previous claim. There is no deficiency in service on their part. Hence prayed to dismiss the complaint.
5) During the course of enquiry before the District Forum, in order to prove his case, the complainant filed his evidence affidavit and got marked Ex.A1 to A- 5 and the opposite party filed evidence affidavit and got marked Ex. B 1 to B5. Heard the counsel on both sides.
6) The District Forum, after considering the material available on record, directed the opposite party to pay Rs.35,726/-, to pay Rs.5,000/- towards compensation and costs of Rs.1,000/- within 30 days, failing which, it carries interest @ 9% pa.
7) Aggrieved by the said order, the opposite parties preferred this appeal before this Commission.
8) Both sides have advanced their arguments reiterating the contents in the appeal grounds, rebuttal there of along with written arguments. Heard both sides.
9) The points that arises for consideration are,
(i) Whether the impugned order as passed by the District Forum suffers from any error or irregularity or whether it is liable to be set aside, modified or interfered with, in any manner?
(ii) To what relief ?
10). Point No.1 :
There is no dispute that the respondent/complainant obtained insurance policy in question for Rs.2,10,000/- to his Maruti car and it met with an accident on 09.06.2011 and the policy was in force at the time of the accident. There is also no dispute that it got damaged and the surveyor of the appellants assessed the loss at Rs.35,726/-. There is also no dispute that the claim submitted by the respondent/complainant was repudiated by the appellant/ opposite party on ground of false declaration that he did not avail any claim previously though he obtained the same and availement of NCB @45% .
11) (i) The main contention of the appellant/opposite party is that the District Forum failed to see the declaration of the respondent/complainant in the proposal form and suppression of availement of NCB @ 45% and as per section 1 of the policy, if, the complainant declares a false statement regarding ‘ NO claim Bonus, then all the benefits of the policy stand cancelled.
(ii) Counsel for the respondent/complainant argued that the complainant simply signed on the proposal form which was filled by one Sudhakar Reddy, the agent of the opposite parties and no copy of the proposal form was furnished to him to verify the contents despite sending three registered letters.
(iii) It is observed that the appellants/opposite parties did not place, the proposal form signed by the respondent/ complainant at least, before this Commission for the reasons best known to them. Ex B-2 shows that the respondent/complainant availed benefit of NCB @ 45% in his earlier policy which was not contradicted by him. It is true that the respondent/ complainant in Ex. A-2 policy schedule made declaration stating ‘ No claim Bonus : 45% and as per the declaration he is not entitled for all benefits in respect of Section 1 of the policy. The District Forum opined that the person who filed the application might have obtained the signature of the respondent/complainant without his knowledge, however, since, he is not claiming the entire insured amount of Rs.2,10,000/-, but, claiming only actual amount paid by him towards repair charges of Rs.35,726/- and hence directed to pay the same. Whether he has knowledge of the terms and conditions or not, and knowingly or unknowingly , he has already availed the benefit of NCB @ 45% , once, and hence he is not entitled for the same again as per the policy conditions.
13). After considering the foregoing facts and circumstances and also having regard to the contentions raised on behalf of the appellants/opposite parties and the respondent/complainant, this Commission is of the view that there is no deficiency in service on the part of the appellants/opposite parties in repudiating the claim of the respondent/complainant and the appeal is liable to be allowed setting aside the impugned order. This Commission answered Point No. 1, accordingly.
14). Point No. 2 :
In the result, the appeal is allowed setting aside the impugned order and consequently the complaint is dismissed. There shall be no order as to costs. Time for compliance four weeks.
PRESIDENT MEMBER
Dated : 14.09.2017.