PER SHRI. S.M. RATNAKAR – HON’BLE  PRESIDENT

1)        The Complainant has prayed that it be held that the Opposite Parties are guilty of deficiency in service and unfair trade practices as per the provisions of the Consumer Protection Act, 1986 (hereinafter referred to as the Act).  The Complainant has further prayed that the Opposite Party be directed to pay Rs.1,17,500/- towards  the claim of the Complainant with interest thereon @ 18% p.a. from 16/01/2010 till its realization.  The Complainant has also prayed that an amount of Rs.1,00,000/- may be granted towards compensation for mental agony, hardship, etc. and Rs.50,000/- towards the cost of this litigation.

2)        It is alleged that Complainant has purchased Tata LPT 2516 TC bearing Regn.No. MH-06-AC-0175 and the same was insured with the Opposite Party under Policy No.250700/31/09/6300001130 for the period from 18/07/2009 to 17/07/2010.  It is alleged that the said vehicle met with an accident near Balsamad on National Highway –3 within the jurisdiction of Czhar Police Station while coming from Indore, Madhya Pradesh to Mumbai on 16/01/2010 at about 11.00 p.m.  Accident was reported to the police on the same day.  The Complainant states that since the vehicle was insured with the Opposite Party at Mumbai, the Complainant lodged claim on 19/01/2010 by giving intimation in writing on 16/01/2010 to the Opposite Party.  The Complainant also requested for appointment of surveyor. The Opposite Party appointed a Surveyor Mr. Rakesh C. Sagar, who gave his report on 25/01/2010.  Thereafter, the vehicle was brought to Mumbai and got repaired at Sai Auto Garage at Shivaji Nagar Govandi, Mumbai as well as at Govind Auto Garage for repair Radiator and at Shree Pandey Auto Garage for repair of front sheet greel etc. at N.K. Auto Glass for repairs of both sides screen glass.  It was also repaired at Farheen Turbo Repairer for repair of Turbo kit, etc. and received bill of Rs.7,500/- on 17/01/2010, Rs.32,500/- on 25/02/2010, Rs.61,350/- on 28/02/2010, Rs.7,550/- on 27/02/2010 and Rs.4,800/- on 28/02/2010, Rs.3,950/- on 26/01/2010, from respective garages the Complainant thus, paid all the said bills for total sum of Rs.1,17,600/- for repair of the said vehicle. 

3)        It is alleged that before the satisfaction of the claim of the Complainant the Opposite Party has appointed another Surveyor M/s. Dara and Sinor, Mumbai for survey of the said vehicle and gave final survey report on 09/02/2010.  Thereafter the Opposite Party appointed the Investigator Ganesh N. Iyer from Mumbai, to verify the bills who verified the bills and submitted the report on 21/05/2010 by making false observations at the instance of officers of the Opposite Party.  According to the Complainant, he personally met with the officers of the Opposite Party who orally promised to settle the claim.  However, by letter dated 28/05/2010, the Opposite Party repudiated the claim made by the Complainant on the ground of submission of bogus bills, cash memos.  The Complainant thereafter by letter dtd.04/08/2010 explained the factual position and denied the allegations of the Opposite Party. The Complainant by letter dtd.11/08/2010 submitted the receipts for payment made to Sai Auto Garage and Shri. Govind Automobiles.  It is alleged that in spite of the repeated demands, the Opposite Party failed and neglected to settle the genuine claim of the Complainant adopting unfair trade practices and thereby was causing grave mental agony, harassment, loss and damage to the Complainant’s business by adopting deficiency in service and negligence on their part.  The Complainant therefore, prayed the reliefs claimed in para 1 of this order may be granted in his favour and against the Opposite Party. 

4)        The Opposite Party contested the claim by filing written statement. It is contended that the Complainant had lodged the claim with the Opposite Party on 19/01/2010 of Rs.1,17,850/- and submitted the bills to the Opposite Party as stated in para 2 of the written statement.  It is the case of the Opposite Party that as per the report of the investigator the bills furnished by the Complainant were bogus/fictitious.  The Investigator noticed the same when he contacted the owner of Shri. Govind Automobiles and made query about the bill dtd.28/02/2010 for Rs.61,350/- and found that the owner of the said garage accepted the cheque only of Rs.36,000/- drawn on Dena Bank, Trombay Branch, bearing No.676016 dtd.08/03/2010 and it was issued by M/s. Pratik Roadlines and not by the Complainant.  The Investigator of the Opposite Party also noticed that the owner of the said garage could not produced any relevant document or cheque showing that he had received the balance amount for the repairs of vehicle No.MH-0/6/AC/0175.  The said garage owner gave vague replies to the queries made by the Investigator.  It is further submitted that when the investigator contacted to Sai Auto Garage regarding Bill No.307 dtd.20/06/2010 for Rs.32,500/- he had vehemently denied that he repaired the Complainant’s aforesaid vehicle. The owner of the said garage on the other hand said that the Complainant had promised him to pay Rs.2,000/- for giving him a blank singed bill.  In the report of Investigator Ganesh N. Iyer dtd.21/05/2010 he had mentioned the aforesaid facts.  It is contended that on the basis of the report of the Investigator the Opposite Party by letter dtd.28/05/2010 repudiated the claim for violating the terms of principles of indemnity.  It is contended that the Complainant by producing fictitious bills has violated the terms and conditions of the policy and therefore, the claim made in the complaint deserves to be dismissed with cost.   

5)        The Complainant filed affidavit of evidence.  The Opposite Party has not filed separate affidavit of evidence.  The Complainant has filed written argument.  The Opposite Party has submitted written pursis that the written statement filed by the Opposite Party be treated as written argument of the Opposite Party.  We heard Shri. Ankush Navghare, Ld.Advocate for the Complainant and Shri. K.H. Gorvankol, Ld.Advocate for the Opposite Party.  We have perused the documents filed on record by both the parties. 

6)        The Opposite Party has repudiated the claim lodged by the Complainant vide letter dtd.28/05/2010 wherein it was informed to the Complainant that the Opposite Party has appointed an investigator to check the geniuses of the bills, receipts and cash memos submitted in support of the claims.  The Opposite Party further informed that as per the Investigator’s report on record the Proprietor of Sai Auto Garage for which the complaint has raised a bill of Rs.32.500/- in respect of labour charges and new parts fittings as categorically denied the repairs done at his garage and the said garage owner informed the Investigator that the Complainant had just taken a letter head from him with a promise to pay Rs.2,000/-.  The Opposite Party has further informed that the Investigator has revealed that the invoice submitted in respect of Shri. Govind Automobiles for Rs.61,350/- though submitted to the Opposite Party indicating that the payment was already effected but the said garage owner had denied that they have received the payment as per invoice and stated that the payment of Rs.36,600/- was only made till the date of investigation vide cheque issued by Pratik Roadlines drawn on Dena Bank, Bombay Branch, dtd.08/03/2010.  According to the Opposite Party, the evidence collected by the Investigator clearly shows that the Complainant had submitted forged/bogus bills, cash memos to take benefit of the insurance policy and the same is in violation of the principle of indemnity.  The Opposite Party has thus, repudiated the claim lodged by the Complainant because of fraudulent act on the part of the Complainant.  Shri. Gorvankol Advocate drew our attention to the report of Investigator Shri. Ganesh N. Iyer, dtd.21/05/2010 wherein he has submitted the details of his investigation and pointed out that due to the above facts as the Complainant has not lodged his genuine claim and he has not come with clean hands the Complainant is not entitle to the reliefs as claimed.  Upon going through the documents placed on record we find that the Complainant failed to satisfy that the report of  the investigator is not acceptable. The Complainant did not file the affidavits of the owners or proprietor of the concerned garages to prove that whatever claim he had lodged to the Opposite Party had been paid to the said garages prior to submitting the claim to the Opposite Party. As per the provisions of the insurance law it is the fundamental principle that utmost good faith must be observed by the contracting parties.  Good faith, if forbids by either party from non disclosure of the facts which the parties known the claim, if any made on the basis of non disclosure of the facts and based on fraudulent act the same is liable to be rejected. In the present case though the Complainant has stated that in his affidavit that an amount of Rs.61,350/- was paid to Shri. Govind Automobiles by cheque of Rs.36,600/- and Rs.24,750/- by cash and produce one xerox copy of the receipt issued by Shri. Govind Automobiles, it appears that the said receipt doesn’t bear receipt number; no date is mentioned on the said receipt therefore, the statement made by the Complainant in his affidavit regarding the payment made to Shri. Govind Automobiles of Rs.61,350/- cannot be relied upon.  The copy of the receipt placed on record of Sai Auto Garage at Exh.‘G’ also cannot be relied upon as in the said receipt it is mentioned that –

             मेरा सेठके साथ कॉप्‍प्रोमाईस हो गया. मुझे मेरा पेमेंट रु.32,500/- पूरा मिलगया है  अब कोई हमारा लेनदेन नही है   इसलिए आप इनका इन्‍शोरन्‍स क्‍लेम  पास

             करनेकी कृपा करे    

            On perusal of said bill it appears that the said bill has been signed by Hari Shankar Vishwakarma. The Complainant has also produced one bill of the same auto garage dtd.25/02/2010 which is in English on which the name of Proprietor appears to be shown as Shankar Welder.  Thus, it appears that the Opposite Party has rightly repudiated the claim lodged by the Complainant in view of the forged and bogus bills submitted to it and as transpired in the investigation carried out by the Investigator Shri. Iyer. We therefore, hold that the submission made by the Complainant’s Advocate relying upon the affidavit of the Complainant in view of fraudulent act on the part of the Complainant cannot be accepted to grant the reliefs claimed in this complaint. In the result we hold that the complaint is liable to be dismissed. We therefore, pass the following order –

O R D E R

                              i.         Complaint No.59/2012 is dismissed with no order as to costs.

                              ii.        Certified copies of this order be furnished to the parties.