JUDGEMENT

          Complainant by filing this complaint has submitted that he purchased a Scorpio M Hawk Car of Mahindra & Mahindra, VLX-8 seater in the year 2010 from Royal Motors for a sum of Rs.9,91,709/-. After purchasing the said car bearing registration No.WB/06E/9182, the complainant took a motor insurance policy being private car package policy from Bajaj Allianz General Insurance Co. Ltd. through his agent.

          Complainant firstly obtained the policy for her Motor car, Scorpio from Bajaj Allianz General Insurance Co. Ltd. on 26.10.2010 being certificate cum policy No.OG-11-2401-1801-00030946 for the period from 26.10.2010 to 25.10.2011 midnight and it is pertinent to mention here that the complainant purchased the Mahindra & Mahindra Scorpip Car bearing registration WB-06E-9182 through the Financer Magma Financial Corporation Ltd. and the said financier Magma Fin Corp. Ltd. arranged the Motor Insurance from Bajaj Allianz General Insurance Company Ltd. after purchasing the said car through their finance.

          The windscreen of the complainant’s said Scorpio M Hawk Car was broken on 30.10.2011 near the residence of the complainant and complainant immediately lodged a claim for own damage to the Insurer Bajaj Allianz Insurance Co. Ltd. on 31.10.2011 and the insurer Bajaj Allianz General Insurance Company Ltd. settled the own damage claim of the complainant on 31.10.2011 for her Scorpio M Hawk to the tune of Rs.8,139/-.  After the expiry of the said policy complainant took the advice of A to Z Insurance Brokers Pvt. Ltd. Insurance broker Firm for obtaining further policy for covering her car.

          The said insurance broker Firm suggested the complainant to take insurance policy from National Insurance Co. Ltd. as the said Insurance Co. is a nationalized insurance company and the said company will protect the interest of the complainant and the said insurance Broker Firm brought a proposal Form of the op and requested to put her signature and the said broker Firm convinced and assured the complainant that the rest portion in the said form will be filled in by them and on good faith and trust complainant being an aged lady put her signature in the place of proposal of the insurance proposal of the insurance proposal form of package (Private Car) policy of the op and handed over a premium of Rs.18,623/- to the said Broker Firm A to Z Insurance Brokers Pvt. Ltd. for depositing in favour of op.

          But it is to be mentioned that the said Broker Firm did not inform the op that previously Bajaj Allianz General Insurance Company Ltd. settled the own damage Motor Insurance Claim of the complainant, as a result of which op allowed the ‘No Claim Bonus’ amount for a sum of Rs.3,808/- in favour of the complainant.

          Op on the other hand did not make query regarding the first policy, and lodging of claim and payment by first insurance, either from the Broker Firm or from the complainant but issued the certificate of Insurance Cum Policy document in favour of the complainant.  That complainant’s said Scorpio M Hawk car met with an accident on 25.02.2013 at NH 2 and the representative of complainant after the said accident immediately visited the local police station and also informed the op and lodged a Motor own damage claim to the op.

          But in the meanwhile op requested the complainant to submit certain documents and complainant after receiving the said letter submitted the relevant papers to the op for the purpose of settling the own damage claim.   Thereafter complainant made payment of Rs.4,50,932/- to the Royal Motors on 25.07.2012 for repairing cost of the said vehicle and forwarded the said bill of Royal Motors to the op for payment which was duly received by the op on 01.10.2012.

          But subsequently by a letter dated 12.10.2012 the op repudiated the legitimate own damage Motor Insurance claim of the complainant after coming to a finding that contract of insurance was voidable and the claim file is closed and treated as no claim and repudiation of claim vide Claim No.15100/31/11/61/90003762.  Complainant submits that the letter of repudiation dated 19.10.2012 so issued by the op is baseless, arbitrary, illegal, bad in law as the grounds so stated in the letter of repudiation has no nexus with the terms and conditions of the policy and in other words the terms and conditions of policy does not relate the grounds so stated in the letter of repudiation of op and after observing the terms and conditions of the policy complainant preferred a Demand of Justice to the op on 20.05.2013 with a request for reconsideration.

          Op after receiving the said Demand of Justice on 21.05.2013 forwarded a further letter of repudiation dated 24.05.2013 which supported their defence.  In the above circumstances complainant again sent after receiving second letter of repudiation on 24.05.2013 regarding General Regulation No.27 of Indian Motor tariff which has never been highlighted to the complainant at the time of taking Motor Insurance Policy from the op and being aggrieved and dissatisfied with the decision of the op, complainant compelled to file the instant complaint for negligence and deficient manner of service of op and for redressal.

          On the other hand Insurance Company by filing written statement submitted complainant made out a cock and bull story to cover by her own misdeed and suppressed the material facts that the said car was previously insured with Bajaj Allianz General Insurance Company Ltd. and also got the benefit of Rs.8,139/- on 31.10.2011 and the complainant suppressed the previous policy with Bajaj Allianz and took another new policy with the National Insurance Co. Ltd. from 26.10.2011 to 25.10.2012.  Thereby complainant by filing up the new policy of National Insurance Co. Ltd. suppressed the facts that there was a Motor Car policy from Bajaj Allianz General Insurance for the period 26.10.2010 to 25.10.2011 and further op after getting the claim of the complainant and other documents and after considering that fact the op’s claim was repudiated vide letter dated 12.10.2012 on the ground that insured preferred own damage claim with M/s Bajaj Allianz General Insurance Co. Ltd. which confirmed by the previous insurer and so the claim was repudiated as no claim.  So, there was no deficiency and negligence on the part of the op and so the present complaint should be dismissed.

                                                      Decision with reasons

          On overall evaluation of the complaint and written version and also considering the repudiation letter dated 12.10.2012, it is clear that the repudiation was made by the op on the ground that at the time of the opening the present policy, complainant did not disclose that previously she had one policy of Bajaj Allianz General Insurance Policy wherefrom she got some own damage claim and for which complainant at the time of opening the present policy of the op got 20% benefit for no claim bonus from National Insurance Co. Ltd.  So, for suppressing that fact practically op repudiated the claim.

          After hearing the Ld. Lawyers of the complainant and the op and also considering the defence of the op, it is clear that op has claimed that complainant suppressed existence of previous policy with Bajaj Allianz General Insurance Policy at the time of purchasing the present policy of the same vehicle.  But the moot question is whether there are two insurance policies for same period covering same period.  But in this regard we have gone through the two policies and it is found that insurance policy which was taken from Bajaj Allianz General Insurance Policy previously by the complainant for the period from 26.10.2010 to 25.10.2011 and the present policy was taken by the complainant from the op for the period from 26.10.2010 to 25.10.2011.  So, under any circumstances it can be said that both the policies were for the same period or covering the same period.  But it was for two different year and different period and the first policy of the vehicle of the complainant expired on 25.10.2011 and the second policy, the present policy started on and from 26.10.2011 to 25.10.2012 and for which there is no nexus in between the two policies and insurance policy is always for one year and in the present case both the policies of two different period and complainant got own damage claim from Bajaj Allianz General Insurance Policy for the    period from 26.10.2010 to 25.10.2011.

          Whereas the present accident took place on 25.02.2012 i.e. during the subsistence of the validity period of the present policy and the present ops insurance policy of the complainant was valid for the period from 26.10.2011 to 25.10.2012.  So, no doubt complainant has rightly submitted his claim for own damage and admitted fact is that the said vehicle faced accident on 25.02.2012 at NH-2 and that was reported to the op and op did not engage any surveyor.  But the complainant’s claim was repudiated only on the ground that complainant got 20% benefit at the time of purchasing the present policy as no claim bonus on the ground that she did not get any own damage claim from any other insurance company previously.

          Fact remains for that purpose complainant got a benefit of Rs.3,808/- from previous policy.  But it is undisputed fact that complainant did not submit the same and but the most interesting factor is that at the time of opening the present insurance policy op did not send any queries to the complainant about any previous insurance policy or any other matter and agent of the op prepared it and op accepted it and issued the policy covering the risk period from 26.10.2011 to 25.10.2012 and for such deduction the policy cannot be declared void and there is no such legal provision, it is not specifically mentioned that for violation of terms and conditions of policy claim shall be repudiated.  But it would be appropriate to deduct 25% out of claimed amount on account of such relief as granted at the time of opening the policy when vehicle was insured for a sum of Rs.8,50,300/- and complainant paid a sum of Rs.16,884/- as premium and value of the vehicle is noted Rs.8,50,000/-.

          For violation of terms op ought to have deduct the said Rs.3,808/- initially because 20% no Claim benefit was given to the complainant and when in this case complainant already paid Rs.4,50,993/- for repairing the same to Royal Motors on 25.07.2012.  Op ought to have relied upon the different ruling of the National Commission and to deduct anyway Rs.3,808/- and thereafter 50% may be deducted on account of violations of terms of the policy and in view of the ruling reported in II (2013) CPJ 48 N.C., we find that principle of doctrine on contribution is applicable in this case when contract is established in between the complainant and op and when premium was paid by the complainant as per contract as established in between complainant and op due to agreement in between the complainant the entire policy is read properly and also relying upon the ruling reported in III (2013) CPJ 15 (CM) (H), it is clear that non-declaration of the previous policy in second policy by insured cannot be the ground to deny benefit totally on the ground a common man is not supposed to know all the clauses but when op accepted the premium insured the vehicle without verifying the fact, the insurance company cannot dis-regard the liability morally by showing that contract was made by mis-representation when the insurance policy was issued such a claim casually cannot be repudiated and such a practice should be strongly dis-appreciated.

          In view of the above ruling we find that for violation of the terms, complainant is entitled to 50% of the total amount as paid by her for repairing of the said vehicle and op is legally bound to pay.  In view of the above findings op release a sum of Rs.2,25,470/- as settlement of claim when the entire repudiation is not legal.

          In the result, complaint succeeds.

          Hence, it is

                                                            ORDERED

          That the complaint be and the same is allowed on contest with cost of Rs.5,000/- against the op.

          Op is hereby directed to release a sum of Rs.2,25,470/- as insurance claim to the complainant after treating her own damage claim praying as final settled and treating the repudiation is not legal and valid as made by the op and op shall be paid the cost awarded including the amount i.e. total Rs.2,30,470/- within one month from the date of this order positively failing which for non-compliance and disobeyance of Forum’s order for each day’s delay op shall have to pay punitive damages @ Rs.300/- per day till full satisfaction of the decree by the op and it shall be deposited to this Forum.

          Op shall have to comply the order very strictly within the stipulated period and in default penal proceeding shall be started for which they shall be liable, even they shall be prosecuted u/s 27 of C.P. Act 1986 and further penalty may be imposed.