BEFORE THE PRESIDENT, DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR
C.C NO-51/2016
Present-Sri Dipak Kumar Mahapatra, President, Smt. Smita Tripathy,Member (W).
Saket Pansari,aged about 38 years,
S/O-Shyam Sunder Pansari,
R/O/P.O- Bareipali, Near Panchgachhia,
City/ Dist- Sambalpur, Odisha-768006. …..Complainant
Vrs.
National Insurance Co. Ltd.,
Divisional Ofice, Nayapara,
Sambalpur-768001,Odisha. …O.P
Counsels:-
- For the Complainant:- Sri P.P.Panigrahi, Advocate & Associates.
- For the O.P :- Sri B.K.Purohit, Advocate & Associates.
DATE OF HEARING : 24.02.2021, DATE OF ORDER : 22.03.2021
SRI DIPAK KUMAR MAHAPATRA,PRESIDENT:-Brief facts of the case is that the Complainant is the owner of a Refrigerator Container bearing no-OD-15-B-3332 registered on dtd.28.02.2014 and met with an accident on dtd 25.02.2016. The said vehicle was having a comprehensive insurance policy availed from the O.P for an Insured Declared Value of Rs.8,93,000/- vide policy no-163400/31/14/6300003132 which was valid from 04.03.2015 to 03.03.2016. The said accident was took place at Kansbahal in Sundergarh damaging the refrigeration container and the vehicle. The repairing was done by one Automakers Body Private Limited who was the manufacturer of Refrigerator Container. The Complainant has incurred an expenditure of Rs. 2,65,140 to restore the vehicle to its previous position. The Complainant has submitted all the relevant documents and money receipts with the O.P to settle the Insurance Claim. Out of the total loss the O.P paid only Rs.70,200/- as the settlement amount and deposited the same in to the account of the Insured in the State Bank of India vie account no- 33064278344. The Complainant claims that the assessment of loss by the O.P was purely arbitrary, devoid of transparency and is in violation of Insurance Policy. The rest amount of Rs.194940 was not indemnified by the O.P and he has not assigned any reason for the less indemnification than the actual loss. Hence the Complainant has prayed to seek certain relief from this Commission as per the complaint petition.
The O.P states that upon receiving information from the Complainant the O.P on dtd. 26.02.2016 has engaged one spot Surveyor and Loss Assessor to assess the loss as per the provision 64UM of Insurance Act from Rourkela Office. Also a final Surveyor and Loss Assessor to assess the loss were engaged at Nasik through its Nasik Office and claim form was submitted accordingly. The Final Surveyor and Loss Assessor assessed the loss at Rs.70,801/- considering the other terms and conditions of the policy like Salvage, IMT 23 deductions and policy excess. The Complainant on request of the O.P submitted Retail Invoice and receipts on dtd. 25.05.2016 which were approved by the O.P at Rs.70,200/- and deposited the same in the bank account of the Complainant. As the above claim has been settled by the O.P, there cannot be further claim for which the case is not maintainable and the Insurance Company is not liable to any deficiency in service. The O.P has submitted that whatever be the amount incurred in the repair of the vehicle , the Insurer will pay the amount payable towards the terms and conditions of the Policy of Insurance which includes the amount after deducting the depreciation, policy excess, salvage and other clauses of policy and not liable to indemnify the Insured. The Complainant at any point of time has not asked for the report of the Surveyor and Loss Assessor. And no protest was made by the Complainant relating to the claim and the claim has been paid fully and finally.
POINTS OF DETERMINATION:-
- Whether the Complainant is comes under the purview of Consumer Protection Act-2019?
- Whether the O.Ps has committed any Deficiency in Service to the Complainant?
From the above discussion and materials available on records we inferred that the Complainant comes under the purview of Consumers as he has purchased a new Refrigerator Container and got it Insured with the O.P on payment of Premium/Consideration. It is seen that the Complainant has incurred an expenditure of Rs. 2,65,140 to restore the vehicle to its previous position and he has submitted all the relevant documents and money receipts with the O.P to settle the Insurance Claim. But out of the total loss the O.P paid only Rs.70,200/- as the settlement amount which is later on objected by the Insured. The Surveyor has simply stated the value of parts without providing any data about the value of each parts which appears to be arbitrary. It is seen in the case of National Insurance Co ltd. Vrs. Bhagabati Charan Agrawala-IV(2003)(CPJ)515-Uttaranchal that, when bills are genuine and true Insurance company is bound to accept the same. In this case since there is no allegation by the Insurance Company that bills submitted by the Complainant are not genuine and true so we have no hesitation to accept it.
In this case the vehicle which was less than two years old met with an accident and suffered substantial damage. The IDV of the vehicle was Rs.8,93,000/-. The Surveyor has arrived at an estimate of loss of Rs. 70,200/- after deducting the value of the salvage. He has arrived at this figure on the basis of the parts. After examining the loss assessment report of the Surveyor and loss assessor has arbitrarily deducted the material and labour charges supplied by the authorised service station Auto makers Body Pvt Ltd. without any supplementary estimate from any other/similar authorized service station and tallied the same. Though it is not binding on the O.P to indemnify the total loss of the insured but there should be some genuine ground, authenticity and evidence that the insured has furnished the bills/estimate that are false/ fabricated and suspicious. In the matter of National Insurance Co. Ltd. vs Vibgyor Structural Construction decided on the 6 February, 2003 by National Consumer Disputes Redressal,Delhi, where the Commission has directed the O.P to pay the full insurance amount to the Insured. The Surveyor, however, simply stated the value of parts without providing any data about the value of each part which appears to be arbitrary. From the above it is inferred that the O.P has committed deficiency in service and we order as under.:-
ORDER
That the Complaint petition is allowed. The O.P is directed to reassess the claim by considering the bills submitted by the Insured/Complainant and make arrangement for payment within one month. Further the O.P is directed to pay an amount of Rs.10,000/-(Rupees Ten Thousand) by way of compensation to the Complainant for causing him mental, physical and financial loss and agony and Rs. 5,000/-(Rupees Five Thousand) as litigation costs. This amount shall be paid by the OP to the Complainant within a period of one month from the date of receipt of a certified copy of this order, failing which the OPs shall pay interest @ 9% per annum on this amount from the date of filing the complaint, i.e., 27.06.2016 till its realisation."
Order pronounced in the open Court today i.e, on 22nd of March 2021 under my hand and seal of this Commission.
Office is directed to supply copies of the Order to the parties free of costs receiving acknowledgement of the delivery thereof.
I agree,
-sd/-(22.03.2021) -sd/-(22.03.2021)
Smt. S.Tripathy Sri. D.K. Mahapatra
MEMBER.(W) PRESIDENT
Dictated and Corrected
by me.
-sd/-(22.03.2021)
Sri. D.K. Mahapatra
PRESIDENT
