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Advocate Bhushan M. Shalukar for the complainant
Advocate C.D.Aiyar for the Opponent No.1.
Advocate Suresh Gujrathi for the Opponent No.2.
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Per Hon’ble Shri. V. P. Utpat, President
:- JUDGMENT :-
Date – 28th February 2014
This complaint is filed by consumer u/s 12 of the Consumer Protection Act, 1986 against the dealer and the Insurance Company for deficiency in service. Brief facts are as follows-
[1] Complainant is resident of Mantri Park II, Kothrud, Pune. Opponent No.1 is the Insurance Company and the Opponent No.2 is the dealer of the Maruti Car. Complainant had purchased SX 4 Model from the Opponent No.2 on 25/3/2009 by making payment of Rs.7,09,871/-. The said car was insured with the Opponent No.1. The car was met with an accident on 4/10/2008 while complainant was proceeding from Satara to Pune. The car was substantially damaged and complainant had sustained serious injury in the said accident. The car was towed to the workshop of the Opponent No.2 on 6/10/2008. Opponent No.2 had prepared estimate as well as survey through Surveyor Sunil Dafatary. According to the Opponent No.2 the estimate for the repairs of the car was Rs.6,51,778/-. Complainant is having moderate income. It was impossible for him to bear such huge amount for the repairs of the car. Hence, he got repaired the said car from Plaza Motor Garage. He paid Rs.2,91,010/- to the Proprietor of the said garage. He had also spent Rs.28,700/- for the battery and new discs for the damaged wheels and Rs.88,000/- for the treatment of the air bags. It is the case of the complainant that eventhough Opponent No.1 had issued Package Policy, it has repudiated his claim on 16/09/2009 on the reason that the intimation of the accident was not given to the Opponent No.1 immediately, surveyor could not be appointed and the vehicle was repaired without any inspection from other unauthorized workshop. It is the case of the complainant that, he was unconscious for one day and bedridden for 4/10/2008 to 11/10/2008. He was not stable till January 2009. The claim was reported to the Opponent No.2 on 24/08/2009. It was the duty of the Opponent No.2 to report the Opponent No.1 about the accident, as the insurance policy was issued by the Opponent No.1 through the Opponent No.2. Opponent No.1 had surveyed the accidental car and prepared the estimate. As the estimate was of Rs.6,51,778/-, complainant has deiced to get repaired the said car through another workshop by paying Rs.2,91,611/-. It is also contended by the complainant that, the terms and conditions were not explained to him by the Opponent Nos. 1 and 2. Opponent No.1 has repudiated his claim mechanically without applying mind. Hence, complainant has filed present complaint and claimed Rs.2,91,000/- towards cost of repairs, Rs.1500/- towards crane charges, and Rs.87,755/- towards expenses incurred for the air bags protection system and associated control. He has further claimed Rs.15,000/- for mental agony and Rs.10,000/- towards expenses incurred.
[2] Opponent Nos. 1 and 2 both have denied the contents of the complaint by filing separate written version. It is the case of the Opponent No.1 that as the accident was not promptly intimated by the complainant, surveyor could not be appointed and the complainant has got repaired the vehicle from unauthorized workshop. It is flatly denied that, the intimated was given by the complainant through the Opponent No.2. It is the case of the Opponent No.2 that the terms and conditions of the policy were explained to the complainant. Complainant had failed to report the accident to the Opponent No.1 promptly. Complainant got repaired the vehicle from unauthorized workshop. Hence, he is not entitled for the claim and the claim is rightly repudiated by the Opponents. Both Opponents have prayed for dismissal of the complaint.
[3] Considering the pleadings of both parties, affidavits, scrutinizing the documentary evidence and argument advanced by both parties, written arguments , following points arise for the determination of the Forum. The points findings and reasons thereon are as follows-
Sr.No. | POINTS | FINDINGS |
1 | Whether complainant has established that the Opponent No.1 has wrongly repudiated the insurance claim of the complainant ? | In the affirmative |
2 | Whether complainant has established deficiency in service at the hands of the Opponent No.2 ? | In the negative |
3 | What order ? | Complaint is partly allowed against the Opponent No.1. |
Reasons-
As to the point Nos. 1 to 3-
[4] Admitted facts in the present proceeding are that, the complainant has purchased the car from the Opponent No.2 and it was insured with the Opponent No.1 for the period of 28/3/2008 to 27/3/2009. It is not in much dispute that the car met with an accident and it was towed to the workshop of the Opponent No.2. It is established by the complainant that the Opponent No.2 has surveyed the car and issued estimated of Rs.6,51,778/-. It reveals from the repudiation letter which was issued by the Opponent No.1 that the claim was repudiated by the Insurance company on the ground that the complainant has not intimated the accident to the Insurance Company promptly as per the terms and conditions. It is the case of the complainant that, the insurance policy was issued through the Opponent No.2 by the Opponent No.1 and it was the duty of the Opponent No.2 to prepare the survey and intimate the Opponent No.1 for the settlement of the insurance claim. It is significant to note that the Opponent No.2 is the authorized dealer of the Maruti vehicles and there is tie-up between the Maruti company and the Insurance company as regards insurance of the vehicle. The Comprehensive Insurance of the new vehicle is mandatory as per the provisions of the Motor Vehicle Act. When the car was brought to the workshop of the authorized dealer who sold out the car to the complainant, it should be presumed that the intimation of the accident was given to the authorized dealer and as there is tie-up between the insurance company and the authorized dealer as well as Maruti Company, it is the boundant duty of the dealer to co-operate the consumer as regards the insurance claim and it is boundant duty of the dealer to make arrangement for the settlement of the insurance claim. One of the reason for repudiation of the claim is that the vehicle was got repaired from the unauthorized workshop. When the consumer has received and unreasonable estimate of Rs.6,51,778/- he has no alternative but to approach private garage for getting the repairs of his car. It reveals from the bills and record that the car was repaired after paying Rs.2,91,010/- to Plaza Motor Garage. In this circumstances, this ground for repudiation also not appeared to be reasonable ground. It is the opinion of the Forum that, when the car was brought to the workshop of the authorized dealer who has obtained policy from the Opponent No.1 and issued the same to the complainant then that was the intimation to the dealer as well as to the Insurance Company. Moreover, when the car can be repaired by paying less amount than the heavy burden of estimate which was prepared by the authorized dealer, cannot be saddled on the consumer. That ground also does not appear to be reasonable ground for repudiation. It further reveals from the averments from the complaint that the complainant had spent Rs.28,700/- for battery and new discs for the damaged wheels. Complainant had also spent Rs.88,000/- for air bags and associated electronic controls. But these were not covered under the policy. Hence, complainant is not entitled to receive that much amount from the Opponent. As the Insurance Company was under obligation to indemnify the claim, the dealer of the vehicle cannot be held responsible for repudiation of the clam.
In these circumstances, Forum answer the points accordingly, and pass the following order-
:- ORDER :-
1. Complaint is partly allowed against the Opponent No.1 only.
2. It is hereby declared that the Opponent No.1 has caused deficiency in service by repudiating the insurance claim of the complainant.
3. Opponent No.1 is directed to pay Rs.2,91,010/- [Rupees Two lakh ninety one thousand and ten only] to the complainant within six weeks from the date of receipt of copy of order.
4. Opponent No.1 is directed to pay Rs.5,000/- [Rupees Five thousand only] towards compensation for physical and mental agony and Rs.2,000/- [Rupees Two thousand only] towards costs, within six weeks from the date of receipt of copy of order.
5. If the amount is not paid or deposited within the stipulated period, it shall carry interest @ 9% p.a. from the date of filing of complaint till its realization.
6. No order as against the Opponent No.2.
7. Both parties are directed to collect the sets which are provided for the Members within one month from the date of order. Else those will be destroyed.
Copy of order be supplied to both the parties free of cost.
