IN THE CONSUMER DISPUTES REDRESSAL FORUM, PATHANAMTHITTA,
Dated this the 14th day of November, 2012.
Present : Sri. Jacob Stephen (President)
Sri. N. Premkumar (Member)
Smt. K.P. Padmasree (Member)
C.C.No.105/2012 (Filed on 24.05.2012)
Between:
Shyni Joseph,
W/o. Joseph Valladen,
Thekkedathu Swathi Bhavan,
Mylapra town, Pathanamthitta.
(By Adv. Sajesh. K. Sam) …. Complainant
And:
1. M/s. National Insurance Co. (Manager),
Branch Office, Pathanamthitta.
2. The Divisional Manager,
National Insurance Co.,
Divisional Office, Kayamkulam.
3. The Regional Manager,
National Insurance Co.,
Regional Office, Ernakulam.
(By Adv. P.P. Mohammed Mustapha
Counsel for 2 & 3) …. Opposite parties
O R D E R
Smt. K.P. Padmasree (Member):
Complainant filed this complaint against the opposite parties for getting a relief from the Forum.
2. Facts of the case is brief as follows: Complainant purchased a new Maruti Suzuki Wagon R Car at a price of ` 3,95,000 and insured the same with the 2nd opposite party. The terms of insurance included comprehensive policy coverage and 3rd party risk. The insurance policy was valid from 23.04.2009 to 22.04.2010.
3. On 07.02.2010 the above said vehicle met with an accident at the north side of Cherukolpuzha Bridge within the limit of Koipuram Police Station and police registered a Crime as 413/2010. Intimation was given to the opposite parties and submitted claim form. Surveyor appointed by opposite parties assessed the loss. Thereafter no positive response from the opposite parties even though complainant sent many reminders. The vehicle sustained heavy damages and hence the estimated repair cost of the vehicle exceeded the price to buy a new vehicle.
4. Even after the expiry of 27 months opposite parties are not willing to settle the claim even though there is a valid policy coverage at the time of the accident and all other documents related to the vehicle were submitted to the opposite parties. The act of the opposite parties is a clear deficiency of service from their part. Hence this complaint for getting insured value of ` 3,40,838 with interest and compensation.
5. 1st opposite party is exparte and 2nd and 3rd opposite parties entered appearance and filed joint version with the following main contentions. Opposite parties admit that the vehicle bearing Reg.No.KL-03-R-8871 Wagon R Car was insured with them. But according to them the alleged accident was occurred on 07.02.2010 whereas the matter was reported to the police only on 23.02.2010. The claim was intimated and claim papers were submitted to the insurance company only on 09.04.2010 with fake signature of the insured.
6. Opposite parties conducted a thorough investigation of the accident and found that M/s. Valladan Travels had hired the said car on rent on the date of accident. From the statement of the driver as well as the passenger of the vehicle it is revealed that the said vehicle was being used on rent. In the above circumstances, the opposite parties had repudiated the claim on the ground that vehicle used for hire or reward at the time of accident, which is not covered as per the policy conditions. The matter was intimated to the complainant through repudiation letter. But it was returned unserved as unclaimed. Hence there is no deficiency in service on the part of the insurance company. Hence the opposite parties’ prays for the dismissal of the complaint with their cost.
7. On the basis of the pleadings of the parties, the only point to be considered is whether this complaint can be allowed or not?
8. The evidence of this complaint consists of Exts.A1 to A8 and Exts. B1 to B8. After closure of evidence, both sides were heard.
9. The Point:- The complainant filed this complaint for getting insurance claim from the opposite parties for the damage sustained to her car which was insured with the opposite parties. Matter was intimated to the opposite parties and claim form submitted with relevant documents. But opposite parties are not willing to settle the claim even after expiry of 27 months, from the date of accident. Hence the complaint for getting insured value of the vehicle along with interest, cost and compensation.
10. In order to prove the complainant’s case, complainant filed proof affidavit along with 8 documents. The documents produced were marked as Exts.A1 to A8. Ext.A1 is the photocopy of insurance certificate cum policy schedule. Ext.A2 is the photocopy of registration certificate of the vehicle. Ext.A3 is the photocopy of FIR and FIS. Ext.A4 is the photocopy of scene mahazar. Ext.A5 is the photocopy of legal notice issued by the complainant. Ext.A6 is the photocopy of AMVI’s vehicle inspector report. Ext.A7 are the postal acknowledgment cards and postal receipts of Ext.A5. Ext.A8 is the photocopy of estimate for the repairs from Popular Vehicles & Services.
11. On the other hand, the contention of the opposite parties is that the repudiation is genuine and legal. Opposite parties contention is that vehicle was being used for hire or reward at the time of accident which is not covered as per the policy conditions. Claim was repudiated by the opposite parties on valid grounds. Hence there is no deficiency of service from the opposite parties.
12. In order to prove the contention of the opposite parties, opposite parties filed 8 documents which are marked as Exts.B1 to B8. Ext.B1 is the unclaimed registered letter sent to the complainant by opposite parties. Ext.B2 is another unclaimed registered letter repudiating the claim sent to the complainant by opposite parties. Ext.B3 is another unclaimed registered letter sent to the complainant. Ext.B4 is the reply notice sent to the complainant in reply to Ext.A5 legal notice. Ext.B5 is the letter sent by the driver of the said vehicle to the 2nd opposite party stating that the vehicle was hired by him from Valladans Travels at the time of the accident. Ext.B6 is the investigation report prepared by Senior investigator Mr. V. Sivan Pillai. Ext.B7 is the final investigation report prepared by Mr. V. Sivan Pillai. Ext.B8 is the photocopy of insurance certificate cum policy schedule.
13. On the basis of the contentions and arguments of the parties, we have perused the entire materials on record and found that complainant’s vehicle is duly insured with the opposite parties and it is valid on the date of accident. In the circumstances, the only point to be considered is whether the complainant is entitled to the insurance benefit as claimed by her. According to the complainant, she is entitled to get the insurance benefit as claimed by her. Whereas the contention of the opposite parties is that the complainant is not entitled to get the benefit as per policy in question because she had violated the policy conditions by giving her private car for hire. In the light of the rival contentions of the parties, we have examined the documents produced by both parties.
14. The first contention raised by the opposite party is regarding belated intimation of the claim. From Ext.A3 and A4 it is seen that the accident took place on 07.02.2010. But it was intimated to the police station only on 23.02.2010. The accident was intimated and papers submitted to the opposite parties on 09.04.2010, with the lapse of more than 2 months. Moreover, this delay is not satisfactorily explained by the complainant. This laches on the part of the complainant cannot be viewed lightly. Moreover, complainant alleged that past 27 months the insurance company is playing hide and seek without giving proper reply to her. Ext.B1 to B3 unserved registered letters revealed that her said allegation is baseless.
15. Second and main contention raised by the opposite parties is that the insured vehicle was being used as Rent a Car purpose at the time of accident. As per Ext.A3, it is seen that the accident was intimated to the police station by the Manager of M/s. Valladan Travels, Konni, doing rent a car business. His statement in FIS is as follows:- ‘Our Car bearing Reg.No.KL-03-R-8871 met with an accident and it is driven by our driver Mr. Naveen’. From this statement it is clear that it is their car at the time of alleged accident and it was driven by their own driver for rent. Ext.B5 to B8 documents were marked without any objection from the complainant’s side. From these documents it is more revealed that Mr. Naveen is the driver of said Valladan Travels and at the time of accident he is traveling with a carpenter who was collected from Thrissur.
16. Ext.B6 and B7 investigation reports were also a part of evidence. On a perusal of these reports, it is found that there is an authentic statement of the driver and injured passenger of the vehicle that the insured vehicle was on hire basis at the time of accident. Complainant failed to produce any cogent evidence to support her case beyond any reasonable doubt.
17. From the overall facts and circumstances and on the basis of the discussions herein, we are of the view that the vehicle in question met with an accident when it was being used as a rent a car which is a breach of the policy condition and hence this complaint is not allowable.
18. In the result, this complaint is dismissed. No cost.
Declared in the Open Forum on this the 14th day of November, 2012.
(Sd/-)
K.P. Padmasree,
(Member)
Sri. Jacob Stephen (President) : (Sd/-)
Sri. N. Premkumar (Member) : (Sd/-)
Appendix:
Witness examined on the side of the complainant: Nil.
Exhibits marked on the side of the complainant:
A1 : Photocopy of insurance certificate cum policy schedule. A2 : Photocopy of registration certificate of the vehicle.
A3 : Photocopy of FIR and FI statement.
A4 : Photocopy of scene mahazar.
A5 : Photocopy of advocate notice dated 03.04.2012 sent by
the complainant to opposite parties.
A6 : Photocopy of AMVI’s vehicle inspection report.
A7 : Postal acknowledgment cards and postal receipts of
Ext.A5.
A8 : Photocopy of estimate of repairs from Popular
Vehicles & Services.
Witness examined on the side of the opposite parties: Nil.
Exhibits marked on the side of the opposite parties:
B1 : Unclaimed registered letter sent by S.P. Engineers &
Surveyors, Collectorate P.O., Kottayam to the
Complainant.
B2 : Unclaimed registered letter dated 10.11.2010 sent
by the opposite parties to the complainant.
B3 : Unclaimed registered letter dated 19.04.2011 sent
by the opposite parties to the complainant.
B4 : Reply notice dated 24.04.2012 sent to the complainant
in reply to Ext.A5 legal notice.
B5 : Letter issued by Naveenkumar. T.N. to the second
opposite party.
B6 : Investigation report prepared by Senior investigator Mr.
V. Sivan Pillai.
B7 : Final investigation report prepared by Mr. V. Sivan Pillai. B8 : Photocopy of insurance certificate cum policy schedule.
(By Order)
(Sd/-)
Senior Superintendent
Copy to:- (1) Shyni Joseph, Thekkedathu Swathi Bhavan,
Mylapra town, Pathanamthitta.
(2) M/s. National Insurance Co. (Manager),
Branch Office, Pathanamthitta.
(3) The Divisional Manager, National Insurance Co.,
Divisional Office, Kayamkulam.
(4) The Regional Manager, National Insurance Co.,
Regional Office, Ernakulam.
(5) The Stock File.
