IN THE CONSUMER DISPUTES REDRESSAL FORUM, PATHANAMTHITTA,
Dated this the 17th day of April, 2012.
Present : Sri. Jacob Stephen (President)
Sri. N. Premkumar (Member)
Smt. K.P. Padmasree (Member)
C.C. No. 55/2010 (Filed on 29.03.2010)
Between:
Rasheeda,
Karamoottu Purayidom,
Edathara, Kalanjoor Village,
Pathanamthitta Dist. … Complainant.
(By Adv. Suhas. M. Haneef)
And:
1. Bajaj Allianz General Insurance-
Company Ltd., represented by its
Regional Manager, 3rd Floor,
Finance Tower, Kaloor,
Cochin – 682 017.
2. Bajaj Allianz General Insurance-
Company Ltd., represented by its
Branch Manager, Parayil Buildings,
R.T. Office Junction,
Pathanamthitta. … Opposite parties.
(By Adv. Sam Koshy)
ORDER
Smt. K.P. Padmasree (Member):
The complainant has filed this complaint against the opposite parties for getting a relief from the Forum.
2. The case of the complainant in brief is as follows: The complainant is the registered owner of a 2007 model Maruti Alto LX1 car bearing registration No. KL-25-7536. The said vehicle was insured with the opposite parties vide policy No. OG-10-1004-1801-0001 4395. The policy is valid from 22.09.2009 to 29.09.2010. While so, the vehicle met with an accident on 25.12.2009 at Koodal Junction and the matter was reported to Koodal Police and they registered a case as Crime No. 451/2009. The matter was also reported to the second opposite party and the vehicle was taken to Indus Motors, Pathanamthitta, the authorized workshop of Maruti vehicles.
3. After that the valuator deputed by the insurance company assessed the loss and the complainant submitted claim form along with all relevant documents to the opposite parties. But the opposite parties repudiated the claim of the complainant and written communication given to that effect stating that the policy obtained from them is not valid as the complainant availed no claim bonus illegally. The act of the opposite parties caused loss, damages, inconvenience and mental agony to the complainant and it is a clear deficiency in service and unfair trade practice. Hence, this complaint for the realization of ` 68,046 with its interest at the rate of 18% per annum spent by him for the repairs of the vehicle along with compensation of ` 25,000 and cost of this proceedings.
4. Opposite parties entered appearance and filed their version and contended that the allegations leveled against the opposite parties are not correct and the complaint is not maintainable. The opposite parties admitted that they have issued a policy to vehicle No. KL-25/7536 for a period from 22.09.2009 to 29.09.2010. They contended that the immediate prior policy was issued by Royal Sundaram Insurance Company. Opposite parties issued the policy to the complainant on the basis of the proposal form and declaration. As per the declaration, the complainant affirmed that no claim has arisen in the expiring policy period. Complainant further declared that if the declaration is found to be incorrect, all benefits in the policy will be forfeited. On relying this declaration, the opposite parties allowed certain percentage of discount in the premium. The opposite parties stated that the insured had given false representation and suppressed the material facts and availed a discount in the premium, thereby committed fraud. There is no deficiency in service or unfair trade practice on the part of the opposite parties. On the basis of these facts, the opposite parties repudiated the claim of the complainant and the same was intimated to the complainant. Hence, the opposite parties are not liable to the complainant and they prayed for the dismissal of the complaint with their cost.
5. On the basis of the pleadings of the parties, the only point to be considered is whether this complaint can be allowed or not?
6. The evidence of this complaint consists of the oral testimony of PW1, DW1 and Exts. A1 to A8 and Exts. B1 and B2. After closure of evidence, opposite parties filed argument note and both sides were heard.
7. The Point: The case of the complainant is that her Alto car baring registration No. KL-25-7536 met with an accident on 25.12.2009 while the vehicle was covered under a comprehensive policy of the opposite parties. The accident occurred within the limit of Koodal Police Station. But the opposite parties repudiated the complainant’s claim for ` 68,046 arbitrarily. According to the complainant, the reason for the repudiation is baseless and illegal and hence opposite parties are liable to the complainant.
8. In order to prove the complainant’s case, the complainant’s Power of Attorney Holder filed proof affidavit in lieu of his chief examination along with 7 documents. On the basis of the proof affidavit, the power of attorney holder was examined as PW1 and the documents produced were marked as Exts. A1 to A8. Ext. A1 is the power of attorney dated 22.06.2011 executed by the complainant in favour of PW1. Ext. A2 is the photocopy of the certificate of registration of the complainant’s vehicle. Ext. A3 is the photocopy of the insurance certificate in question. Ext. A4 is the photocopy of the notice sent by the complainant to the opposite parties. Ext. A5 is the photocopy of the reply notice dated 27.02.2010 issued by the opposite parties to the complainant. Ext. A6 is the photocopy of the First Information Report prepared by Koodal Police in connection with this accident. Ext. A7 is the original receipt dated 16.04.2010 for ` 1,120 issued by the opposite parties in the name of the complainant. Ext. A8 is the job card retail invoice dated 30.12.2009 issued by Indus Motor Company Pvt. Ltd., Pathanamthitta in respect of the damages and repairs of the vehicle.
9. On the other hand, the contention of the opposite parties is that the repudiation is genuine and legal. According to the opposite parties, the complainant was a policy holder and he availed the benefits of no claim bonus suppressing the real facts. It is a violation of the policy condition and hence the complainant is not entitled to get any benefits from the opposite parties.
10. In order to prove the contentions of the opposite parties, an authorized officer of the opposite parties filed a proof affidavit in lieu of his chief examination along with one document. On the basis of the proof affidavit, he was examined as DW1. The original proposal form was marked as Ext. B1 and a particular portion of Ext. B1 was marked as Ext. B1(a) through PW1 and the document produced along with the proof affidavit, GR 27- No Claim Bonus, was marked as Ext. B2.
11. On the basis of the contentions and arguments of the parties, we have perused the entire materials on record and found that the parties have no dispute with regard to the insurance policy and the damages caused to the vehicle. The dispute raised by the opposite parties is that the complainant’s policy was invalid at the time of accident due to the violation of the policy condition committed by the complainant by availing no claim bonus by suppressing the real facts.
12. The basic issue in this case is with regard to the no claim bonus. The opposite parties have not adduced any evidence to prove that the complainant had availed any claim in the previous year from the previous insurer as contented by them. Moreover, the deposition of DW1 is also relevant in this case “A]-I-S-k-a-b¯v Cu hml-\-¯n\v R§-fpsS insurance Dm-bn-cp-¶p. hmZn NCB A\Àl-ambn hm§n-b-Xm-sW¶v R§Ä¡v a\-Ênem-bXv claim h¶-t¸m-gmWv”. As per the deposition of DW1, the policy in question is found valid at the time of the incident. Moreover, as per the direction of the opposite parties, complainant remitted ` 1,120 after the repudiation of the claim. Ext. A7 is the receipt for the same. The accident occurred on 25.09.2009. The claim repudiated on 27.02.2010 and the receipt of ` 1,120 i.e. Ext. A7 issued on 16.04.2010. In re-examination, DW1 admitted that Ext. A7, “Ext. A3 policy bpsS expiry date hsc-bpÅ period te¡pÅ _m¡n premium BWv”. From this, it is clear that after the repudiation of claim they have collected ` 1,120 from the complainant. As per the deposition of DW1, the policy in question is valid on the date of accident. As per the available evidence, they have not cancelled the policy. What prevented opposite parties to cancel the policy with intimation to the complainant when they got the information regarding the suppressions of material facts and why they have issued a policy without ascertaining the genuineness of the complainant’s claim for No claim bonus. Instead they have collected an amount of ` 1,120 for the short payment made by the complainant in respect of no claim bonus availed by the complainant. After collecting the short payment from the complainant, opposite parties are not entitled to repudiate the claim. It clearly indicates that the contention is baseless and is raised only for repudiating a genuine claim. If opposite parties acted promptly at the time of issuing the policy such situation would not have been occurred. Therefore, we find that the repudiation of the complainant’s claim is a clear deficiency in service and opposite parties are liable for the same to the complainant. Hence, this complaint is allowable with cost and compensation.
13. In the result, this complaint is allowed, thereby the opposite parties are directed to pay an amount of ` 68,046 (Rupees Sixty eight thousand and forty six only) as per Ext. A8 which is the amount spent for repair works along with compensation of `3,000 (Rupees Three thousand only) and cost of ` 1,500 (Rupees One thousand five hundred only) to the complainant within 20 days from the date of receipt of this order, failing which the complainant is allowed to realize the whole amount with 10% interest per annum from today till the realization of the whole amount.
Pronounced in the Open Forum on this the 17th day of April, 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:
PW1 : Shefeek. S.
Exhibits marked on the side of the complainant:
A1 : Power of attorney dated 22.06.2011 executed by the
complainant in favour of Shefeek S.
A2 : Photocopy of the certificate of registration of the
complainant’s vehicle.
A3 : Photocopy of the insurance certificate and policy schedule. A4 : Photocopy of the notice sent by the complainant to the
opposite parties.
A5 : Photocopy of the reply notice dated 27.02.2010 issued by the
opposite parties to the complainant.
A6 Photocopy of the First Information Report prepared by Koodal
Police in connection with the accident.
A7 : Original receipt dated 16.04.2010 for Rs. 1,120 issued by the
opposite parties in the name of the complainant.
A8 : Job card retail invoice dated 30.12.2009 issued by Indus
Motor Company Pvt. Ltd., Pathanamthitta.
Witness examined on the side of the opposite parties:
DW1 : Alice John.
Exhibits marked on the side of the opposite parties:
B1 : Original proposal form.
B1(a): Relevant portion of Ext. B1 proposal form.
B2 : GR-27 – No claim bonus.
(By Order)
(Sd/-)
Senior Superintendent
Copy to:- (1) Rasheeda, Karamoottu Purayidom, Edathara, Kalanjoor
Village, Pathanamthitta Dist.
(2) Regional Manager, Bajaj Allianz General Insurance
Company Ltd., 3rd Floor, Finance Tower, Kaloor,
Cochin – 682 017.
(3) Branch Manager, Bajaj Allianz General Insurance Company
Ltd., Parayil Buildings, R.T. Office Junction,
Pathanamthitta.
(4) The Stock File.
