Complainant    :   K.D.Ashokan, Kothandath House, Anthikkadu,

                             P.O.Padiyam, Thrissur.

                             (By Adv.A.M.Shajan, Thrissur)

Respondents             :     1.  Reliance General Insurance Co. Ltd., Iind Floor,

                                 Global Plaza, Opp.New Railway Plat Form,

                                 Vanchikulam Road, P.O.Poothole, Thrissur, rep. by its

                                 Manager.

                             2. Reliance General Insurance Co. Ltd., Vishnu Bldg.,                    

                                 K.P.Vallon Road, Kadavanthra, Cochin, rep.  by its

                                 Manager.                             

                             3. Reliance General Insurance Co. Ltd., 570-Rectifier

                                 House, Naigaum Cross Road, Wadalu(W) Mumbai.

                             (By Adv.S.Mammu, Ernakulam)

                                                          ORDER

By Smt.Rajani.P.S., Member

            The complainant’s case is as follows:  The complainant is the owner and in possession of a 2004 model Mahindra Scorpio Saloon No.KL-08/AC 8962 vehicle which  is duly insured with the respondents vide policy No.2204372338100061 for the period  from 16/12/07 to 15/12/08.  The above said vehicle met with an accident and sustained damages on 29/12/07 at 11.40 at Kuttipuram and  case was registered as crime No.516/07 there.  He had given the said vehicle for repairs at M/s. Sean Motors, Punkunnam, Thrissur and preferred a claim for a sum of Rs.3,75,296/- and the claim has been registered by the respondent vide No.2081006537.  The respondent’s surveyor inspected the vehicle and submitted a report admitting the complainant’s claim true and correct.  After that when he contacted the 1^st and 2^nd respondents they assured that the claim amount will be paid within one month.  But did not paid the amount as agreed inspite of his repeated  requests.   The respondents are simply  protracting  the payment without assigning any valid reason, but saying that the matter is pending before the  3^rd respondent.  So he sent a lawyer notice to the respondents.  But no reply and no remedy so far.  The above said acts of the respondents amounts to unfair trade practice and deficiency of service.  Hence the complaint.

          2. The version filed by the respondents are as follows:  It is admitted that the vehicle No.KL-08 AC 8962 was insured with these respondents at the time of alleged accident dated 29/12/07 and the complainant had lodged a claim for damages to be caused in that accident. It is denied that the surveyor submitted a report admitting the complainant’s claim.  It is incorrect and denied that the complainant sustained damages to the tune of Rs.3,75,296/-.  It is also denied that the respondents assured to pay the claim amount within one month and protracting the payment without assigning any valid reason, but saying that the matter is pending before the 3^rd respondent.  It is submitted that while going through the claim papers submitted by the complainant these respondents observed that the validity of the fitness certificate to the   vehicle involved in the alleged accident had expired on 11/12/07 were as the alleged accident is on 29/12/07.  So at the time of alleged accident there was no valid fitness certificate to the vehicle, as such the complainant has violated the policy conditions and stipulation of the Motor Vehicle Act.  Under the above circumstances these respondents have no other way but to repudiate the claim.  The repudiation of claim was properly communicated to the complainant and as such there is no delay on the side of these respondents.  It is also submitted that the complainant is well aware that his vehicle  was not having fitness certificate at the alleged accident and he had piled the vehicle  without having fitness certificate.  As such the complainant is violator of law, who is not entitled to claim for the damages happened due to his violation.  It is submitted that though these respondents have deputed a surveyor to carryout the assessment regarding the alleged damages, he has not submitted any assessment since the fitness certificate was found expired on 11/12/07 and since the complainant failed to produce the valid fitness certificate.  It is also submitted that the repairer has not submitted any estimate also.  The assessment of loss is subject to the terms and conditions of the policy.  The value to be assessed is not the market value throughout the policy without any further depreciation.  Neither these respondents nor the surveyor have received any copy of the estimate by Scan Motors, without which it is not possible to arrive at a quantum of alleged loss.  The vehicle is registered as a transport vehicle and as per Motor Vehicles Act all transport vehicles shall not be deemed to be validly registered for the purposes of Section 39 of Motor Vehicles Act, unless it carries a certificate of fitness.  Hence the complainant cannot put on the stand that he is entitled for compensation fixing the value of the vehicle as Rs.3,75,296/-.  There was no denial of claim by the respondents as alleged in the complaint.  There is no deficiency in service on the side of the respondents in settling the claim of the complainant.  Every detail was made known to the complainant in the due course.  So the complainant is not entitled for a sum of Rs.3,75,296/- and also for compensation. In fact there is no latches on the part of these respondents.  The complaint may be dismissed with costs.

          3. Points for consideration are :

1) Whether the claim was processed ?

2) If so whether entitled for the claim amount and other reliefs ?

          4. The evidence consists of the oral testimony of PW1 and Exhibits P1 to P6.  No evidence adduced by the respondents.

          5. It is the case of the complainant that his vehicle NO.KL-08 AC 8962 was insured with the respondents and the above said vehicle met with an accident and sustained  damages on 29/12/07 which was within the policy period.  He preferred a claim or Rs.3,75,296/- and the respondent’s surveyor inspected the vehicle and prepared a report admitting the complainant’s claim. But the respondents did not paid the amount.

          6. The respondents in their counter stated that the complainant’s vehicle’s validity of the fitness certificate had expired on 11/12/07 where as the alleged accident was on 29/12/07.  So there is violation of policy conditions and stipulation of the Motor Vehicles Act.  So not entitled to claim for the damages happened due to his violation.  The surveyor has not submitted any assessment since  the complainant failed to produce the valid fitness certificate.  No copy of estimate received and hence not possible to arrive at a quantum of alleged loss.  There was no denial of claim by these respondents. 

          7. The complaint was filed to get claim amount for the damages to his insured vehicle from the respondent insurance company.  The respondents in their counter admitted that the complainant had submitted a claim for his vehicle which was insured with them and possess a valid policy during the alleged accident.  But their main contention is that the surveyor deputed by them has not submitted any assessment, since the complainant failed to produce the valid fitness certificate and no estimate also received.  Hence not possible to arrive at a quantum of alleged loss and not denied the claim.  So from the statement of the respondents itself it is revealed that the matter is still pending before the respondents.  Whatever be the result of the claim submitted it is the  bounden duty of the respondents to intimate the claim results to the insured without any delay.    Exhibits P3 to P5 series reveals that the complainant had intimated the respondents the delay occurred for processing the claim.  Neither the respondents sent a reply nor paid the claim amount till this date.  PW1 also deposed that the respondents never intimated him regarding the repudiation.  So there is serious latches committed by the respondents regarding the processing of the claim submitted by the complainant.  Hence the complainant is entitled to get Exhibit P6 amount.

          8. In the result the complaint is allowed and the respondents are directed to pay the Exhibit P6 amount and Rs.1,000/- as compensation and Rs.500/- as costs within two months from the date of receipt of copy of this order  If not the Exhibit P6 amount will carry 12% interest from today till realization.

          Dictated to the Confdl. Asst., transcribed by her, corrected by me and pronounced in the open Forum this the 16^th    day  of April 2012.

                                                                             Sd/-

                                                                   Rajani.P.S., Member

                                                                             Sd/-

                                                                   Padmini Sudheesh, President

                                                                             Sd/-

                                                                   M.S.Sasidharan, Member

                                                Appendix

Complainant’s Exhibits

Ext. P1 Copy of FIR

Ext. P2 Copy of policy

Ext. P3 Copy of lawyer notice

Ext. P4 series Postal receipts

Ext. P5 series Acknowledgement cards

Ext. P6 Bill dated 2/1/08

Complainant’s witness

PW1 -  Asokan.K.D.

                                                                             Id/-

                                                                       Member