DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
SOUTH 24 – PARGANAS,
AMANTRAN BAZAR, BARUIPUR, KOLKATA-700 144
C.C. CASE NO. 16 OF 2019
DATE OF FILING: 29.01.2019 DATE OF JUDGEMENT: _5.9.2019
Present : President : Ananta Kumar Kapri
Member : Jhunu Prasad
COMPLAINANT : Ismail Khan, Ghateswar Musalman Para, Durgapur, P.S Mandir Bazar, Dist. South 24-Parganas, Pin-743336 and at present at Sonarkella Apartment, P.S Baruipur, Kolkata-144.
O.P/O.Ps : Royal Sundaram Insurance Co. Ltd. through Chaitali Roy, Senior Officer, Mottor OD Claims Eastern Regional Office, Millenum City IT Park United No.T-2-2A Tower, 2//Plot no. DN-62, Sector 5, Salt Lake, Kolkata-91.
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JUDGMENT
Sri Ananta Kumar Kapri, President
Facts leading to the filing of the instant case may be epitomized as follows.
Complainant is an owner of a motor car bearing registration no.WB-06E-2592 and the said car stood insured with the O.P Insurance company with validity from 7.7.2018 to mid-night of 6.7.2019. On 23.7.2018 the said car met with an accident at about 2 p.m and the vehicle got badly damaged by fire. The complainant, who was driving the car, however escaped unhurt. Local police station i.e Mandir Bazar P.S was informed that day by the complainant. But, the said P.S unfortunately started Mandir Bazar P.S case no. 247/2018 dated 24.7.2018 against the complainant. The vehicle was seized in that case by the police. Thereafter, the complainant claimed Rs.10, 82,852.14 as repair charge. This claim of the complainant was repudiated by the O.P Insurance Company and, therefore, the complainant has filed the instant case ,praying for passing an order directing the complainant to pay the repair cost , compensation etc.
The O.P Insurance company has filed written version to contest herein. It is submitted in the written version that the company has appointed one Investigator namely Mr. Debojit Chakraborty on receipt of the intimation of the accident of the complainant and the said Investigator has also filed report. From the report, it is learnt that the vehicle hit a pedestrian and tried to flee away. Local people gheraoed the vehicle and set fire to the vehicle. The complainant has suppressed all these material facts and has submitted claim and, therefore, the claim has been lawfully rejected. It is further submitted in the written version that the accident was not the result of any external impact and, therefore, the same is not covered by the policy. The complaint has not also come before the Forum with clean hands and ,therefore, he is not entitled to relief or reliefs as prayed for.
Upon the averments of the parties, the following points are formulated for consideration.
POINT FOR DETERMINATION
- Has the O.P Insurance company committed any deficiency in service by repudiating the claim of the complainant?
- Is the complainant entitled to get relief or reliefs, if any, as prayed for?
EVIDENCE OF THE PARTIES
Petition of complaint is treated as evidence of the complainant vide his petition dated 31.5.2019. Similarly, written version is treated as evidence of the O.P vide its petition dated 25.6.2019.
DECISION WITH REASONS
Point no.1 & 2 :
Already heard the submissions of Ld. Lawyers ,appearing for both the parties. Perused the petition of complaint, written version and also the materials on record. Considered all these.
In the instant case, the complainant has claimed Rs. 10,82,852.14 as repairing charge and this claim of the complainant has been repudiated by the O.P on the ground that the accident is not covered by the policy. In the face of rejection of the claim of the complainant, it is to be seen whether the repudiation of the claim of the complainant is made properly or not.
It is contended on behalf of the O.P Insurance Company that the complainant has not come before the Forum with clean hands , that he has not disclosed the material facts before the Forum in respect of the accident. According to the submission of the Ld. Lawyer of the O.P, the complainant has not divulged anything as to how the vehicle met with the accident. Upon investigation conducted by the Investigator of the O.P Insurance company, it has come to light , as goes the submission of the Ld. Lawyer for the O.P, that the local people set fire to the vehicle when the vehicle tried to flee away after having knocked down a pedestrian. So, according to the submission made on behalf of the O.P Insurance company, the complainant has not divulged the actual fact before the Forum and, therefore, he is not entitled to any relief or reliefs from the Forum. It is his further submission that the accident which the subject vehicle faced is not an accident caused by external means and ,therefore, the said accident is not covered by the policy. The complainant is, therefore not entitled to indemnity of any claim as made by him.
Admittedly, the subject vehicle was insured with the O.P Insurance company. The validity of the insurance policy was effective on the date of accident i.e on 23.7.2018. The insurance policy was in force on the date of accident. The complainant himself drove the vehicle and he had valid driving licence at the relevant point of time of accident. All these things are not at all controverted by the O.P Insurance Company. What is raised on behalf of the O.P is that that the accident was caused by some unruly mob. They set fire to the vehicle and caused damage to the vehicle. This accident does not fall within the permissible event “By accidental external means “as provided in Section 1- Loss of or damage to the private car insured of ‘the private car package policy’ and, therefore, the complainant is not entitled to get any reimbursement from the O.P insurance company for the loss suffered by him.
An attempt is made on the part of the O.P Insurance Company to cast blame on the complainant that the complainant has suppressed the material facts. The complainant has divulged in his petition of complaint that the vehicle met with an accident and got badly damaged. He also informed the police of the accident and it is mentioned in police report that the vehicle got burnt. So, in the circumstances, we failed to understand how the complainant has suppressed the material facts before the Forum. In our opinion, the complainant has suppressed nothing. Everything has been fully disclosed on record before the Forum. So, the blame which has been cast upon the complainant by the O.P appears to be unfounded and we cannot say that the complainant may be deprived of his legitimate right to indemnity on the ground of allegation that he has suppressed the material facts before the Forum. It has been contended on behalf of the O.P company that the accident of the vehicle was not caused by ‘accidental external means’ and, therefore, the complainant i.e the insured is not entitled to indemnity from the insurance company. Section 1 of the Insurance Policy is produced herein below for better clarification on our point of view:-
“Sec. 1- LOSS OF OR DAMAGE TO THE PRIVATE CAR INSURED
The Company will indemnify the insured against loss or damage to the Private Car insured hereunder and/or its accessories whilst thereon
- By fire explosion self ignition or lightning;
- By burglary housebreaking or theft;
- By riot and strike;
- By earthquake (fire and shock damage);
- By flood typhoon hurricane storm tempest inundation cyclone hailstorm frost;
- By accidental external means;
- By malicious act;
- Whilst in transit by road rail inland waterway lift elevator or air;
- By landslide rockslide”.
The above provisions of the policy reveals that the company will indemnify the insured if the loss or damage is occasioned to the insured inter alia by ‘accidental external means’. Now to see, whether the accident of the subject vehicle is the accident caused by the accidental external means or not.
It is the fact, which the O.P does not dispute, that the vehicle was put on fire by the gangs of unruly mob when the vehicle tried to flee away after having knocked down a pedestrian. It is not the case of the O.P Insurance company that the complainant himself has set fire to the vehicle to recover indemnity from the insurance company. The accident to the vehicle has not been caused by the complainant; it has been caused by some other persons. When an accident to a vehicle is caused by some other persons i.e by some other external agents, we can satisfactorily hold that the accident was the result of ‘Accidental external means’ as provided under section 1 of the policy. This being so, rejection of the claim of the complainant by the O.P-1 Insurance company is not in accordance with the terms and conditions of the Insurance policy. Such an unlawful rejection of the claim of the complainant by the O.P company is nothing but deficiency in service on the part of O.P-1 Insurance company. The Insured Declared Value of the vehicle was Rs.5,50,000/- vide the copy of certificate of insurance filed on record by the complainant. So, the complainant is not entitled to more than Rs.5,50,000/-. He is entitled to get this amount at the most as indemnity.
In the result, the case succeeds.
Hence,
ORDERED
That the complaint case be and the same is decreed on contest against the O.P Insurance company with cost of Rs…5000/-.
The O.P Insurance company is directed to pay Rs.5,50,000/- i.e the maximum IDV of the vehicle to the complainant and also to pay a sum of Rs.15,000/- as compensation for harassment and mental agony caused to the complainant by the unlawful rejection of the complainant’s claim, within a month of this order, failing which, the compensation amount of Rs.15,000/-, awarded amount of Rs.5,50,000/- and also the cost of Rs.5000/- will bear interest @10% p.a till full realization thereof.
Registrar-In-Charge of this Forum is directed to send a copy of the judgment free of cost at once to the parties concerned by speed post.
President
I / We agree
Member
Dictated and corrected by me
President
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