BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BANGALORE. (ADDL. BENCH)
DATED THIS THE 2nd DAY OF AUGUST, 2023
PRESENT
SRI RAVI SHANKAR, JUDICIAL MEMBER
SMT. SUNITA C.BAGEWADI, LADY MEMBER
CONSUMER COMPLAINT NO.413/2015
Sri.Krishnappa.C,
Residing at #741, 11th Cross, … Complainant/s
C.K.Nagar, New MIW Road,
Electronic City, Bengaluru
(By Sri.Pradeep Kumar.S.P, Advocate)
V/s
M/s.Universal Sompo General
Insurance Co. Ltd.,
Regd. Office: 201-208, Crystal Plaza,
Opp: Infinity Mall, Link Road,
Andheri West, Mumbai-400 058
.. Respondent/s
Also at Regional Office,
#217, 3rd Floor, KUV Samrat,
3rd Main, Kasthuri Nagar
Outer ring Road,
Bengaluru-560 043
(By Sri.Ravi.S.Samprathi, Advocate)
O R D E R
BY SRI.RAVISHANKAR, JUDICIAL MEMBER
This complaint is filed by the complainant against the Opposite Party alleging deficiency in service in not settling the own damage claim to the tune of Rs.48,51,651/- and prayed for a direction to be given to the Opposite Party to pay the Rs.48,51,651/- towards own damage along with 6% interest per annum and compensation of Rs.20,00,000/-, in the interest of justice and equity.
2. The brief fact of the complaint is that the complainant is the owner of the Jaguar Land Rover Free lander 22.2d SE MY 13 vehicle with engine No.DZ784087124224DT and Reg.No.KA-51-MD-9394 which was insured with the Opposite Party Company vide policy No.2311/53173821/00/000, the policy valid from 24-4-2013 to 23-4-2014. The complainant had paid a premium of amount of Rs.1,73,942/- towards purchase of the said policy which covers own damage and third party risk (comprehensive policy).
That on 15-7-2013 the vehicle met with an accident at New Central Jail Road, in front of Chennakeshwara School, Bangalore due to which four persons died on spot and seven persons injured, apart from that the vehicle intensively damaged. The police have registered a case against the complainant and charge sheet was also filed.
The complainant after accident a tendered the vehicle for repairs at Popular Auto works Pvt. Ltd. on 18-9-2013 and the said service station has given an estimation for repair of the vehicle to the tune of Rs.48,51,651/-. After obtaining the said estimation, the complainant made a representation for payment of the said repair charges by virtue of the policy under the own damage claim.
Subsequently the injured and LRs of the dead persons have filed claim applications before the Claims Tribunal against this complainant and Opposite Party i.e. this Opposite Party had settled the third party claim before the MACT and claim of injured persons were settled before the Lok-Adhalath dated 13-6-2015.
Though the complainant had provided all relevant documents and also given explanation towards the queries made by this Opposite Party. Inspite of giving all details informations, the Opposite Party Company had not settled the claim, due to which the complainant suffered a financial loss and unable to use the vehicle. Subsequently the complainant issued legal notice and called upon the Opposite Party to settle the own damage claim. Inspite of receipt of the legal notice, the Opposite Party has not settled the claim. Hence, the Opposite Party rendered deficiency in service in not settling the claim and prays for settlement of the claim to the tune of Rs.48,51,651/-, in the interest of justice and equity. Hence this complaint.
3. After service of notice, the Opposite Party appeared through his counsel and filed version and contended that they have issued a policy in favour of complainant with respect to the vehicle bearing Reg. No.KA-51-MD-9394 for a period from 24-4-2013 to 23-4-2014, the liability of this Opposite Party Company, if any under the above policy is subject to the terms, conditions and exclusion of the policy.
During the validity of the above mentioned policy, the complainant informed through a call centre to this Opposite Party regarding the damages on 1-8-2013 and also informed that the vehicle was met with an accident on 15-7-2013. Later claim form was submitted by the complainant on 12-2-2014. The terms and conditions of the policy is binding on the both party and as per the terms and conditions, the insured/complainant should intimate the Opposite Party immediately after accident as per the condition No.1 and written notice with all particular should be given to the company immediately after occurrence of the event, but the complainant had failed to inform the accident immediately and acted against the terms and conditions of the policy.
The complainant in his claim form has categorically mentioned that the insured vehicle was stolen whilst it was parked in front of his house with the keys being left inside. Subsequently the vehicle met with an accident and claimed for compensation under own damage. In fact, the complainant had left the key inside the vehicle which invited for theft. As per the terms and conditions of the policy, the complainant ought not to keep the key inside the vehicle when parked, hence he had violated the terms and conditions of the policy.
After receipt of the claim from the complainant, this Opposite Party in order to ascertain the correctness of the claim collected hospital records pertaining to the injured and police records pertaining to the accident. On perusal of the all records, it was proven that the bloodstains picked up by the police found in the insured vehicle was driven by the complainant himself at the time of accident, but the complainant has stated a different version with respect to the incidence in the claim form. The complainant has claimed wrongfully in the claim in order to gain wrongfully.
The Opposite Party further contended that after noticing the accident reported in the local newspaper and the eye witness statement this Opposite Party came to know that the complainant was driven the vehicle under the influence of intoxicating alcohol and he was driven with rash and negligent manner which caused death of four persons and injuries to seven persons. Due to rash and negligent driving with alcohol, the complainant had violated the terms and conditions of the policy.
The claim made by the complainant is falls outside the purview and scope of the policy it cannot be considered. Hence the claim of the complainant towards own damage was not considered for payment and any damage. There is no any deficiency in service on the part of this Opposite Party in not considering the claim made by the complainant. This Opposite Party has also not aware of the extent of damages sustained to the insured vehicle. Therefore, the claim was repudiated and there is no any deficiency in service in repudiating the claim of the complainant, hence prays for dismissal of the complaint, in the interest of justice and equity.
4. The complainant filed affidavit evidence and marked documents as Exs.C1 to C20. In spite of granting sufficient time, the Opposite Party did not come forwarded to file any affidavits in support of their defence. Later the Opposite Party filed notes of arguments.
5. Heard.
6. On perusal, the following points will arise for our consideration;
(1) Whether the complainant has proved deficiency in service on the part of Opposite Party?
(2) Whether the complainant is entitled to the reliefs as sought?
(3) What Order?
7. The findings to the above points are;
(1) In the affirmative
(2) In the affirmative
(3) As per final Order.
R E A S O N S
Point Nos. (1) & (2):
8. On perusal of the pleadings, affidavit evidence and documents produced by the complainant, it is an admitted fact that, the complainant is the owner of the vehicle bearing Reg.No.KA-51-MD-9394 who had obtained a comprehensive policy from the Opposite Party vide No.2311/53173821/ 00/000, which is valid from 24-4-2013 to 23-4-2014. It is also not in dispute that, the vehicle met with an accident on 15-7-2013 which resulted in death of four persons and injury to seven persons and also damage to the vehicle. The police have registered FIR and charge sheet was filed against the complainant under rash and negligence. The complainant appeared before JMC Court, Bengaluru; subsequently the claims made by 3rd parties were also settled in Lok-Adhalath held on 13-6-2015. The only dispute raised by the complainant is that by virtue of the policy the complainant claimed for own damage to the tune of Rs.48,51,651/-, the said amount which was estimated by the Popular Auto works Pvt. Ltd., but the Opposite Party has repudiated the claim without any valid reasons and submits that the Opposite Party is liable to settle the claim by virtue of the policy. Hence alleging deficiency in service and claimed for the above said compensation.
9. On the other hand, the Opposite Party has taken two different types of grounds for repudiation, the first ground they have taken for repudiation is that the complainant has claimed own damage claim stating the vehicle was stolen when he was parked the vehicle near the home, subsequently which was met with an accident. After noticing the said they have shown their inability to settle the claim and other grounds for repudiation of the claim is that, the complainant had driven the vehicle in an intoxication mood which resulted in accident and caused death of four people and injuries to seven people.
10. On perusal of the documents produced by the complainant i.e. FIR and Charge sheet marked as Ex.C20, it is noticed that the complainant, as on the date of accident was driving the vehicle and the vehicle was intensively damaged. When the documents speaks about complainant is driving a vehicle mere mentioning the reasons that the vehicle was stolen in the claim form is irrelevant, when the documents speaks the Opposite Party ought to consider that the complainant himself was driving the vehicle as on the date of accident. Further on perusal of the alleged IMV report and letter issued by Jaguar Company marked as Ex.C5. The accident took place due to hitting of the Tyre to hard surface due to which tyre was burst. When the report says that the accident was caused due to burst of the tyre due to hitting to hard surface and there is no any mention with respect to the complainant was driving in intoxicated condition, the grounds taken for repudiation that, the complainant was driving the vehicle in intoxicated mood is not acceptable. Though the statement given by witness in that charge sheet says that the complainant was driving the vehicle in intoxicated condition, the same cannot be taken as valid grounds for repudiation of the claim of the complainant. The Opposite Party ought to consider the document with respect to the complainant is driving the vehicle as on the date of accident and also consider the cause of accident. Hence, the grounds urged for repudiation of the claim by the Opposite Party is not justifiable.
11. We noticed the complainant had valid driving licence as on the date of accident and the policy was also in force as on the date of accident. The cause of accident is clear as per the records. Under this circumstance the claim of the complainant ought to settled by the Opposite Party, but instead of settling the claim, the Opposite Party has repudiated the claim even without appointing any surveyor for assessment of the loss. Hence it is clear case of deficiency in service on the part of the Opposite Party.
12. The complainant had filed estimation towards the repair of the vehicle, but had not produced any receipt to show that the complainant repaired the vehicle. In the absence of such, we are of the opinion that the Opposite Party is liable to pay an eligible repair charge of the vehicle as per the policy terms and conditions. Further, we are of the opinion that, the entire estimation amounts are not payable to the complainant, because as per the terms and conditions of the policy the repair charges have to be paid after applying a required depreciation on the materials and repair charges of the vehicle. As such the Opposite Party is liable to pay eligible repair charges to the complainant. Further the Opposite Party could have assessed the loss by appointing a surveyor after inspection, but merely basing on the claim, the Opposite Party has repudiated the claim and it is clear case of deficiency in service. Therefore, the Opposite Party is liable to pay a compensation of Rs.2.00 lakhs for deficiency in service along with litigation expenses of Rs.10,000/-. As such the complaint is allowed and accordingly we proceed to pass the following:-
O R D E R
The complaint is allowed with cost of Rs.10,000/-
The Opposite Party is directed to pay eligible repair charges of the vehicle to the complainant within 60 days from the date of receipt of this order.
The Opposite Party is further directed to pay compensation of Rs.2.00 lakhs towards deficiency in service to the complainant
Further the Opposite Party is directed to comply the above order within 60 days from the date of receipt of this order. Failing which, the payable amount shall carry interest @9% p.a. from the date of default till realization.
Send a copy of this order to both parties.
Lady Member Judicial Member
Jrk/-
