Sri Shyamal Gupta, Member
This statutory Appeal is filed u/s 15 of the Consumer Protection Act, 1986 to assail the order dated 19-10-2016 of the Ld. District Forum, Siliguri passed in Consumer Case No. 45/2015 whereby the complaint case has been allowed.
The factual matrix of the Appeal are that a comprehensive package motor insurance policy was issued to the Respondent No. 1 in respect of a Truck bearing registration no. WB 23 B 0540 by the Appellants. The said vehicle met an accident on 19-05-2014 for which Respondent No. 1 claimed Rs. 6,23,253/-as insurance benefit. However, the same was repudiated for giving false declaration by the Respondent No. 1 in order to get No claim bonus. Despite this, the complaint case since been allowed by the Ld. District Forum, aggrieved with such decision, this Appeal is moved by the Appellants.
Ld. Advocates for the parties were heard at sufficient length and documents on record, including the citation referred to by the Ld. Advocate for the Appellants, duly perused.
It is argued by the Ld. Advocate for the Appellants that the Respondent No. 1 did not file requisite cash memo to show that he spent Rs. 6,23,253/- for repairing the damaged vehicle.
It is, however, seen from the survey report that the Respondent/Complainant did furnish the relevant bills/cash memo to the Surveyor.
Further, it is argued by the Ld. Advocate for the Appellants that the independent Surveyor deputed by them estimated the loss at Rs. 1,43,707/-. In view of this, according to the Ld. Advocate, there was no reason for the Ld. District Forum to allow the entire claimed amount.
It transpires from the record that the subject peril occurred on 19-05-2014 and the Surveyor submitted his final report on 13-12-2016; i.e., after the Ld. District Forum delivered its verdict on 19-10-2016. Quite naturally, such belated action on the part of the Surveyor concerned left no scope for the Ld. District Forum to go through the same and decide the fate of the case accordingly.
Lastly, it is argued by the Ld. Advocate that the instant claim was rightly repudiated by them as the Respondent No. 1 did not make an honest and candid disclosure in respect of the subject vehicle for availing of No Claim bonus.
It is alleged in the WV that the Respondent No. 1 received certain amount from the previous Insurer, i.e., M/s Royal Sundaram Alliance Insurance Co. Ltd. as ‘Own damage’ against the subject vehicle during the policy year 2011-12. Allegedly, at the time of transferring the policy from the previous Insurer to the Appellants, Respondent No. 1 did not disclose such fact.
Although the subject claim was repudiated on the solitary ground of non-disclosure of material fact, it appears that No Claim Bonus @ 50% was allowed in respect of the policy for the period 19-11-2013 to 18-11-2014. There is nothing to show that the Respondent No. 1 availed of any insurance benefit during the policy year 2012-2013. In view of this, such repudiation of the instant claim of the Respondent No. 1 by the Appellants was highly improper and illegal.
Now, let us decide, whether by directing the Appellants to reimburse Rs. 6,23,253/-, the Ld. District Forum committed any illegality.
As noted hereinabove, the survey report being finalized two months after the impugned order was pronounced, the Ld. District Forum got no such opportunity to traverse through the findings of the Surveyor.
Also, it is obligatory on the part of the Surveyor to submit his report within six months from the date of his appointment. In this case, the Surveyor took more than 2-½ years to finalize his report in gross violation of the guideline laid down by the IRDA [Insurance Regulatory and Development Authority (Protection of Policyholders’ Interests) Regulations, 2002]. No plausible reason is shown from the side of the Appellants as to why the Surveyor concerned took so much time to finish his report.
Another aspect of the matter that has driven our mind is the fact that, thanks to such dilly-dallying tactics of the Appellants, the Respondent No. 1 suffered massive financial loss, not to speak about the immense mental pain and trauma that he was subjected to all these years.
On one hand, the Respondent No. 1 claimed reimbursement of the sum of Rs. 6,23,253/- and on the other hand, the Surveyor estimated the loss at Rs. 1,43,707/-. On a reference to the survey report, we find that there is no clarity as to whether, while computing the loss, the Surveyor took into consideration all spare parts at their original price or not. This aspect assumes significance as in most of the cases, Surveyors tend to allow lesser number of spare parts and also lesser price than what is charged to the Insuree by the service centre without assigning any reason whatsoever for doing so.
It is the consistent view of this Commission that every single penny being deducted by the Surveyor should be accounted for in the survey report by giving proper explanation in the larger interest of probity which is sorely missing in this case.
Ld. Advocate for the Appellants though tried hard to convince us that the report of the Surveyor, being an independent expert opinion, it is not wise to call in question the same, it is an open secret that the Surveyors make their ends meet by carrying out the assignments being given by Insurance Companies. Thus, while Surveyors remain at the beck and call of the Insurance Companies for their livelihood, if we take an empirical view, there always remains the probability of conflict of interest. Therefore, we cannot always take such reports at their face value.
Considering all these aspects into perspective, we, therefore, refuse to take any cognizance of the same.
On due consideration of everything, we find not much infirmity with the impugned order. However, to be fair to the Appellants, we exonerate them from the liability of paying punitive damage as ordered by the Ld. District Forum.
The impugned order is, accordingly, modified to the extent that the Appellants need not pay any punitive damage. Otherwise, the impugned order shall remain unaltered. The Appeal, thus, stands allowed in part.
