Date of Filing:26/06/2014
Date of Order:17/01/2017
ORDER
BY SRI.SYED ANSER KHALEEM, PRESIDENT
1. This complaint is filed under Section 12 of Consumer Protection Act, 1986, alleging the deficiency in service on the part of the OPs(hereinafter referred in short as O.Ps), against the repudiation of the claim and prays for direction to pay Rs.28,006/- along with interest at 15% per annum from 28/11/2013 till the date of realization and also sought for direction to pay Rs.25,000/- towards damages and loss incurred by the complainant with interest @15% per annum.
2. The facts of the complaint in brief are that, the complainant has purchased a Honda City Car bearing registration No. KL 35 A 9010 under Auto Secure Package policy in the year 2009, which covers entire repair costs except to incur Rs.1,000/- to avail services of the Opposite party, in other words, getting the benefit of “Bumper to Bumper” coverage in the said policy. The complainant states that at the time of renewal of the said policy in the year 2013-14, the OPs assured to continue the same benefits to the policy and accordingly complainant has taken the policy. Further states that, the complainant’s car met with accident and he left the Car for repair and repair expenditure came up to Rs.69,241/- and the OPs settled the claim for Rs. 41,235/- only and demanded to meet the balance amount. Hence the complainant questioned the OP regarding the non settling the whole claim and the OPs did not respond to the complainant. Thereafter , the complainant approached the Insurance OMBUDSMAN with a petition and ultimately the said petition was dismissed. The complainant alleges that OPs has breached the policy conditions by not paying the insurance amount and hence alleged that OPs committed deficiency in service. Further stated that, OPs has not informed about the terms and conditions of the policy package at any point of time except stating that policy covers the entire “Bumper to Bumper” repair and damages. Hence this complaint.
3. Upon issuance of notice, OP No.1 remained absent and hence placed exparte. However OP No.2 appeared through its counsel and filed its version. In the version of OP No.2, it is admitted that they have issued the insurance policy in favour of the complainant bearing policy NO:010045711004 covering the risk of Honda City Private Car bearing registration No: KL 35 A 9010 for the insured declared value of Rs.3,59,628.80ps. The validity of the insurance from 3/11/2013 to midnight of 2/11/2014. Further OP No.2 admitted that, as per the package of policy, the complainant would be benefitted with the entire repair cost i.e., likely to, in case of an accident subject to depreciation on parts and policy excess of Rs.1,000/- only, which the claimant has to pay for availing the services of the OP. It is contended that, if certain add on covers like depreciation, reimbursement is also taken charge towards the same may be reimbursed accordingly, however, there is no term “Bumper to Bumper” as stated by the complainant, since any policy is subject to certain terms and conditions under which it has to operate. The OP submitted that, while renewing the said policy for the year 2013-14 it was very specifically informed the complainant that the value added cover “Depreciation Reimbursement Cover” shall be extended to the policy issued for the vehicles up to three years “Depreciation Reimbursement Extension” which shall be observed from the schedule of premium on the face of the policy issued for the period from 2013-14. The OP contended that, policy issued to the insured was not extended to cover nil depreciation by the insurer. As such claim was rightly admitted by the insurer in terms of policy and there is no short settlement of claim and hence contended that complaint being devoid of merit is to be dismissed without any relief. Further contended that complainant lodged two claims on 14/3/2010 and 9/11/2012 in the first policy and in the fourth policy respectively and on that ground two claims in one policy period, the present claim was not processed and settled at Rs.41,235/- and processed the claim as if a single claim only lodged by the complainant taking in to consideration terms and conditions of the policy issued by them. The complainant’s Car was more than three years old as the payment of the entire amount including the value of depreciation also for which no additional premium was received from the complainant and even extending such coverage outside the scope of the under writing guidelines and prevented to collect the extra premium. Hence contended that the Insurance OMBUDSMAN dismissed the petition of the complainant. Further contended that no cause of action accrued to the complainant and also contended that there is no deficiency in service on the part of the OP No.2 and on other grounds prays for the dismissal of the complaint.
4. In order to substantiate the case of the parties and both parties filed their affidavit evidence and also heard the arguments.
5. On the basis of the pleadings of the parties, the following points will arise for our consideration are:-
(A) Whether the complainant has proved
deficiency in service on the part of the O.Ps?
(B) Whether the complainant is entitled to
the relief prayed for in the complaint?
(C) What order?
6. Our answers to the above points are:-
POINT (A) & (B): In the Negative.
POINT (C): As per the final order
for the following:
REASONS
POINT No.(A) & (B):-
7. On perusal of the pleading of the parties it is not in dispute that the complainant insured his car with the O.Ps. Further it is not in dispute that the complainant car more than three years old. On perusing the policy nowhere it has been stated the insurance coverage against the accident will cover bumper to bumper charges. Furthermore complainant failed to place any cogent evidence in order to establish that he has paid entire amount including the value of depreciation also for which no additional premium was received from the complainant. In the absence of the credible evidence the mere allegation of the complainant not sustainable and hence O.ps rightly contended that, policy issued to the insured was not extended to cover nil depreciation by the insurer. The complainant also approached the insurance OMBUDSMAN with a petition and on perusal of the orders passed by the insurance OMBUDSMAN, rightly rejected the claim of the complainant with a detailed order. Furthermore as per Section 3 of the Consumer Protection Act, 1986 it reads thus:
8. The provisions of this Act shall be in addition and not derogations of the provisions of any other law for the time being in force. It is worth to note that, once the insurance OMBUDSMAN passed the detailed order by rejecting the claim of the complainant but the complainant once again approached this Forum. If the Forum by exercise his jurisdiction to adjudicate the matter once again it is nothing but pulling down the decision given by the Insurance OMBUDSMAN.
9. Furthermore the counsel for the O.Ps also filed decision of the Hon’ble Apex Court reported in II (2009) CPJ 34 (SC) wherein the Hon’ble Apex Court held that: “Insurance is a contract, this species of commercial transaction must be construed like any other contract. Hence held that the terms of the contract have to be strictly construed to determine the extent of liability of insurance and also endeavor of court must always be to interpret the word contract and not expected to venture into extra liberalism that may result in rewriting the contract”.
10. In the light of above discussion, we reached to conclusion the complainant failed to prove deficiency in service on the part of the O.ps and hence complainant is not entitle to any relief sought in complaint. Accordingly we answered these points in the negative.
POINT No. (C):-
11. On the basis of the reasons assigned while answering the Point No.(A) and (B) and in the result we proceed to pass the following :-
ORDER
1. The complaint is hereby dismissed. No order as to cost.
2. Send a copy of this order to both parties free of cost.
(Dictated to the Stenographer, transcribed and computerized by him, corrected and then pronounced by us in the Open Forum on this the 17th Day of January 2017)
MEMBER MEMBER PRESIDENT
*Rak
