(Passed on 11/05/2023) Per Mr. Atul D. Alsi, Hon’ble President - The complainant filed a complaint case against partly repudiation of insurance claim of Rs. 4,17,967/- for own damage claim of complainant’s vehicle and thereby claiming compensation along with interest and cost.
- The story in short are as under.
- The complainant owned Hyundai Verna car bearing No. MH34/AM 7786 insured with OP for the period between 18/05/2018 to 17/05/2019 bearing policy No. 0158314060000 for the insured declared value of Rs. 5,28,967/-.
- On 23/02/2019, the driver Mr. Arvind Malekar while driving the complainant’s car at 11.00 pm met with an accident with head on collusion at Kamgar Chowk, bypass road, Chandrapur. The outcome of accident, FIR bearing No. 213/2019 came to be registered at City Policy Station, Chandrapur on 24/02/2019. The vehicle thereafter sent for repairs to Hyundai authorized service station but the repair charges will be 75 percent of price of car. Therefore, the OP assured and paid part claim of Rs. 1,65,000/- towards salvage of vehicle and promise to paid Rs. 4,17,967/- towards the sum assured of the policy of Rs. 5,82,967/-. Thereafter the OP arbitrarily repudiated the remaining claim amount because the vehicle was being used for hire services by issuing letter dated 18/11/2019. The complainant thereafter issued legal notice through advocate Mr. Pritam Nagpure on 3/12/2019 but the OP failed to comply the notice. Therefore, the petition is filed.
- The OP filed reply and denied the allegations against it and admitted the insurance policy of complainant’s vehicle and insured declared value of vehicle Rs. 5,28,967/-. The OP also admitted that the vehicle after accident was sent for repairs to authorized service station of Hyundai and the estimated expenditure were 75 percent to the actual cost of vehicle. The complainant’s vehicle was being used for hire purpose and therefore the complainant has not intentionally mentioned the name of passengers at the time of accident. The vehicle has been purchased for personal use but the vehicle was being used for hire purposes. Therefore, rejection of insurance claim for the reason is not unfair trade practices on the part of the OP.
- The counsel for complainant argued that there is no evidence of hire paid passengers and the complainant’s vehicle was being used to hire the passengers. The rejection of remaining claim by OP for the reason without the proof for the allegation thus amounts to deficiency in service.
- The non disclosure of the name in FIR and the passengers were resident of different area of Chandrapur. Therefore, it is clear cut evidence of vehicle had been used on hire and paid basis. Therefore, rejection of remaining claim does not amount to deficiency in service.
REASONING - The complainant who is resident of Chandrapur, and running ice factory and owner of Hyundai Verna four wheeler car bearing registration No. MH34/AM 7786. The insurance of the vehicle has been admitted by OP. on 23/02/2019, the complainant’s vehicle and truck bearing No. MH40/BG 8787 met with an accident with head on collusion at 11.00 pm near bypass road and FIR bearing No. 213/2019 came to be registered on 24/02/2019 at City Police Station, Chandrapur. The OP has paid part of the claim Rs. 1,65,000/- for the price sold at auction by OP and failed to disburse the remaining claim of Rs. 4,17,967/-
- The basis dispute of repudiation of remaining claim is only for the reason of the vehicle being used of hire and reward purposes. The OP has failed to submit any receipt of payment of amount paid by the passengers towards travelling charges. The investigator or any person on behalf of OP has failed to file affidavit, statement of passengers for the payment of travelling charges. The vehicle has been registered as private vehicle. In case of accident of head on collusion, both drivers of vehicles are liable for the negligence in driving of the vehicle. The OP has failed to bring on record, the reliable, cogent evidence in respect of vehicle being used for hire and reward purposes. Therefore, rejection of part of the claim of Rs. 4,17,967/- thus amounts to deficiency in service. Therefore, the OP is liable to pay Rs. 4,17,967/- towards remaining amount of claim to the complainant along with compensation of Rs. 25,000/- towards physical and mental harassment and Rs. 15,000/- towards cost of litigation as per following order.
ORDER - The complaint is partly allowed.
- The OP shall pay to the complainant remaining unpaid insurance claim of Rs. 4,17,967/-
- The OP shall pay Rs. 25,000/- towards physical and mental harassment and Rs. 15,000/- towards cost of litigation to the complainant.
- Copy of order be furnished to both parties, free of cost.
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