By. Smt. Bindu. R, President:

            This complaint is filed by Muhammed Shafi, S/o. Abdul Salam, Kunduthodi House, Kottakunnu, Meenangady Post, Purakkadi, Sulthan Bathery Taluk, Wayanad against the Branch Manager, ICICI Lombard Insurance Company, 6/255/C Second Floor, City Plaza, YMCA Cross Road, Kozhikode-673001 as Opposite Party alleging deficiency of service and unfair trade practice from the side of the Opposite Party.

            2.  The Complainant states that he is the owner of 2018 Model Honda Activa Scooter with Registration No.KL-73-B-7674 with Policy No.3005/211723669/00/B00 (Package Policy) issued by Opposite Party on 09.12.2020 and which has validity till 08.12.2021. On 17.12.2020 during night at 9.30 pm while the vehicle was parked opposite to Meenangady Community Hall by the side of the Highway, a vehicle came of which the whereabouts were not known, from the side of Kalpetta and hit on the vehicle of the Complainant.  The Complainant states that since Meenangady town was containment zone during that time and since the Opposite Party informed the Complainant that no police case is necessary for obtaining the claim, the Complainant had not complained the incident to the police.  Thereafter the Complainant entrusted the vehicle to the dealer Kacheri Motors, service  centre, Kalpetta and the fact of incident was intimated to the Opposite Party through the dealer.  According to the Complainant, the dealer informed the Complainant that the expenses will come to about Rs.60,000/- and hence he Complainant had to pay the amount and then to claim for insurance.  Hence the Complainant took the vehicle to Vishnumaya Two Wheeler workshop at Theneri, Kakkavayal and the vehicle was repaired for Rs.42,217/- on 28.07.2021.  Due to the financial difficulties, the Complainant could not take the vehicle after completing the repair and delay was occurred in taking the vehicle from the workshop.  After completing the works, the Complainant submitted claim from along with bills and entrusted it to Sini Varghese, agent of the Opposite Party on July 3^rd but the claim was repudiated and hence the Complainant approached the Commission praying for direction to the Opposite Party to pay the bill amount and also for compensation.

            3.  Upon notice the Opposite Party entered in to appearance and filed their version stating that the complaint is filed suppressing material facts as an attempt to obtain unlawful gain.  The Opposite Party admitted the ownership of the vehicle and the insurance from 09.12.2020 to 08.12.2021.  The fact of accident was not known to the Opposite Party and the allegation that the Opposite Party made to believe the Complainant that police case is not necessary is denied by the Opposite Party.  The allegation regarding the entrustment of the vehicle to the dealer and then shifted to Vishnumaya workshop at Theneri are denied by the Opposite Party.  The statements by the Complainant that the submission of claim form through Sini Varghese, agent and subsequent denial of claim by Opposite Party are also denied.  It is contented by the Opposite Party that the Complainant submitted a claim form to the Opposite Party alleging the accident on 14.12.2020 and scooter sustained heavy damage.  According to the Opposite Party, they have immediately appointed an IRDA approved licensed insurance investigator Mr. Sojil. K, ASCOM Associates, Calicut to assess the loss and damage to the scooter and to ascertain the reason for the alleged accident who filed a detailed report stating that on investigation it is revealed that the accident took place at Meenangady Town while the insured was driving the vehicle and at the time of accident the insured had no valid license.  The policy was a break policy and at the time of accident the vehicle did not have a valid policy.  The job card given to the workshop, Kachery Honda was cancelled by the relative of the insured and the scooter was taken from the workshop on 17.12.2020 itself.  The investigator found that the claim is by misrepresenting the facts and the claim is not payable.  According to the Opposite Party the Insurance Policy conditions stipulates that “Drivers clause: Any person including the insured provided that a person driving the vehicle holds an effective driving license at the time of the accident.  The insured in not indemnified if the vehicle insured or driven otherwise than in accordance with the policy”.  General exceptions condition Clause No.1 specifically covenants that “1.  Notice shall be given in writing to the company immediately up on the occurrence of any accident or loss or damage and in the event of any claim and thereafter the insured shall give all such information and assistance as the Company shall required.  Every letter, claim, writ, summons, and/or process shall be forwarded to the Company immediately on receipt by the insured.  Notice shall also be given in writing to the Company immediately the insured shall have knowledge of any impending prosecution, inquest and fatal injury in respect of any occurrence which may give rise to a claim under this policy.  In case of theft or other criminal act, which may be subject of claim under this policy, the insured shall give immediate notice to the Police and co-operate with the Company in securing the conviction of offender”.  The policy further stipulates that No claim under the policy shall be payable unless the terms of this condition have been complied with.  Insurance is a contract between the insured and the insurer and hence the terms and conditions of the policy are equally applicable to the insured and the insurer.  Non-compliance of the terms and conditions of the policy is very vital.  Opposite Party states that the Complainant failed to provide satisfactory evidence to prove the accident was really occurred on 14.12.2020 at 9 pm and there is no deficiency of service on the part of the Opposite Party and prays for dismissal of the complaint with cost.

            4.  Evidence in this case consists of the oral evidence of PW1 and Ext.A1 to A3 from the side of the Complainant and Ext.B1 and B2 marked from the side of the Opposite Party.

            5.  The following are the main points to be analyzed in this complaint to derive in to an inference of the fact

1. Whether the Complainant had sustained to any deficiency of service or unfair trade practice from the side of Opposite Party?
2. If so, the quantum of compensation and costs for which the Complainant is eligible to get.

6.  Heard both sides and perused the records in detail.

7.  In this case the specific case of the Complainant is that on 17.12.2020 at 9.30 pm while the vehicle belonging to the Complainant bearing Registration No. KL-73-B-7674, 2018 model Honda Activa Scooter with policy No.3005/211723669/00/B00 having validity till 08.12.2021, was parked opposite to Meenangady Community Hall an unknown vehicle came from Kalpetta side and hit on the scooter and thereby the scooter sustained serious damages.  It is the case of the Complainant that since it was told by the Opposite Party that no police case is necessary for obtaining claim, the accident was not reported to the police also.  According to the Complainant the same was intimated to the Opposite Party through the dealer and the dealer informed the Complainant that the vehicle is to be repaired on payment and then to claim for reimbursement.  Since the dealer asked for an amount above Rs.60,000/-, the vehicle was taken to Vishnumaya Two wheeler workshop at Theneri, Kakkavayal and worked the vehicle for Rs.42,217/- and received the vehicle on 28.07.2021 from the workshop.  The claim submitted by the Complainant was repudiated by the Opposite Party which amounts to deficiency of service on the part of the Opposite Party.

8.  Ext.A1 is the Copy of RC of the vehicle bearing Registration No.KL-73-B-7674.  Ext.A2 is the Certificate of insurance cum policy schedule.  Ext.A3 series are the bills (only in 2 bills the vehicle number is noted and in other bills neither the vehicle number nor the name of the owner is seen mentioned).  During cross examination PW1 deposed that “tIt¨cn motors te¡v sIm­p t]mbXv aq¶v Znhkw IgnªmWv.  A]ISw \S¶Xv F¶msW¶v correct HmÀ½bnà 17.12.2020 \v accident BbXmbn complaint  ]dªn«p­v. Insurance Company  sImSp¯ claim form  14.12.2020  A]ISw D­mbn F¶v ImWp¶ps­¦n H¶pw ]dbm\nÃ. Date HmÀ¡p¶nÃ.  B A]IS kab¯v license CÃmbncp¶p”.  PW1 further deposed that “08.12.2020  BWv insurance ]pXp¡p¶Xv.  AXn\v ap¼pff policy Ahkm\n¨ date HmÀ½bnÃ.  A]IS¯n\v ap³]p­mbncp¶ policy GXv Insurance Company tSXmWv F¶v HmÀ½bnÔ. He further deposed that “A]ISw D­mbn F¶v ImWn¡m³ Hcp tcJbpw I½oj³ ap¼msI lmPcm¡nbn«nÃ. Insurance claim In«m³ th­nbmWv accident sâ date amän ]dbp¶XmWv F¶v ]dªm icnbÔ.

9.  From the side of Opposite Party they have produced Ext.B1 copy of Certificate of Insurance cum policy Schedule (Which is same as Ext.A2).  Ext.B2 is the copy of the claim form for motor vehicle in which the details of the driver at the time of accident is mentioned as Sajeer. P, Panakkal House, Kottakunnu, Pazhamkuni.  In the column, details of accident, it is stated that the date is on 14.12.2020 at 09.00 pm.  The details mentioned as “while parked my vehicle in front of my shop at Meenangadi, while returning back to shop from house the vehicle was in accident condition ( I think any another vehicle have hit on my vehicle and that vehicle ran away).

10.  The overall consideration of the evidence and the contentions in the complaint and version, the Complainant had to prove his case on merit which is not done by the Complainant.  According to the Complainant he is not certain about the date of accident whether it is 17.12.2020 as stated in the complaint or on 14.12.2020 as stated in the claim form.  The specific case of the Opposite Party is that the Complainant was not having license which is also not disproved by the Complainant with any documentary evidences.  More over the Complainant had no case that the Vehicle was run by another person named Sajeer at the time of accident as stated in the claim form.  The said Sajeer. P is not examined also.  More over accident is not intimated to the Opposite Party and the loss is not assessed either by the Opposite Party or by an Expert.

11.  In these circumstances, the Complainant had not discharged the initial burden on his part to prove his case on merit.  Point No.1 is found against the Complainant and hence Commission finds that the complaint is only to be dismissed.

Hence Consumer Case dismissed without costs.

Dictated to the Confidential Assistant, transcribed by him and corrected by me and pronounced in the Open Commission on this the 15^th day of April 2024.

Date of Filing:-25.09.2021.

PRESIDENT   : Sd/-

MEMBER       : Sd/-

APPENDIX.

Witness for the Complainant:-

PW1.              Muhammed Shafi.                         Coolie.

Witness for the Opposite Party:-

Nil.

Exhibits for the Complainant:-

A1.                  Copy of Registration Certificate.

A2.                  Copy of Certificate of Insurance cum Policy Schedule for the

period of 09.12.2020 to 08.12.2021.

A3 (Series).  Bills (5 Numbers).

Exhibits for the Opposite Party:-

B1.                  Copy of Certificate of Insurance cum Policy Schedule for the

period of 09.12.2020 to 08.12.2021.

B2.                  Copy of Claim form.                                              Dt:17.12.2020.

PRESIDENT   :Sd/-

MEMBER       :Sd/-

/True Copy/

Sd/-

                                                                                             ASSISTANT REGISTRAR

                                                                                                  CDRC, WAYANAD.

Kv/-