Non action to the insurance claim by the OP has aggrieved the consumer to lodge the instant complaint for redressal u/s 12 of the C.P Act 1986.
The instant case may be epitomized in the language that the insured, herein the complainant had maintained an insurance policy for his vehicle EON SPORTZ BS iv bearing registration No.WB-62E-5307 for the period from 26.08.2015 to 25.08.2016 vide policy No.51300131150100000536 of the OP. On 21.06.2016 the vehicle met with an accident at Narayanpur under Banshihari police station of Dakshin Didnajpur at 9 a.m. Due to the accident the number plate of the vehicle was detached but the complainant proceeded further. When he reached Buniadpur, the engine of vehicle stopped automatically and the smoke came out. The complainant immediately contracted the authorized company showroom and servicing centre Durga Hyundai, Malda. On 22.06.2016 the complainant intimated the OP about the accident and prayed for appointment of a surveyor. On 23.06.2016 the complainant got the estimated bill from the service centre and on 20.07.2016 the complainant again intimated the OP about the completion of the repairing work and requested to do the need full. On 25.07.2016 the complainant paid Rs. 43771/- to the service centre from his own fund though the primary estimate was Rs.48,728 /-. In response to letter dated 29.11.2016 from the OP, the complainant submitted all documents including claim form to the OP on 15.12.2016. Further on 21.03.2017 the complainant submitted his bank account and driving license as wanted by the OP. On 19.05.2017 the complainant further sent a reminder to the OP for settlement of his claim. But till date of filing this complaint i.e. on 27.02.2018 the OP has taken no steps for settling the claim. The complainant in his averment has claimed the total amount of repairing cost amounting Rs.43, 771/- plus 10.2% interest w.e.f 15.12.2016 and a compensation amounting Rs.50,000 (Fifty thousand) and a litigation cost of an amount Rs.15,000/-(Fifteen thousand).
The OP in their written version has stated that their surveyor Sri Joyram Das has assessed the damage of the vehicle for an amount of Rs. 4850 and submitted his report on 22.10.2016. The OP has averred more that the complainant has shown no interest to submit necessary papers between 21.06.2016 and 29.11.2016. He has actually submitted his papers on 15.12.2016 insufficiently and this has been actually completed sufficiently on 21.03.2017. So the delay on the part of the complainant is the root of delay in settling the claim and they have no deficiency.
On argument the complainant stated to this Forum that though the cost for repairing from the company service centre amount to Rs.43771 but the OP has verbally contracted him to settle the dispute at Rs.4850 as per report of their surveyor submitted on 22.10.2016. He questioned though he has informed every step from the very next date of the accident to the OP in writing (Filed as documents kept in this record) but their surveyor had assessed it at 11% of the total cost met by him in his absence on a date when the car has already been repaired and on road. It is a willful negligence to a valid customer by the OP. The Ld. Lawyer for the complainant questioned how the surveyor made an assessment of the damage when the car is fully repaired.
The Ld. Lawyer for the OP argued that the surveyor has made survey of the damaged car time and again and on 22.10.2016 he has submitted his final report. The complainant is responsible for heavy damage due to driving the car even after the accident when the coolant of the engine has been malfunctioning due to the accident. On question the Ld. Lawyer for the OP could not satisfy the Forum why the survey was made in absence of the insured and whether the insured was cautioned not to drive a car when coolant is malfunctioning and if it is done, no claim will be paid to the insured.
Points for decision:
- Whether the complainant is a consumer to the OP?
- Is there any deficiency in service on the part of the OP?
DECISION WITH REASONS
From the above discussion it has been settled that the complainant is a consumer as the OP has not denied him as a valid insuree. All the averments and the arguments of both the parties have been taken into consideration for deciding the second point. The OP has failed to prove why the exorbitant difference between the assessment of the surveyor and the actual cost incurred by the complainant. In this context we must taken into consideration the importent point ‘Insurance company cannot resort to undue deduction without basis’ in the case New India Assurance Company vs A.K.Kariappa [2015(3) CPR(NC)]. If it is considered the completion of submitting all necessary documents for settlement of the claim has been made on 21.03.2017, the question rises why such a delay of settling the claim. Further we take resort to the important point ‘Insurance claim must be settled with utmost expedition’ [2015(3) CPR 366(NC)] in the case Pavan Kumar Nandkishor Agrawal vs Branch Manager , Oriental Insurance Company. Moreover, the surveyor has done his duty only in the absence of the insured. So it is found that the OP has shown his deficiency in service.
Hence, it is
O R D E R E D
- The Op will pay Rs.43771/- as the actual repairing cost to the complainant.
- A compensation amounting to Rs.20,000/- along with a litigation cost of Rs.5,000/- is to be paid to the complainant by the OP.
- The complaint on receipt of the whole amount from the OP will deposit Rs.10,000/- to the state legal aid fund under this Forum.
- The whole amount is to be paid within 30 days from the date of this order, failing which an additional 8% interest is to be borne on the actual repairing cost and the compensation amount.
The case succeeds on contest & is disposed of.
Let a plain copy of this order be furnished to the parties forthwith free of cost.
