A. K. BHATTACHARYYA, PRESIDENT
Case of the complainant, in brief, is that she took a Private Car Package Policy being no. 51260331120100000040 in respect of her vehicle no. WB-30F-7371 after paying due premium thereof and the said policy was valid for the period from 07.04.2012 to 06.04.2013 (midnight). It is stated that the said vehicle met an accident on 20.08.2012 at Astara under P.S. Tamluk and as a result of such accident, the vehicle got badly damaged and Tamluk P.S. started a case being no. 27/2012 dt.22.08.2012 in respect of such accident. Complainant informed OP insurance company about occurrence of such accident on 22.08.2012 and as per their advice, sent the damaged vehicle to Bhandari Automobiles, Kharagpur for repairing who raised a bill of Rs. 1,14,774/- and the complainant, after paying the said repairing cost, took delivery of the vehicle on 05.11.2012 and later on, she submitted her claim form to OP for reimbursement of the repairing charge of the damaged vehicle. The complainant filed the instant case over inaction on the part of the OP insurer to settle her claim despite repeated reminders.
In support of her claim complainant filed photocopies of Certificate of Registration of the vehicle in question, policy certificate, GD copy, her letters to OP insurer, Service Estimate as well as receipt issued by Bhandari Automobiles (P) Ltd. and thereafter, also filed some original documents including original receipts issued by Bhandari Automobiles.
OP insurer contested the case by filing written version and also filed WNA. They also took a positive part in the entire proceeding. By their written version, OP denied inter alia all the material allegations of the complainant. It is alleged by OP that although the accident took place on 20.08.2012, complainant apprised them about such accident on 22.08.2012 and on the very same day, she handed over the vehicle to Bhandari Autolbiles for which they could not carry out proper spot inspection; that their authorized surveyor assessed the damage to the tune of Rs. 56,000/-; that after repair, neither the petitioner nor Bhandari Automobiles showed salvaged parts to the insurer yet they called the complainant for settlement of her claim on several occasions but the complainant did not respond to their call and therefore, they cannot be held responsible for deficiency in service.
In their defence, OP insurer submitted photocopy of Surveyor Report.
Points for consideration
On the basis of materials on record and averments of ld. lawyers, we frame the following points to arrive at a decision.
- Whether the loss assessed by the surveyor of OP is justified?
- Whether there is any deficiency in service on the part of OP?
- Whether complainant is entitled to get any relief?
Decisions with reasons
Point nos. 1,2& 3:
All these points are taken up collectively for the sake of brevity of discussion.
Admittedly, complainant is a bona fide policy holder under OP insurer and the accident occurred while the policy in question was effective. There is no dispute that OP insurer delegated two surveyors – one for spot inspection and another for assessing the loss.
The only dispute that emerges between the partiesis the quantum of compensation. From a bare perusal of the report of the aforesaid Surveyor/Loss Assessor appointed by OP it transpires that, the loss as assessed by him, is quantified, at, Rs. 56,000/-, whereas, complainant sought to be indemnified by Rs. 1,14,774.00 as insurance benefit which she paid to the service centre, M/s Bhandari Automobiles toward repairing charge of the damaged vehicle. Therefore, we are to decide whether the loss assessed by the surveyor of OP insurer is adequate or not.
It is alleged by OP that as the complainant shifted the damaged to the service centre for repairing on the very same day of giving intimation as regards occurrence of accident to the insured vehicle, they could not carry out proper spot inspection. We, however, find that one Mr. Satrajit Khatua made spot inspection of the vehicle in question on 22-08-2012 and there is nothing on record to show that the complainant shifted the damaged vehicle against the wish of the said surveyor. On the contrary it is stated by the complainant that she shifted the damaged vehicle to the authorized service centre as per the advice of OP/surveyor.
On perusal of the documents on record we find that OP insurer has neither filed any photograph of the damaged vehicle nor the copy of Survey Report submitted by Mr. Satrajit Khatua who made spot inspection on 22-08-2012. In any case, from the particulars of damage as noted in the final Survey Report it is clear that the vehicle in question got badly damaged in the accident.
The surveyor's report is undoubtedly an important piece of document that deserves due consideration as the surveyoris a sovereign expert, but the same is certainly not the last and final word so claimed by the OP insurer. It is not that sacrosanct that it cannot be departed from.A surveyor cannot act in an arbitrary manner, rather as an independent loss assessor he got to do something that enhances the acceptability, impartiality and credibility of his report. Probity demands that reason for not allowing replacement of any particular spare part/certain parts is properly explained and recorded in the Survey report so that it can be accepted by one and all without a shadow of doubt. We, however, find that although the surveyor put his stamp of approval for replacement of 47 items, he did not allow replacement of 63 items as mentioned in the service estimate without assigning any reason thereof. Surveyor also did not state the reason behind applying separate rate of depreciation in respect of different kinds of parts in his survey report. In the circumstances, we do not find any good ground to accept the report of surveyor in toto.
The OP though cited poor maintenance of tyre as the cause of accident; no credible evidence is put forth by OP insurer like police report to corroboratesuch fact.There is nothing on record to show that complainant was duly apprised by OP that the surveyor had refused to allow replacement of majority of the spare parts of the damaged vehicle in terms of the estimate of service centre though it is always desirable that an insured would always be taken into confidence about the decision of the surveyor so that in the event of refusal by the surveyor to allow replacement of a particular/certain parts, the insured can take a judicious decision before replacing said part(s). It is claimed by the OP that complainant did not respond to its repeated calls for settlement of her claim. However, it is not understood what prevented them from sending the settlement cheque to the complainant by post and in fact, OP has also not placed on record the photocopy of cheque or specified anywhere in their written version the particulars of cheque which they issued in favour of the complainant, if any such cheque was issued at all.All these facts clearly point out gross deficiency in service on the part of the OP.
As a sequel of our foregoing discussion and applying rule of thumb,we feel it would be just and fair to quantify the loss at Rs. 80,000/-. Besides, complainant is also entitled to a compensation of Rs. 10,000/- for the harassment, mental stress and agony that she suffered due to non-settlement of her claim together with litigation cost Rs. 1,000/-.
All these points are thus disposed in favour of the complainant.
Hence, it is
ORDERED
that the instant C.Case no. 24/2013 be and the same is allowed on contest against the OP. OP is directed to pay Rs. 80,000/- towards settlement of claim lodged by the complainant together with compensation Rs. 10,000/- and litigation cost Rs. 1,000/- within 45 days from the date of communication of this order i.d. complainant is at liberty to execute the order in accordance with law in which case, OP shall be liable to pay interest over the aforesaid settlement amount @ 10% p.a. from the date of this order till full and final settlement.
