Sri Ranjan Ray, Ld. Member
FINAL ORDER/ JUDGEMENT
This complaint U/S 12 of C.P. Act, 1986 was initially filed against the Opposite Party (O.P.)- The Branch Manager, United India Insurance Company Ltd., 142, Hill Cart Road, P.O.- Siliguri – 734001 who contested the case by filing Written Version (W.V.).
The case of the complainant as per his complaint is as follows-
The complainant argued in his plaint that for his livelihood and self employment he purchased a policy of the O.P being Policy No. 031901/ 46/ 13/ 70/ 00000229 for his vehicle and the validity period of the policy was from 17.10.2013 to 16.10. 2014 and on 28.12.2013 the said vehicle met with an accident and due information of the same was intimated to the local police on the same day. The complainant also added that he intimated the insurance company regarding the said accident and the insurance company appointed surveyor but the surveyor report did not share with the complainant and all other substantiating documents were in the custody of the O.P.
The complainant also argued in his plaint that he submitted the claim form for a sum of Rs. 12, 06, 000/- (Rupees Twelve Lac Six Thousand) only to the O.P. and the claim amount was almost equal to the surveyor’s report but without showing any reason on 15.06.2015 the O.P. paid Rs. 8, 36, 843/- (Rupees Eight Lac Thirty Six Thousand Eight Hundred and Forty Three) only to the complainant which was credited in the complainant’s account on 19.06.2015.
The complainant also argued in his plaint that in reply of the legal notice sent by him on 09.07.2015 the O.P. replied on 04.08.2015 that the claim had settled finally and the O.P. was not ready to pay any further amount and as at the time of taking payment the complainant did not make any objection as such the same would be treated as full and final payment. The complainant also argued in his plaint that meanwhile the O.P. called upon the complainant through his agent for negotiation but that too failed and having no alternative the complainant filed this complaint.
The prayers of complainant are as follows :
- To pass an order directing the O.P. to pay the balance amount of the claim as per the survey report that is Rs. 12,06,000/- (Rupees Twelve Lac Six Thousand) only minus Rs. 8,36,843/- (Rupees Eight Lac Thirty Six Thousand Eight Hundred and Forty Three) only = Rs. 3,69,157/- (Rupees Three Lac Sixty Nine Thousand One Hundred and Fifty Seven) only plus 18% interest accrued there over since the date of claim till the date of actual payment.
- To pass an order directing the O.P.s to pay Rs. 25,000/- (Rupees Twenty Five Thousand) only against mental agony and a sum of Rs. 10,000/- (Rupees Ten Thousand) only by way of cost of litigation against such deficiency in service and harassment.
List of Documents filed by the complainant:
Sl. No. 01 Photocopy of Insurance Policy.
Sl. No. 02 Photocopy of Information of accident to police.
Sl. No. 03 Photocopies of Payment vouchers.
Sl. No. 04 Photocopy of complainant’s advocate notice.
Sl. No. 05 Photocopy of O.P.’s lawyer reply.
On behalf of the Opposite Party (O.P.)- The Branch Manager, United India Insurance Company Ltd., 142, Hill Cart Road, P.O.- Siliguri – 734001 who contested the case by filing W.V. and as per their W.V.s the case is as follows.
The O.P. in his Written Versions denied all allegations made by the complainant and also argued that the Carriers Legal Liability Policy No. 031901/ 46/ 13/ 70/ 00000229 for the period from 17.10.2013 to 16.10.2014 was issued to the complainant for his goods carrying commercial vehicle bearing no. BR- 1GA/ 9345 subject to the terms, conditions, exclusions and limitations and subject to the compliance of 64VB of Insurance Act, 1938 and the commercial vehicle package policy containing terms and conditions was duly provided to the complainant at the time of subscribing to the policy. The O.P. also added in his W.V. that the complainant for his livelihood and by self employment purchased the said vehicle in question.
In his W.V. the O.P. also argued that on receipt of the claim intimation of the complainant, the O.P. as per rules, regulation and guidelines of I.R.D.A. appointed an independent approved and licensed surveyor, Mr. Navin Chandra Jha, of Bhagalpur to assess the loss and the said survey report was in question.
The O.P. also argued in his W.V. that on 15.06.2015 the O.P. paid Rs. 8,36,843/- (Rupees Eight Lac Thirty Six Thousand Eight Hundred and Forty Three) only to the complainant which was credited in the complainant’s account on 19.06.2015 and the complainant received the same without any objection and therefore, the question of further payment of balance amount does not arise at all. The O.P. also argued in the W.V. that the Settlement Intimation Voucher, i.e., Discharge Voucher was signed by the complainant without any objection and the amount mentioned in the Settlement Intimation Voucher, i.e., Discharge Voucher was accepted by the complainant voluntarily and unconditionally in full and final settlement of his claim. In the W.V. the O.P. also added that on 04.08.2015 he sent a reply in respect of the legal notice of the complainant but the complainant did neither sent any objection nor send any reply.
The O.P. also argued in his W.V. that once the complainant had voluntarily and willingly received the said amount unconditionally he ceases to be consumer as per the C.P. Act, 1986.
List of documents filed by the O.P. No.1 are as follows :
- Photocopy of the Carriers Legal Liability Policy No. 031901/ 46/ 13/ 70/ 00000229 valid from 17.10.2013 to 16.10.2014 issued in the name of Mr. Binod Kumar Agarwal along with the terms and conditions etc.
- Photocopy of Settlement Intimation Voucher for Rs. 8,36,843/- (Rupees Eight Lac Thirty Six Thousand Eight Hundred and Forty Three) only issued by the O.P. to the complainant.
- Photocopy of registration for NEFT/ RTGS payments submitted by the complainant to the O.P. showing his IFSC Code and Bank Account number and Bank Branch.
- Photocopy of cancelled cheque submitted by the complainant to the O.P.
- Photocopy Statement of Account lying with the State Bank of India, Agri Market Yard, Gulabbagh Branch, submitted by the complainant showing his IFSC Code, MICR Code and Bank Account.
- Photocopy of legal reply dated 04.08.2915 issued by the Advocate of the O.P. against the legal notice of the complainant’s advocate.
Other papers and documents will be filed at the time of final hearing of the above case and/ or as and when directed by this Ld. Commission.
Having heard, the Ld. Advocate of both the side and on perusal of the Complaint, Written Version and documents filed by the parties the following points are taken to be decided by this Commission.
Points for consideration
1) Whether the complainant is a consumer?
2) Whether the case is maintainable under the CP act 2019?
3) Whether this Commission has its jurisdiction to decide this case?
4) Whether there is any deficiency in service in the part of the O.P. as alleged by the complainant?
5) Is the complainant is entitled to get any award and relief as prayed for? If so, what extent?
Decision with reasons:-
All the points are taken up together for consideration and decision.
Seen and perused the complaint petition and Written Version filed by the parties which are supported by the affidavit, documents filed by the parties. We are also heard arguments of both the parties in full length.
The O.P. is carrying his business in 142, Hill Cart Road, P.O.- Siliguri – 734001. Thus, the Commission has no doubt that the complainant is a very much consumer as per the Consume Protection Act, 1986 and Consumer Protection Act- 2019 and also there is no doubt that this Commission has its jurisdiction to decide this case.
At the time of argument Ld. Advocate of the Complainant submits that the Complainant has been able to prove its case against the O.P not only through his Written Deposition but also by producing documents.
In this case, copy of the insurance policy submitted by the complainant being Policy No. 031901/ 46/ 13/ 70/ 00000229 for his vehicle and the validity period of the policy was from 17.10.2013 to 16.10. 2014 and on 28.12.2013 the said vehicle was met with an accident.
From the evidence of the Opposite Party it is very much clear that the insurance company has knowledge of this accident and after satisfying the fact they engaged a Surveyor from their end by following the guideline issued by the Govt./ I.R.D.A. In the report of that said Surveyor it is clear that on 31.12.2013 he conducted the survey and assessed the loss of Rs. 11, 36, 157/- (Rupees Eleven Lac Thirty Six Thousand One Hundred and Fifty Seven) only. From the Surveyor’s report it is crystal clear that Surveyor enquired the matter and on the basis of his observation he assessed the loss. The complainant submitted necessary documents to the Surveyor and finally on 20/03/2014 the Surveyor submitted his report to the Insurance Company. But astonishingly, without showing any reason the O.P. deducted the claim amount of the surveyor and settled the claim amount of Rs. 8, 36, 843/- (Rupees Eight Lac Thirty Six Thousand Eight Hundred and Forty Three) only and paid to the complainant.
The decision of Hon’ble Supreme Court of India reported in 2023 ACJ 396- referred by the side of the complainant is well applicable in our present case. In view of the said decision the Hon’ble Supreme Court of India in the case of Karnavati Veneers Co. Ltd. vs. New India Assurance Co. Ltd. and others reported in 2023 ACJ 396- Fire insurance- Repudiation of claim- Fire broke out in the factory of insured and surveyor of insurance company assessed loss at Rs. 21,76,524- Insurance company repudiated the claim on the ground that insured failed to submit required document in breach of policy condition- State Commission upheld repudiation of the claim- National Commission affirmed the findings of State Commission- Policy condition with regard to submission of required documents on desires necessary documents for assessment of claim and all material documents available with insured were given to the surveyor of the insurance company who after extensive inspection assessed the loss- Insurance company has not disputed the loss assessed by its surveyor- Whether insurance company was justified in invoking policy condition with regard to submission of required documents for repudiating the claim- Held: no: insurance company directed to pay Rs. 21,76,524.
The Commission here adopted the principal laid down in the above noted case.
The Commission has given an opportunity to the O.P., vide Order No. 44, dated 14.09.2023, to file a clarification that on what ground the O.P. deducted the claim amount of the complainant which was calculated by the surveyor appointed by the O.P. but the O.P. did not file any document in support of them.
So, as per the above discussion it is very much clear that there was a deficiency of service from the part of O.P.s and this Commission has no doubt that there was a deficiency of services from the part of the O.P. The complainant is entitled to get the balance amount of Rs. 2, 99, 314/- (Rupees Two Lac Ninety Nine Thousand Three Hundred and Fourteen) only from the O.P. (from Insurance Company) by an account payee cheque with a simple interest @ 6% per annum from the date of filing of this case within 30 (thirty) days from the date of this order. The complainant is also entitled to get Rs. 5,000/- (Rupees Five Thousand) only for mental pain and agony and Rs. 5,000/- (Rupees Five Thousand) only for litigation cost from the O.P. and the O.P. is also directed to deposit Rs. 10,000/- (Rupees Ten Thousand) only to Consumer Legal Aid Account of this Commission within 30 (thirty) days from the date of this order.
Hence, it is,
O R D E R E D
That the Consumer Case No. 52/2016 be and same is allowed in contest against the Opposite Party (O.P.)- The Branch Manager, United India Insurance Company Ltd., 142, Hill Cart Road, P.O.- Siliguri – 734001.
The complainant is entitled to get the balance amount of Rs. 2, 99, 314/- (Rupees Two Lac Ninety Nine Thousand Three Hundred and Fourteen) only from the O.P. (from Insurance Company) by an account payee cheque with a simple interest @ 6% per annum from the date of filing of this case within 30 (thirty) days from the date of this order. The complainant is also entitled to get Rs. 5,000/- (Rupees Five Thousand) only for mental pain and agony and Rs. 5,000/- (Rupees Five Thousand) only for litigation cost and the O.P.s are also directed to deposit Rs. 10,000/- (Rupees Ten Thousand) only to Consumer Legal Aid Account of this Commission within 30 (thirty) days from the date of this order.
Let a copy of this judgment be given to the parties directly or through their representative Ld. Advocate for compliance free of cost.
