Orissa

Rayagada

CC/36/2023

Sri Dharmendra Chintada - Complainant(s)

Versus

The Manager, Cholamandalam Ms General Insurance Co. Ltd., - Opp.Party(s)

Self

28 Feb 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION RAYAGADA, ODISHA.

Date of Institution: 15.04.2024

     Date of Final Hearing:25.01.2024

          Date of  Pronouncement: 28.02.2024

                                    CONSUMER COMPLAINT NO. 36 / 2023

Sri   Dharmendra   Chintada,

S/O: Sri  Chandala  Chintada,

AT:Bhujabala, Kolnara, Dist: Rayagada,  

765 017  (Odisha).  

Cell No. 8895904532, 6370239208

 (Represented  in person)                                            …Complainant

 

Versus

The  Manager, 

Cholamandalam MS General Insurance Co. Ltd.,

2^nd. Floor, Dare house, 2 NSC Bose Road,

Chennai- 600 001.

(Shri  K.Ch.G.S.Kumandan, Advocate  for the O.Ps  ).                                                                                                                                                                                                                                            …Opposite Parties

 

Present:           Sri Rajendra Kumar Panda, President.

                        ORDER U/S-39  R/W  U/S-64  OF C.P.ACT,2019

Brief facts of the case:-

Case in hand is the allegation of  deficiency in service and unfair trade practice by the O.Ps  for  non payment  of repair bill   of accident vehicle  Car bearing Regd.  No.TN19AK5872 towards insurance policy No.3362/60002658/000/00   which  the complainant sought  redressal.

The Back ground  facts in a nutshell  are that  the complainant    is a registered owner of the Tigor 1.2 Revotron XM   Tata Make vehicle 5(five)  person seated  capacity including Driver bearing  Regd.  No.  TN19AK5872  which met accident  on Dated.05.01.2023  at about 6 P.M. while  the vehicle  was proceed towards village At: Koopari  to meet the relative on the way  Ratacuan  chhawk suddenly buffalo come out on the road  in intented to  save the bufflo  the Car TATA Tigor XM bearing  Regd.  No.  TN19AK5872 suddenly  dash on  culvert for which  the front side  of car fully damaged  but the driver Sri Mahendra Naik saved  self  through the ballon. The  above vehicles  had  a  insurance  policy  No.3362/60002658/000/00 total   I.D.V value  Rs. 4,36,125.00  which  was valid from  01.02.2022 to 31.01.2023  and during the existence of said  policy, the vehicle met accident  on Dt. 05.01.2023.  After the said accident  F.I.R.  was also  filed at  Andhirakancha   Police station  on Dt. 23.01.2023 bearing  diary No.02 (copies of the F.I.R. is enclosed  herewith).  That after accident  the above vehicle  the  complainant  had informed the same to the  insurance company and on his direction  the above  damaged vehicle  shifted to  Lankeswari Motors Pvt. Ltd., Jeypore for necessary repair. The above show room had made estimate for repair of the above damaged   vehicle  and given  Estimate a sum of Rs.3,43,341.70. But the O.P(Insurance Co.) till date has not paid the above  estimate amount to the   Lankeswari Motors Pvt. Ltd., Jeypore  for  release of the damaged vehicle. The Complainant prays the  Commission direct the O.Ps to pay the repair bill of the  above accident  vehicle for Rs.3.43.341.70 and such other  relief as the  Commission deems fit and proper.

  On being noticed  the  O.Ps  filed written version  through their learned counsel inter alia  challenged  the maintainability of the  petition before the commission. The averments made in the  petition are  all false, and O.Ps  deny   each and every allegation made in the petition. The O.Ps taking other grounds in the written version   sought to dismiss the complaint as it is not maintainable  under the C.P. Act,.  The O.Ps prays the commission to dismiss the complaint petition  for the best interest of justice.

The O.Ps  learned  counsel Sri K.Ch.G.S.Kumandan   appeared in person before this commission  and defend the case.  Heard arguments from the  learned counsel for  the  O.Ps.    Perused the record, documents,  written version filed by the parties. 

This commission  examined the entire material on record  and given  a thoughtful consideration  to the  arguments  advanced  before us by  the  parties touching the points both on the facts  as well as on  law.

ISSUES:-

1. Whether Complainant is a Consumer under the OPs?
2. Whether the complaint petition is maintainable ?

            3. Whether Repudiation of claims is justified as made by O.P  (Insurance  Co.)  as per Law?

            4. Whether complainant is entitled to get relief as sought for?

Findings

Issue No-1-

In the instant case the O.P  Insurance company simply raised the question “The complainant is not a Consumer” this commission observed that, the complainant is a consumer U/S- 2(7)(i)(ii) of consumer protection Act, 2019 as he paid premium amount to the O.P to become policy holder under the business of OP  and the said O.P  promised/agreed to provide the services stipulated therein the policy bond. Further it is also observed that, the policy taken by the complainant can never be for profit making as payment of claim amount is towards indemnification of the loss occurred during the period of the insurance. The purpose of taking the policy against consideration was only to make good the loss or indemnify the insured.

Accordingly issue No.1 is answered.

Issue No-2 -

As far as the preliminary objection made by the Opposite party   (Insurance Company) with regard to the maintainability of the case, the complainant filed the complaint within the period of limitation i.e two years from the date of occurrence or cause of action. The incident took place on 5.1.2023 and the case was instituted  by the Complainant on 15.04.2023. The Motor liability period commence from  01.2.2022 to 31.01.2023 which is evident from the policy bearing no-3362/60002658/000/00   dated. 1.2.2022 to the vehicle Car TATA Tigor XM bearing  Regd.  No.  TN19AK5872  in favour  of  the name of the complainant  Marked Annexure-1. This Dist. Commission has got jurisdiction as the complainant resides within  the territorial jurisdiction of this commission.

Accordingly issue No.2 is answered.

Issue No-3  &  4 –

            The   O.P. in their written version  contended that  the date of loss as on Dtd. 5.1.2023  there is delay of 24 days in intimating  the O.P. which violates  policy condition  No.1.

In this connection the learned counsel for the complainant  relied citation  of Apex Court  in the case of OM Prakash Vrs. Reliance General   Insurance in Civil appeal No. 15611 of 2017 where in the  Hon’ble Supreme Court observed “ Insurance claim can not rejected mere delay intimating  to  insurer ”.

It is held as reported in SCC (1979) 4   page- 178  where in  the hon’ble  apex court observed that   “Resort to the plea of limitation by public authority to defeat just  claim of citizen depreciated- Though  permissible under law, such technical pleas should only be taken when claim is not well founded”.

During  the course of   hearing  the complainant  submitted  that after accident due to  life  risk  from the   public  they  have  intimated the  above  fact to the   Police  and   also   O.P.  late. The  intimation to the police  and O.P. was not intentional  i.e.  circumstantial.

The  O.P. appointed  the surveyer  who submitted the final survey report  for an amount of Rs. 3,34,654/-.  So  at  present there is  no  impediment  on the part of the O.P.  to pay the insurance amount  as arrived by the Surveyor in his final  Survey report.

The learned counsel  for the  complainant  during  course of hearing showed  the  F.I.R.  copy  dtd. 23.01.2023 (Marked as Annexure -2).  Estimate  copy after  Accident  of the  above  vehicle  which was  issued by   Lankeswari  Motors  Pvt. Ltd., Jeypore(marked as Annexure-3). 

In a  Catena of Judgements the Hon’ble  National Commission has held and reported  in  C.P.R. 2009(1)  page No. 44  the Hon’ble National Commission, New Delhi  where in  observed “ when a company or any one obtains  an Insurance it is not part of commercial activity, but it  is obtaining in order to cover the risk to the commercial activity, hence, even companies  obtaining a insurance cover  will fall within the defination of ‘Consumer’ “.

Further Para- 21 as per regulation 9(3) of the IRDA Protection of policy holders interest regulation 2002   the Insurance company was obliged to finalise the view  based on the report of the surveyor within a period of 30 days. Section 9(5) states that if the  insurer on the receipt of the survey report  finds that it is in complete in any respect, he shall require the surveyor under  intimation to the insured  to furnish an additional report on certain specific issue as may  be  required by the   insurer such a request may  be made within 15 days of receipt of the original survey report. Provided that the facility of calling for an additional report by the  insurer shall not be resorted more than once in the case of claim.  The other facts which is necessary is also dealt within Sub- section (4) and (5).

Again   this commission  perused the case law  in the instant case. It is held and reported in  CPC- 1991, page -540 the  Hon’ble  Hariyana State  Commission held that  when ever there is any delay or dilatoriness in finalizing  the insurance claim, the same would be tantamount to a  deficiency  in service and thus comes squarely within the  purview of District Commission.  Once it is held that default or negligence in the  settlement of an insurance claim is a deficiency  in service then an arbitrary  or mischievous  rejection  of an insurance claim  would patently  be a default  within its larger  meaning. On principle , it would   seem  some what manifest that the mere repudiation of the insurance claim cannot itself operate  as a  jurisdiction bar for redressel    commissions  under the Act.  This is further  made it clear  it is held and reported  in CPR-1991(2), page No.18  the Hon’ble National Commission  clearly defines  the mere unilateral  rejection of an insured parties  claimed by the insurer does not  per  se  operate as jurisdictional bar to seek redressal before  the forums under the Act. It is on the strength of the  above decision  the instant case is admitted by this  District Commission.

Further It is held and reported  in CPR 2008(3) page No.51 wherein the Hon’ble National Commission  observed  “Surveyor report is an important document and can not be washed  aside without any compelling  evidence to the contrary”.

Again it is held and reported  in CPR- 2023(2) page No.192  in the case  of  M/S   Syndicate Shipwright  Vrs. New India Assurance Co. Ltd  where in  the  Hon’ble  National Commission observed  “Surveyor’s report  - While a Surveyor’s report under  Section  64 UM of the  Insurance Act, 1938 is an  essential  requirement in finalizing insurance claims”.

On  going  through  the final  surveyor report  of O.P.  (Insurance Company)  this  commissions view that the  complainant is entitled to get Rs.3,34,654.00 who opted  to receive  compensation   on   loss basis  as calculated  by the surveyor   of the  insurance  company. 

On the strength of the aforesaid rulings of the Apex court  this   District Commission  allow this case  in  part.

Hence  to  meet the  ends of justice, the following order is passed.    

                                              ORDER.

In the result with these observations, findings  the complaint petition is allowed  in  part  on  contest against  the O.P  (Insurance company) .

The O.P  (Insurance  company)  is    ordered  to pay Rs.3,34,654.00(Rupees three lakhs thirty  four thousand six hundred fifty four )only      to the complainant as per the Survey report .    Parties are left to bear   their  own cost.

The O.P  (Insurance  company) is   ordered to make compliance the aforesaid Order within  45 days from the  date of  receipt  of the  order. 

Miscellaneous  order if any  delivered by this  commission  relating to this case  stands vacated. 

 

A copy of this order be provided to all the parties at  free of cost as mandated by the Consumer Protection Act,  2019 or they may download same from the confonet.nic.in to treat the same as if copy of order received from this Commission.

The judgment be uploaded forthwith on the website of the Commission for the perusal of the parties.

File be consigned to the record room along with a copy of this Judgment.

Dictated and corrected by me.

Pronounced on this    28th. Day of   February, 2024.                                                     

                                                                                                                                           PRESIDENT