Order No. 11 dt. 03/09/2019
The case of the complainant in brief is that the complainant is an owner of the vehicle being no.WB 19G 5304 and the said vehicle is being used by the complainant for the purpose of his livelihood by way of self employment and his family members are also depending on the said business of the complainant. The vehicle was insured with o.p. insurance company vide policy no.100300311710005283 and the policy was valid from 18.11.17 to 17.11.18. The complainant paid the premium of Rs.47,394/- including GST. The said vehicle met with an accident in Madhya Pradesh and immediately the driver of the said vehicle lodged a complaint to the Amarpartan P.S. and the said fact of accident was also informed to o.p. The o.p. thereafter, sent one surveyor and the vehicle was sent for repairing to authorized workshop. The spot survey was conducted and the workshop raised repair estimate and asked the complainant to pay initial payment of Rs.80,000/-. The complainant paid the said amount and after repairing of the vehicle the workshop demanded the balance amount to the tune of Rs.1,84,919/-. The complainant made claim to o.p. but o.p. did not pay the amount to the workshop, for which the vehicle has not been released. The complainant, thereafter, made several correspondences to o.p. but no effective step was taken, ultimately after lapse of several months the complainant informed the o.p. that due to non production of the documents sought for by o.p. the claim of the complainant was closed. Since the complainant provided all the documents at the time of making claim from o.p. but o.p. in order to evade their responsibility to pay the claim amount raised fictitious points to deny the claim of the complainant. On the basis of the said fact the complainant filed this case praying for direction upon the o.p. to pay the insurance claim of Rs. 1,84,919/- as well as compensation and litigation cost.
The o.p. contested this case by filing w/v and denied all the material allegations of the complaint. It was stated that o.p. sent two letters dt.24.1.19 and 28.2.19 respectively to the complainant wherein reported accident vehicle no. WB 19G 5304 against the policy no. 100300311710005283 mentioned that they have received the survey report in respect of the said vehicle and the same is undergoing their scrutiny. In the meantime they requested the insured to forward the following papers to insurance company. But since those papers were not provided by the complainant within 15 days from the date of those letters it as presumed that the insured was not interested in the claim, for which insurance company closed the file as ‘no claim’. The o.p. also stated that the complainant is a businessman and for commercial purpose the said vehicle was used, thereby the claim of the complainant cannot be entertained as per the provision laid down u/s 2(1)(d) of the C.P. Act. It was further stated that the complainant since failed to provide those documents, therefore, o.p. had no other alternative but to close the case. on the basis of the said fact o.p. prayed for dismissal of the case.
On the basis of the pleadings of parties the following points are to be decided:
- Whether the complainant had the policy at the relevant point of time?
- Whether the complainant informed the insurance company after the said accident?
- Whether the surveyor was appointed by o.p. to assess the loss?
- Whether the surveyor assessed the loss?
- Whether there was any deficiency in service on the part of o.ps.?
- Whether the complainant will be entitled to get the relief as prayed for?
Decision with reasons:
All the points are taken up together for the sake of brevity and avoidance of repetition of facts.
Ld. lawyer for the complainant argued that the complainant is an owner of the vehicle being no.WB 19G 5304 and the said vehicle is being used by the complainant for the purpose of his livelihood by way of self employment and his family members are also depending on the said business of the complainant. The vehicle was insured with o.p. insurance company vide policy no.100300311710005283 and the policy was valid from 18.11.17 to 17.11.18. The complainant paid the premium of Rs.47,394/- including GST. The said vehicle met with an accident in Madhya Pradesh and immediately the driver of the said vehicle lodged a complaint to the Amarpartan P.S. and the said fact of accident was also informed to o.p. The o.p. thereafter, sent one surveyor and the vehicle was sent for repairing to authorized workshop. The spot survey was conducted and the workshop raised repair estimate and asked the complainant to pay initial payment of Rs.80,000/-. The complainant paid the said amount and after repairing of the vehicle the workshop demanded the balance amount to the tune of Rs.1,84,919/-. The complainant made claim to o.p. but o.p. did not pay the amount to the workshop, for which the vehicle has not been released. The complainant, thereafter, made several correspondences to o.p. but no effective step was taken, ultimately after lapse of several months the complainant informed the o.p. that due to non production of the documents sought for by o.p. the claim of the complainant was closed. Since the complainant provided all the documents at the time of making claim from o.p. but o.p. in order to evade their responsibility to pay the claim amount raised fictitious points to deny the claim of the complainant. On the basis of the said fact the complainant filed this case praying for direction upon the o.p. to pay the insurance claim of Rs. 1,84,919/- as well as compensation and litigation cost.
Ld. lawyer for the o.p. argued that o.p. sent two letters dt.24.1.19 and 28.2.19 respectively to the complainant wherein reported accident vehicle no. WB 19G 5304 against the policy no. 100300311710005283 mentioned that they have received the survey report in respect of the said vehicle and the same is undergoing their scrutiny. In the mean time they requested the insured to forward the papers to insurance company. But since those papers were not provided by the complainant within 15 days from the date of those letters it as presumed that the insured was not interested in the claim, for which insurance company closed the file as ‘no claim’. The o.p. also stated that the complainant is a businessmen and for commercial purpose the said vehicle was used. Thereby the claim of the complainant cannot be entertained as per the provision laid down u/s 2(1)(d) of the C.P. Act. It was further stated that the complainant since failed to provide those documents, therefore, o.p. had no other alternative but to close the case. on the basis of the said fact o.p. prayed for dismissal of the case.
Considering the submissions of the respective parties it is an admitted fact that the complainant purchased the vehicle for the purpose of maintaining his livelihood as mentioned in the petition of complaint. The o.p. merely made an allegation that the said vehicle was used for commercial purpose, but nothing has been produced by o.p. to substantiate the said claim. Apart from the said fact, the complainant hired the service of o.p. by paying premium and the policy was opened, therefore, the denial of the claim of the complainant cannot be said that the complainant cannot file the case against the insurance company since the complainant used the vehicle for commercial purpose. It is an undisputed fact that during the subsistence of the policy the said vehicle met with an accident and the said fact was informed the concerned P.S. as well as to insurance company. The o.p. appointed a surveyor who assessed the loss and as per the advice of the surveyor the vehicle was sent to the authorized workshop for repairing. The workshop demanded the initial payment of Rs.80,000/- and the said payment was made by the complainant. The workshop claimed the balance amount of Rs.1,84,919/- for repairing of the vehicle. The complainant repeatedly requested the o.p to disburse the said amount but o.p. did not pay any heed, for which the complainant filed this case. The o.p failed to produce any document to show as to what was the amount assessed by the surveyor. The complainant since failed to pay the amount to the workshop the vehicle has not been released. It is also an admitted fact that the complainant after repairing of the said vehicle claimed the amount from insurance company. The complainant filed several e-mails wherefrom it is evident that o.p. did not take any step for releasing the amount in favour of the complainant. After the lapse of several months the complainant sent lawyer’s notice asking for releasing the fund in favour of the complainant to be paid to the workshop, but o.p did not respond to the said notice. Subsequently after the lapse of several months o.p. sent two letters demanding some documents which had already been submitted by the complainant at the time of filing his claim to insurance company. Since o.p. failed to pay the amount to the workshop, for which the vehicle has not been released resulting in the financial loss to the complainant as well as we hold that there is deficiency in service on the part of o.p. and the complainant will be entitled to get the amount from o.p. so that the vehicle can be released from the custody of the workshop and the complainant can run the vehicle accordingly. Thus all the points are disposed of accordingly.
Hence, ordered,
That the CC No.347/2018 is allowed on contest with cost against the o.p. The o.p. is directed to pay an amount of Rs. 1,84,919/- (Rupees one lakh eighty four thousand nine hundred nineteen) only to the complainant along with compensation of Rs.50,000/- (Rupees fifty thousand) only for harassment and mental agony and litigation cost of Rs.10,000/- (Rupees ten thousand) only within 30 days from the date of communication of this order, i.d. an interest @ 8% p.a. shall accrue over the entire sum due to the credit of the complainant till full realization.
