By Sri.  A.S. Subhagan,  Member:

          This is a complaint preferred under Section 35 of the Consumer Protection Act 2019.

          2. Facts of the case in brief:-  Complainant is the  owner of the Maruti Ritz Car with Registration No.KL-60H-2111 which was insured  with the Opposite Party from 10.06.2020 to 09.06.2021 with  policy No.2311100793005400000. Things being so, the vehicle met with an accident,   hitting a wall and caused damage to the vehicle.  On the same day itself,  this matter was intimated to the Opposite Party and as per their direction  the vehicle was entrusted to workshop.  Afterwards,  the Complainant submitted claim application together with all required documents to the  Opposite Party on 15.06.2020. Then the Surveyor had investigated the vehicle and submitted report to the Opposite Party.  But inspite of repeated requests and a lawyer’s   notice, the  Opposite Party did not make payment of the claim so far.  The act of the  Opposite Party is deficiency in service  and  hence  this complaint  with prayer  to direct the Opposite Party to settle the claim of Rs.45,206/-,  being  the repair charges of the vehicle together with interest at the rate of 12%,  to pay compensation of Rs.50,000/-  and cost of Rs.10,000/-.

          3. On getting notice,  the Opposite Party appeared before the Commission and filed version.

          4. Contents of version filed by the Opposite Party in brief:-  All the allegations in the complaint except the claim application,  the report of the Insurance Surveyor and the repudiation of the claim application of the  Complainant are denied  by the Opposite Parties.  According to the Opposite Party the Complainant had not informed the accident on 12.06.2020.  The Opposite Party contented that the Complainant had not conducted a survey by  Mithun Mathew.  The Opposite  Party has even denied the G.D  entry.  According to the Opposite Party, the damages caused to the vehicle are accumulated damages and hence  they are  not liable  for payment of the claim.  They say that, by letter dated 18.06.2020, they had initiated the Complainant that “during survey it has been observed that the damages to quarter panel,  feeder  RH,  front door RH,  Running  board claimed in the alleged accident are  unrelated to the cause of accident as reported in the claim”.  The damages do not commensurate  with the cause of loss as mentioned in the claim form.  The damages are accumulated in nature.  The Complainant had misrepresented the material facts.  The Opposite Party denied that the Complainant had to expend Rs.45,206/-  for repair of the vehicle.  They contented that there has been no deficiency in  service or unfair trade practice  from their side.  Hence  prayed  for dismissal of the complaint with cost.

          5. Chief affidavit was filed by the Complainant,  Exts.A1 to A6 were marked from his side and he was examined as PW1.  Ext.B1 was marked from the side of the  Opposite Party but they  had not adduced any oral evidence.  The complaint was finally heard on 03.05.2023.

          6. Considering the above,  we raised  the following points.

1.  Whether there  has been deficiency in service  from  the part of the Opposite Parties?
2. If so, whether the Complainant has the right to get compensation? and
3. If so,  whether the Complainant has the right to get cost  of this complaint?

7. Point No.1:-  Commission  perused  the  complaint,   version,   affidavit of

Complainant,  documents marked from both the sides and the arguments of the counsels for the parties.  The  allegation of the Complainant is that the Complainant’s vehicle hit on the wall  and  caused damages and subsequently he submitted  insurance claim application on his policy with the Opposite Party but  they repudiated the claim of the Complainant.  The Complainant had also sent a lawyer notice to the Opposite Party in this regard, with postal receipt which are marked as Ext.A5(a) and A5(b) respectively,  which was not  responded by the  Opposite Party.  The Opposite Party denied that the  Complainant had to spend Rs.45,206/-.   The Opposite Party also contents that the Complainant had not conducted a survey by Mithun Mathew.  The Opposite Party also denied the G.D entry.  Ext.B1 document was  marked  by the Opposite Party which shows  that the Complainant had a valid insurance policy with the Opposite party company.  Ext.A2 shows that the claim of the Complainant  was repudiated.  Ext.A3 is the reminder notice issued by the Opposite Party to the Complainant seeking some documents.  The  Complainant had submitted that he had produced all the documents to the Opposite Party as required by them.  Ext.A4 is the G.D entry  report of the police regarding the accident with regard to the vehicle of the Complainant.  In short,  there is  the G.D entry of the accident,  lawyers notice sent by the Complainant to the Opposite Party demanding to settle the claim of the Complainant and also the claim application of the Complainant.  So the allegation of the Opposite Party that the matter was not intimated to the Opposite party,  No G.D entry as to the accident etc. are  seen false and hence cannot be accepted.  Another allegation of  the Opposite Party is that the claim is not payable due to  suppression of  material facts relating to the accident by the Complainant. On verification of the  court proceedings of this  Commission dated 15.10.2022, it is seen stated by the Opposite Party that “ the matter is being settling” and so, the case  was  posted  to 31.10.2022 for settlement.  On 31.10.2022, the Opposite Party and the Complainant had submitted before the Commission to place the case in Adalath to be  held on 12.11.2022.  From the above  two prayers of the Opposite Party regarding  settlement of the claim of the complaint, it is evident that the claim of the complaint is a genuine one.  If it was  not a genuine one,  the  Opposite Party would  not try  to settle the matter as  there was  no need to do so.  Therefore,  Commission  finds it true that (1)  as  per the G.D entry of the police , the vehicle  owned by the Complainant was met with an accident and damage was caused,  (2)  claim  application was submitted by the Complainant to the Opposite Party (3)  Lawyer’s notice was issued by the Complainant to the Opposite Party (4)  No reply  was given to the lawyer’s notice  by the Opposite Party (5)   the Opposite Party had tried to settle the claim and  ultimately (6) the claim was repudiated by the Opposite Party.  From the  above,  it is very clear that  the Complainant would have forwarded the report or statement of the amount of damage of the amount of repair charges to the Opposite Party.  Otherwise the Opposite Party would not try to settle the claim of the complaint requesting settlement.  Moreover, in   re-examination of the Complainant,  he has deposed that “FÃm  tcJ-Ifpw claim e`n-¡p-¶-Xn\v th­n insurance company  bv¡v  \ÂIn-bn-cp-¶p.  AXp-sIm-­mWv tImS-Xn-bn lmP-cm-¡m-Xn-cp-¶Xv”   From the facts and circumstances of the case,  we are of the view that all the records regarding the   actual accident with regard to the vehicle are with the Opposite Parties which is more evident from the  sworn statement of the Complainant in re-examination.  Usually,  insurance companies persuade persons to  get them  joined in insurance policies with pleasing  approach and attractive offers and when claim applications are submitted,  they are conducting research to find unreliable, unsustainable and flimsy  grounds for repudiation of claims.  This attitude of the insurance companies shall ultimately  affect the confidence of the policy holders in insurance  companies  which shall in the long run result in the liquidation of the insurance companies.  Insurance is a contract of utmost good faith.  So the parties to the contract shall act upon good faith.  Here,  we find that the Opposite Party has repudiated the claim of the Complainant not in good faith.  So,  there has been deficiency in service from the part of the Opposite Party by repudiating the claim of the Complainant while having a valid  insurance policy.  Other contentions of the Opposite Party are immaterial  and hence discarded.    So,  point No.1 is proved against the Opposite party for which they are liable to compensate the complaint.

          8. Point No.2:-  As point No.1 is proved against the Opposite Party,  the Complainant has the right to get compensation, but  the amount claimed is seen exorbitant. 

          9. Point No.3:-  As point No.2 and 3  are against the Opposite party,  the Complainant has the right to get cost of the complaint.

          In the result,  the complaint is partly allowed and the Opposite Party is ordered:

1.  To pay Rs.45,206/- (Rupees Forty Five thousand Two hundred and Six only) being the repair charges of the vehicle as insurance claim together with interest at the rate of  8% per annum from the date of the complaint.
2. To pay compensation of Rs.25,000/-  (Rupees Twenty Five thousand only) and
3. To pay cost of Rs.6,000/-  (Rupees Six thousand only).

The above amounts shall be paid to the Complainant within  one month from

the date of this complaint,  failing which the amounts will carry interest at the rate of 8% per annum from the date of this order.

          Dictated to the Confidential Assistant, transcribed by him and corrected   by   me   and  pronounced  in  the  Open  Commission on this the   23^rd    day of May  2023.

          Date of filing:29.01.2021.

                                                                             PRESIDENT:   Sd/-

                                                                             MEMBER    :   Sd/-

                                                                             MEMBER    :   Sd/-

APPENDIX.

Witness for the Complainant:

PW1.            Arundas.  V.S.                        Complainant.       

Witness for the Opposite Party:

Nil.

Exhibits for the Complainant:

A1.        Copy of Private Car Package Policy.        dt:02.06.2020.

A2.        Letter.                                                      dt:18.06.2020.

A3.       First Reminder Letter.                               dt:27.06.2020.

A4.        General Diary Abstract.                            dt:20.06.2020.

A5(a)     Copy of Letter.                                        dt:01.11.2020.

A5(b)    Postal Receipt                                          dt:09.11.2020.     

A6.        Acknowledgment.                                                               

Exhibit for the Opposite Party:

B1.        Copy of Private Car Package Policy.        dt:02.06.2020.

                                                                                                PRESIDENT:  Sd/-

                                                                                                 MEMBER    :  Sd/-

                                                                                                 MEMBER    :  Sd/-