IN THE CONSUMER DISPUTES REDRESSAL COMMISSION, ALAPPUZHA
Monday the 20th day of September 2021.
Filed on 05-12-2019
Present
- Sri.S.Santhosh Kumar BSc.,LL.B (President )
- Smt. Sholy P.R, B.A.L,LLB (Member)
In
CC/No.324/2019
between
Complainant:- Opposite parties:-
Sri.Suresh.K 1. The Manager
S/o Kaliyappan Reliance General Insurance
Sreenilayam Company Ltd, 2nd Floor
District Court Ward Vishnu Building
Thathampally.P.O K.P.Vallom Road
Alappuzha Kadavanthara, Kochi
(Party in Person)
2. The Manager
Reliance General Insurance
Company Ltd, Reliance
Centre 19 Walchan Hirachand
Marg Ballard Estate, Mumbai
Pin-400001
(Adv. Sri. C. Muraleedharan
For Ops 1 and 2)
3. The Manager
Policy Bazar Insurance Web
Aggregator Pvt. Ltd
Registered Office No.
Plot No. 119, Sector-44
Gurgaon ,Haryana (Party in Person)
O R D E R
SRI. S.SANTHOSH KUMAR (PRESIDENT)
Complaint filed u/s 12 of the Consumer Protection Act,1986
Material averments briefly stated are as follows:-
On 27/11/2018 complainant took a policy for his Hundai Eon Era car bearing Reg. No. KL-04-AD-4640 from M/s Reliance General Insurance company through M/s Policy Bazaar Insurance Web Aggregator. The vehicle was fully insured and so that he had not made any claim, complainant is entitled to get the claim amount fully. On 21/8/2019 complainant submitted the bill for Rs.15,791/- before the insurance company. However it was repudiated as per letter dated 5/9/2019 on a contention that earlier there was an insurance claim.
2. After insuring the vehicle with the opposite parties complainant had never made any claim and so rejecting the claim is deficiency in service from the part of opposite parties. Hence the complaint is filed claiming insurance amount.
3. Opposite parties 1 and 2 filed a joint version mainly contenting as follows:-
There is no deficiency in service on the part of these opposite parties. The claim of the complainant was duly entertained and repudiated on the basis of policy condition. Hence the complaint is not maintainable and it is to be dismissed in-liminae with cost.
4. The complainant availed a private car package policy for his vehicle KL-04 –AD-4640 for the period from 27/11/2018 to 26/11/2019. At the time of availing policy 45% NCB(Non Claim Bonus) was obtained as he has assured and stated in the online format that he has not availed any claim during the previous policy period. The insurance company of the previous policy was stated as Bajaj Alliance. He has made a claim during the present policy period. On verification it was found that the insurance company was not Bajaj Alliance but it was United India and the complainant made claim on the previous policy. NCB can be claimed only when no claim on previous policy. Hence there is misrepresentation and breach of utmost good faith the basic principle of insurance. and as per condition No.8 The due observance and fulfillment of the terms, conditions and endorsements of this policy in so far as they relate to anything to be done or complied with by the insured and truth of the statements and answers in the said proposal shall be conditions precedent to any liability of the company to make any payment under this policy. Hence on the above circumstances the company repudiated the claim of the complainant. The company acted fairly, reasonably, justifiably repudiated the claim and hence there is absolutely no deficiency in service. There is no merit on the contentions of the complainant and he is not entitled for any compensation. Hence the complaint may be dismissed with compensatory cost.
5. 3rd opposite party filed a version mainly contenting as follows:-
This opposite party is an intermediary between the service providers and the customers and it does not have any interference in the modus operandi or working of merchants/service providers and the liability for any changes, deficiencies related to the services provided by the service providers. This opposite party is merely a facilitator of services on behalf of 3rd party service providers. This opposite party is a platform with the domain name and URL of www.policybazaar.com where the customers can view search, compare and then choose the most suitable product/ insurance policy matching with their requirements. After choosing the insurance company the premium is paid directly to them and the policy is issued.
6. Complainant insured the vehicle with opposite parties 1 and2 from 27/11/2018 to 26/11/2019. If there is any deficiency of service opposite parties 1 and 2 are liable for the same. There was no deficiency of service from the part of this opposite party and so the complaint may be dismissed.
7. On the above pleadings following points were raised for consideration:-
1. Whether there is any deficiency of service from the part of opposite parties?
2. Whether the complainant is entitled to realize an amount of Rs. 15,791/- from the opposite parties as claimed.?
3. Whether the complainant is entitled for compensation ?
4. Relief and cost?
8. Evidence in this case consists of the oral evidence of PW1 and Ext.A1 to A6 from the side of the complainant. Opposite parties did not adduce any oral evidence . Ext.B1 to B3 were marked from the side of opposite parties 1 and 2.
9. Points No.1 to 3:-
PW1 is the complainant in this case. He filed an affidavit in tune with the complaint and marked Ext.A1 to A6.
10. The case advanced by PW1, the complainant is that he is the owner of Hundai Eon Era car bearing Reg.No. KL-04- AD-4640. It was insured for a period of one year from 27/11/2018 to 26/11/2019. The policy was selected through 3rd opposite party M/s Policy Bazaar. The vehicle had full coverage. On 21/8/2019 he sent a bill for Rs. 15,791/- claiming the amount. However on 5/9/2019 the claim was repudiated. According to him he had no claimed any amount previously from opposite parties 1 and 2 and so rejection of his claim was not proper and hence the complaint was filed. Per contra the case advanced by opposite parties 1 and 2 is that they issued the policy for a period of one year through online portal. At the time of issuing policy it was informed byPW1 that the previous policy of the vehicle was with M/s. Bajaj Alliance and that there is no claim for the vehicle in the previous year. Accordingly No Claim Bonus at the rate of 45% was granted to PW1. On getting the claim form opposite parties 1 and 2 they made enquires and it was noticed that the vehicle had previous insurance with M/s United India Insurance and not Bajaj Alliance. Further it was also noticed that during the previous year there was claim for the vehicle and it was suppressed at the time of application and PW1 availed No Claim Bonus. In said circumstances according to opposite parties 1 and 2 since there is suppression of material facts PW1 is not entitled for any relief and so the complaint is only to be dismissed with their cost.
11. The cross examination of PW1 is relevant in this case, since there are certain admissions which proves the case advanced by the Opposite parties 1 and 2. PW1 admitted that he had availed No Claim Bonus for the insurance issued from opposite parties 1 and 2. If there was no previous claim then only one is entitled for No Claim Bonus. While availing the policy he informed that the previous policy was with M/s Bajaj Alliance. But actually the policy was issued by M/s United India Insurance Company. He frankly admitted that availing No Claim Bonus from opposite parties 1 and 2 is not fair. Though he admitted receipt of Ext.A6 repudiation Letter dtd. 5/9/2019 he contended that since he could not understand English he could not read the same. However he frankly admitted that the content was explained to him by the opposite parties. Opposite parties explained as to why the claim was rejected. He also admitted that he was sure from the explanation of opposite parties that he is not entitled for claiming the amount. Still he filed the complaint before this Commission may be on an experimental basis.
12. Ext.A6 is the repudiation Letter issued by opposite parties 1 and 2 on 5/9/2019. The claim was rejected mainly on two grounds. 1st it was disclosed that the earlier insurance company was with M/s Bajaj Alliance General Insurance. On enquiry it was found that it was not correct and the insurance was issued by M/s United India Insurance Company Ltd. Secondly PW1 availed 45% NCB claiming that there was no claim on the previous year. On enquiry it was found that there was previous claim and so he is not entitled for No Claim Bonus. Ext.B1 is the policy issued by opposite parties 1 and 2 from which it is seen that PW1 had availed an amount of Rs.890.72/- as discount being 45% No Claim Bonus. From Ext.B2 it is seen that at the time of availing policy it was disclosed by PW1 that the previous insurance was from M/s Bajaj Alliance General Insurance Ltd. Ext.B3 is the copy of Ext.A6. It is to be remembered that PW1 availed the policy through 3rd opposite party which is having online platform and the details were disclosed by him.
13. The matter is well settled by various judicial pronouncements. It was held by Hon’ble Supreme Court in (1991) 1 SCC 357 (LIC of India Vs. G.M. Channabasamma)
“ It was held that a contract of insurance is a contract of Uberrima-fides and there must be complete good faith on the part of the assured and the assured is under a solemn obligation to make full disclosure of material facts which may be relevant for insurer to take into an account the claim of the complainant.”
A similar view was taken by the Hon’ble National Commission in the decision reported in (2010) (2) CPJ (NC) 272 ( TATA AIG General Insurance Company Limited & Another Vs. Gulzari Singh) in that case “ The insurance policy regarding the vehicle was obtained by suppressing the material facts regarding making of claims under the previous insurance policy and by giving wrong declaration regarding “ No Claim Bonus”. It was held that the party is not entitled. The same view was reiterated in Harjinder Singh Vs. Branch Manager, Oriental Insurance Co. Ltd & Another by the Hon’ble National Consumer Dispute Redressal Commission in order dated 15/2/2016.
14. Here in this case there was wrong declaration regarding the name of previous insurance company and regarding the previous claim. By such wrong declaration PW1 obtained insurance policy with 45% No Claim Bonus. Hence applying the principles laid down by the Hon’ble Supreme court and Hon’ble National Dispute Redressal Commission it is pellucid that complainant is not entitled for any relief.
15. In Amrik Singh Vs. M/s United India Insurance Company Ltd. [1993 (2) CPR 203] it was held
“ Consumer must come with clean hands. Suppression of material fact by the complainant disentitles him to relief in this jurisdiction. A consumer knocking at the door of the redressal agencies under the Act for relief of a consumer dispute must do so with clean hands.”
In this case the cross examination of PW1 which was narrated earlier will show that fully knowing from the opposite parties that he is not entitled to claim the amount, he filed this complaint on an experimental basis. In other words opposite parties were dragged into this litigation fully knowing the consequences. In said circumstances opposite parties 1 and 2 who only had participated in the trial are entitled for compensation. These points are found accordingly.
17. Point No.4:-
In the result, complaint is dismissed with a direction to pay Rs.2000/- as cost to opposite parties 1 and 2.
Dictated to the Confidential Assistant, transcribed by him corrected by me and pronounced in open Commission on this the 20th day of September, 2021.
Sd/- Sri.S.Santhosh Kumar(President)
Sd/-Smt. Sholy.P.R(Member)
Appendix:-Evidence of the complainant:-
PW1 - Suresh( Complainant)
Ext.A1 - Reliance Private car package policy Schedule
Ext.A2 - Copy of RC Book
Ext.A3 - Copy of Driving licence
Ext.A4 - Invoice Summary dtd. 31/8/2019
Ext.A5 - Receipt dtd.5/8/2019
Ext.A6 - Repudiation Letter dtd.5.9.2019
Evidence of the opposite parties:-
Ext.B1 - Reliance Private car package policy Schedule
Ext.B2 - Proposal Form for Reliance Private car package policy Schedule
Ext.B3 - Repudiation Letter dtd.5/9/2019
// True Copy //
To
Complainant/Oppo. party/S.F.
By Order
Senior Superintendent
Typed by:- Br/-
Compared by:-
