Before the District Forum: Kurnool
Present: Sri K.V.H. Prasad, B.A., LL.B., President
And
Smt C.Preethi, M.A., LL.B., Member
Sri R.Ramachandra Reddy, B. Com., LL.B., Member
Thursday the 11th day of November, 2004
C.D.No.07/2003
Y.K.Padmnabha Reddy,
S/o.Thimma Reddy,
Rathana (V) & (P),
Thuggali (M),
Kurnool Dist. . . . Complainant represented by his counsel
Sri M.L.Srinivasa Reddy.
-Vs-
The National Insurance Co., Ltd,
Rep by its Branch Manager,
Adoni. . .. Opposite party represented by his counsel
Sri P. Ramanjaneyulu.
O R D E R
(As per Smt C.Preethi, Member)
1. This CD complaint of the complainant is field under section 12 of C.P. Act, 1986, seeking a direction on the opposite party to pay Rs.50,750.- with interest from 25.2.2000, Rs.15,000/- towards mental agony, cost of the complaint any such other relief or reliefs which the complaint is remaining entitled in the circumstances of the case.
2. The gist of complaint of complainant is that the complainant is the owner of Jeep bearing No. A.P 21 B.5454 and the same was insured with opposite party. On 25.2.2000 at about 12.00 noon, the said jeep met with accident near Garladinne Village near Peapuly Mandal, Kurnool District and the said vehicle was badly damaged and inmates of the vehicle also received injuries. Thereafter, the complainant submitted all necessary documents along with claim form requesting the opposite party to settle the claim as assessed at Rs.50,750/-. Inspite of several requests the opposite party did not settle the claim on some pretext or other and also asked the complainant to submit original driving license of the driver, as the driver left employment of the complainant, the Xerox copy of driving license of the driver was submitted for verification. As the claim was neither settled nor repudiated by the opposite party, the complainant got issued legal notice dt 28.11.2002 and the opposite party replied on 2.12.2002 stating that the complainant has not complied with required documents demanded by the opposite party, so the claim of the complainant was closed as “No claim” and also further alleged that the complainant violated terms and conditions of the policy as the vehicle was used for hire purpose at the time of the accident. Non settlement of claim of the complainant even after a gap of sufficient time is amounting to deficiency of service.
3. In substantiation of his case the complainant filed the following documents Viz (1) legal notice dt 28.11.2002 issued by complainant’s counsel (2) reply dt 2.12.2002 issued by opposite party’s counsel to complainant’s counsel and (3) Xerox copy of driving licence of Sri Shaik Shavali, besides to his sworn affidavit in reiteration of his complaint avernments and the above documents are marked as Ex A.1 to A.3 for its appreciation in this case.
4. In pursuance to the notice of this Forum as to this case of the complainant the opposite party appeared through its standing counsel and contested the case by filling denial written version alleging not maintainable of case either in Law or on facts.
5. It admits the complainant’s Temp Trax bearing Reg No.A.P 21-B 5454 was insured with opposite party under comprehensive policy for a private car only for one year, commencing from 8.11.1999 to 7.11.2000 and the said policy was in force at the time of the alleged accident on 25.2.2000. The said vehicle turtled and the inmates of the vehicle were also injured but the vehicle was not badly damaged. On information by the complainant the opposite party appointed Mr M.R Srinivasan, Insurance Surveyor and Loss assessor of Kurnool to assess the damages caused to the said vehicle and he submitted his report along with photos on 14.6.2000 and assessed damages to the extent of Rs.18,000/- only.
6. It further submits that at the time of the accident the complainant used the vehicle for transporting passengers in the private car and the driver of the said vehicle has no valid driving licence to drive the said vehicle, therefore the opposite party insisted the complainant to produce R.C Book and DL of the driver and thereafter the complainant did not show any interest to the settle the claim and the opposite party issued remainder letters dt 14.9.2000 and 22.9.2000, as there was no response from the complainant, the claim of the complainant was closed as “NO CLAIM’.
7. It further submits that the claim of Rs.50,750/- is excessive and as per surveyor’s report actual amount entitled by the complainant was to the extent of Rs.18,000/-only. As the complainant violated terms and conditions of the policy by carrying passengers and also the driver on wheels had no valid driving licence and after a lapse of limitation the complainant filed this complaint before this Forum, hence the complainant is not remaining entitled to any of the reliefs sought in the complaint and seeks for the dismissal of complaint with exemplary costs.
8.In substantiation of its case the opposite party filed the following documents Viz (1) office copy of the policy issued by opposite party to the complainant bearing policy No.551002/1999 6100440 (2) C/C F.I.R. No.8 dt 26.2.2000 (3) letter dt 1.3.2000 of complainant (4) Assessment and five bills along with claim form (5) letter dt 17.4.2000 of opposite party to the complainant to furnish certain information (6) letter dt 8.6.2000 of opposite party to the complainant (7) private and confidential Motor Survey Report final 30.5.2000 (14.6.2000) of M.R Srinivasna along with photos and Negatives. (8) post repair inspection report by A.Govindappa dt 24.7.2000 along with photos and Negativies (9) letter dt 7.8.2000 of opposite party to the complainant (10) letter dt 14.9.2000 of opposite party to the complainant along with postal Acknowledgement (11) letter dt 22.9.2000 of opposite party to the complainant along with postal acknowledgement and (12) office copy of reply notice given by opposite party’s counsel to the complainant, besides to its sworn affidavit in re iteration of its written version as defence and the above documents are marked as Ex B.1 to B.12 for its appreciation in this case.
9. Hence the point for consideration is whether the complainant made out any deficiency of service on part of the opposite party?:
10. The opposite party is not denying the complainant as the owner of the jeep bearing No. 21-B-5454 and that he got insured his jeep with opposite party and obtained policy. While the said policy was in force the complainant’s jeep met with accident on 25.2.2000 at about 12 noon near Garladinne Village near Peapuly Mandal, Kurnool Dist. The complainant submitted necessary claim form with all necessary/ relevant documents to the opposite party but to the dismay of the complainant, the opposite party did not settle the claim of the complainant on the ground firstly, the jeep was carrying passengers at the time of the accident, secondly the driver of the jeep was not possessing valid driving licence, which is, in violation of terms and conditions of the policy and thirdly the complaint filed by the complainant is after the lapse of limitation period.
11. The first contention of the opposite party is that the jeep was carrying passengers and was being used as commercial vehicle in utter violation of policy condition as the policy is for private car. In the absence of any cogent substance in support of supra stated contention of the opposite and there is no evidence on the record to show that the jeep was used as commercial vehicle and passengers traveling in the said jeep were fare paying passengers and thus the owner of the jeep cannot be held guilty of any breach of policy condition obligating him to the insurer, hence there remains every bonafidies of the complainant in his hesitation on the said grievance. The complainant in support of his case regarding legal aspects placed reliance on the following citation report in 1996 (2) CPR Page 5 National Commission, in case of United India Insurance Co Ltd Vs Dashrath Lal Jetha bai patel, where in the National Commission, held, that claim was repudiated on the ground that the complainant committed breach of conditions of policy by carrying passengers on fare paying, no evidence led by the opposite party that the persons traveling were fare passengers, hence the complainant is entitled to insurance claim under the policy.
12. Hence, in the above said circumstances, no evidence was placed by the opposite party to show that the passengers traveling in the said jeep has paid any fare or the driver was plying it as taxi and merely by lifting one person or two or even three by the driver of the jeep cannot be said to be such fundamental breach that complainant should in all event be denied of compensation. Hence, there is deficiency of service on part of the opposite party in not settling the claim of the complainant.
13. The second contention of the opposite party is that the driver on wheels at the time of the accident was not possessing valid driving licence to drive the said jeep, which is in violation of terms and condition of the policy, the complainant brought on record Ex A.3 attested Xerox copy of driving licence of A Shaik Shavali S/o. A. Imam Sahib, bearing DL No.600/91 dt 3.12.1991 and the said licence was valid upto 15.3.2002. The entry in the said exhibit goes to show that the driver Shaik Shavali is authorized to driving as paid employee for a transport vehicle i.e light Motor Vehicle, the said licence was issued by Additional Licensing Authority, Adoni of Kurnool Dist. The facts borne in the above exhibit is not denied by the opposite party’s side and the further from Ex B.7 Private and Confidential Motor Survey Report (final) Dt 30.5.2000 of M.R Srinivasan Insurance Surveyor/ loss assessor on page one mentioned the particulars of vehicle damaged and DL of the driver on wheels at the time of the accident. Hence, from them it remains clear that DL was produced before the surveyor and the said surveyor noted DL particulars in his report (B7). Hence, the plea of the opposite party that original DL was not produced remains as plea for plea sake. If there is any doubt on the said DL the opposite parties must have verified the DL particulars from the issuing authority of the said DL. All the above said material indicates in uni-tone that the DL particulars was given to the opposite party and in Ex B.7 surveyor mentioned DL particulars, hence the stand taken by the opposite party that claim of the complainant was closed as “No claim” as the complainant did not furnish necessary particulars is rejected as it neither inspires any confidence nor can be acted and relied upon.
14. The third contention of the complainant is that the complaint of the complainant is filed after the lapse of limitation period, the contention of the complainant is that the complainant submitted claim form with all necessary documents but the opposite party did neither settle the claim nor repudiate the claim. Now the point for consideration is delay in settling or repudiating the claim of the complainant. The explicit condition of the Insurance is that the insurer’s claim must be settled with utmost expedition, either by way of acceptance or repudiating the same, what ever be the merit of insurance claim, it is certainly not open to the insured to sit smugly over the same and hang to swords of Damolies in ordinately for years. What ever may have been the situation earlier, it appears that with the present technological advances, which are now freely available to the large insurance companies, it would not be difficult for them to either settle or repudiate an insurance claim within a reasonable of period of 3 months. But unless, it is established other wise for cogent reasons, a delay beyond three months to either settle or repudiate would in essence be a deficiency of service undertaken to be rendered by the insurance companies at least within the Consumer Jurisdiction as per the decision of SCDRC, Haryana at Chandigarh between Smt Surrindu Kaur V/s The Oriental Insurance Co Ltd reported in CPR 1993(III) pg 438. In the present case the opposite party alleges that the claim of the complainant was closed as “No claim” but it does not makes mention on which date it closed the claim as “No claim”, hence the limitation period extend till the opposite party repudiates the claim of the complainant. The complainant being vexed with the doscile conduct of the opposite party neither repudiating nor settling the claim has approached this Forum by seeking redressal is assumed as within limitation period. The opposite parties by their conduct in not repudiating nor settling the claim of the complainant, there appears every deficiency of service from the opposite parties side towards the complainant.
15. The opposite party except alleging the defaultive and non co-operative conduct of the complainant in not submitting original DL and filing Ex B.1 to B.12 did not substantiate their bonafidies and malafides of the complainant by substantiate by the same by any accepting corroborative material.
16. To conclude, from the above discussions and following the afore mentioned decisions, the reasonable time frame within which the Nationalised Insurance Companies must settle or repudiate the insured claims would normally be a period of 3 months. Any delay beyond that would pesse odium of deficiency of service, unless the same is cogently explained by the Insurance Companies and the burden must necessarily rest on them. There is no doubt that opposite party did neither settled nor repudiated the claim of the complainant and there is no merit in the contention of the opposite party that as the claim of the complainant was closed as no claim, the complainant is not remaining entitled to any claim amount. The liability of opposite party to pay claim amount as per surveyor report arises because of deficiency in service due to its negligence in not settling nor repudiating the claim of the complainant. Hence, in the circumstances discussed above the complainant is certainly remaining entitled to get the amount which he spent in getting the said jeep repaired for damages it sustained in the said accident covered under the policy and opposite party is liable to pay the same as there is deficiency of service on part of the opposite party in not paying the said amount.
16. In the present case the complainant has claimed a sum of Rs.50,750/- but the opposite party has submitted that certain depreciation are to be deducted from the repairs. The Ex B7 Final Survey Report assessed the loss after depreciation to Rs.18,000/-. Thus basing on Ex B.7 the claim has been reduced to Rs.18,000/-which the opposite party has to pay to the complainant.
17. In the result, the complaint is allowed directing the opposite party to pay to the complainant Rs.18,000/- with 9% interest per annum from the date of filing of this complaint till realization along with Rs.2,000/- as costs of the complaint and the opposite party is directed to pay the supra awarded amount within one month of the receipt of this order.
Dictated to the Stenographer, Typed to dictation corrected by us pronounced in the Open Court this the 11th day of November, 2004.
PRESIDENT
MEMBER MEMBER
