By Smt. Padmini Sudheesh, President: The case of complainant is that the complainant had insured with the respondent his Maruti Esteem car having registration No.KL8/N-7122 for the period from 5.9.2001 to 4.9.02.The vehicle was insured for an amount of Rs.4,50,000/-. The vehicle was stolen and in subsequent to that the complainant approached the respondent to get the insurance claim. The company sanctioned only Rs.3,00,000/- and the complainant accepted the amount under protest. The claim application was submitted to the company on 26.6.2002 and it was considered and cheque was issued dated 30.7.04 only. The complainant is eligible to get the balance Rs.1,50,000/-. Hence the complaint. 2. The counter of respondent company is that the company admits that the vehicle No.KL-8/N-7122 is having a valid policy issued in the name of complainant for a period from 5.9.01 to 4.9.02. The limit of the liability of this respondent is as per the terms and conditions of the policy. The complainant submitted the claim form unfilled on 26.2.02. This respondent processed the claim. The final report of the police was not submitted by the complainant. The file has been closed by the police as undetected only on 30.12.03. The investigation was taken through Mr. A. Vinod and he submitted a report on 4.3.02. The report regarding the value of the vehicle was called for by appointing surveyor named Mr. U. Ramanathan. He submitted a report on 29.3.04 stating that the market value of the vehicle is Rs.3,00,000/- as on 25.2.02. The vehicle is of model 1999. As per the condition of the policy this respondent is liable to pay only the market value of vehicle at the time of accident. On 26.3.04 the complainant has sent a letter to the respondent stating that he is ready to settle the matter for a sum of Rs.3,00,000/- in full and final settlement of the entire claim. After getting survey report from U. Ramanathan this respondent sent a letter on 1.7.04 to the complainant stating that the respondent is ready to settle the matter provided the complainant submits original R.C. book, tax book endorsed with the non-use of vehicle due to the theft endorsement, letter of subrogation, original policy, etc. The matter was prolonged to settle since the concerned documents are not obtained from the petitioner in time. Since the complainant was ready to settle the matter for a sum of Rs.3,00,000/- for the then market value of the vehicle, the matter was settled for the said sum and an amount of Rs.3,00,000/- was given to the complainant in full satisfaction of the entire claim. The complainant accepted the claim without any protest. The claim could be adjudicated only after obtaining the final report from the police stating that the same is undetected. The delay in settling the claim was caused only due to the delay of obtaining the documents from the complainant. The complainant is not entitled to get the insured’s estimate value of Rs.4,50,000/-. As per the policy condition, if the market value of the vehicle is less than the insured’s estimated value the amount of loss has to be calculated based on the then market value. Hence the complainant is not entitled to get Rs.1,50,000/- as prayed in the complaint. There is no deficiency in service. Hence dismiss the complaint. 3. The points for consideration are: (1) Is there any deficiency in service? (2) If so, reliefs and costs. 4. The evidence consists of Exts. P1 to P4 and Exts. R1 to R7. No oral evidence adduced by both. 5. Points: The case is filed for realization of balance amount of Rs.1,50,000/- and compensation. The complainant stated in the complaint that he had insured his vehicle No.KL8/N-7122 with respondent for the period from 5.9.2001 to 4.9.02 for an amount of Rs.4,50,000/-. The vehicle was stolen and he preferred a claim with the Company and the Company paid Rs.3,00,000/- only. According to him, since the vehicle was insured for Rs.4,50,000/- he is entitled for that amount. The respondent company filed their counter and contended that as soon as the claim is reported they have started investigation. The police has closed the file only on 30.12.03. The final report was necessary to adjudicate the claim and the investigation report showed that the market value of the vehicle is Rs.3,00,000/- and as per the condition No.3 of the policy the company is liable to pay only the value of the vehicle at the time of accident. 6. According to the complainant, since the vehicle was insured for Rs.4,50,000/- he is eligible to get that amount as the insurance claim. He has produced Exts. P1 to P5 documents to prove his case. Even if chances were given he failed to adduce oral evidence and submitted no oral evidence. The stealing of vehicle and the policy etc. are admitted by the Company and the Company settled the claim for an amount of Rs.3,00,000/- on the basis of the investigation report. The Company produced Exts. R1 to R6 documents to substantiate their case and according to them, Rs.3,00,000/- is the claim amount which the complainant is entitled to get. According to them, the complainant expressed his willingness by a letter dated 26.3.04 to settle the matter for a sum of Rs.3,00,000/- in full and final settlement of the entire claim. The respondent produced the letter and marked as Ext. R4. The letter is sent by the complainant to the Senior Divisional Manager of respondent Company. In this letter it is stated that he agrees to settle the theft claim for Rs.3,00,000/- as full and final settlement. But in this case according to the complainant, he accepted the amount under protest. But he kept mum with regard to thisExt. R4 letter. He did not object the letter and he has no case that he never issued such a kind of letter. He simply stated that he accepted the amount under protest. This averment is not sufficient to prove that the amount he had accepted was under protest. He failed to adduce oral evidence also in support his claim. Ext. R4 is the best evidence against the complainant and he is not eligible for any amount without the amount accepted by him. 7. The respondent states that as per Condition No.3 of the policy they had given Rs.3,00,000/- as the value of the vehicle at the time of accident. Condition No.3 would say that “the Company may at its own option repair reinstate or replace the Motor Car or any part thereof and/or its accessories or may pay in cash the amount of the loss or damage and the liability of the Company shall not exceed the actual value of the parts damaged or lost less depreciation plus the reasonable cost of fitting and shall no case exceed the insured’s estimate of the value of the Motor car (including accessories thereon) as specified in this Schedule or the value of the Motor Car (including accessories thereon) at the time of the loss or damage whichever is less”. The certified copy of the policy with terms and conditions is produced by the respondent and is marked as Ext. R2. The complainant cannot say that he was unaware of the terms and conditions because he has produced the original terms and conditions of the policy and he is well aware of the terms and conditions. As per that the respondent is liable to pay only the market value of the vehicle at the time of accident. In order to fix the market value and to find out the real things the Company deputed Investigators and the report of one investigator Mr. V. Ramanathan is produced and marked as Ext. R7. In his report it is reported that based on enquiries considering that the vehicle is used only for private use, market demand etc., in his opinion the market value of the vehicle of the above description would be around Rs.3,00,000/- as on 25.2.2002. As per Ext. R2 the complainant will be entitled for only the market value. According to the respondent the market value as on 25.2.2002 is Rs.3,00,000/- and the complainant failed to establish his claim that he will be entitled for Rs.4,50,000/-. He failed to adduce evidence to show that the market value of the vehicle as on 25.2.02 will come to Rs.4,50,000/-. His version is that since the vehicle was insured for Rs.4,50,000/- he will be entitled for that amount. But that is not so and he is entitled for the amount given by the Company. The Company has also produced Ext. R4 letter sent by the complainant to the respondent. Since there is no objection with this letter the complainant is entitled only for the amount worth Rs.3,00,000/-. 8. The complainant further stated that there was delay in releasing the amount of Rs.3,00,000/-. He had put the claim application on 26.6.02 and the amount was given by a cheque dated 30.7.04. So the complainant stated that there is delay for releasing the amount. The respondent Company stated that only because of delay in getting relevant documents from the complainant this delay was happened and also because of delay in completing the police investigations and investigations done by the Company. The complainant did not adduce any evidence to show that he had produced the documents required by the respondent in time. Even if there is no records to show the report of police there is no denial on the part of complainant and no steps were taken by him to call for the police report. So the version of the respondent is forced to believe. The complainant miserably failed to prove his case and the complaint is liable to be dismissed. 9. In the result, the complaint stands dismissed. Dictated to the Confidential Assistant, transcribed by her, corrected by me and pronounced in the open Forum, this the 22nd day of April 2010.
| | HONORABLE Rajani P.S., Member | HONORABLE Padmini Sudheesh, PRESIDENT | HONORABLE Sasidharan M.S, Member | |
