CONSUMER DISPUTES REDRESSAL FORUM
PALAKKAD, KERALA
Dated this the 26th day of April, 2012.
Present: Smt. Seena. H, President
: Smt. Preetha. G. Nair, Member
: Smt. Bhanumathi. A.K, Member Date of filing: 31/10/2011
CC / 180/ 2011
Rasheed.C,
S/o.Chella Rawther,
Aged about 35 years,
H.No.10/455,Panakkal House,
Mattayi, Pothundi Post, - Complainant
Palakkad-678 508
(BY ADV. K.SuresHkumar)
Vs
The Regional Claim Manager,
M/s. HDFC ERGO General Insurance Co. Ltd.,
#4E, 4th Floor,
K.G Oxford Business Centre,
Sreekandath Road, Ravipuram, - Opposite party
Kochi 682 016
(BY ADV. P.Prasad)
O R D E R
BY SMT. BHANUMATHI. A.K, MEMBER
Facts of the case in brief:
The complainant is the registered owner of the vehicle autorikshaw Reg.No. KL-49/B 3862. The said vehicle is insured with the opposite party vide policy No. 2314200042422500001. The total sum assured as per the policy is Rs.1,30,000/-(Rupees One lakh thirty thousand only) and policy has got a unique feature ie. Accidental Death coverage and full coverage on the vehicle. The said vehicle was met with an accident on 30.6.2011 and the Nemmara Police has registered a crime as FIR No.213/11. This fact was informed by the complainant to the opposite party and the said vehicle was repaired at its authorized service centre SML Motors. All the repair works had been done after the inspection of the vehicle by the insurance Surveyor of the opposite party. After finishing the work the complainant claimed compensation before the opposite party and entire documents in connection with the vehicle repair was submitted to them. The total repair cost of the vehicle comes to Rs.58,000/-(Rupees Fifty eight thousand only) and the same was paid by the complainant. After completion of the repair work, the Surveyor of the Insurance company directed the company to produce the original policy, R.C.Book, Driving License and Badge. All the available documents with the complainant were produced in time to the surveyor. On 21/09/2011 the opposite party informed the complainant that the complainant is not eligible to get any amount as compensation for the reason that he was not having valid badge at the time of the accident. But Hon'ble Supreme Court had already stated in several cases that the badge is not a mandatory for claiming compensation. The repudiation of a genuine claim by the opposite party amounts to deficiency in service on the part of the opposite party. The vehicle was having a valid insurance protection and coverage on the relevant time. As per the terms and conditions of the policy the complainant is entitled to get Rs.1,30,000/-(Rupees One lakh thirty thousand only). The act of opposite party caused financial loss and mental agony to the complainant. So the complainant seeking an order directing the opposite party to pay an amount of Rs.58,000/- on the cost of the repair charge and Rs.10,000/- as compensation for mental agony along with cost to the complainant.
Opposite party entered appearance and filed version. Opposite party contents that the complainant is not a third party. He is the insured and if there is violation of policy condition on his part then he is not entitled to get the repair work reimbursed after depreciation. This is a contract between the complainant and the respondent if the complainant violated the terms and conditions of the policy by driving the vehicle without badge then the complainant is not entitled to get reimbursement. The badge is mandatory for the driver to drive transport vehicles. If there is no violation of policy then as per Section 1(1) of policy loss or damage of the vehicle insured is 50% depreciation is to be deducted towards all rubber/nylon/plastic parts, tyres and tubes; batteries and air bags. A depreciation of 30% is to be deducted towards fibre glass components and for all other parts will be 5% for vehicles aged more than six months but not exceeding one year.
There is no deficiency of service on the part of opposite party and the complaint is to be dismissed.
Both parties filed their respective affidavits and Exbt.A1 to A7 and B1 marked.
Heard the parties.
Issues to be considered are:
1. Whether there is deficiency of service on the part of opposite party?
2. If so, what is the relief and cost?
Issue No.1 &2
The complainant is the registered owner of the autorikshaw Reg.No. KL-49/B 3862. The said vehicle is insured with the opposite party. The policy has got a unique feature ie accidental Death coverage and full coverage on the vehicle. Total sum insured as per the policy is 1,30,000/-. The vehicle was met with an accident on 30.6.2011 and the Nemmara Police has registered a crime as FIR No.213/11. This fact was informed by the complainant to the opposite party and the vehicle was repaired at its authorized service centre after the inspection of insurance Surveyor. The complainant spent Rs.58,000/- for the vehicle to get repaired. But opposite party has repudiated the claim on the ground that at the time of accident the driver was not having a valid badge. All these facts are born out from documents. These facts are admitted by the opposite party also. Only dispute is that driver was not having valid badge at the time of accident. After finishing the work the complainant made a claim before the opposite party to reimburse the repairing charge. But opposite party repudiated the claim.
It is the settled law that the insurance company cannot repudiate the claim of the insurer in toto in a case where there is breach of policy condition. Where there is breach of condition it is material to assess the loss and the amount had to be determined at the maximum of 75% of the assessed amount of loss. It is observed in the case of Amalendu Sahoo Vs Oriental Insurance Co.Ltd 11(2010) CPJ 9 (SC) that the insurance company cannot repudiate the claim in toto. Even assuring that there was a breech of condition of the insurance policy, the company ought to have settled the claim on non standard basis.
In this case the Insurance Surveyor has not assessed the amount of loss. The report of the Surveyor after inspection is also not produced.
From the above discussions we are of the view that opposite party is liable to pay 75% of the repairing charge of the vehicle. As per A3 document the repairing charge including labour charge is Rs.58,000/-(Rupees Fifty eight thousand only) that would work out Rs.43,500/- (Rupees forty three thousand five hundred only).
In the result complaint allowed. Opposite party is directed to pay an amount of Rs. 43,500/- (Rupees forty three thousand five hundred only) with 12% interest from the date of repudiation ie on 21/09/2011 to date of receipt of order and Rs. 1,000/- (Rupees one thousand only) as compensation of the proceedings.
Order shall be complied within one month from the date of receipt of order, failing which the complainant is entitled for 9% interest per annum for the whole amount from the date of order till realization.
Pronounced in the open court on this the 26th day of April, 2012
Sd/-
Smt. Seena. H
President
Sd/-
Smt. Preetha.G.Nair
Member
Sd/-
Smt. Bhanumathi.A.K
Member
A P P E N D I X
Exhibits marked on the side of complainant
Ext. A1 –Policy and claim issued by the opposite party for the period 26.11.10 to 25.11.11 (Photocopy)
Ext. A2 – Copy of the RC of the vehicle (Photocopy)
Ext. A3 – 2 cash bills issued by SML Motors one for Rs.6,500/- and another for Rs.51,500/-.(Photocopy)
Ext.A4– Letter dt.21/09/2011 issued by the opposite party.
Ext.A5- FIR No.213 dt.01/07/2011 of Nemmara Police Station.
Ext.A6- Self attested copy of driving licence.
Ext.A7- Notice issued by the Surveyor of the opposite party
Exhibits marked on the side of opposite party
Ext. B1 – Passenger carrying vehicle certificate cum policy schedule issued by the opposite party to the complainant.
Witness examined on the side of complainant
Nil.
Witness examined on the side of opposite party
Nil
Cost allowed
Rs. 1,000/- (Rupees One thousand only) allowed as cost of the proceedings.
