Per Shri Atul D. Alsi – Hon’ble President.

              The private vehicle of the complainant bearing No. MH-35-M-0685 is insured with O. P. vide Private Car – Package Policy No. 230903/31/11/01/00010256 for total Rs. 1,00,000/- for period start from 30.11.2011 to 29.11.2012.  The complainant paid Rs. 3362/- on 29.11.2011 to the Opposite Party.

2.            There was an accident occurred of the complainant on 01.05.2012.  The complainant sustained various injuries.  The vehicle of the complainant is 100% damaged in the said accident.  Accordingly the claim was submitted to the O. P.   The surveyor have inspected the vehicle and found 100% loss to the vehicle.  The O. P. allowed the claim of Rs. 57,700/-, the cost of the salvage was assessed at Rs. 32,000/- and have also adjusted Rs. 10,500/- towards excess.  The O. P. transferred the Rs. 57,700/- by NEFT to the account of the complainant on or about October 2013.  The benefit of the salvage is also given to the complainant.  But the complainant is also entitled for Rs. 10,500/- which is deducted illegally by the opposite party.  As the vehicle is insured for total Rs. 1,00,000/- and premium is also obtained for the same.     

3.            The O. P. is service provider and the O. P. is deficient as submitted herein above and therefore the present complaint is filed.  The complainant is therefore entitled for the balance amount of Rs. 10,500/- from the O. P.   The complainant is also entitled for the interest @ 12% p.a. for 17 month i.e. for delay in paying the amount of Rs. 57,700/- to the complainant.  The complainant is also entitled for the cost of Rs. 10,000/- for the mental and physical harassment.  The complainant is also entitled for Rs. 5,000/- for the expenses caused to the complainant to present the matter.  Thus the complainant is entitled for total amount Rs. 25,500/- and interest also.

4.            After receiving the notice issued by the Forum, the O.P. appeared through their counsel and filed their written statement before the forum. 

5.            In their reply, the O. P. mentioned that in insurance policy there is specifically mentioned about the IMPOSED EXCESS Rs. 10,000/- AND COMPULSARY EXCESS Rs. 500/-.  Thus the complainant very well knew this fact from the very day of purchase of insurance policy.  The deduction of said amount of Rs. 10,500/- is legal.  The complainant when accepted the amount of claim disbursed to him voluntarily without any protest & has forfeited his legal right of further claim.  As per record the complainant/insured submitted the claim form in company on 14/01/2013.  The process of claim began only after submission of duly fill up “claim form” submitted by insured.  It is pertinent to state here that in the entire complaint there is no whisper about this delay and on the contrary claiming interest on delayed payment.  There is no deficiency in service on the part of O. P. who has rightly processed the claim of complainant and also disbursed the amount without any delay.   

              In their specific submission the opposite party submitted that the terms of policy conditions are very simple and understandable needed no interpretation and the insurance company can’t go beyond the policy conditions.  Thus the complaint of the complainant is liable to be dismissed or he be directed to file the suit before the Civil Court for the proper adjudication by withdrawing this case.  The claim of the complainant is liable to be rejected by the Hon’ble Forum on the ground that the case does not fall within the meaning of deficiency of service.  Same is deserved to be dismissed with compensatory cost.            

6.            The complainant has filed Copy of vehicle registration certificate at page no. 10 & 11, Copy of insurance policy at page no. 12 & 13, Copy of letter from O. P. at page no. 14 on record.

7.            The learned counsel for complainant Mr. N. S. Popat argued that the surveyor submitted report of 100% damage to vehicle.  The O. P. paid Rs. 57,700/- after deducting Rs. 10,000/- towards benefit of salvage.  On the other hand there was delay of 17 months for the payment of insured claim of Rs. 57,700/- for which O. P. is liable to pay interest @ 12% p.a. to complainant along with compensation & litigation charges.

8.            The learned counsel for opposite party Mr. M. K. Gupta argued that the complainant accepted the insurance claim amount of Rs. 57,700/- towards full & final satisfaction of claim, hence this complaint is not tenable.  The complainant submitted insurance claim on 14.01.2013 & accident took place on 01.05.2012.  The claim submitted by the complainant was delayed claim.  The O. P. after completing all formalities disbursed the amount; hence there is no deficiency on the part of opposite party.  

9.            Considering the rival contention of the party & submission made before us the following points arise for consideration & finding there on along with reasons.

REASONING & FINDINGS

10.                   The complainant’s vehicle bearing No. MH-35/M-0685 met with an accident with a vehicle bearing No. CG/04/3791 on 01.05.2012 within the jurisdiction of forum at Gondia.     

11.                   Accordingly the claim was submitted with opposite party.  The opposite party allowed the claim of complainant’s vehicle which was damaged 100% as per survey report of Surveyor.  The O. P. allowed the claim of vehicle of Rs. 57,700/- and cost of salvage was assessed at Rs. 32,000/-.  The O. P. have deducted Rs. 10,000/- towards imposed excess & Rs. 500/- towards compulsory excess.  The amount of imposed excess was deducted because the vehicle of complainant was 8 years old. This amount is calculated by surveyor after considering the date of manufacturing of vehicle that is the year of 2003.  The registration certificate is filed by the complainant on page no. 11 contained the year of manufacturing is 2003.  This deduction is made as per terms & conditions of policy.  Therefore the deduction is legal & binding upon insured.  

12.                   The complainant has filed the letter issued by Branch Manager to complainant dated 02.09.2013 bearing no. 444/2013 describing the payment made towards accident claim of complainant amounting to Rs. 57,700/- after deducting the amount of Rs. 32,000/- towards salvage value and  Rs. 10,500/- towards imposed excess & the balance amount of Rs. 57,700/- has been paid through bank to the complainant’s bank account.  The above amount has been paid to the complainant as full & final settlement or net loss basis.  Hence once the amount of accident claim has been accepted as full & final settlement of claim no further claim in respect of that accident is tenable in court of law.  Hence the complaint is dismissed as not tenable; hence the complainant is not entitled to recover the amount of Rs. 10,500/- deducted imposed excess.  Hence the issue decided as “No”.                       

13.                   The complainant’s vehicle’s accident occurred on 01.05.2012.  The insurance claim is submitted on 14.01.2013 with opposite party.  The amount of insurance claim was disbursed in the month of October 2013.  The period of adjudication of claim after submission was reasonable.  There was no delay in disbursement of claim by opposite party.  Hence O. P. is not liable to pay any interest for the delay in disbursement of claim.  Hence the issue is decided as “No”. 

              Therefore the complaint is dismissed as per following order.        

-: ORDER :-

     1.                 The complaint is dismissed.

     2.                 No order as to cost.