CC No.35 of 2013

Shilesh Kumar Layak   …………………………….. Complainant

Vs

Branch Manager, Oriental Insurance Company, Ltd, Dumka ………OP

  05.11.2015                                                     ORDER

By filing this complaint, under the provision of The consumer Protection Act 1986, the complainant has sought relief to direct the Ops to indemnify the repairing cost amounting to Rs.297000/ to which he is said to be entitled to. 

 Case of the complainant is that he is the owner of the vehicle No.JH04D/9642 which he got insured with OP vide Policy no. 332401 effective from 08.12.2011 to 07.12.2012e. It is said that the said vehicle involved in accident on 04.11.12 in which it was damaged. But the claim of the complainant for damaged repairing cost is refused by the OP, although all relevant papers were provided with the claim application.  Hence the case.

The OP entered its appearance and filed its versions  whereby it is said that the claim of the complainant is properly addressed and repudiated on violation of limitation as to use clause. it is submitted that the vehicle in question was being used for commercial purpose for transporting the passengers on contract basis on the date of accident as also  reflected in the  FIR. It is said that the OP(1) has got investigated the matter through Mr A.K.Janasureyor, Dumka  who conducted preliminary survey on 05.11.12 and submitted his report. It is further said that the complainant shifted the accidental vehicle to the workshop of M/S Utkal Autocoach Pvt.Ltd, Jamshepur for repairing and submitted Claim Form and estimate to the Divsional Office Jamshedpur where final survey was conducted by Sri S.K. Sadhu who submitted his report assessing the loss to the tune of Rs.190000 (one lac ninety thousand ) only and the claim of the complainant for Rs.297000 is false and concocted It is accordingly said that the OP1 has rightly repudiated the claim of the complainant on the basis of violation of “Limitation as to use”  as well as violation of terms and conditions of the policy. The information regarding repudiation on that basis is communicated to the complainant through letter dated 07.06.2013 . On these versions the complaint is prayed to be dismissed.

We have heard the parties and have gone  through the record.

There is admitted facts that there was valid policy covering the period of accident . A copy of the policy No 332401/31/2014/3746 covering the period of accident is also filed   (amendment vide order 03.11.15 in the complaint removed the confusion of covering period). It is also not denied that the information of accident was given without delay. The Surveyor was appointed by the OP to assess the loss. The preliminary survey shows the estimated damage of Rs.190000/. But the final surveyor reported that the insured vehicle was in use for carrying passengers and that is why the claim of the complainant was repudiated in toto.

* The claim of the complainant is repudiated by OP solely on the ground that the vehicle was used for commercial purpose violating the limitation as to use clause.The point for consideration before us is that the repudiation of claim in toto is legal or there exists any guidelines to settle the claim as per Procedural Manual of Motor claims.

 Firstly we have to consider as to whether there was violation as to use clause or not?

The complainant has filed affidavited evidence of his own and one Danial Tuddu. The complainant, Shailesh Layak has not sworn that the vehicle was in his own use at the time of accident. Rather the witness Danial  Tuddu has taken oath that he and his wife were going to Bolpur on 04.11.12 on their friend’s vehicle JH4D9642 when the accident took place. The copy of the FIR dated 04.11.12 indicates that on the Fardbayan of one Chaukidar,Manager Mirdha of Masanjor PS, the FIR No.147 of 2012 was lodged indicating injury to one woman and driver. By the evidence adduced on behalf of the complainant himself we are of the opinion that the insured vehicle was not in private use at the  time of accident.

  Then    the relative question is whether repudiation of the  claim in toto by OP is    justified or not. We are brought to notice that there did exist a policy based on the guidelines of settling certain claims, which are not strictly. falling within the limitation as to  use  clause in the Policy, as non-standard claim and provided that such claims could be sett led up to  maximum of 75%. Reference may be made II(2001)CPJ 60 (NC). Such guidelines are contained in the Procedural Manual of Motor claims

In view of the existence of this procedure and practice ,  we are of the view that the repudiation of the claim of the complainant in toto is not justified.  

   So for the estimated loss or damage is concerned we are of the view that the Preliminary assessment of the OP’s surveyor be safely relied for assessing and settling the claim. In the facts and circumstances of the case and our findings that the complainant is entitled to get  75% of  the assessed loss Rs.19000/ by the surveyor i.e

We therefore direct the OP (Oriental Insurance Company Limited) to pay 75% of the  assessed loss which comes to Rs 142500/(one lac forty two thousand and five hundred ) .  There shall be no order as to other cost.            

       The order shall be complied within one month from receiving the copy of this order or from the date of producing a copy to the OP1 by the complainant failing which the

Complainant will be at liberty to take action u/s25 and 27 of the consumer Protection Act, 1986.

   Let free copy of the order be supplied to the parties.