1. The fact of the case of Complainant is that he insured his vehicle Hyundai Xcent bearing Regd. No. OD-02-AX-3674 with the Opp. Party No. 3 through the O.P. No. 1 vide policy no. MF397422 valid from 22.08.2020 to 21.08.2021 on premium of Rs. 16,650/- with an assurance to cover all damages of the vehicle.  The allegations of complainant is that on 10.03.2021, his vehicle met with an accident with a road lying stone which resulted damage of the chamber part of engine and leakage of oil and immediate after he lodged a claim with O.P.No.3 vide no. 37190619 and shifted his vehicle to the garage by paying Rs. 3000/- for toeing charge, where the estimate was prepared for Rs. 2,52,428/- by M/s Hindustan Sales Pvt. Ltd dated 01.04.2021 bearing bill no. ET21040002 and submitted all the bills to the O.P. No.2, who in return demanded Rs. 15,000/- for settlement of insurance claim but the complainant paid Rs. 5,000/-.Further allegation of complainant is that the O.P. No.2 assessed the loss value of Rs.28,500/- which is not justified as per complainant.Thus he lodged a complaint with the IRDA authority vide complaint no. 06-21-00-6155 but to no effect.Thus alleging deficiency in service on the part of Opp. Parties, he filed this case claiming to settle the insurance claim on estimated value alongwith Rs. 1,00,000/- and Rs. 10,000/- towards compensation and costs of litigation and refund of Rs. 5,000/- from the O.P. No. 2.

2. O.P. No. 1, though received the notice from the Commission, did not choose to appear in this case, nor filed his counter version nor also participated in the hearing, as such we lost every opportunities to hear from him.

3. O.P. No. 2, though received the notice from the Commission sent through R.P. vide R.L. No. RO025011415IN dated 01.07.2021, did not choose to appear in this case, nor filed his counter version nor also participated in the hearing, as such we lost every opportunities to hear from him.

4. The O.P. No. 3 appeared and filed their counter version admitting the issuance of insurance policy against the alleged vehicle and accident of the alleged vehicle and also survey made by their surveyor but denied the facts of contending that the vehicle was dismantaled prior to survey without any consent and as per surveyor only the Oil Pan found damaged and given approval for replace of Oil Pan.  Also contended that the estimate of the repairer having with Engine internal parts like Bearing, Engine Oil, Packing Kit, are not covered under the insurance policy conditions and complainant was asked for to submit the estimate as per the approved parts, but complainant did not submit any such bill to settle the claim, thus showing their no liabilities they prayed to dismiss the case.

5. Parties have filed certain documents in support of their submissions.  Perused the case record and material documents available therein.

6. In the instant case, issuance of insurance policy against the alleged vehicle and accident caused to the vehicle during valid policy period of policy and also survey work carried out by O.P. 2, are admitted facts.  The allegation of complainant is that the total estimate towards repair of the alleged vehicle is made for Rs. 2,52,428/- but the O.P. No.3 approved for Rs. 28,500/- on the basis of surveyor’s report (O.P. 2).  Whereas the contentions of O.P. No.3 is that as per the survey report they asked the complainant to submit the repairer bill but he did not submit the bill, hence claim could not settled.  After careful observation and hearing from the parties, the only dispute arose to decide that whether the surveyor assessed the valuation properly ?

7. In this regard, we have gone through the documents filed by the parties. It is ascertained that complainant has filed one estimate document issued by one M/s Hindustan Sales Pvt. Ltd. vide bill No. ET21040002 dated 01.04.2021 for Rs. 2,52,428/- towards repair of the alleged vehicle related to entire parts of the engine of the alleged vehicle.  Whereas the O.P. 3 filed the survey report which shows assessment of only few limited parts.  From the above document we feel, without the entire parts as mentioned in the estimated bill prepared by the authorsied service center, the engine cannot be work, whereas the survey report shows about only few parts which is beyond the imagination.  In our view, if the engine contains with a limited part, then why the authorized service center prepared estimate bill for entire part.  It is well known to all that an engine contains various parts but how the O.P. 3 considered for less parts.  Further the surveyor report shows assessment of those parts which contain lesser amount, whereas he has left the major parts of the engine like Bearing Parts and many more which are of heavy costs being the basic life of engine.  In our view, the insurance coverage shall cover the all parts of engine except plastic, rubber, oil and water related parts.  Hence we think that the surveyor has not assessed the loss properly and approved the claim for Rs. 28,500/- is not justified.

8. The further allegation of complainant is that the O.P. No.2 demanded Rs. 15,000/ towards settlement of claim, but the complainant could able to pay Rs. 5,000/- only.  Since the O.P. No. 2 is absent throughout the proceeding, as such the allegations made against him became unrebuttal and unchallenged to that effect due to non compliance of payment as demanded by the Surveyor, the claim amount approved only for Rs. 28,500/-.  Since the O.P. No.2 did not raise any contradiction, inspite of notice served on him validly, we have no hesitation to disbelieve the version of complainant.

9. Further it is ascertained that due to non settlement of insurance claim, complainant tried his level best to get reliefs and also lodged claim with the IRDA authorities vide no. 06-21-00-6155, but did not get fruitful result. 

10. Considering the above discussions, we are of the opinion that the insurance claim should be settled on the estimated value deducting the costs of plastic, rubber, oil and water related parts.  But without doing so, the O.P. No. 2 & 3 want to play with the complainant very cunningly, which clearly shows the deficiency in service on their part, which compelled the complainant to face mental agony, physical harassment so also financial hardship and also to seek redress before the Commission, which entitled the complainant with appropriate reliefs.  Hence this order.

                                                                                                             ORDER

          The complaint petition is allowed in part. The O.P. No. 3 being the insurer of the alleged vehicle is herewith directed to pay Rs. 2,45,185/- (Rs. 2,52,428/- - Rs.7,243 towards plastic parts) after deducting the appropriate depreciation alongwith to pay compensation of Rs. 20,000/- and Rs. 5,000/- towards costs of litigation to the complainant within 30 days from the date of receipt of this order, failing which, the amount of Rs. 2,45,185/-shall carry interest @ 10% p.a. from the date of insurance claim till payment.  Further the O.P. No.2 is directed to refund Rs.5,000/- with interest @ 10% p.a. from the date of assessment of loss i.e 20.04.2021 till payment.

Since no specific allegations made against the O.P. No. 1, no order against them.

Pronounced the order in the open Forum on this the 8^th day of August, 2022.  Issue free copy to the parties concerned.