IN THE CONSUMER DISPUTES REDRESSAL COMMISSION, ALAPPUZHA
Friday the 06th day of May 2022.
Filed on 07.12.2020
Present
1. Sri.S.Santhosh Kumar BSc.,LL.B (President )
2. Smt. Lekhamma C K, B.A., LLB (Member) In
CC/No.318/20
between
Complainant:- Opposite parties:-
1. Sri Pradeep V, 1) Reliance General Insurance Company Ltd.,
Elampadathu Padeettathil, Reliance Centre, South Wing, 4th Floor,
Peringala P.O., Western Express Highway Santa Cruz (E),
Kayamkulam, Mumbai-400055.
Alappuzha - 690559 2) The Branch Manager,
(Adv. Prasanth S Pillai & Reliance General Insurance Co. Ltd.,
Adv. Sheeja T A) 1st & 2nd Floor Vishnu Building,
K P Vallon Road, Kadavantra,
Cochin-682020.
(Rep.Op 1 & 2 by Adv.C Muraleedharan)
O R D E R
SRI. S.SANTHOSH KUMAR (PRESIDENT)
Complaint filed under Sec.35 of the Consumer Protection Act, 2019.
1. Material averments briefly discussed are as follows:-
Complainant availed a reliance private car package policy to his car bearing Reg. No.KL 29 M 3744 on 14.03.2019. The policy is valid from 16.03.19 to 15.03.2020 and an amount of Rs.11,923/- was paid as premium.
2. On 13.03.2020 the vehicle met with an accident at Thengana Junction on Changanachery / Vazhur road. The vehicle lost its control and hit the divider and after that hit a tipper lorry which was parked on the side of the road. Due to the impact of the forcible hit the front bumper, bonnet, radiator, grill, head lights were damaged and wind glass were broken, right wheel axle had separated from the car and the right two doors and running board were bent inside. The air bags were busted, the dash board was broken and the doors could not open. Thrikodithanam Police entered the matter as G.D entry No.004 dated 13.03.2020.
3. On the same day the matter was informed to the Reliance General Insurance Company Ltd., Kayamkulam branch and it was assured that action will be taken soon. Due to pandemic situation of Covid 19 and lock down the vehicle could not be taken from the spot of the accident. After 64 days survey was done upon the vehicle. The vehicle was totally damaged. Till the survey was completed the vehicle was at the spot of the accident. Due to the pandemic situation of covid 19 and lock down complainant could not follow up the procedure of the company as the complaint has already intimated the matter to the opposite party’s branch office at Kayamkulam. Complainant could produce all the documents before the authority only on 15.05.2020. All the documents demanded by the opposite party were produced.
4. On 21.10.2020 complainant received a letter stating that the claim is dismissed due to the condition No.1 of the policy ie, accident was not informed to the company immediately. Opposite party rejected the complainant’s claim without any bonafides and without considering the pandemic situation. The policy was a bumper to bumper nil depreciation policy and the vehicle was totally damaged. The IDV value of the vehicle was Rs.3,36,205/-. Complainant is entitled to get Rs.3,36,205/-from the opposite parties as the vehicle was totally damaged. Hence the complaint is filed for realizing an amount of Rs.3,36,205/- along with interest and for a compensation of Rs.1 lakh along with cost of Rs.5,000/-.
5. Opposite parties filed a joint version mainly contenting as follows:-
The complaint is not maintainable either in law or on facts. There is no deficiency of service on the part of this opposite parties. Complainant availed a private car package policy for his vehicle from 16.03.2019 to 15.03.2020. A claim for damages sustained to the vehicle was submitted on 15.05.2020. On verification it was noticed that alleged damage was sustained on 13.03.2020 and intimation was given after a period of 64 days. As per condition No.1 intimation is to be given immediately upon the occurrence of an accidental loss or damage. Even then opposite party had sent a letter on 14.10.2020 seeking clarification of the delay but no reply was received. The delay in submitting the claim is a breach of a policy condition No.1 and hence the opposite parties repudiated the claim. Company acted fairly, reasonably and justifiably and hence there is not deficiency of service. The averment that the claim was intimated on the date of accident is absolutely false. There is total loss is also false. Complainant submitted estimate along with claim form on 15.05.2020 for repair cost of Rs.69,360/-. This amount is also not payable. Surveyor could not be deputed and assess the loss due to the latches on the part of the complainant. Since there is no deficiency of service the complaint may be dismissed with compensatory cost.
6. On the above pleadings following points were raised for consideration:-
- Whether there is any deficiency of service from the part of opposite parties as alleged?
- Whether there is a delay in intimating the accident whereby there is breach of condition No.1?
- Whether the complainant is entitled to realise an amount of Rs.3,36,205/- along with interest as prayed for
- Whether the complainant is entitled to realise an amount of Rs.1 lakh as compensation?
- Reliefs and cost?
7. Evidence in this case consists of the oral evidence of PW1 & PW2 and Exts.A1 to A6 (a) from the side of the complainant and the oral evidence of RW1 and Ext.B1 to B3 from the side of opposite parties.
8. Point No.1 to 4
PW1 is the complainant in this case. He filed an affidavit in tune with the complaint and marked Ext.A1 to A5.
PW2 is the supervisor of M/s.Car Tech All Service Centre, Kayamkulam. He had inspected the vehicle and prepared an estimate. It is marked as Ext.A6.
RW1 is the Manager of the 1st opposite party. He filed an affidavit in tune with the version and marked Ext.B1 to B3. During cross examination Ext.A6 was marked.
9. PW1, the complainant is the owner of motor car bearing registration No. KL.29-M-3744. PW1 had availed an insurance policy from the opposite parties for a period of one year from 16/3/2019 to 15/3/2020 and an amount of Rs.11,923/- was paid was premium. On 13/3/2020 the vehicle lost control at Thengana Junction in Changanasery – Vazhur Road, hit on a divider and thereafter hit on a tipper lorry and sustained heavy damage. The matter was informed at Thrikodithanam Police station and a GD entry was made. Accident was informed at the Kayamkulam branch of the opposite parties. A claim petition was filed before the opposite parties claiming total damage. However on 21/10/2020 the claim was repudiated on a contention that as per condition No.1 of the policy notice shall be given in writing to the company immediately upon the occurrence of any accident. Aggrieved by the repudiation the complaint is filed for realizing an amount of Rs. 3,36,205/- being the IDV of the vehicle along with interest. Complainant is also seeking an amount of Rs.1 lakh as compensation for deficiency of service along with cost of Rs.5,000/-. Opposite parties filed a joint version admitting the policy. According to them though the vehicle sustained damage on 13/3/2020 only after a period of 64 days it was informed to the opposite parties. Though on 14/10/2020 a letter was sent to the complainant seeking clarification of the delay there was no reply. Since the matter was not informed in time, opposite parties could not appoint a surveyor to assess the damage. It was also contended that in the claim form filed on 15/5/2020 the repair cost is shown as 69,360/- and so the claim of Rs. 3,36,205/- as IDV value is unsustainable. The claim was repudiated since there was violation of condition No.1 which states that immediately upon the accident it is to be informed to the company in writing. Since there is no deficiency of service on the part of opposite parties and the repudiation is justified the complaint is only to be dismissed. Complainant got examined as PW1 and marked Ex.tA1 to A5. From the side of the complainant, the supervisor of M/s Car Tech All Car Srvice was examined as PW2 and Ext.A6 was marked. The legal claims manager of the 1st opposite party was examined as RW1 and Ext.B1 to B3 were marked. It is noticed that on 16/2/2022 RW1 was examined and during his cross examination Ext.A6 was marked. Thereafter the evidence was re-opened and PW2 was examined on 25/3/2022. During his chief examination again a document was marked as Ext.A6 without noticing the marking of Ext.A6 earlier through RW1. Hence the document marked through PW2 is considered as Ext.A6 (a).
10. The fact that PW1 is the owner of the car and that it has got a valid insurance at the time of accident is not in dispute. It is also proved by Ext.A1(Ext.B1) the copy of policy which is valid from 16/3/2019 to 15/3/2020. It is seen that an amount of Rs. 11,923/- was collected as premium. Though PW1 contented that it was a bumper to bumper policy from Ext.A1 it is seen that it is a Reliance Private car package policy. The fact that the vehicle met with an accident is also proved by the oral evidence of PW1 coupled with Ext.A2 abstract of general diary. Ext.A2 is the abstract of GD entry No. 004 dtd. 13/3/2020 of Thrikodithanam Police station. Ext.A2 shows that on 13/3/2020 during day time micro car bearing Reg. No. KL-29-M-3744 hit on the divider and there after hit on a tipper lorry which was parked in the road. Ext.A2 also shows that the vehicle sustained heavy damage during the accident. Since there was no casualty crime was not registered.
11. Now the question to be considered is whether PW1 was prevented from filing a claim petition before the opposite parties immediately after the incident. Claim was repudiated as per Ext.A5 repudiation letter on a contention that claim form was filed after 64 days of the accident ie, on 15/5/2020.
Condition No.1 reads as follows:- “Notice shall be given in writing to the company immediately upon the occurrence of any accidental loss or damage in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require.”
12. So according to the opposite parties though the accident occurred on 13/3/2020 claim petition was filed only on 15/5/2020 ie, after 64 days of the accident. Ext.A4 is the claim form produced by the complainant. The same document is seen produced by the opposite party and marked as Ext. B2. Ext.A4 and Ext.B2 are photo copies and both documents are not readable. According to PW1 due to the spread of Covid -19 pandemic he could not file the claim form immediately after the incident. Though PW1 contented that on the date of accident itself ie, on 13/3/2020 the matter was informed to the branch office Kayamkulam, from where Ext.A1 policy was issued there is no evidence to prove the same. According to opposite parties Ext.B2 motor claim form was filed only on 15/5/2020 ie, with a delay of 64 days. Admittedly on 24/3/2020 there was a nationwide lockdown on account of spread of Covid -19 pandemic and so there was restriction for movement of persons and most of the offices were kept closed. As discussed earlier Ext.A2 copy of abstract of general diary of Thrikkodithanam Police station shows that accident occurred on 13/3/2020 and there was extensive damage to the motor car. The nationwide lockdown was declared on 24/3/2020 and there was only 11 days in between 13/3/2020 and 24/3/2020. So PW1 was prevented from informing the matter or filing a claim form before the opposite parties in time. It is true that as per the terms and conditions of the policy the matter has to be informed immediately to the opposite party insurance company. In said circumstances we are of the opinion that the delay of 11 days can be condoned.
13. The next question to be considered is regarding the amount claimed as damages. According to PW1 there was total damage to the vehicle and so he is entitled for Rs.3,36,205/- being the total IDV shown in Ext.A1 policy. Per contra according to opposite parties since the matter was not informed to them in time they could not even appoint a surveyor to assess the damage. During cross examination PW1 stated that one Eby Kurian who was deputed by the opposite party had inspected the vehicle and prepared a survey report. However it was denied by the opposite party and they had not deputed any surveyor. Though PW1 had to a definite case that surveyor Eby Kurian had inspected the vehicle no survey report is seen produced. The said Eby Kurian was also not examined as a witness for the best reason known to the complainant. On the other hand complainant had examined PW2 who is the supervisor attached to M/s Car Tech all car service, Kayamkulam. According to PW2 he had inspected the vehicle assessed the damage and prepared Ext.A6(a) estimate. According to him the estimate was prepared as total loss of the vehicle. Ext.A6(a) is dtd. 15/5/2020. However Ext.A6(a) does not contain signature of PW2 in any of the pages. RW1 produced Ext.B2(a). It is also seen prepared by PW2. Ext.B2 a contains signature of PW2. The total amount shown in Ext.B2(a) is Rs. 69,360/-. It is noticed that the 4th page of Ext.A6(a) is similar to Ext.B2(a). The amount and the spare parts shown in both are one and the same. In Ext.B2(a) the registration number of the vehicle date and it also contains the signature of PW2. Since Ext.A6(a) is not having any signature of the person who prepared the same, the genuiness of the same is doubtful. On the other hand Ext.B2(a) contains signature of Pw2 and the total amount is shown as Rs.69,360/-. In the version filed by opposite parties it is stated that in the estimate submitted along with the claim form on 15/5/2020 the repair cost is noted as Rs.69,360/- which is the amount shown in Ext.B2(a). Since Ext.A6(a) cannot be relied upon and there is no acceptable evidence to show that the vehicle had a total loss, the claim of Rs. 3,36,205/- being the IDV cannot be allowed. As pointed out by the learned counsel appearing for the opposite parties since the claim form was not submitted in time, opposite parties could not appoint a surveyor to assess the damage. Even though it was contented by the complainant that even now also the vehicle is lying at the workshop unrepaired, there is no acceptable evidence regarding the condition of the vehicle. In said circumstances according to us the amount shown in Ext.B2 (a) which is proved by PW2 can be accepted and the amount shown in the same can be allowed.
It was held by the Hon’ble Supreme Court in Om parakash Vs. Reliance General Insurance on 4/10/2017 in Civil Appeal No. 15611 of 2017.
“Rejection of the claim on purely technical grounds in a mechanical manner will result in loss of confidence of policy – holders in the insurance industry. It needs no emphasis that the Consumer Protection Act aims at providing better protection of the interest of consumers. It is a beneficial legislation that deserves liberal construction. This laudable object should not be forgotten while considering the claims made under the Act.”
14. Though PW1 is claiming an amount of Rs. 1 lakh as compensation. It can be seen that the insurance amount was not paid by the opposite parties since there was violation of condition No.1. As discussed earlier as per condition No.1 accident is to be informed immediately where as in this case it was informed only on 15/5/2020 ie, after a period of 64 days. It is true that there was lockdown due to covid -19 pandemic, but the accident occurred on 13/3/2020 and the lockdown was declared only on 24/3/2020. Though PW1 has got a case that the matter was informed at the Kayamkulam office from where the policy was issued there is no acceptable evidence for the same. In said circumstances complainant is not entitled for compensation. These points are found accordingly.
15.Point No.5
In the result complaint is allowed in part.
A) Complainant is allowed to realize an amount of Rs.69,360/- which is shown in
Ext.B2(a) along with interest @ of 9% per annum from the date of complaint ie, on 7/12/2020 till realization from the opposite parties.
B) Complainant is allowed to realize an amount of Rs.2000/- as cost.
The order shall be complied within one month from the date of receipt of this order
Dictated to the Confidential Assistant, transcribed by him corrected by me and pronounced in open Commission on this the 6th day of May, 2022.
Sd/-Sri.S.SanthoshKumar(President)
Sd/-Smt.C.K.Lekhamma (Member)
Appendix:-
Evidence of the complainant:-
PW1 - Pradeep V (complainant)
PW2 - Rahul Raj (witness)
Ext.A1 - Copy of Insurance policy dated 14.3.19
Ext.A2 - Copy of General diary abstract dated 13.3.20
Ext.A3 - Copy of Registration Certificate
Ext.A4 - Copy of Motor Claim Form
Ext.A5 - Letter dated 21.10.2020
Ext.A6 - Letter dtd12.8.2020 from Reliance General Insurance Co.Ltd
Ext.A6(a) - copy of estimate
Evidence of the opposite parties:-
RW1 - Arun Chandre (witness)
Ext.B1 - Policy with condition
Ext.B2 - Copy of Motor Claim Form
Ext.B2(a) - Copy of Estimate
Ext.B3 - Letter dttd 21.10.2020
///True Copy ///
To
Complainant/Oppo. party/S.F.
By Order
Assistant Registrar
Typed by:-Br/-
Compared by:-
