State Consumer Disputes Redressal Commission
Icici Lombard General Insurance ... vs Regula Ram Prasad, S/O.Late R.Rajaiah, ... on 24 November, 2009
FA
BEFORE THE A.P STATE CONSUMER
DISPUTES REDRESSAL COMMISSION AT HYDERABAD.
FA.No.615/2007 AGAINST C.D.No.233/2005 DISTRICT FORUM, KARIMNAGAR.
Between:
ICICI Lombard
General Insurance Company Limited,
Rep. by its
authorized Signatory, Near Old Bus Stand,
Besides Madhavi
Mass, Sircilla, Post & Mandal,
Sircilla,
Karimnagar District. Appellant/
Opp.party
No.2.
And
1. Regula Ram
Prasad, S/o.late R.Rajaiah
Age 29 years, Occ:Lab Technician,
R/o.H.No.9-4-5, Bhagwantha Rao Nagar
Locality of Vemulawada Village
and Mandal
Karimnagar District. Respondent
No.1/
Complainant
2. ICICI Smart
Money Associates, DSA ICICI
Rep. by its Branch Manager and Authorised
Signatory Near Old Bus Stand, Beside
Madhavi
Mess, Sircilla Post and Medical, Sircilla,
Karimnagar District. Respondent No.2/
Opp.party
No.1
Counsel for the
Appellant: Mr.Katta Laxmi Prasad
Counsel for the Respondents:M/s.V.Gourisankara Rao-R1
QUORUM: THE
HONBLE JUSTICE SRI D.APPA RAO, PRESIDENT,
SMT.M.SHREESHA, MEMBER
& SRI K.SATYANAND, MEMBER TUESDAY, THE TWENTY FOURTH DAY OF NOVEMBER, TWO THOUSAND NINE (Typed to the dictation of Sri K.Satyanand,Honble Member) *** This is an appeal filed by the opposite party against whom the District Forum passed an order granting relief to the complainant.
The facts of the case are briefly as follows:
The complainant purchased a Maruthi zen car bearing registration AP 23 G 2828 by availing loan under hire purchase agreement and hypothecation with GMAC-TCFC Finance Limited, Hyderabad. The complainant insured the said vehicle with the opposite parties for the period from 5-8-2005 to 22-5-2006. On 12-8-2005, the complainants friend by name Uyyala Bhooma Goud took the said vehicle and went to Dharmapuri along with the driver to attend to his personal work.
After completing his work, he was proceeding to Vemulavada. as the car reached Chinnapur village bus stage at about 11.30 p.m. the driver of the car had driven at a high speed and while it was running, he tried to avert hitting a forest pig by turning the car towards right side. But he lost control over the vehicle and it dashed against the culvert, turned turtle and fell into the pit beside the culvert. It seems the car was completely damaged while the driver of the car sustained grevious injuries, Bhoomaiah received simple injuries.
On the next day, the complainant claimed to have informed about the accident to the opposite parties who thereupon appointed a surveyor. The surveyor visited the accident spot, took photographs to estimate the loss due to the damage that occurred to the vehicle. It seems a panchanama was conducted and a crime was also registered, the car was shifted to car club, Maruti Care Centre, Kothirampur, Karimnagar.
The complainant obtained quotation for estimation of damages from the car club proprietor and the damages were assessed to a tune of Rs.3,59,579/-. The engine damage was separately assessed at Rs.40,000/-, so the complainant claimed to have sent a claim form to the opposite parties enclosing FIR, Panchanama etc. claiming the insurance amount. The opposite party No.2 finally sent a letter dated 20-10-2005 repudiating the claim stating that the accident itself was not proved and some other frivolous grounds. Challenging the repudiation, characterizing it as clear deficiency in service, the complainant filed the consumer complaint in question.
The opposite party No.2 filed a counter which was adopted by opposite party No.1. It is mainly the case of the opposite parties that the complainant was a petty professional, lab technician and in fact he had no capacity to maintain a car and obviously he acquired the car to give it on hire and the said Bhooma Goud was merely the hirer of the said vehicle and this hiring definitely was violative of the policy conditions. They also urged that the damage was very marginal and the claim came to be exaggerated in order to get unjust gain. They also commented upon the conduct of the complainant for his failure to take the car to the authorized workshop of Maruthi company and on the other hand taking it to some private workshop and they also relied upon the estimated arrived at by the surveyor and contended that the damage would not cost him more than Rs.1,26,761/-. They further contended that they would have readily given that amount but for the basic violation of the policy conditions, namely the hiring of the vehicle contrary to the policy conditions. Thus they stoutly resisted the claim both on the ground of violation of the policy conditions as also on the ground of exaggeration of the claim calculated to get unlawful gain.
In support of his case, the complainant filed his own affidavit and got marked Exs.A1 to A17. The opposite party No.2 filed affidavit and also relied upon Ex.B1, the surveyors report.
On a consideration of the evidence adduced on either side, the District Forum came to the firm conclusion that the theory of hiring of vehicle was not established and also repelled the contention that the damage was slight and in conformity thereof, the District Forum granted substantial relief to the complainant.
Aggrieved by the said order, the opposite party No.2 preferred the present appeal urging quite a good number of grounds which are highly repetitive. It is mainly urged that there was no proof of accident cutting at the very root of the claim.
The jurisdiction of the District Forum was questioned in general terms. The expenditure for the repairs claimed to have been effected is not proved by any record. The Forum below failed to note and appreciate that the survey report had only given the correct estimate. The claim was exaggerated and unsubstantiated. The quantification of the relief failed to take into consideration the salvage deduction etc., The Forum failed to see that there was delay in giving the FIR rendering the very accident suspicious. The relief granted was on the high side. The Forum failed to see that the documents were fabricated.
Heard both sides.
The point that arises for consideration is whether the order of the District Forum suffers from any infirmities and calls for interference by this Commission?
The letter of repudiation is marked as Ex.A17. As could be seen from Ex.A17, it is totally devoid of any reasons justifying the repudiation. The said letter in so far as it is relevant to this discussion reads as follows:
This has been with reference to the insurance claim registered on 12-8-05 in our Mumbai office.
During the claim appraisal process, while verifying the documents produced by you, we concluded that, the facts produced by you regarding the accident are not true.
Hence we are regret to inform you that we will be unable to process the claim and we would be treating this claim as No claim and ICICI Lombard General Insurance Co.
Ltd., shall not have any liability in respect of the captioned matter.
Naturally the repudiation letter ought to have been a reasoned order as obviously it affects the insured adversely. It simply dismissed the claim on the ground that the very accident was false. But this finding of the appellant in its repudiation letter came to be negatived by their own version in their counter wherein they changed the theme by saying that the damage was slight without thereby assailing the factum of accident. Even otherwise, the factum of accident is abundantly proved by several public documents as FIR, marked as Ex.A2 and other documents. No doubt while the accident was on 12-8-2005, the FIR came to be registered on 20-8-2005. But this by itself cannot be a circumstance of suspicion enuring for the benefit of the opposite party, appellant as there is subsequent record emanating from the police which in fact conducted investigation and also filed a charge sheet. So it is nave to contend that there was no accident at all. Even otherwise, the appellants themselves ate their own words by changing the version that the damage in the accident was merely marginal which amounts to admitting the factum of accident by implication. As a matter of fact, the insurance company did appoint a surveyor and that surveyor had filed report, Ex.B1. There is absolutely no whisper in the said survey report casting any dobut on the occurrence of the accident. Thus the only ground that prompted the appellants to repudiate the claim is established to be wrong. No doubt the appellants have taken several other grounds subsequently in the counter and much more as it came to drafting the memorandum of grounds. Strictly speaking the absence of all these grounds in the repudiation letter, which in itself is unjustifiably bald, is proof positive that all these improvised grounds were mere after thoughts. The mass of evidence including the photographs clearly give an idea as to the extent of damage to the vehicle. The appellants laid much emphasis on one of the new grounds which did not find a place in the repudiation, to the effect that the car was given to the person who had used it only by way of hire and this kind of loaning the car for gain is violative of terms and conditions.
But this line of argument suffers from the vice of double presumption. Even according to the appellants and the surveyor, it was only their suspicion.
They tried to substantiate it by adverting to the fact that the owner was a mere technician and he had purchased the car basically to make money by hiring it. All these ideas are mere conjectures without any proof. The courts cannot take cognizance of such sweeping allegations without proof. The next ground that they harped upon is that the claim was exaggerated. For that again, the appellants placed reliance upon the surveyors report. There is absolutely no warrant for holding that the surveyors report is entitled to a grater credibility than what the other evidence tendered by the complainant as the bills etc., which are duly marked as exhibits.
So even the plea, of the claim being on the high side cannot be readily accepted as being charged with a grater probative value. The District Forum has gone into all these aspects and given cogent reasons for its findings and in any view of the matter, the appellants did not show any independent proof to reduce the quantum of relief. For every thing they relied upon only the surveyors report and such approach cannot be accepted in the adjudication. For these reasons stated above and for the reasons well articulated by the District Forum, we are of the opinion that there are no merits in the appeal.
Accordingly the appeal is dismissed but without costs in the circumstances of the case.
Sd/-PRESIDENT.
Sd/-MEMBER.
Sd/-MEMBER JM Dt.24-11-2009