State Consumer Disputes Redressal Commission
Future Generali India Insurance ... vs M/S Crystal Infrastructure on 17 January, 2023
STATE CONSUMER DISPUTES REDRESSAL COMMISSION UTTARAKHAND
DEHRADUN
FIRST APPEAL NO. 178 / 2022
1. Future Generali India Insurance Company Limited
NCR Plaza, 3rd Floor, Hathibarkala
Dehradun
2. Future Generali India Insurance Company Limited
6th Floor, Tower - B, Indiabulls Finance Center
Senapati Bapat Marg, Elphinstone Road
Mumbai - 400 013
...... Appellants / Opposite Parties
Versus
M/s Crystal Infrastructure
2-C/487-A, Sunder Vihar, Malhipur Road
Saharanpur - 247 001 and
Office at 53-F, Rajpur Road, Dehradun
through its Partner Sh. Nadeem Akhtar Tyagi
...... Respondent / Complainant
Sh. Deepak Kumar Sati, Learned Counsel for the Appellants
Sh. K.G. Kalra, Learned Counsel for Respondent
Coram: Hon'ble Mr. Justice D.S. Tripathi, President
Mr. Udai Singh Tolia, Member-II
Dated: 17/01/2023
ORDER
(Per: Udai Singh Tolia, Member-II):
This appeal under Section 41 of the Consumer Protection Act, 2019 has been preferred against the impugned judgment and order dated 28.07.2022 passed by the District Consumer Disputes Redressal Commission, Dehradun (in short "The District Commission") in consumer complaint No. 137 of 2016; M/s Crystal Infrastructure Vs. M/s Future Generali India Insurance Company Limited and another, by which the consumer complaint was allowed and the appellants - opposite parties were directed to pay sum of Rs. 97,353/- to the respondent - complainant towards claim amount together with 2 Rs. 25,000/- towards mental agony and Rs. 5,000/- towards costs, within a period of 30 days', failing which the respondent - complainant was further held entitled to interest @9% p.a. on the above amount from the date of institution of the consumer complaint till payment.
2. Facts giving rise to this appeal, in brief, are that according to the consumer complaint, the respondent - complainant is the registered owner of one Caterpillar Backhoe Loader Machine bearing registration No. UK07-BK-3836, which was insured with the appellants - opposite parties (insurance company) for the period from 30.04.2015 to 29.04.2016 at an IDV of Rs. 20,80,500/-. During the course of reconstruction work of Rudraprayag to Gandhar Gadidhar Dasiula Motor Road on 15.09.2015 at 10:00 a.m., all of a sudden, an old dry scupper of road broke out and hit the insured machine, with the result that the machine fell into a deep ditch and got extensively damaged. The intimation of the accident was given to the insurance company. On 16.09.2015, Sh. Ravinder Kumar, complainant's surveyor conducted spot survey and instructed the complainant to take out the machine from ditch for repair purposes. The insurance company appointed Sh. Atul K. Singhal, surveyor / loss assessor for assessment of loss, who telephonically instructed the complainant to submit the claim form along with repair bills as well as relevant papers, which were submitted by the complainant in the first week of March, 2016. The complainant submitted repair bills to the tune of Rs. 4,60,487.94/- with the surveyor of the insurance company, but even after lapse of 1½ month, the claim was not settled by the insurance company. The insurance company is liable to pay sum of Rs. 4,60,487.94/- to the complainant. A notice dated 15.04.2016 was issued to the insurance company, thereby seeking payment of the claim amount, but inspite of notice, neither the claim was settled by 3 the insurance company, nor the same was repudiated, which amounts to deficiency in service. Therefore, the consumer complaint was filed before the District Commission.
3. The appellants - insurance company filed written statement before the District Commission, wherein it was pleaded that on receipt of intimation, they have deputed Innovative Insurance Surveyors & Loss Assessors Pvt. Ltd., surveyor & loss assessor, for assessment of loss, who per their report dated 29.12.2015, assessed the loss of Rs. 97,353/-. Sh. Rakesh Kumar, driver of the vehicle (machine), was not holding a valid and effective driving licence. This apart, inspite of letters dated 17.11.2015; 05.12.2015 and 20.12.2015 issued by the insurance company, the complainant has not submitted claim form duly filled, signed and stamped; valid driving licence of the driver; log book of the machine; repairing bills and NEFT form & cancelled cheque, on account whereof, the claim could not be settled and is still pending. For want of submission of required documents by the complainant, the claim was closed as "Nil Claim" and a letter dated 30.03.2016 in this regard was issued to the complainant. There has not been any deficiency in service on their part.
4. After giving opportunity of hearing to the parties, the consumer complaint has been decided by learned District Commission vide impugned judgment and order dated 28.07.2022, thereby allowing the consumer complaint in the above terms. Feeling aggrieved, the appellants have preferred the instant appeal.
5. We have heard rival arguments advanced by learned counsel for the parties and perused the record.
6. It is admitted fact that the insured vehicle (machine) met with an accident during the validity period of insurance policy. The subject 4 claim was turned down by the insurance company on the ground that the required documents were not submitted by the complainant.
7. So far as validity of driving licence of the driver - Sh. Rakesh Kumar on the date of accident is concerned, copy of training certificate issued by Tractors India Private Limited, Dehradun has been filed (Paper No. 19), whereby it has been certified that Sh. Rakesh Kumar has successfully completed on-site and maintenance program in Rudraprayag under guidance of their trainer Sh. Aslam Khan for the period from 01.10.2011 to 15.10.2011 and he was found efficient to operate CAT Backhoe Loader Machine. It would not be out of place to mention here that the machine insured with the insurance company was Backhoe Loader and the date of accident is 15.09.2015. This apart, the copy of driving licence of the driver on record (Paper No. 16) shows that by way of the same, the licence holder was authorised to drive transport vehicle till 04.03.2016, which falls after the date of accident. Thus, it can safely be inferred that the driver was fully competent to drive the vehicle in question on the date of accident and the said ground taken by the insurance company is not tenable. Hence the finding recorded by learned District Commission on this score, is well reasoned and justified.
8. So far as submission of other documents by the complainant is concerned, the complainant has specifically mentioned in para 6 of the consumer complaint that while submitting the claim form, repair bills and other relevant documents were submitted by the complainant. Even if the repair bills were not submitted by the complainant with the insurance company, the same has got no relevance now, for the reason that the District Commission has awarded claim in consonance with the loss assessed by the surveyor of the insurance company, to which no challenge has been made by learned counsel for the appellants. Since the amount of Rs. 97,353/- has been awarded by the District 5 Commission as per the loss assessed by the surveyor, the same needs no interference.
9. Learned counsel for the appellants submitted that the amount of Rs. 25,000/- awarded by learned District Commission towards mental agony is on the higher side, keeping in view that a sum of Rs. 97,353/- has been allowed to the complainant towards claim. We find force in the said submission. Considering the entire facts and circumstances of this matter, we are of the considered view that the same needs to be reduced to Rs. 15,000/-. The costs of Rs. 5,000/- awarded by the District Commission is perfectly justified.
10. For the foregoing reasons, this appeal succeeds partly and is to be allowed accordingly, thereby modifying the impugned judgment and order passed by the District Commission.
11. Appeal is partly allowed. Impugned judgment and order dated 28.07.2022 passed by the District Commission is modified to the extent that the amount of Rs. 25,000/- awarded by the District Commission towards mental agony, is reduced to Rs. 15,000/-. Rest of the impugned judgment and order passed by the District Commission is confirmed. Costs of the appeal made easy.
12. A copy of this Order be provided to all the parties free of cost as mandated by the Consumer Protection Act, 1986 / 2019. The Order be uploaded forthwith on the website of the Commission for the perusal of the parties.
(U.S. TOLIA) (JUSTICE D.S. TRIPATHI)
Member-II President
K