State Consumer Disputes Redressal Commission
Bajaj Allianz Gen Ins Co Ltd vs Yogeshbhai L Pujara on 15 February, 2023
Details DD MM YY
Date of disposal 15 02 2023
Date of filing 21 12 2018
Duration 25 01 04
BEFORE THE CONSUMER DISPUTES REDRESSAL COMMISSION
GUJARAT STATEAHMEDABAD
COURT N0:03
APPEALNO.375 of 2019
1. Bajaj Allianz General Insurance Co. Ltd.
Prasham Building, 6th Floor
Rajkot.
Represented through its Legal Hub at
4th Floor, Turquoise,
Panchvati Cross Roads, C G Road,
Ahmedabad-380009
2. Bajaj Allianz General Insurance Co. Ltd.
4th Floor, Tercois, Near Panchavati Circle,
C. G. Road, Ellisbridge
Ahmedabad-380009. Appellant.
V.s
Yogeshbhai Laxmidasbhai Pujara
Resi: "Guruhome"
2- Kotechanagar
Rajkot. ..Respondent.
BEFORE: Mr. I. D. Patel, Judicial Member
APPERANCE: Mr. D. M. Soni L.A. for the appellant,
Respondent Served Absent.
ORDER BY Mr.J.D.PATEL JUDICIAL MEMBER.
JUDGMENT
1. Appellants Bajaj General Insurance Co. Ltd. has filled this appeal under Section 15 of the Consumer Protection Act 1986. Being aggrieved and dissatisfied with the judgment and order dated 07.08.2018 rendered by Ld. Consumer Disputes Redressal Forum, Rajkot (Main), in Consumer K.Navlakha A/19/375 Page 1 of 10 Complaint No. 14/179 on the ground stated in the appeal memo. The appellants are the original opponents where as the respontent is the original complainant in this appeal. Hence for the sake of the convenience, parties are hereinafter referred to by their original nomenclature/status.
2. Briet tacts of the complaint that the complainant is owner of the BMW Car bearing registration No. GJ-03-CR-8194 and has purchased private for the car package policy bearing No OG-14-2202-180100010338 said BMW car from the period from 03.06.2013 to 02.06.2014 for the Rs.27,287/- During opponent No. 2 and paid premium to the tune of due to 26.09.2013 at 8:30am.
existence of the said insurance policy, on wk at in the Raiya Circle Ch heavy rain, the water was accumulated hat was waiting for clearance of tratlic at Rajkot and the complainant side of BMW car of the complainant time a Dumper passed at opposite in the engine of accumulated on the road was entered and the water was stopped running and BMW c a r was also complainant's car, the engine case of complainant that the complainant tried stopped.It is further, the to three times, but it could not start. The start c a r two BMW to his residence by toeing and then after, the c a r at complainant took BMW Ahmedabad by way Parsoli Motor Works Pvt. Ltd., BMW car was sent to informed about the said fact by of toeing. The complainant immediately Claim to the opponent insurance company. submitting Motor Insurance the case of complainant that as per Sub Clause-V of That it is further caused due and conditions of the policy the damage Section-1 of terms to be granted in favour of the insured (complainant).
to flood is required over for repairing to Parsoli Motor Works Pvt.
After BMW car handed on 27.11.2013 and total expenses for Ltd., Ahmedabad, it was repaired The complainant informed repairing was to the tune of Rs.3,84,487/-.
and
the office of opponent at Rajkot personally
about said expenses to
but there was no response from the opponent
on phone frequently,
Page 2 of 10
A/19/3755
K.Navlakha
insurance company. The said amount was paid by the complainant on 06.12.2013 and has obtained receipt thereof. The opponent insurance company vide its letter dated 02.01.2014 and 08.01.2014 called for some explanations from the complainant and informed the complainant to comply with the queries within 7 days and also asked the should not De complainant as to why claim of the complainant the letter dated repudiated. It is further, the case of complainant that 08.01.2014 02.01.2014 was received on 10.01.2014 and letter dated complainant was received on 13.01.2014 by the complainant. The the opponent No. 2 vide submitted joint reply of both the letters to R.P.A.D. letter dated 16.01.2014. Then after, the opponent No. 2 wrote a which was received by the letter dated 24.02.2014 to the complainant, said letter it was stated by the complainant on 09.03.2014, in the to the c a r and claim of the no external impact opponents that there w a s the basis of letter dated been repudiated on complainant has In the said 08.01.2014 written by the opponents to the complainant.
that there was no external impact letter main c a u s e of repudiation was the surveyor as well as from the to the vehicle as confirmed by the complainant that the surveyor. It is not say of photographs taken by water and it is not say of the complainant that the c a r w a s drown in the external impact, but it was clarified that the BMW car was damaged by of water in the engine of BMW car, the engine due to accumulation has file the c a r was stoPped. Hence complainant stopped running and claimed relief a s the District Forum, Rajkot, and the complaint besore per para 18 of the complaint.
issued against the opponents, the opponents filed
3. In response to notice Exhibit-13 and inter-alia contended that it is not in written statement at insurance company has issued Private Car dispute that the opponent No. GJ-03-CR-
of the complainant for BMW Car Package Policy in favour and to 02/06/2014 a s per terms 8194 for the period from 03/06/2013 Page 3 of 10 K.Navlakha A/19/375 conditions of the policy. In the present case, after receiving claim submitted by the complainant, the claim was processed and after due consideration of documents and survey report of IRDA licensed Surveyor SAP Surveyors Pvt. Ltd, it was found that the loss of the subject vehicle was not covered under the policy. Therefore, after considering technical opinion of IRDA licensed Surveyor SAP Surveyors Pvt. Ltd. and coverage granted under the policy, it was found that the claim was not payable and therefore, in good faith claim was repudiated. The opponents have relied upon Section - 1: Loss of Damage to the Vehicle Insured - as per said Section, the Company will indemnify the Insured against loss or damage to the Motor Car insured hereunder and /or its accessories whilst thereon -(e) By flood, Typhoon, Hurricane, Storm, Tempest, Inundation, Cyclone, Hailstorm Frost and (1) By accidental external means. The opponent insurance company has relied upon the condition No. 4 of the policy and the damage caused to the complainant does not fall under the ambit and scope of insurance policy terms and conditions and hence, can only be attributed to a mechanical failure/consequential loss due to the following reasons:
1. There is no external impact to the vehicle as confirmed by the surveyor as well as from the photographs taken by the surveyor.
2. There is no sign of vehicle fully or partially submerged in water.
Repeated attempts were made to start ht engine which was already in damaged conditions. There was no sign of vehicle fully or partially submerged in water. It was also noted that there was no scope for water being sucked by a running engine in running vehicle. This is not the case of damage to the vehicle by flood. The complainant has failed in his duty to take care expected from him while driving the vehicle. It is further submitted that, the damage to the internal components is solely attributable to the failure on the of the complainant and there is no deficiency in service rendered by the K.Navlakha A/19/375 Page 4 of 10 oPponents and the opponents prayed to dismiss the complaint with cost.
4. That at the time of final hearing of this appeal Ld. Advocate of the appellant Insurance Company Mr. D. M. Soni, has not remain present and though the notice of the appeal duly served upon the respondent original complainant respondent has also not appeared in this matter.
That it is also pertaining to note that herein this appeal neither of the parties that is appellants as well as respondent have produced any evidence or oral evidence/affidavits of the parties documentary produced before the Ld. Consumer Disputes Redressal Forum, Rajkot be decided (Main), in this appeal. Therefore, this appeal is require to well as only on the basis of the appeal memo of the appellant as impugned judgment and order of the Consumer Complaint No. 179/14.
5. That the appellants have stated various grounds in the appeal memo vide mark A to mark F as mentioned on page 3 and 4 thereby, appellant Insurance Company question the impugned judgment and order passed That the by the Ld. Consumer Disputes Redressal Forum, Rajkot (Main). main ground raised by the appellant Insurance Company is that though the report of the surveyor is produced by the Insurance Company and affidavit of the surveyor Ajay Premnath Sharma is also produced by the Insurance Company before the Ld. Forum. Ld. Forum, has not given due weightage to the survey report of SAP surveyors Pvt. Ltd. and affidavit of surveyor Ajay Premnath Sharma which is against the settled principal of law. That the appellant Insurance Company has also raise the contention in the appeal memo. Against the impugned judgment and order of the Ld. District Forum, that Ld. District Forum failed to accept specific defence of the appellant Insurance Company that there was no external impact to the vehicle as confirmed by the surveyor as well as from the photographs taken by the surveyor and there is no sign of K.Navlakha A/ 19/375 Page 5 of 10 vehicle fully or partially submerged in water as well as water being sucked by the running engine in a running vehicle is ruled out arnd water is not combustible, hence, engine cannot run on water even 1or a iraction of second to compress water to cause hydrostatic lock contrary has also to the claim made. That the appellant Insurance Company in Forum, erred stated in the ground of appeal memo that the Ld. covered under the Poliey presuming that the alleged damage was failed that the respondent Wordings and Ld. Forum, erred to appreciate covered under the that the damage w a s to discharge his onus proving Insurance terms and how the action of the repudiation of the Policy service also failed to examine the Company was wrong and respondent the appellants engineer who repaired the alleged damage to disprove decision a s well a s evidence.
Consumer
passed by the Ld.
6. That looking to the impugned judgment
Complaint No. 179/14 it
Consumer
Redressal Forum, in
Disputes Insurance Policy of his
had taken Car
that the complainant
appears
GJ-03-CR-8194 from the appellant
No.
BMW Car bearing registration
from 03.06.2003
Co. Ltd. for the period
General Insurance
Bajaj Allianz between the parties.
It
is not disputed
and the said fact
to 02.06.2014 and order that a s
on
judgment
from the impugned
also further, appears the water was
due to heavy rain,
8.30am.
at about
26.09.2013 the
and the water from
the Raiya Circle
Chowk, Rajkot,
accumulated in because
cars
the complainant
a r e a entered
in the engine of
surrounding not start
and it could
of the car stop running
of that the engine residence by toeing and
took the BMW Car at his
therefore, complainant Works Pvt. Ltd.
sent to Parsoli Motor
Car w a s
thereafter, BMW it is a c a s e of the
of toeing for repairing and
Ahmedabad, by way Motor Works Pvt.
w a s repaired
at Parsoli
the said c a r
complainant that was a
expenses of repairing
2 7 . 1 1 . 2 0 1 3 and total
on
Ltd. Ahmedabad,
the complainant.
tune of Rs.
3,84,487/- paid by
Page 6 of 10
A/19/375
K.Navlakha
7That in this case after ldging the claim for the reimbursement of the
O ol repairing with the Insuranee Company by the complainant,
haurane Conmpany repudiated the claim of the complainant on the
rOUnd vile letter daled O4.01.2014 and vide letter dated 03.03.2014 hat "there was no external impaot to the vehlole as conflrmed by the surveyor a well as from the photographs taken by the urveyor. And there ls no slgn of vehlole fully or partially submerged in water." "Therefore, the complainant filled the complaint before the lat. Conumer Disputen Redressal Forum, Rujkot (Mainj, Against the appellunt Insurance Company that looking to the impugned Consumer judgment of the Consumer Complaint No. 179/14 of the Ld. the Disputes Redresal Porum, it also appeared that before the Forum, have filed various complainant a s well as opponent Insurunce Company documents a s well a s aflidavit of the complainant and the surveyor on of the Ld. Forum, it perusal of the s a m e from the impugned judgrment retail invoice for repuiring of car issued by the appeurs thut a s per the Ltd. Ahmedabad, on the name of the Parsoli Motor Works Pvt.
mentioned that engine could not complainant in which it is categorically Rs. 3,83,289/- for repairing. That the start and complainunt has paid Lukshmidus Pujara, has file an affidavit in complainant Yogeshbhai stated in the complaint and on the which he has reiterated the facts the Insurance Company report of the other side that is on the part of and affidavit of surveyor namely SAP Surveyors Pvt. Ltd. Ahmedabad, Prenmnath Shrma were produced before the Forum, but in surveyor Ajay the survey report it is not mentioned that Ajay Premnath Shrma is and as per the pursis holding degree of Auto Mobile Engineering merits certificate and original produced by the Insurance Company certificate on the name of surveyor Ajay Premnath Shrma issued by Technical Examination Board, Gujarat State, were show that Ajay Premnath Shrma has pass Auto Mobile Engineering at first rank from Puge 7 of 10 K.Navlakha A/19/375 Ahmedabad in the year 19987 but in the affidavit Exh. 29 surveyor Ajay Premnath Shrma has not mention the said fact regarding his degree of Auto Mobile Engineering. That as per the decision of the Hon'ble National Commission reported in 2017(0) AlJ-Co4024509 (Tata Aig General Insurance Company Ltd. Vs. Sandesh J. Choutha) in the aftidavit of the surveyor, surveyor has to mention his qualification and experience to give opinion regarding the cause for seizure of the engine of the subject car and in this case also surveyor Ajay Premnath Shrma ot mention that he has adequate knowledge and experience to give opinion for the cause of seizure of the engine of the subject car and Insurance Company has not file any opinion/report from the manufacture of the car of Auto Mobile Engineer or from the work shop where the vehicle was repaired and it is the case of the complainant that at the relevant point of time the vehicle was submerged in the rain water and due to accumulation water in the engine the engine of the vehicle could not start therefore, naturally there was no external impact to the BMW Car.
8. Therefore, the question of no external impact to the car raised by the opponent Insurance Company for repudiation of claim of the complainant is not tenable in eye of law. Therefore, according to my considered opinion the reasons and finding recorded by the Ld. Consumer Disputes Redressal Forum, Rajkot (Main), are just and proper and there is no reason to disbelieve in the impugned judgment and order the same in absence of any documentary evidence produced by the Insurance Company before this appeal. Therefore, in view of the detailed discussion made herein above and in the view of the findings recorded by the Ld. Consumer Disputes Redressal Forum, Rajkot (Main), partly allowing the complaint of the complainant. there is no any reason to disbelieve the said findings of the Consumer Forum, and accordingly the impugned judgment and order passed by the Ld. K.Navlakha A/19/3755 Page 8 of 10 Consumer Disputes Redressal Forum, cannot be said to be erroneous and against the settle principal of law. Hence, impugned judgment and order passed by the Ld. Consumer Disputes Redressal Forum, Rajkot (Main), in Consumer Complaint No. 179/2014 dated 07.08.2018 requires to be confirmed in this appeal also and merit in the accordingly there is no appeal filled by the Insurance Company hence, I passed the following final order.
ORDER The present appeal No. 375/19 filled by the appellant Bajaj Allianz General Insurance Company Limited is hereby dismissed.
2. Impugned judgment and order passed by the Ld. Consumer Disputes Redressal Forum, Rajkot (Main), in Consumer Complaint No. 179/14 dated 07.08.2018 is hereby confirmed.
3. No order as to costs.
4 Appellant is directed to apply to the Account Department of the State Commission with all details of Appeal No. 19/375, Xerox copy of the receipt to withdraw the amount deposited in the State Commission. The office is hereby ordered to pay deposited amount with accrued interest on proper verification to the appellant by Account payee cheque and the cheque be handed over to the learned advocate for the appellant after obtaining receipt.
5. Registry is hereby instructed to send a copy of this order in PDF format by E-mail to learned District Forum, Rajkot (Main), for taking necessary action.
K.Navlakha A/ 19/375 Page 9 of 10Office is directed to forward a free of cost certified copy of this judgment and order to the respective partics.
Pronounced in the open Court today on 15th February,2022.
I. D. Patel
Judicial Mcmber
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K.Navlakha A/19/375