State Consumer Disputes Redressal Commission
Sri. K. Srinivas, vs Icici Lombard General Insurance on 4 August, 2023
Cause Title/Judgement-Entry KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION BASAVA BHAVAN, BANGALORE. First Appeal No. A/1649/2022 ( Date of Filing : 05 Aug 2022 ) (Arisen out of Order Dated 05/07/2022 in Case No. CC/1784/2019 of District Bangalore 2nd Additional) 1. Sri. K. Srinivas, S/o. Sri. Kempaiah, Aged about 45 years, Residing at No.25/79, 8th Cross, Sri Gandhanagar, Vishwaneedam Post,Bengaluru 560 091. ...........Appellant(s) Versus 1. ICICI Lombard General Insurance Co. Ltd,89, SVR Complex, Hosur Main Road, Madivala, Koramangala, Bengaluru560 068 Represented by its Manager. ...........Respondent(s) BEFORE: HON'BLE MR. JUSTICE Huluvadi G. Ramesh PRESIDENT HON'BLE MR. Krishnamurthy B.Sangannavar JUDICIAL MEMBER HON'BLE MRS. Smt. Divyashree.M MEMBER PRESENT: Dated : 04 Aug 2023 Final Order / Judgement Date of filing: 05.08.2022 Date of Disposal: 04.08.2023 BEFORE THE KARNATAKA STATE CONSUMR DISPUTES REDRESSAL COMMISSION, BENGALURU (PRINCIPAL BENCH) DATED: 04th Day of August 2023 PRESENT HON'BLE Mr. JUSTICE HULUVADI G. RAMESH: PRESIDENT Mr K. B. SANGANNANAVAR: JUDICIAL MEMBER Mrs DIVYASHREE M: LADY MEMBER APPEAL NO.1649/2022 O R D E R
BY HON'BLE Mr. JUSTICE HULUVADI G RAMESH : PRESIDENT This Appeal filed by complainant under Section 41 of Consumer Protection Act, 2019, aggrieved by the order dated 05.07.2022, passed in CC/1784/2019 by II Additional District Consumer Disputes Redressal Commission, Bengaluru (herein after referred as District Commission and the parties arrayed as in the Consumer Complaint) Commission examined grounds of appeal, impugned order, appeal papers and heard learned counsel for appellant and now we have to decide on the appeal whether impugned order call for an interference for the grounds set out in the appeal memo?
Complainant raised Consumer Complaint before the Commission below alleging deficiency of service on the part of OP for repudiating the claim of the complainant on the ground that there is a misrepresentation of facts by the complainant. Upon service of notice OP contested the matter and denied all the allegations made by complainant. Commission below after holding enquiry recorded findings in favour of OP and thereby dismissed the complaint without cost. It is this order being assailed in this appeal contending that Commission below failed to consider/observe the fact that as per police records/documents i.e., FIR, Charge Sheet etc., Sri.Ramaiah B.C. was the driver at the time of accident. Further alleged the Commission below failed to observe that 25 days before submitting the survey report to OP and before 01 month of repudiation of claim, complainant voluntarily visited OP Company and explained entire real facts and given letter in this regard. Also the Commission below failed to discuss on letter dated 13.11.2017 (marked as Ex.P30) which is given by the complainant to manager of the OP. Thus sought for setting aside the impugned order.
It is undisputed fact that complainant/appellant is the owner of Dzire/Maruti Swift Car and had insured the said vehicle with OP/respondent Insurance Company for the period commencing from 02.05.2017 to 03.05.2018 by paying premium of Rs.21,595/-. It is also not in dispute that on 27.08.2017 the said car met with an accident near Kadabahalli, Bindiganavile Hobli, Nagamangala Taluk at about 7:00am. The only dispute is related to repudiation of claim of the complainant/appellant by OP/respondent due to misrepresentation of facts. Let us examine the merits of the case by examining the documents placed by both the parties before the Commission below which are marked as Ex.P1 to Ex.P42 and Ex.R1 to Ex.R5.
Complainant/appellant had availed insurance policy to his car Dzire/Maruti Swift from OP/respondent under the policy type (Commercial Vehicle - Passenger Carrying) for the period from 02.05.2017 to 01.05.2018 which could be seen from Certificate Cum Policy Schedule marked as Ex.P1. Further complainant/appellant had produced Certificate of Registration and DL of one Mr.Srinivasa K who is none other than complainant to show that he is the owner of the said car and had valid DL of driving LMV till 31.05.2025. Ex.P6 is the DL of one Mr.Ramaiah B.C. who said to be the driver of the car at the time of accident on 27.08.2017. Mr.Ramaiah B.C. had valid DL of driving LMV till 19.06.2018. Ex.P7 are the photographs of the damaged car to show the extent of damage due to accident. Ex.P8 is the Copy of typed complaint given by one Mr.Mohan K.V to Sub-Inspector of Police, Bindiganavile Police Station, Bindiganavile narrating the incident of accident taken place on 27.08.2017 between his car and the complainant/appellant car. Spot Mahazar had been made by the concerned police and FIR had been registered as per Ex.P9 and Ex.P10. Notice U/s 133 of IMV Act came to be issued by the police concerned to complainant/appellant on 29.08.2017 as per Ex.P11 and as per Ex.P12 on 29.08.2017 complainant/appellant had given reply to the said notice stating that his friend Mr.Ramaiah B.C. is driving the said car at the time of accident. Ex.P16 is the motor vehicle accident report prepared by transport department as per the requisition received by PSI Bindiganavile Police Station. The Police concerned submitted a charge sheet on 27.08.2017 as per Ex.P17 for the offence of Sec.279 and 337 of IPC. The said charge sheet discloses that one Mr.Ramaiah B.C. was driving the car of the complainant/appellant at the time of accident. Ex.P18 is the Medico Legal Wound Certificate of Mr.Srinivas R issued by Matru Nursing Home and Trauma Care Centre on 30.09.2017. Ex.P20 is the Body Repair Job Slip issued by Mandovi Motors Private Limited, Authorised Dealers for Maruti Vehicles. As per the said Job Slip the said dealer had received the vehicle/car of complainant/appellant on 30.08.2017. On 31.01.2018 the Mandovi Motors Private Limited had issued Job Card Retail - Tax Invoice wherein the Net Bill Amount of Rs.2,57,795/- is incurred for body repair of the car which could be seen from Ex.P21. Ex.P22 to Ex.P24 are the original receipts showing that complainant/appellant had paid an amount of Rs.1,00,000/- on 07.12.2017, Rs.50,000/- on 20.01.2018 and Rs.1,07,795/- on 03.02.2018 to the said dealer. We shall skip Ex.P25 to Ex.P27 and Ex.P28 which is the letter dated 25.09.2017 issued by ICICI Lombard General Insurance who is none other than OP/respondent to Mr.Srinivas K catechizing for requirement of Mr.Ramaiah B.C. statement in person and Valid DL Copy for processing the Motor Claim within 07 days from the date of receipt of the said letter. On 28.09.2017 as per Ex.P29 complainant/appellant had replied to the letter dated 25.09.2017 stating as thus:
"I State that Ramaiah B.C. was travelling as a co-passenger only and he was not driving my Car. Therefore, the said Ramaiah B.C. is appearing in person or producing his Driving License and to give his statement does not arise at all."
Ex.P30 is the hand written letter dated 13.11.2017 from complainant/appellant to the Manager, ICICI Lombard wherein he states as thus:
"Since my friend Mr.Ramaiah does not have valid badge I have given my DL for claim purpose. Hence requesting you to consider my statement and do the needful."
Ex.P31 is the repudiation of claim by the OP/respondent for misrepresentation of facts (Driver details are misrepresent at intimation/claim form from actual and try to hide the material facts). Hence on 19.09.2019 complainant/appellant issued legal notice to OP/respondent which could be seen as per Ex.P32.
Let us examine the Exhibits of OP/respondent placed before the Commission below. Ex.R1 is the Claim Form for Motor Vehicle dated 30.08.2017 wherein could see complainant/appellant himself had mentioned his name in the column of Details about the Driver (at the time of accident) and had also filled the details of accident in the said form. On 11.09.2017 complainant/appellant wrote a letter to OP/respondent stating that he was the driving the car at the time of accident which could be seen from Ex.R2. Ex.R3 is the Surveyor Report dated 07.12.2017 issued by Licensed Surveyor wherein in the driver particulars the name of the driver is mentioned as Srinivasa K who is none other the complainant/appellant herein and the surveyor had assessed loss to the tune of Rs.1,10,948/-.
It is therefore; on re-appreciation of materials on record found that accident of the said car was taken place in Kadabahalli, Bindiganavile Hobli, Nagamangala Taluk at about 7:00am on 27.08.2017. The very fact is not denied by OP/respondent and is proved by Spot Mahazar, FIR and Charge Sheet. OP/respondent repudiated the claim of the complainant/appellant on 13.12.2017 only on the ground of misrepresentation of fact by the complainant/appellant that too only in respect of misrepresenting the driver details by complainant/appellant. As admitted by complainant/appellant one Mr.Ramaiah B.C. was driving the car of complainant/appellant at the time of accident. This was also intimated by complainant/appellant to OP/respondent on 13.11.2017 by hand written letter. OP/respondent had sent a letter to complainant/appellant on 25.09.2017 catechizing for requirement of Mr.Ramaiah B.C. statement in person and Valid DL Copy for processing the Motor Claim within 07 days from the date of receipt of the said letter. Thus we could draw an inference that OP/respondent before intimation given by complainant/appellant regarding the details of the driver who was driving the car at the time of accident, knew that one Mr.Ramaiah B.C. was driving the car at the time of accident and had called complainant/appellant to give statement of Mr.Ramaiah B.C. as in person and Copy of Valid DL to process the claim of complainant/appellant. Further the Licensed Surveyor who is appointed by OP/respondent insurance company had submitted a report on 07.12.2017 stating that the driver of the car at the time of accident is Mr.Srinivas K who is the complainant/appellant. This clearly shows that the Licensed Surveyor had not examined or inquired or investigated or verified or checked upon the causes and the circumstances of the loss in question. It is therefore, repudiating the claim of the complainant fully, only on the ground of misrepresentation of driver details by the complainant/appellant is not acceptable since OP/respondent neither denied the accident which taken place on 27.08.2017 nor denied the premium paid by complainant/appellant. The said accident had taken place well within the period of insurance.
It is therefore, in our view, awarding 75% of the amount assessed by licensed surveyor in his report would meet the ends of justice since complainant/appellant had not denied the said surveyor report and though surveyor had failed to examine or to inquire or to investigate or to verify the causes and the circumstances of the loss in question had examined the extent of loss, nature of ownership in detail and complainant/appellant in his letter dated 13.11.2017 had agreed upon that one Mr.Ramaiah B.C. was driving the said car at the time of accident. The Ex.P6 the DL of Mr.Ramaiah B.C shows that he has the valid DL of driving LMV till 19.06.2018. Since the said accident taken place on 27.08.2017, we could conclude that one Mr.Ramaiah B.C was having valid DL at the time of accident and though as stated by complainant/appellant himself in his hand written letter dated 13.11.2017 i.e., Ex.P30 Mr.Ramaiah B.C was not having valid badge, facts remained that complainant/appellant had ensured that as per the terms and conditions of the policy the insured vehicle is being driven by the person holding a valid DL. In view of such conclusion, impugned order does call for interference. Hence, Commission set aside the impugned order dated 05.07.2022 passed in CC/1784/2019 by II Additional District Consumer Disputes Redressal Commission, Bengaluru and proceed to allow the appeal in part in the following terms:
OP is directed to pay a sum of Rs.83,211/- (75% of the loss assessed by the surveyor in his survey report) along with interest @ 09% p.a. from the date of repudiation till realization.
Further OP is directed to pay a sum of Rs.25,000/- as compensation towards rendering deficiency in service and Rs.10,000/- towards cost of litigation.
OP is directed to comply the order within 30 days failing which the aforesaid amount shall carry interest @ 10% p.a. Send a copy of this Order to the District Commission and parties to the appeal.
Lady MemberJudicial MemberPresident *GGH* [HON'BLE MR. JUSTICE Huluvadi G. Ramesh] PRESIDENT [HON'BLE MR. Krishnamurthy B.Sangannavar] JUDICIAL MEMBER [HON'BLE MRS. Smt. Divyashree.M] MEMBER