State Consumer Disputes Redressal Commission
The Icici Lombard General Insurance ... vs S.B. Kudbudeen, 813/25, Flat Glenden ... on 26 June, 2012
THE TAMILNADU STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CHENNAI THE TAMILNADU STATE CONSUMER DISPUTES REDRESSAL COMMISSION, CHENNAI. Present: Honble Thiru Justice R.REGUPATHI, President Thiru.A.K.Annamalai, Judicial Member Thiru.S.Sambandam, Member. F.A.No.458/2011 [Against order in C.C.No.321/2010 on the file of the DCDRF, Coimbatore ] TUESDAY, THE 26th DAY OF JUNE 2012. 1. The ICICI Lombard General Insurance Co., Ltd., Represented by its General Manager, Zenith House, Keshavarao Khade Marg, Mahalakshmi, Mumbai 400 034. 2. The ICICI Lombard General Insurance Co.,Ltd., Represented by its Manager, Vigneswara Cresta, 1st Floor, 1095, Avinashi Road, Pappanaichenpalayam, Coimbatore Appellants/Opposite Parties Vs S.B. Kudbudeen, 813/25, Flat Glenden Place, Poonamallee High Road, Kilpauk, Chennai. Respondent/Complainant The appeal having come before us for final hearing on 08.06.2012, upon hearing the arguments of both sides and perused the documents, written submissions as well as the order of the District Forum, this Commission made the following :- ORDER
A.K.ANNAMALAI, JUDICIAL MEMBER.
The opposite parties are the appellants.
1. The complainant filed a complaint against the opposite parties claiming damages for the insured car TN-01-W-1284 from the opposite parties under the Private Car Package Policy for the accident involved on 12.11.2008 for Rs.3,92,451/- and when the claim form was submitted to the opposite parties and on certain documents regarding the injured persons were also submitted the opposite parties not entertained the claim and thereby after giving legal notice on 06.03.2004 as the opposite parties have not taken steps to assess the value of the repairs and to settle the claim, the complainant filed a consumer complaint claiming a sum of Rs.4,25,000/- towards the repair charges and Rs.50,000/- towards compensation for mental agony and Rs.5000/- as costs.
2. The opposite parties denied the allegations in their written version and contended that the complainant intimated the accident only after 96 days delay, and only on 17.02.2009. Since 2 persons said to have injured in the accident calling for concerned records like FIR and accident register etc., in order to consider the claim a letter was sent on 17.04.2009 and no reply was received and alleged email letter was addressed to the opposite parties was not received. Hence for want of documents and clarifications the claim could not be assessed and the claim was made against the policy conditions and as per the surveyors assessment, a sum of Rs.1,25,203/- was alone estimated for the repairs and since the complainant had not fulfilled the obligations as per the policy the claim could not be settled and therefore there was no deficiency in service.
3. On the basis of both sides materials and after the enquiry the District Forum allowed the complaint by accepting the contentions of the complainant and directed the opposite parties to pay a sum of Rs.3,92,450/- towards charges for the damages caused to the vehicles and Rs.10,000/- towards compensation for mental agony and Rs.1000/- towards costs
4. Aggrieved by the order of the District Forum, the opposite parties have come forward with this appeal and contended that the District Forum failed to consider the delay in reporting the accident to the opposite parties at once and non submitting the relevant documents regarding the accident in order to make the actionable claim against the driver and that of only and injured in case of settlement by the insurance company and thereby as the complainant failed to follow the conditions of the policy and the District Forum failed to consider the surveyors report and thereby the complaint has to be dismissed.
5. while considering both the sides arguments, averments and contentions, it is not in dispute that the complainant had insurance policy relating to the vehicle involved in accident for which claim was made as per Exhibits B2 and B3 and as per letter under Ex B6, the opposite party called for certain documents regarding the accident like copy of FIR, hospital records, and the injured persons details and since the complainant has not supplied those documents, the claim was not processed which compelled the complainant to file a consumer complaint. According to the complainant, he had incurred a sum of Rs.3,92,450/- towards repair charges as estimated by the TVS Sundaram, workshop under Ex A8 and claimed for the same which was allowed by the District Forum. Whereas the opposite parties contended that as per their surveyors estimate and record under Ex B8, the amount estimated for repair was only for Rs.1,25,203/- even that amount was not granted by the opposite party on the ground that the claim intimation was given belatedly and other documents required for the process of claim were not submitted and thereby for claim the opposite parties relied on the conditions of the policy under Ex B1 in which under condition No.1, it is stated that notice shall be given in writing to the complainant immediately upon the occurrence of any accidental loss or damages in the event of any claim and thereby in this case, even though the accident was occurred on 12.11.2008 and as per the claim form under Ex B2 it was informed only on 17.02.2009 nearly after 95 days for which the claim was not considered even though it is necessary to give notice in writing immediately regarding the accident as per the condition No.1 under the policy. In the policy, nowhere mentioned that specific period for such information and in those circumstances, the delay in intimation of accident for claim purpose would not have been a reason for rejection of claim when the claim was made bonafidely and the accident and the damages to the vehicle were not in dispute. In those circumstances, since the complainant already submitted certificate from the police concerned relating to the accident under Exs A2 and A3 and the statement of injured persons were given as Exhibits A4 and A5 and also under Exs B4 and B5 even though not in the form of FIR and accident register, copy of etc., and otherwise proving the accident and nature of damages caused to the vehicle by way of inspection and estimate given by TVS Sundaram concern under Ex A8 and also the opposite parties own surveyor estimated the damages after inspection the complainant should have been compensated with the claim for the damages properly. In this case, even though, the complainant submitted estimation under Ex A8 for Rs.3,92,450/-, the insurance companys surveyor estimated the same for Rs.1,25,203. The opposite party should have granted the same as compensation for damages for the vehicle as insurance claim which was not done which lead to deficiency of service.
The opposite party contended that the surveyors report ought to have been taken into consideration while granting the claim amount by the District Forum as valid one as per the reported cases and thereby we are of the view to that extent alone the complainant should be compensated by allowing the claim for damages to the vehicle insured under the opposite party for the same. Accordingly, we are of the view that the District Forum order to be modified to that extent alone. The District Forum awarded a sum of Rs.10,000/- as compensation for mental agony and deficiency of service which also to be reduced to the reasonable extent and in our view which could be reduced to Rs.5000/- from Rs.10,000/-.
6. In the result, the appeal is allowed in part by modifying the order of the District Forum as follows: The opposite parties are directed to (1) pay only a sum of Rs.1,25,203/- towards repair charges, (2) to pay a sum of Rs.5000/- alone towards compensation for mental agony and for deficiency in service and to pay a sum of Rs.1000/- towards cost. The above directions shall be complied within two months from the date of order, failing which the complainant is entitled to claim interest for the amount at the rate of 9% per annum from the date of default. No order as to cost in this appeal.
MEMBER JUDICIAL MEMBER PRESIDENT S. SAMBANDAM. A.K. ANNAMALAI. R. REGUPATHI