State Consumer Disputes Redressal Commission
The Oriental Insurance Company ... vs 1..M.Palakshi Reddy,Anantapur ... on 28 February, 2012
BEFORE THE A BEFORE THE A.P STATE CONSUMER DISPUTES REDRESSAL COMMISSION AT HYDERABAD . F.A.No.1271/2010 against C.C.No.84/2009, District Forum, Kurnool. Between The Oriental Insurance Company Limited, Kurnool represented by Authorized Signatory, Appellant/ Opp.party no.1 And 1.M.Palakshi Reddy, S/o.Hanumanth Reddy, Proprietor of M/s.Datta Borewells, D.No.9/632/55m. J.R.S. Colony, Raidurg, Anantapur District - 515 865. Respondent/ Complainant 2. The Oriental Insurance Company Limited, P.B.No.59, Mayura Complex, Railway Feeder Road, Anantapur 515 001. Respondent/ Opp.party no.2 (Respondent no.2 is not necessary party) Counsel for the Appellant : M/s. Bhaskar Poluri Counsel for the respondent : M/s.G.Madhusudhan Kumar QUORUM:THE HONBLE JUSTICE SRI D.APPA RAO, PRESIDENT AND SMT.M.SHREESHA, HONBLE MEMBER.
TUESDAY, THE TWENTY EIGHTH DAY OF FEBRUARY, TWO THOUSAND TWELVE (Typed to dictation of Smt.M.Shreesha, Honble Member) **** Aggrieved by the order in C.C.No.84/2009 on the file of District Forum, Kurnool, first opposite party preferred this appeal.
The brief facts as set out in the complaint are that the complainant is the owner of a Drilling Rig Mounted Vehicle and he insured it with the opposite parties for the period from 4.2.2003 to 3.2.2004 for an amount of Rs.30 lakhs . On 14.10.2003 the vehicle was damaged by known culprits . The opposite party sent a spot surveyor who prepared a report and another surveyor was appointed to assess the final damage. On 10.9.2007 the opposite parties repudiated the claim on the ground that the bills for Rs.1,36,277/- given by Pioneer Automobiles and Rafi Brothers are fabricated. The complainant applied under RTI for the Surveyors Report. The opposite party furnished copy of the loss assessment and as per the said assessment the opposite parties estimated the loss at Rs.8,76,003/- . The opposite parties also repudiated the claim only after four years of the incident. Hence the complaint seeking direction to the opposite party to pay Rs.8,76,003/- as estimated by the surveyor together with interest, compensation and costs.
Opposite party no.1 filed counter stating that the policy was issued to the complainants Rig Mounted Vehicle . They contend that opposite party no.2 conducted an investigation and disclosed that bills worth Rs.1,36,277/- were fake and that the complainant did not provide the insurance surveyor with necessary documents like repair estimate, FIR and final bills and as such the surveyor could not assess the loss correctly. Further the complainant did not file any surveyor report along with photos and therefore their repudiation is totally justified.
The District Forum based on the evidence adduced i.e. Exs.A1 to A4 and B1 to B7 allowed the complaint directing the opposite parties jointly and severally to pay compensation of Rs.8,76,003/- together with costs of Rs.500/- with interest at 9% p.a. from the date of repudiation till the date of realization.
Both sides filed written arguments.
The facts not in dispute are that the issuance of the policy by the opposite party to the complainants drilling Rig Mounted vehicle for the period from 3.3.2003 to 3.2.2004. for an amount of Rs.30 lakhs. It is the complainants case that on 14.10.2003 the vehicle was damaged by known culprits evidenced under Ex.A1 which is the copy of the FIR in Crime No.119/2003 . In Ex.A1 it is stated that the drilling rig was damaged by B.Srinivasulu Reddy and his followers on 14.10.2003. The learned counsel for the appellant/opposite party contended that the claim made by the complainant was not followed by correct procedure. After the vehicle has been investigated by the licensed surveyor on the spot, photos have to be taken on different angles by the spot surveyor and then the mechanic has to give an estimate of the damaged parts and then the final survey has to be made by the licensed surveyor. The spot surveyors report along with the final report will be the basis for the settlement of claim. The complainant failed to file insurance surveyors report with necessary documents like FIR and final bills etc. It is the appellants case that the complainant submitted fake repair bills of Pioneer Automobiles and S.Rafi Brothers. The bill for Rs.1,36,277/- given by the shop at Disukhnagar is closed and the fake bills were investigated by one Mr.Satyadev Goud, Advocate. The complainant also failed to produce ownership certificate.
We observe from the record that the respondent/complainant had made an application under RTI Act to the opposite party to furnish the surveyors report in which it is clearly shown that the surveyor had estimated the loss for a sum of Rs.8,76,003/-. The complainant in his affidavit denied that the bills of Pioneer Automobiles and S.Rafi Brothers were fake. It is an admitted fact that the vehicle was damaged on 14.10.2003 as evidenced under Ex.A1 FIR. Ex.A4 is the surveyor report dt.27.11.2004 which is dated one year after the date of the accident. The surveyor, after inspection, assessed the loss on final bills on repair basis at Rs.8,76,003/- as evidenced under Ex.A4.
The contention of the appellant/opposite party that the complainant did not furnish the surveyor report is unsustainable. Ex.A4 evidences that P.N.Vaidyanadhan is a licensed surveyor and in his conclusion the surveyor has clearly mentioned that the survey work was assigned to him through Chennai Regional Office and therefore when the insurance companys own licensed surveyor has conducted the survey and submitted his report on 27.11.2004, the contention of the appellant/opposite party that the complainant did not furnish the survey report cannot be sustained. Without assigning any substantial reasons the opposite parties have appointed another investigator to investigate the fake bills to the tune of 1,36,277/- issued by the Pioneer Automobiles and Rafi Brothers and contend that these shops were located at Dilsukhnagar which were reportedly closed. They did not choose to file affidavits of the relevant shop owners to establish that these bills are fake. Even otherwise the opposite parties have repudiated the entire claim on this sole ground alone in the absence of any affidavit or documentary evidence in proof of their case. We rely on the judgement of Apex Court in UNITED INDIA INSURANCE COMPANY LIMITED v. M/S.M.K.J.CORPORATION reported in 1986-1999 Consumer 4781 NS(1998 (2) CLT 489 SC in which it is held as follows:
two months is reasonable time for the insurance company to take a decision, whether the claim requires to be settled or rejected in accordance with the policy.
As per the aforementioned judgement 2 months is the reasonable time for settlement of the claim . In the instant case it is observed that the accident took place on 14.10.2003. The surveyor filed his report on 27.11.2004 and the repudiation was done on 10.9.2007 (Ex.A2) i.e. 4 years after the date of cause of action. This inordinate delay of 4 years on behalf of the insurance company in repudiating the claim without any substantial grounds constitutes deficiency in service on their behalf and we see no reason to interfere with the well considered order of the District Forum . The District Forum has given a reasonable order and has infact awarded interest only from the date of repudiation which was four years after the date of cause of action .
In the result this appeal is dismissed and the order of the District Forum is confirmed. Time for compliance four weeks. No costs.
PRESIDENT MEMBER Pm* Dt.28.2.2012