PRAVIN KUMAN JAIN v. UNITED INDIA INSURANCE CO. LTD.
2006-05-10
R.S.AWASTHI, V.K.AGARWAL, VEENA MISRA
body2006
DigiLaw.ai
ORDER Shri V.K. Agarwal, President:- 1. This appeal, under section 15 of the Consumer Protection Act, 1986 is directed against the order dated 15.9.05 in complaint No.2/2004 by District Consumer Disputes Redressal Forum, Korea, Baikunthpur (hereinafter called the 'District Forum' for short) dismissing the appellant's complaint. 2. Indisputably, the complainant is the owner of vehicle ‘Qualis’ bearing registration No.CG-16/1364 which was comprehensively insured by the respondent/insurer, covering the risk there of from 23.6.02 to 22.6.03. The insurer's declared value of the vehicle as well as the assured amount was Rs.5,30,000/-. It is also not in dispute that the vehicle while proceeding from Manendragarh to Raipur met with an accident on 12.10.2002 near ‘Gadaria Nala’. FIR was lodged on the same day, i.e. on 12.10.2002 and an offence was registered. Two passengers one of whom was Dr. Swati Pandey, died in the accident. 3. The averments in the complaint are that the complainant intimated about the accident to the insurer by his letter dated 19.10.2002. The complainant's uncle Raj Kumar Jain also intimated about the incident to the respondent/insurer by his letter dated 14.12.02. The respondent/insurer appointed surveyor who inspected the vehicle and assessed the loss. However, the claim preferred by the complainant before the respondent/insurer was not settled. The complainant therefore, served notice on the respondent/insurer and approached the District Forum where he filed the complaint. It was prayed that the respondent/insurer be directed to pay to the complainant the amount required for repairs of the vehicle or to give him a new vehicle. Compensation was also claimed. 4. The respondent/insurer in their written version averred that the vehicle was being plied in breach of terms of policy, in as much as it was being used for carrying passengers and the driver of the vehicle was also not having valid driving license, It was averred in the above context that the license purportedly held by the driver Kale Mistry was discovered to be a forged one and was not issued by competent licensing authority. It was also averred that the surveyor assessed the loss at Rs. 3,05,000/- only. It was averred that in the above circumstances, the respondent/insurer was not liable to pay any amount. 5. The District Forum, in the impugned order held that the complainant failed to prove as to why the accident occurred and he possibly has suppressed the real cause for accident.
3,05,000/- only. It was averred that in the above circumstances, the respondent/insurer was not liable to pay any amount. 5. The District Forum, in the impugned order held that the complainant failed to prove as to why the accident occurred and he possibly has suppressed the real cause for accident. It was also held that the accident may have taken place as the vehicle was carrying engine of some other vehicle. District Forum therefore, held that the complainant was not entitled to any compensation and the respondent/insurer cannot be held to be guilty of deficiency in service. The complaint was accordingly dismissed 6. Learned counsels for the parties were heard. Record and impugned order perused. 7. As noticed earlier, the vehicle was comprehensively insured by the respondent/insurer and its risk was covered by the policy issued by respondent' insurer at the time when the accident occurred on 12.10.2002, near Gadaria Nala. FIR was lodged on the same date i.e. on 12.10.2002 by Ramkumar and an offence was registered. The driver Kale Mistry as well as one Dr. Swati Pandey who was also traveling in the same vehicle died in the accident. It is also not in dispute that the complainant preferred claim before the respondent/insurer who appointed surveyor Raj Kumar. The surveyor submitted his report dated 27.6.2003. 8. The surveyor in his report dated 27.6.03 stated that the net amount payable on repair basis is Rs.5,41,592/-. The market value of the vehicle was assessed by the surveyor at Rs.4,65,000/- including the value of salvage. The salvage value was assessed at Rs. 1,60,000/- and thus net liability of the insurer was calculated without salvage at Rs.3,05,000/-. 9. It may be noticed that though the complainant claimed assured amount, his claim was not settled. The letter dated 31.5.04 of the respondent/insurer stated that the enquiry conducted by them revealed that the vehicle was being used at the time of accident for carrying passenger and goods. It may be noticed that the said letter was sent after the complaint was filed by the complainant in the District Forum. Thus, there appears to be inordinate delay in sending-the said letter. It thus appears that the complainant's claim was not settled by the insurer for a long time though, the complainant made all efforts in that regard. 10.
It may be noticed that the said letter was sent after the complaint was filed by the complainant in the District Forum. Thus, there appears to be inordinate delay in sending-the said letter. It thus appears that the complainant's claim was not settled by the insurer for a long time though, the complainant made all efforts in that regard. 10. It may also be mentioned that according to the insurer, the driver of the vehicle was not having valid driving license. However, there is no material on record to establish the above fact. Similarly, though in the above mentioned letter of the respondent as well as the report of the surveyor it has been stated that the vehicle was used for carrying passengers, but there is no reliable material to support the contention as above. Similarly, the allegation that the vehicle was loaded with some engine of other vehicle is also not duly substantiated. Therefore, breach of terns of policy have not been established by the respondent/insurer. 11. In view of above, it is clear that the respondent/insurer have failed to settle the claim of the complainant, for which there was no justification. Their letter dated 31.5.04 is also not only belated and appears to be based on unjustified premises. 12. It may be pointed out here that District forum has observed that the complainant has failed to establish as to how the accident occurred and further observed that possibly the vehicle having gone out of control had met with an accident. It is clear that the complainant was not obliged to establish how the accident occurred. Unless one was present on the spot, the explanation as above could have been offered. It would also be clear that the complainant is entitled to get compensation in case he successfully establishes that the vehicle met with an accident and was damaged. The fact as above has been fully established in the instant case. 13. In view of what has been stated above, non-settlement of the claim of the complainant and non payment of compensation by the respondent/insurer clearly amounts to deficiency in service. The findings of the District Forum that the insurer were justified in not paying the compensation and that the respondent/ insurer has not committed deficiency in service, cannot be sustained. 14.
In view of what has been stated above, non-settlement of the claim of the complainant and non payment of compensation by the respondent/insurer clearly amounts to deficiency in service. The findings of the District Forum that the insurer were justified in not paying the compensation and that the respondent/ insurer has not committed deficiency in service, cannot be sustained. 14. So far as quantum of compensation is concerned, as noticed earlier, the surveyor has assessed the loss and market value of the vehicle to the tune of Rs.4,65,000/- and the value of the salvage at Rs. 1,60,000/-. Learned counsel for complainant submitted that salvage is still lying as it is, after the accident and that he has no objection, if the said salvage is taken by the respondent/insurer. 15. In view of above, it is directed that respondent/insurer shall pay to the complainant/appellant compensation of Rs. 4,65,000/- (Rupees four lacs, sixty five thousand) and that the insurer would be entitled to take back the salvage of the vehicle. The above amount shall be payable with interest of 91% p.a. from 1.1.2003 i.e. after about 2 month after the claim was preferred. The respondent/insurer shall also be liable to pay to the complainant cost of this litigation including that of the complaint as well as of this appeal, which is quantified at Rs.2,000/- Rupees two thousand) only. Appeal Allowed.