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Himachal Pradesh High Court · body

2018 DIGILAW 1077 (HP)

United India Insurance Company Ltd. v. Surat Ram

2018-06-11

P.S.RANA, VIJAY PAL KHACHI

body2018
ORDER P.S. Rana (R) President - Present appeal is filed under section 15 of Consumer Protection Act 1986 against order dated 24.03.2017 passed by Learned District Forum in consumer complaint No.141/2015 title Surat Ram vs. United India Insurance Company Ltd. Brief facts of consumer complaint: 2. Shri Surat Ram filed consumer complaint under section 12 of Consumer Protection Act 1986 pleaded therein that vehicle No. HP-52B-1100 was duly insured with the opposite party and premium was paid to opposite party. It is pleaded that on dated 02.09.2014 when vehicle reached near Kotli Arki District Solan suddenly a pickup vehicle came from opposite direction and light flashes came into the driver''s eyes and car went out of the road and rolled down 100 feet away from the road and damage was caused to the vehicle. It is pleaded that matter was also reported in police station Arki Solan (H.P). It is further pleaded that driver Suresh Kumar died at civil hospital Arki Solan and other occupant namely Shri Leela Dass Negi sustained minor injuries in the accident. It is pleaded that complainant submitted claim form before opposite party but opposite party did not settle the claim and close the claim. It is pleaded that opposite party committed deficiency in service. Complainant sought relief of payment of Rs. 235000/-(Two lac thirty five thousand) alongwith interest @ 18% per annum. In addition complainant sought relief of payment of Rs. 2.00 lac as punitive damages for mental agony and harassment. In addition complainant also sought relief of payment of Rs. 25000/-(Twenty five thousand) as litigation costs. Prayer for acceptance of consumer complaint sought. 3. Per contra version filed on behalf of opposite party pleaded therein that opposite party did not commit any deficiency in service. It is pleaded that complainant did not supply Driving Licence of driver and also did not submit any estimate of repair from repairer. It is pleaded that accident took place on 02.09.2014 and intimation of accident was given to opposite party on 02.10.2014. It is further pleaded that opposite party appointed Shri Suresh Sharma surveyor cum loss assessor who has submitted the report. It is further pleaded that complainant did not complete codal formalities. It is pleaded that opposite party did not commit any deficiency in service. Prayer for dismissal of consumer complaint sought. 4. Complainant filed rejoinder and reasserted the allegations mentioned in the complaint. It is further pleaded that complainant did not complete codal formalities. It is pleaded that opposite party did not commit any deficiency in service. Prayer for dismissal of consumer complaint sought. 4. Complainant filed rejoinder and reasserted the allegations mentioned in the complaint. Learned District Forum allowed the complaint and directed opposite party to settle the claim of complainant on the basis of total loss within forty five days from the date of receipt of copy of order. Learned District Forum further ordered that in case complainant would not be satisfied with the settlement of claim by opposite party complainant would be at liberty to approach the Forum again in accordance with law. Feeling aggrieved against order passed by Learned District Forum insurance company filed present appeal before State Commission. 5. We have heard learned advocates appearing on behalf of parties and we have also perused entire record carefully. 6. Following points arise for determination in present appeal. 1. Whether appeal filed by appellant is liable to be accepted as mentioned in memorandum of grounds of appeal? 2. Final order. Findings upon point No.1 with reasons: 7. Learned advocate appeared on behalf of complainant has given statement before learned District Forum on dated 28.06.2016 that complaint alongwith affidavit and documents annexures-C1 to C4 already filed be read in evidence. State Commission has perused all annexures filed by complainant carefully. 8. Opposite party filed affidavit of Shri Ashok Negi Sr. Divisional Manager in evidence. There is recital in affidavit that opposite party did not commit any deficiency in service and also did not indulge in any unfair trade practice. There is recital in affidavit that complainant did not comply with the required formalities for settlement of claim. There is further recital in affidavit that factum of accident was not informed to opposite party immediately and intimation was given to opposite party after expiry of one month which is fundamental breach of terms and conditions of insurance policy. There is recital in affidavit that opposite party appointed surveyor cum loss assessor namely Suresh Sharma who has conducted spot survey and submitted the report. There is recital in affidavit that complainant did not submit estimate of loss and also did not submit R.C, Driving Licence and copy of F.I.R. State Commission has carefully perused all annexures filed by opposite party. 9. There is recital in affidavit that complainant did not submit estimate of loss and also did not submit R.C, Driving Licence and copy of F.I.R. State Commission has carefully perused all annexures filed by opposite party. 9. Submission of learned Advocate appearing on behalf of insurance company that complainant did not submit estimate of repair and driving licence of driver and on this ground appeal be allowed is decided accordingly. It is proved on record that opposite party appointed surveyor cum loss assessor namely Suresh Sharma and surveyor had submitted report on dated 03.10.2014 annexure-R5. Surveyor cum loss assessor has submitted in the report that vehicle was insured w.e.f. 18.11.2013 to 17.11.2014 under private car package policy. Surveyor cum loss assessor has specifically mentioned in the spot survey report that IDV value of vehicle was Rs. 235000/-(Two lac thirty five thousand). Surveyor namely Suresh Sharma has specifically mentioned in his spot survey report that accident took place on 02.09.2014 at 6.30 P.M at place Kotli Arki Solan due to reason that suddenly pickup came from opposite direction and light flashes came into driver''s eyes and vehicle rolled down 400 feet away from the road and caused damage to the vehicle. Surveyor cum loss assessor has mentioned in his report that there was apparent damages i.e. 1. Body sheel assy damaged/cramped/crashed badly. 2. All doors frames/body dented/cramped. 3. Both head lamps assy broken. 4. Front bumper/grill centre bent/broken. 5. Steering wheel may be bend. 6. Steering column assy may be bend. 7. Dash board assy may be bend/broken. 8. FR. Glass, both side glass and all window glasses found broken. 9. RHS front suspension may be damaged. 10. LHS front suspension may be damaged. 11. Read bumper cracked/damaged. 12. Both tail lamps broken. 13. Front both seats cushions bend/disaligned. 14. Roof top headlining assy damaged/worm-out. 15. Fuel tank assy/silencer assy dents and damages. State Commission is of the opinion that in total loss basis of vehicle claim repair bills are not required. It is held that repair bills are required only in repair bills basis claim. 10. Surveyor cum loss assessor has specifically submitted that driving licence of deceased driver was not produced because same was missing as reported by insured to the surveyor cum loss assessor. It is held that repair bills are required only in repair bills basis claim. 10. Surveyor cum loss assessor has specifically submitted that driving licence of deceased driver was not produced because same was missing as reported by insured to the surveyor cum loss assessor. Surveyor cum loss assessor has specifically mention in the report that he has perused insurance policy, copy of police report, copy of R.C, and copy of postmortem report issued from civil hospital Arki of deceased Suresh driver. State Commission is of the opinion that driving licence could not be produced by the insured because driving licence was in the possession of driver and driver of vehicle had died in the accident. All other documents were submitted by insured before surveyor cum loss assessor. State Commission is of the opinion that report submitted by surveyor cum loss assessor is binding upon insurance company because surveyor cum loss assessor was authorized agent of the insurance company and documents submitted to the authorised agent of the insurance company would be deemed to be submission of documents to the insurance company under law. 11. Submission of the learned Advocate appearing on behalf of insurance company that accident took place on 02.09.2014 and intimation of accident was given by insured on 02.10.2014 and insured has committed fundamental breach of insurance policy and on this ground appeal be allowed is decided accordingly. We have carefully perused the repudiation letter dated 17.02.2015 annexure-R-I issued by opposite party to complainant. There is no recital in repudiation letter dated 17.02.2015 issued by opposite party that claim was repudiated on the ground of delayed submission of intimation of accident to insurance company. State Commission is of the opinion that it is not expedient in the ends of justice and on the principle of natural justice to allow the insurance company to take the plea of delay intimation of accident in pleadings after filing of consumer complaint by complainant under Consumer Protection Act 1986. See 2018 (1) CLT titled Tata AIG Insurance Co. Ltd. vs. Dr. Tilak Gupta and others. 12. Submission of learned Advocate appearing on behalf of complainant that order passed by learned District Forum is in accordance with law and in accordance with proved facts is decided accordingly. See 2018 (1) CLT titled Tata AIG Insurance Co. Ltd. vs. Dr. Tilak Gupta and others. 12. Submission of learned Advocate appearing on behalf of complainant that order passed by learned District Forum is in accordance with law and in accordance with proved facts is decided accordingly. It is held that it is not expedient in the ends of justice to interfere in the order passed by learned District Forum because son of insured has died in the accident and insured was in extreme shock of death of his son in accident. Point No.1 is decided accordingly. Point No.2: Final Order 13. In view of findings upon point No.1 above appeal is dismissed. Order passed by learned District Forum is affirmed. Repudiation letter issued by insurance company dated 17.02.2015 annexure-R1 and report of surveyor cum loss assessor namely Suresh Sharma annexure-R5 will form part and parcel of order. Parties are left to bear their own litigation costs before State Commission. File of learned District Forum alongwith certified copy of order be sent back forthwith and file of State Commission be consigned to record room after due completion forthwith. Certified copy of order be transmitted to parties forthwith free of costs strictly as per rules. Appeal is disposed of. Pending application(s) if any also disposed of.