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HARYANA STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, CHANDIGARH
Hon’ble Mr. Justice S.S. Sandhawalia, President; S. Kulwant Singh, Member
THE ORIENTAL INSURANCE CO. LTD.—Complainant
versus
RACHPAL SINGH—Opp. Party
First Appeal No. 513 of 1993—Decided on 2.3.1994

Advocates:
Counsel for the Parties :
For the Complainant :Mr. R.K. Chhibbar, Sr. Adv. with Miss Rattan Laxmi, Advocate.
For the Opp. Party :Mr. S.C. Jaswal, Advocate.

Headnote:Consumer Protection Act, 1986 - Sections 2 & 14 - Car insured under comprehensive policy - Steering wheel of car got free & driver lost control & car met with accident causing serious damage to it - Policy covered risk by "accidental external means" - Exclusionery clause provided that any consequential loss, depreciation, wear tear not covered under policy where any mechanical or electrical break down takes place - Exclusion clause is confined to mechanical or electrical break down within the car & in the context of total absence of any road accident or loss or damage by accidental external means - Rejection of claim by insurance Co. was arbitrary & deficiency in service - Order of District Forum awarding damages is liable to be up held. (Paras 10 & 18)

       Result: Appeal dismissed.

       

ORDER

Mr. Justice S.S. Sandhawalia, President— Whether loss or damage by accidental external means occasioned by a mechanical failure or defect in a Motor Vehicle is covered by a Comprehensive Insurance Policy, therefore? This is the somewhat significant issue raised in the present appeal.

2. The respondent-consumer had got his Motor Car insured under the comprehensive policy and the same met with an accident during the period of the insurance cover on the 23rd of June, 1992 whilst the vehicle was being driven to Delhi. The steering wheel thereof got free and the driver having lost control, the vehicle hit a big heap of stones causing serious damage thereto including the engine block thereof itself. Inevitably, the respondent-consumer filed a claim for Rs. 22,000/- and completed the required formalities including the submission of regular bills etc. However, the appellant insurers rejected the claim on the ground that the damage to the vehicle had been occasioned due to a mechanical fault or break down therein. Unable to get redress, the respondent knocked at the door of the District Forum.

3. The appellant-insurers contested the claim, whilst admitting the broad matrix of facts as regards the insurance cover and also the happening of the accident. The plea however, was that the claim of the complainant was examined by a qualified and a competent surveyor, who opined that the accident & loss was occasioned by a mechanical break down in the vehicle and was therefore, not payable under the terms and conditions of the policy.

4. The parties led evidence in support of their respective cases. The appellant rested themselves on the report of Shri Shamsher Chand, Surveyor dated the 21st of July, 1992. On the other hand, the respondent filed a survey report dated 29th of September, 1993 of an equally reputed insurance surveyor Shri M.L. Banerjee, opining that the damage was due to external accident and not due to internal break down of the engine. He also explained that Shri Shamsher Chand, surveyor had left some material questions, unanswered in his report.

5. The District Forum on a consideration of the evidence and the law cited before it came to the conclusion that the surveyor’s report appointed by the Company had left many blanks and considering every factor came to a firm conclusion on facts that the respondent’s story about the damage done to vehicle was due to an accident and within the coverage of loss or damage by accidental external means. The complaint was consequently allowed and compensation of Rs. 22,000/- being got seriously challenged as costs of repairs was directed to be paid.

6. Mr. R.K. Chhibbar, learned Senior Counsel for the appellant with his usual vehemence had first sought to assail the order of the District Forum on the ground of its reliance on the report of the insurance surveyor Shri M.L. Banerjee rendered at the instance of the respondents. It was contended that the said report was rendered behind the back of the appellant-Insurance Company and in any case was not binding upon the appellant and could not over-ride the report of their surveyor Shri Shamsher Chand. The further submission was that in the event of the conflicting reports of the surveyor, the District Forum should have relegated the respondent to his ordinary remedy by way of a civil suit because there was no deficiency in the insurance service, when the appellants had bona fide acted upon the report of the surveyor appointed by them.

7. We deem it unnecessary to adjudicate on the aforesaid submission. This is so because assuming the case of the appellants at the highest and taking into consideration only the report of Shri Shamsher Chand, surveyor only, the rejection of the respondent’s claim is patently arbitrary and contrary to the true interpretation of the insurance policy. We would, therefore, at the earnest behest of the learned Counsel for the appellant excluded, the report of M.L. Banerjee entirely out of consideration and examine the issu






































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