NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION, NEW DELHI
Anup K. Thakur, Presiding Member
Vishwa Nath Puri – Petitioner
versus
IFFCO Tokio General Insurance – Respondent
Revision Petition No.1090 of 2020
(Against the Order dated 09/09/2020 in Appeal No.460/2016 of the State Commission Delhi)
Decided on 4.3.2021

IMPORTANT POINT
“Compensation in insurance claim are subject to terms and conditions of policy.”

Headnote:

Consumer Protection Act, 1986 – Section 21 : [Consumer Protection Act, 2019 – Section 58] – Motor Vehicle – Damage – Insurance Claim – Scope – Petitioner-complainant while driving his vehicle was hit by a dog – Radiator and other parts were damaged – Insurance company settled the claim for Rs.12,995/- – District Forum found that petitioner-complainant had failed to prove any deficiency in service an part respondent – Appeal against dismissed by State Commission – Hence this revision petition – Part of claim not allowed related to damage sustained which was attributable to the complainants own negligence – Compensation in insurance claim are subject to terms and conditions and the claim allowed was based on the report of surveyor – Interference with declined.

Held: I have gone through the record carefully including the citation invoked by the learned counsel for the complainant. In the instant case, insurance claim filed has been considered and allowed by the OP stating reasons for not allowing the amount claimed in full. This can be clearly seen in the relevant portion of the order of the District Forum reproduced in para 3 above. It is this that has been upheld by the State Commission which has, in addition, also opined that since part payment had already been accepted, there was no case for filing any further claim, in the facts of the case. A closer examination of the letter dated 3.2.2016 (supra) reveals that it was in response to Op’s letter dated 20.11.2015 which had explained that the claim had been settled on the basis of the surveyor’s report and that the complainant’s grievance qua non-approval of some parts (radiator assy, silicone adhesive SE, magnetic professi, spark plug, Ignition coil) had also been duly considered and allowed in part ( radiator assy, coolant additive) while the remaining could not be considered as there was no accidental impact on these parts. Read together, it is clear that this was the final amount settled by the OP and was not a partial reimbursement as made out by the complainant. Acceptance of this meant the acceptance of the settled amount. It is my considered view that in the facts of this case, the orders of the lower fora appear to be most reasonable. The OP has examined the claim of the complainant and found that the part of the claim not allowed related to damage sustained which was attributable to the complainant’s own negligence. Indeed, in the complaint itself, the complainant has described, in para 3 thereof, how some of the expenses were incurred: “3. However this payment of Rs12,295/- does not include cost of radiator which was damaged and reason for subsequent repairs and towing of vehicle. This is the crux of the claim – expenses borne en route and replacement of radiator.” This is further amplified in para 9 of the complaint which reads as below:

“9. The claim being made is based on that because of the accident the radiator was damaged and in order to save cost and continue the journey, repairs were done at site i.e. Shahabad.

Initial repairs failed to sustain the running of the vehicle and a new radiator was put in at Panipat.

This too collapsed at the outskirts of Delhi and the engine seized and the vehicle had to be towed to the residence (at 0300hrs).”

A plain reading of the above would indicate that it was indeed the case that the complainant, having hit a dog, adopted the course of action that it did viz. resort to temporary repairs which ultimately may have been the reason why the radiator etc. ended completely damaged. It is this facet of the case that the OP has taken note of while settling the claim. This cannot be said to have been unreasonable on the part of the OP. Compensation in insurance claims are subject to terms and conditions and the claim allowed was based on the surveyor’s report. OP cannot be faulted for this.

Finally, the law in respect of revisionary jurisdiction is fairly clear and well laid down by the Hon’ble Apex Court in the case of Mrs. Rubi (Chandra) Dutta Vs. M/s United India Insurance Co. Ltd., (2011) 11 SCC 269.

In view of the discussion above, I am of the view that no interference in the impugned order of the State Commission is warranted. Accordingly, this revision petition, after consideration, is dismissed at the stage of admission. (Paras 6 to 9)

Result: Petition Dismissed.