UTTARAKHAND STATE CONSUMER DISPUTES REDRESSAL COMMISSION, DEHRADUN
Kumkum Rani, President and B.S. Manral, Member
Tanzeem Ali – Complainant
versus
Manager SBI, General Insurance Company Ltd. and Ors. – Opp. Parties
Consumer Complaint No.4 of 2014
Decided on 31.7.2024
Consumer Protection Act, 1986 – Section 17 – Consumer Protection Act, 2019 – Section 47 – Services – Insurance – Repudiation of Claim – On facts, the insured amount of repair work is so huge, so that the complainant cannot get the repair work started without giving the amount to the concerned garage – Besides, there was a valid reason on the part of the complainant for not sending his damaged insured vehicle to the garage for repair work. There is no cogent, reliable and material evidence on record that the repair was not required in the damaged subject vehicle – The company loss assessor / surveyor has also observed that the repair work is required to be done in the subject vehicle for its proper running – Thus, the insurance company should give the assessed amount immediately after the receipt of survey report in the office, so that the complainant could send his subject vehicle to the garage for its repair work. It is true that on account of not paying the insured amount to the complainant, the complainant has to suffer financial loss because his subject vehicle could not run on road since a long time, therefore, the complainant had to suffer huge loss on account of vehicle parked in the garage due to the accident – By not paying the insured amount in time, the insurance company has committed unfair trade practice and deficiency in service on their part – Compliant allowed. [Paras 10 to 18].
Result: Compliant disposed off.
ORDER
Kumkum Rani, President.—This complaint case under Section 17 of The Consumer Protection Act, 1986 was filed on behalf of the complainant - Sh. Tanzeem Ali alleging that the complainant is the registered owner of the Truck No. UK08-CA- 3469 (Twelve Tyres), which was insured with the opposite party Nos. 1, 2 & 4 company having validity from 09.07.2013 to 08.07.2014 vide policy No. 00001104082 for the sum insured of Rs. 19 Lacs (Rupees Nineteen Lacs only). The said vehicle met with an accident at Barpetta Goverdhan Road, Baksa, Assam on dated 30.08.2013, consequent upon the driver of the said vehicle was found dead and insured vehicle was badly damaged. The opposite party No. 3 (Surveyor) of SBI General Insurance Co. Ltd. had inspected the damaged vehicle on the spot and subsequently after it was towed and parked in Bahadrabaad Eicher Company. The surveyor of the company Sh. Narendra Nath Kalita considering the accident of the vehicle insured had given an estimate of repair of Rs. 18,79,723/-. The opposite party Nos. 1, 2 & 4 could neither paid the insured amount, nor gave any satisfactory answer regarding the repair work of the insured vehicle, therefore, the complainant could not get his vehicle repaired from the appropriate garage. The complainant has to incur huge amount, i.e. Rs. 3 Lacs (Rupees Three Lacs only) from bringing dead body of the driver and from bringing the damaged insured vehicle to Bahadrabaad, but the surveyor of the company did not cooperate him. The complainant is facing huge financial loss because the insured vehicle is parked in the company and without payment of insured amount, the complainant could not get his vehicle repaired from the appropriate garage. The opposite party Nos. 1, 2 & 4 submitted a reply notice dated 03.12.2014 against his legal notice on incorrect basis, but has not paid insured amount to the complainant, therefore, there was an unfair trade practice and deficiency in service on the part of the opposite parties and the complaint should be allowed directing the opposite parties to pay the insured amount of Rs. 18,79,723/- with financial loss to the tune of Rs. 6,76,500/- and compensation for mental agony Rs. 1,00,000/- with Rs. 20,000/- towards litigation charges.
2. The opposite party No. 3 has not appeared before the Commission in this case, therefore, an ex-parte order has been passed against him vide order dated 16.05.2024.
3. The opposite party Nos. 1, 2 & 4 have submitted their joint written statement (paper No. 28 & 29) alleging that the complaint is not legally maintainable and is liable to be dismissed. It is further pleaded in the written statement that the subject vehicle was insured with the answering opposite parties vide policy No. 00001104082 for the period from 09.07.2013 to 08.07.2014 and the subject vehicle met with an accident on dated 30.08.2013 as per the information given by the complainant. The answering opposite parties approached Sh. Narendra Nath Kalita, Independent Surveyor, to conduct the spot survey of the damaged vehicle who submitted his report on dated 02.09.2013, thereafter, Sh. Preetesh Joshi an IRDA approved Independent Surveyor to conduct the final survey, who assessed the loss at Rs. 11,29,447.03ps. and the complainant was advised to get the vehicle repaired, so that the final report could be prepared for further processing of the claim. The complainant refused to get the vehicle repaired and insisted on total loss assessment of the claim, but the terms and conditions of the policy mandate that the insurance company is under an obligation to indemnify the insured for repairs of the vehicle, if the vehicle is in a repairable condition. The complainant did not get the vehicle repaired as directed by the surveyor, despite several reminders; the subject vehicle is in a repairable condition and the demand of the complainant for indemnification on total loss basis is unjustified and wrong. The complaint was filed by the complainant on wrong basis, h
Repair Work – the insurance company should give the assessed amount immediately after the receipt of survey report in the office, so that the complainant could send his subject vehicle to the garage ....
Surveyor – The surveyor should have given the reason why he has disallowed the cost of such parts.
Driving License – As it is proved that the vehicle was in stationary condition, therefore, there was no necessity of driving licence of the insured and in the given facts and circumstances of the cas....
Damage to vehicle in accident – Surveyor is duty bound to properly calculate loss occurred to insured vehicle.
Insurers are obligated to act fairly in claim assessments, and claims under insurance policies cannot be dismissed solely based on survey reports lacking independence.
Surveyor Report - the report of the surveyor is an important piece of document and it cannot be disbelieved unless there is any cogent and convincing reason to do so and the assessment made by the su....
Insurance companies must provide substantial proof when denying claims; unjust repudiation leads to enforceable obligations to pay agreed amounts.
(1) Deductions not permissible to be deducted to determine total loss per terms of insurance policy.(2) Surveyor assessed the liability of the under the lowest liability, whereas it is a case of tota....
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