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KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, THIRUVANANTHAPURAM
B. Sudheendra Kumar, President and K.R. Radhakrishnan, Member
ICICI Lombard General Insurance Co Ltd. and Anr. – Appellants
versus
Sheeja Sreeni – Respondent
First Appeal No.16 of 2018
(Arisen out of Order Dated in Case No.CC/537/10 of District Trissur)
Decided on 5.12.2024
Consumer Protection Act, 1986 – Section 15 [Consumer Protection Act, 2019 – Section 41] – Appeal – Insurance – Breach of terms and conditions – repudiation justified – Insurance Company cannot always repudiate the claim of the insured if at all there was any breach of the conditions in the contract of insurance. In order to repudiate the claim of the insured, there should be fundamental breach of the conditions contained in the contract of insurance. This being the position, Commission proceeded to determine as to whether the absence of fitness certificate on the date of accident could be considered as a fundamental breach of the conditions contained in the contract of insurance – It is clearly borne out from Exhibit R3 that the vehicle of the complainant was not having fitness certificate on the date of accident. By driving the lorry along the public road without having the certificate of fitness as provided under the Act, the complainant committed fundamental breach of the terms and conditions contained in the contract of insurance, and consequently, the opposite parties were justified in repudiating the claim of the complainant. In the said circumstances, no deficiency in service can be attributed to the opposite parties. Consequently, the order passed by the District Commission cannot be sustained – Appeal allowed. [Paras 15 to 24]
Result: Appeal allowed.
JUDGMENT
B. Sudheendra Kumar, President—The appellants are the opposite parties in C.C.No.537/2010 on the files of the District Consumer Disputes Redressal Commission, Thrissur (for short ‘the District Commission’).
2. The respondent herein is the complainant before the District Commission.
3. The lorry of the complainant bearing registration No. KL 08 AH 3117 met with an accident on 06.02.2009. The said vehicle was having valid insurance policy for the period from 30.11.2008 to 29.11.2009. The lorry sustained severe damage in the accident. The complainant lodged a claim before the opposite parties in connection with the damage sustained to the lorry. However, the said claim was repudiated by the opposite parties on the ground that the vehicle did not have a fitness certificate as on the date of accident.
4. Aggrieved by the repudiation of the claim by the opposite parties, the complainant filed the above complaint alleging deficiency in service on the part of the opposite parties.
5. The opposite parties filed version admitting the policy coverage of the vehicle. However, the opposite parties contended that since the vehicle of the complainant did not have a valid fitness certificate as on the date of accident, the claim of the complainant was repudiated by the insurance company as per the terms in the policy and in the said circumstances, there was no deficiency in service on the part of the opposite parties in this regard.
6. PW1 was examined and Exhibits P1 to P4 were marked for the complainant. Exhibits R1 to R4 were marked for the opposite parties.
7. After evaluating the evidence, the District Commission directed the opposite parties to pay Rs.1,07,015/- (Rupees One Lakh Seven Thousand and Fifteen only) towards the claim of the complainant along with costs of Rs.5,000/- (Rupees Five Thousand only), against which this appeal has been filed.
8. Heard both sides. Perused the records.
9. The learned advocates on both sides have advanced argument supporting their respective contentions.
10. It is not disputed that the vehicle of the complainant had met with an accident on 06.02.2009, which was during the period when the policy was in force. The vehicle sustained damage in the accident. Exhibit R4 is the report of the Surveyor, which would show that the vehicle sustained damage to the tune of Rs.1,07,015/- (Rupees One Lakh Seven Thousand and Fifteen only). Exhibit R3 is the certificate issued by the Motor Vehicle Inspector, which would show that the vehicle of the complainant was having fitness certificate for the period from 31.01.2008 to 30.01.2009 and from 05.06.2009 to 04.06.2010. It is clear from Exhibit R3 that the vehicle of the complainant did not have any valid fitness certificate as on 06.02.2009, the date of accident.
11. The question to be considered is as to whether the opposite parties were justified in repudiating the claim of the complainant on the reason that the vehicle of the complainant had no fitness certificate on the date of accident.
12. A three Judge Bench of the National Commission in G. Kothainachiar vs United India Insurance Co. Ltd. and others reported in 2007 4 CPJ 346 : 2008 1 CPR (NC) 50 held in paragraph 18 as hereinbelow:-
“18. As stated above, in the present case, the insured was having fitness certificate with regard to the vehicle till 30th May, 1995. The accident took place on 20th June, 1995. Further, as per the RTO Inspection Report, the vehicle was in good condition for its being plied at the time of accident. In this view of the matter, the impugned order passed by the State Commission cannot be sustained and is set aside. The order passed by the District Forum is restored”.
13. The Hon’ble Supreme Court in United India Insurance Co. vs Sushil Kumar Godara (Civil Appeal No.5887/2021) held that when an insurable incident that potentially results in liability occurs, there should be no fundamental breach of the conditions contained in the contract of insurance.
14. In paragraph 15 in
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