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2019 Supreme(HP) 1297

HIMACHAL PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION
P.S. Rana (R), President, Vijay Pal Khachi, Sunita Sharma, Members
Ajeet Pathania - Appellant
Versus
Shriram General Insurance Company Ltd. - Respondent
First Appeal No. 172 of 2018
Decided On : 06-03-2019

Advocates Appeared:
Ashok Kumar Verma, Adv., Jagdish Thakur, Adv.

The legal significance of the report submitted by the licensed Surveyor cum Loss Assessor under the Insurance Act 1938 and the Insurance company's legal obligation to pay the assessed claim amount.

Headnote:

Consumer Protection Act - Insurance Claim - 1986 - [12, 15, 64UM(2) of Insurance Act 1938] - The court found that the Insurance company was legally obligated to pay the assessed claim amount by the licensed Surveyor cum Loss Assessor under the Insurance Act 1938. The court also held that the complainant was entitled to compensation for mental agony and harassment due to the Insurance company's failure to pay the assessed amount. The court emphasized the importance of the report submitted by the Surveyor cum Loss Assessor and its legal significance under the Insurance Act 1938.

Fact of the Case:

The complainant filed a consumer complaint against the Insurance company for not settling the claim after a vehicle accident. The Insurance company claimed that the complainant did not accept the assessed claim amount and did not submit the required documents.

Finding of the Court:

The court found in favor of the complainant, holding the Insurance company liable to pay the assessed claim amount by the licensed Surveyor cum Loss Assessor under the Insurance Act 1938. The court also awarded compensation for mental agony and harassment, litigation costs, and allowed the appeal partly.

Issues: The issues involved the settlement of the insurance claim, the legal obligations of the Insurance company, and the entitlement of the complainant to compensation.

Ratio Decidendi: The court emphasized the legal significance of the report submitted by the Surveyor cum Loss Assessor under the Insurance Act 1938 and held the Insurance company liable for not paying the assessed claim amount. The court also recognized the complainant's entitlement to compensation for mental agony and harassment.

Final Decision: The court partly allowed the appeal, set aside the order of the District Forum, and ordered the Insurance company to pay the assessed claim amount, compensation for mental agony and harassment, and litigation costs to the complainant.

JUDGMENT

P.S. Rana (R), President - Present appeal is filed under section 15 of Consumer Protection Act 1986 against order dated 22.05.2018 passed by Learned District Forum in consumer complaint No.234/2016 titled Ajeet Pathania Versus Shriram General Insurance Company Ltd. & Ors.

    Brief facts of consumer complaint:

    2. Shri Ajeet Pathania filed consumer complaint under section 12 of Consumer Protection Act 1986 pleaded therein that complainant is owner of vehicle No.HP-28-5051. It is pleaded that vehicle was duly insured with Insurance company w.e.f. 03.03.2016 to 02.03.2017. It is pleaded that on dated 29.03.2016 vehicle met with accident at place Nalyana. It is pleaded that on a curve brakes of vehicle failed and vehicle gone out of order and hit with a tree and ultimately overturned and was badly damaged. It is pleaded that claim was filed before Insurance company but Insurance company did not settle the claim and committed deficiency in service. Complainant sought O.D claim on total loss basis alongwith interest till realization. In addition complainant sought additional relief of payment of Rs.50/-(Fifty) per day w.e.f. 29.03.2016 as parking charges. In addition complainant sought relief of payment of Rs.20000/-(Twenty thousand) per month w.e.f. 29.03.2016 for loss of earning. In addition complainant sought relief of payment of Rs.200000/- (Two lac) for mental pain and agony. In addition complainant sought relief of payment of litigation costs. Prayer for acceptance of consumer complaint sought.

    3. Per contra version filed on behalf of opposite parties No.1 & 2 pleaded therein that Insurance company has duly processed the claim of complainant and claim filed by complainant was closed as no claim vide letter dated 12.05.2016. It is pleaded that Insurance company appointed Surveyor cum Loss Assessor and he recommended loss to the tune of Rs.80801/-(Eighty thousand eight hundred one) on repair basis. It is pleaded that complainant did not accept the loss assessed by Surveyor cum Loss Assessor and did not submit relevant documents and claim was closed as no claim by Insurance company. It is further pleaded that complicated facts are involved in the present matter and complainant be relegated to civil court. It is pleaded that Consumer complaint is bad for non-joinder of necessary party and Himachal Gramin Bank Sarkaghat is necessary party. Prayer for dismissal of consumer complaint sought.

    4. Complainant filed rejoinder and reasserted the allegations mentioned in the complaint. Learned District Forum dismissed the Consumer complaint. Feeling aggrieved against order passed by Learned District Forum complainant 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. Complainant filed his affidavit in evidence. There is recital in affidavit that deponent is owner of vehicle No.HP28-5051. There is recital in affidavit that vehicle was duly insured with Insurance company and premium was also paid to the Insurance company by deponent. There is recital in affidavit that on dated 29.03.2016 vehicle met with accident and claim was submitted before Insurance company. There is recital in affidavit that M/s. Sagar View Automobiles has submitted estimate claim of repair to the tune of Rs.483256/- (Four lac eighty three thousand two hundred fifty six). There is recital in affidavit that Insurance company did not settle the claim and committed deficiency in service.

          8. Complainant also filed affidavit of Shri Ajay Kumar Manager of M/s. Sagar View Automobiles in evidence. There is recital in affidavit that estimate of repair of vehicle No.HP28-5051 to the tune of Rs.483256/-(Four lac eighty three thousand two hu

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