DISTRICT CONSUMER DISPUTES REDRESSAL FORUM MYSURU No.1542 F, Anikethana Road, C and D Block, J.C.S.T. Layout, Kuvempunagara, Kuvempunagara, (Behind Jagadamba Petrol Bunk), Mysuru-570023 Complaint Case No. CC/1328/2016 1. Jayaram R Jayaram.R., S/o Ramakrishna, LIG 37, 3rd Stage, Near Forest Office, KHB Colony, Hunsur. ...........Complainant(s) Versus 1. M/s.universal Sompo General Insurance Co.Ltd., M/s Universal Sompo General Insurance Co.Ltd., 3rd Floor, KVV Samrat, 217/A, 3rd Main, Outer Ring Road, Kasturi Nagar, Bangalore-560043, Locak office at No.363, 2nd Floor, Gurukar, Devanna Street, Fort Mohalla, Mysuru-570004. ............Opp.Party(s) BEFORE: HON'BLE MR. M S RAMACHANDRA PRESIDING MEMBER HON'BLE MR. Y S THAMMANNA MEMBER For the Complainant: For the Opp. Party: Dated : 02 Jan 2018 Final Order / Judgement BEFORE THE ADDITIONAL BENCH DISTRICT CONSUMER DISPUTES REDRESSAL FORUM AT MYSURU. Consumer Complaint (C.C.)No. 1328/2016 Complaint filed on 14.07.2016 Date of Judgement.02.01.2018 PRESENT : 1. Shri Ramachandra M.S., B.A., LL.B., PRESIDENT 2. Shri Thammanna,Y.S., B.Sc., LL.B., MEMBER Complainant/s : Mr. Jayaram.R S/o Ramakrishna Aged about 40 years, R/at LIG 37, 3rd stage, Near Forest Office, KHB Colony, Hunsur (Smt. K.S. Sugandhi., Advocate) V/s Opponent /s : 1.M/s. Universal Sampo General Insurance Co, Ltd., 3rd floor, KVV Samrat, 217/A, 3rd main, outer Ring road, Kasturi Nagar Bangalore-560043. Local Office at # 363, 2nd floor, Gurukar Devanna Street, Fort Mohalla, Mysore-570004. (Sri. Jaganath Sureshkumar., Advocate) Nature of complaint : Deficiency in service Date of filing of complainant : 14.07.2016 Date of Issue notice : 06.12.2016 Date of Order : 02.01.2018 Duration of proceeding : 1 year 5 month 18 days SHRI RAMACHANDRA . M.S., PRESIDENT JUDGEMENT The complainant filed the complaint Under Section 12 of Consumer Protection Act, 1986 against the opposite party seeking for relief of insurance claim amount and prayed for other relief. 2. The brief facts of the complainant that, the complainant is the owner of Scorpio SUV car bearing No. KA-28-N-6939 which he had purchased with the help of financial assistance from Indian Overseas Bank at Hunsur. As per RC, and the policy, it has been manufactured in 2011. The original chassis No. 34141 has been replaced now after the accidental loss as it got damaged in the accident. The new chassis number has been mentioned in the RC book. He is in possession of valid and effective DL to drive the LMV Car. The complainant took the comprehensive policy with the opposite party at the local office situated at Mysore by paying the amount of Rs. 18,556/- towards the premium of the policy covering the period from 19.09.15 to 18.09.16 bearing no 2311/154427312/01/000. 3.It is further submitted that, on 05.04.16 at about 11 Am, when the complainant was driving from Mysore to Bangalore near Gopalan Mail, Bangalore, he applied sudden brake due to which the wheels got twisted resulting in damages to the insured vehicle. At the relevant point of time, the policy was in force and the complainant had valid and effective DL having not violated any terms and conditions of the policy as he had immediately informed the company about the accident. As per the advice given by the official , the vehicle was towed to Mysore by spending Rs. 6,000/- and left it for repair at the authorized service center by name IG workshop situated at Hebbal Industrial Area, Mysore. Hence the said amount has to be repaid by the opposite party. 4. It is respectfully submitted that, the opposite party, got appointed the surveyor by name G. Lakshmi Chaitanya who visited the workshop and surveyed the damaged insured vehicle and gave a report on 22.04.16 opining that the total loss would be Rs. 89,627/- which amount may go up by 10 to 15% when the vehicle is dismantled. He has taken the value of salvage at Rs. 8760/- which is not depicting true figures as it is not even worth more than Rs. 1,000/- Similarly the other figures also not reflecting the reality. However, the workshop repairer had estimated the cost of repair as Rs. 1,55,0193.26/- without dismantling the vehicle. 5. It is further submitted that, after the survey, the complainant went to meet the opposite party and requested for the release of the funds as per the schedule for which the opposite party did not oblige and kept up the promise. After several rounds of visits and discussion the opposite party issued a repudiated letter dated 05.05.2016 rejecting the claims as accident was not due to any external damages and thus, the loss is not covered. The complainant was shocked to see the rejection letter. He was not able to understand the logic behind such refusal to entertain the claim of the complainant. 6. It is respectfully submitted that, till such letter of repudiation received, the complainant had not got his vehicle dismantled. He requested the opposite party to reconsider the stand but of no use. Thus, the complainant asked the workshop owner to repair the vehicle and collected the vehicle by paying the amount of Rs. 1,44,682/- towards the spare parts and labour charges, on 13.06.16 which amount is required to be reimbursed by the opposite party. 7. Notice to the opposite party duly served represented by counsel filed version. 8. The complainant and opposite party filed chief examination affidavit and filed documents arguments heard, reserved for orders. 9. Heard arguments. 10. The points that arise for our consideration are; Whether the complainant proves that there is deficiency in service on the part of opposite party by not settling the insurance claim amount and thereby proves that he is entitle for the relief sought? What order? 11. Our answer to the above points is as follows; Point No.1: In the affirmative Point No.2: As per final order for the following; REASONS 12. Point no.1 :- That there is no dispute between complainant and opposite party in so for as the transaction of issuance of policy to the complainant vehicle bearing no KA-28-N-6939 and its validity as on the date of alleged incident occurred on 05.04.16 and due to which the complainant vehicle gat damaged and to repair the same the estimated cost it Rs. 1,55,019.26/- as the said vehicle was insured with opposite party company. Since there is indiminifaction clause in insurance contract entered between complainant and opposite party company. The complainant has raised the claim and upon which opposite party company has appointed surveyor and report is submitted on 22.04.2016 and total loss is assessed for Rs. 89,627/- and it is also observed that the accident was not occurred due to any kind of external damages so the cause of loss is not covered. Basing on the observation in report opposite party company has rejected to settle the claim of complainant as the conditions of policy does not permit them to entertain such claim. 13. Here it is apparent on the face of surveyor report that at one breath he estimated the loss to the tune of Rs. 89,627/- and in the final report he observed to dis honour the complainant claim by assigning his own reasons the report very clearly shows that he is trying to blow both hot and cold at one breath, which is not permissible under law another a signification observation to be made in the surveyor report is that, as per the say of surveyor he has only inspected and examined the above said vehicle externally and when there is no external damages to the vehicle he opined that as the loss to the vehicle is not due to any kind of external damage. 14. Further it appears surveyor who has inspected and submitted report has only examined the outer part of the above said vehicle and it is apparent from the report submitted by the surveyor who is an expert in the technical aspects has only examined external part of the vehicle. Why he has not examined the entire vehicle and opposite party has also failed to explain any terms and condition which prevented them from entertaining the lawful claims of complainant. From the bald reading of survey report we can come to the conclusion that the report submitted by surveyor cannot be accepted in total. As he has only submitted his report basing on the external examination of the above said vehicle. The opposite party company has utterly failed to establish that any internal damage which is occurred to the vehicle due to the impact of alleged apply of brake suddenly by the complainant. Here in this case the surveyor has only submitted the report to the satisfaction of company it appears that it is only a fabricated report which is planned and prepared at the instance of opposite party company. In order to defeat the lawful claim of complainant. From the above observation we can defiantly say that there is a deficiency in service on the part of opposite party company and they have also failed to justify the repudiation of complainant claim. 15. Further the complainant has prove his case beyond reasonable doubt and also deficiency of service on the part of opposite party. Under such circumstance the complaint is liable to be allowed. Accordingly we answered point no.1 in the affirmative. 16. Point no.2:- From the above discussion we hereby proceed to pass the following :- ORDER The complaint is hereby allowed in part. The opposite party is directed to pay sum of Rs. 89,627/- to the complainant within 30 days of this order with interest at the rate of 15% p.a. from the date 05.04.2016 till payment made. The opposite party is directed to pay of Rs.. 5,000/- towards deficiency in service and Rs.3,000/- towards mental agony Rs. 3,000/- towards cost of proceedings to the complainant within 30 days of this orders. In default to comply the above order opposite party shall pay interest on the said amount of 11,000/- at the rate of 10% p.a. from the date of order till payment made. In case of default to comply this order, the opposite party shall undergo imprisonment and also liable for fine under section 27 of the CP Act, 1986. Give the copies of this order to the parties, as per Rules. (Dictated to the stenographer transcribed , typed by her, transcript corrected by us and then pronounced in open court on the 2nd January 2018) Shri Thammanna Y.S., Shri Ramachandra M.S., Member. President. [HON'BLE MR. M S RAMACHANDRA] PRESIDING MEMBER [HON'BLE MR. Y S THAMMANNA] MEMBER