UNITED INDIA INSURANCE CO LTD vs Ganesh Kumar Jain

THIS appeal, under Section 15 of the Consumer Protection Act, 1986, is directed against the order dated 22.6.2004 in Complaint No. 34/2004 by District Consumer Disputes Redressal Forum, Rajnandgaon (hereinafter called the District Forum for short), whereby the complaint was partly allowed. Aggrieved by this order, the O.P./Insurer has preferred this appeal.

BRIEF facts necessary for disposal of this appeal are that Maruti Zen vehicle of the complainant bearing No. CG -08/0051 was insured with the O.P./Insurer, bearing policy No. 190587/31/02/03482 for the period from 15.2.2003 to 14.2.2004. On 9.6.2003 the aforesaid vehicle met with an accident near Tumdibod. The complainant had immediately informed the Development Officer of O.P./Insurer regarding the accident and has filed relevant documents relating to the claim. It was further averred in the complaint that Mr. L.K. Dudeja was appointed as Surveyor. Despite the report of the Surveyor as aforesaid, the insurer failed to make the payment of the claim amount to the complainant, hence the complainant has filed the complaint before the District Forum. O.P./Insurer averred in the written version that the complainant did not immediately intimate Rajnandgaon Branch Office regarding the accident on 9.6.2003 itself but had intimated Bhilai Branch regarding the accident on 12.6.2003. It was further averred that the complainant did not co -operate with the Surveyor and did not furnish necessary documents required by the Surveyor. It was further averred that during the survey, it was revealed that the engine installed in the vehicle was a different one and the same was not insured by the insurer. It was further averred that the complainant had also failed to lodge any report regarding the accident. The complainant further failed to assign any reason for not lodging the report and the complainant had also laid exagerated claim with the insurer. It was averred in the written version that due to the aforesaid reasons the complainant was not entitled to get the claim under the policy.

ON the strength of the reasons given in the impugned order learned District Forum did not agree with any of the objection raised by the O.P./Insurer and had partly allowed the claim as assessed by the Surveyor.

ARGUMENTS of both the parties were heard. Record perused. Learned Counsel for the appellant submitted that the learned District Forum has erred in ignoring the discrepancy in engine number found in the vehicle in question and the one which was insured. It was further averred that the Surveyor L.K. Dudeja had clearly mentioned that the engine number of the vehicle was 502246 whereas the engine numer of the vehicle insured with the O.P./Insurer was 502248. It was a discrepancy which goes to the root of the case hence the order of the District Forum cannot be sustained.

LEARNED Counsel for respondent drew our attention to the application filed on behalf of the respondent whereby the respondent had prayed for direction to the appellant for filing letter dated 10.11.2003 of Surveyor L.K. Dudeja in order to make clarification regarding the engine number. In compliance of the directions given by this Commission regarding the aforesaid application, the appellant had filed the copy of the aforesaid letter whereby it was intimated to Branch Manager of the insurer at Rajnandgaon that the engine number of the Maruti Zen vehicle of the complainant bearing No. CG -08/0051 was 502248. Learned Counsel for respondent further submitted that Branch Manager had received the aforesaid letter on 28.11.2003 as is clear from the endorsement made on the copy of the letter i.e., during the dependency of the complaint before the District Forum. Subsequently, the impugned order was passed on 22.6.2004 and O.P./Insurer preferred to file the instant appeal even though the insurer was fully aware that the claim of the complainant was genuine and there is no discrepancy in the engine number as the point was clarified by the Surveyor by his letter dated 10.11.2003. Learned Counsel for the respondent further submitted that in view of the aforesaid facts and circumstances, it is clear that the appellant has not come before this Commission with clean hands. He prayed that the appeal be dismissed with heavy cost.

ON perusal of the record it appears that in the Certificate of Registration of Maruti Zen Vehicle in the name of Ganesh Jain, the engine number is clearly mentioned as 502248 and the chassis number of the said vehicle is mentioned as 545486. The registration number allotted to the said vehicle is CG -08/0051. In both the policy cover note as well as Certificate of Insurance, the engine number of the aforesaid vehicle has been clearly mentioned as 502248. It appears that the controversy arose simply because the Surveyor L.K. Dudeja had wrongly mentioned the Engine Number as 502246 instead of 502248. As pointed out by learned Counsel for respondent that the aforesaid Surveyor vide his letter dated 10.11.2003 mentioned that the engine number of the aforesaid vehicle was 502248, we are of the opinion that on receiving such intimation the insurer was under an obligation to correct the mistake by allowing the claim which had been wrongly repudiated simply because the Surveyor had wrongly mentioned the engine number of the vehicle in question. Instead of so doing the insurer has suppressed this fact and did not disclose it before the District Forum and even went to file an appeal against the impugned order solely on the ground that the engine number of the vehicle in question was found to be mentioned by the Surveyor as 502246 whereas the engine number mentioned in the policy document was 502248. In view of the aforesaid discussion we are of the opinion that though initially the insurer had reasonable doubts regarding the engine number and under the circumstances the repudiation cannot be said to be mala fide. However, subsequently when the dispute regarding the engine number was clarified by the Surveyor and the insurer came to know vide his letter dated 10.11.2003 that the engine number of the vehicle was the same as was mentioned in the registration book as well as in the policy documents, then the insurer was under an obligation to correct their mistake by submitting true facts before the District Forum and allow the claim as assessed by the Surveyor.

IN the aforesaid circumstances, we are of the opinion that the order of the District Forum is just and proper and the same is affirmed. This appeal is dismissed. Besides bearing its own cost of this appeal, the appellant shall pay that of the respondent which is quantified at Rs. 5,000 (Rupees five thousand) only. Appeal dismissed.