ORIENTAL INSURANCE COMPANY LIMITED Vs. JOY B STEPHEN

JUDGEMENT

(1.) THIS is a fifteen -year -old consumer dispute. The complainant (the respondent herein) is the owner of a Tata Mini Bus insured with the opposite party (the appellant). The vehicle met with an accident on 24.12.1992 near Dabal Kulsai road when it crashed against a big tree. The vehicle was taken for repairing to "Shripad Garage" at Sanvordem Goa, and a claim was filed with the opposite party. A surveyor deputed by the opposite party inspected the vehicle. An estimate was prepared by M/s. Shripad Garage upon inspection and a list of parts was furnished to the complainant vetted by the surveyor. Accordingly, the complainant procured the parts and submitted original bills to the opposite party to enable settlement of his claim, in addition to complying with other requirements. The salvage was also handed over to the opposite party. However, the claim was not settled in spite of followup and fulfilling of all legal formalities by the complainant. Instead, the opposite party issued a letter dated 4.5.1994 repudiating the claim on the ground that the claim was false and based on serious misrepresentation of facts. The so -called misrepresentation of facts was not made known. A legal notice was issued by the complainant on 11.6.1994, but it evoked no action or response from the opposite party. This, in a nutshell, is the case of the complainant in his complaint filed before the Consumer Disputes Redressal Forum (District Forum) South Goa, registered as Complaint No. 214/1994. Case of the opposite party/appellant

(2.) THE complaint was contested by the Insurance Company. Succinctly, it is their defence that the complainants claim for alleged loss/damage to the vehicle was approved for repairs and replacement of certain parts. However, the complainant submitted false and fraudulent bills towards the purported replacement of certain parts aggregating to Rs. 71,220. Two separate bills of M/s. Dhanlaxmi Associates and M/s. Shriman Spares Company that were submitted were found to be fake and fraudulent having been issued by shops which did not exist. Hence the repudiation. The legal notice was replied by the Advocate of the opposite party. Order of the District Forum

(3.) THE District Forum, upon considering the case of the parties and the material on record accepted the case of the complainant in its order dated 1.10.2007 and found that the repudiation of the claim conclusively construed deficiency in service on the part of the opposite party and directed them to pay the complainant an amount of Rs. 88,000 with interest @ 12% p.a. from 1.10.1993 and further to pay cost of Rs. 10,000. The opposite party, being aggrieved by the said order, has preferred appeal before this Commission. Submissions