MEGH PAL THAKUR Vs. ORIENTAL INSURANCE COMPANY LIMITED

JUDGEMENT

(1.) The present complaint has been filed on the allegations that the complainant had purchased Truck No. HP -10 -0833 on 9.321998 and the same was registered with the Registration" & Licensing Authority, Shimla on 18.3.1998. It was purchased by for his self employment in order to earn livelihood. The finance for the purchase was arranged through a loan of Rs.5.00 lacs from India Lease Development Limited carrying an interest of 18% per annum. The balance amount was arranged by taking private loans from his relations and friends on returnable basis.

(2.) The truck, in question, was insured with the opposite party on 9.2.1998 for a sum of Rs.6.50 lacs, and the insurance was valid for a period of one year with effect from 9.2.1998 to 8.2.1999. The complainant duly paid the premium amount of Rs.13,450/ - to the opposite party on the date of insurance i.e. 9.2.1998, policy No. being 2794. Unfortunately, the truck, in question, met with an accident on 15.4.198 within about two months of its purchase at Village Shalli, Tehsil Suni, District Shimla, resulting total loss as a result of the extensive damage caused in the accident. F.I.R. was lodged with the Police Station, Delhi in this connection and the factual of accident was also conveyed to the opposite party -Insurance Company. It got conducted a spot survey and an interim report was prepared. Subsequently, final survey was also done by one Shri H. Kumar from Delhi appointed as Surveyor by the opposite party. He submitted his report regarding loss to the vehicle as assessed by him to the opposite party, the assessed loss being the total one. In other words, the complainant was entitled to be indemnified - to the extent of the total insured amount of Rs.6.50 lacs. However, the Insurance Company obtained his consent to settle the claim at a sum of Rs.5.80 lacs. Despite this, it failed to settle the claim at the agreed and consented amount of Rs.5.80 lacs. In this connection -, the complainant event sent two representations to the Divisional Manager of the opposite party but to no avail. Ultimately on 10.2.1999, he was shocked and surprised to receive a letter from the opposite party that his claim had been assessed for the payment of Rs.4,33,500/ - only. When he visited the office of the opposite party to find out the reasons for scaling down the amount of the claim, he was given a vague and unsatisfactory reply to the effect that the amount had been reduced since the terms and conditions of the Police had been violated. Hence the complaint which is duly supported by his own affidavit by the complainant.

(3.) In the reply filed by the opposite party, the truck, in question, having been insured with it, for the period 9.2.1998 to 8.2.1999 has been admitted. It has also been admitted that the insured amount is Rs.6.50 lacs. It has further been admitted that the Surveyor Shri H. Kumar assessed the loss on total loss basis of the damaged vehicle in the accident. It has further been admitted that on the recommendations of the Surveyor that net liability of the loss on total loss basis being Rs. 5,78,500/ -, the complainant gave his consent on 14.7.1998 to the Branch Office of the opposite party at Parwanoo for settlement of his claim. However, when the offer of the complainant was brought to the notice of the Divisional Officer of the opposite party at Shimla, it was found that his claim falls under the category of » non -standard claim in as much as there were unauthorized passengers traveling in the truck which was the breach of Insurance Policy. Hence, the claim was recommended upto 75% of the assessed loss i.e. for a sum of Rs. 4,33,500/ - which was intimated to the complainant. This decision of the opposite party was also ratified by its Regional Office at Chandigarh which was the competent authority.