Decided on April 06,2006

Tata Aig General Insurance Co Ltd Appellant
B Balasubramanian And Anr Respondents


- (1.)THE 1st opposite party is the appellant. The respondent No. 1/complainant filed a complaint directing the appellant/opposite parties to pay cost of repairs to his damaged car and compensation of Rs. one lakh.
(2.)THE case of the complainant is as follows:
The complainant is the owner of the Toyota Qualis F3 car bearing Registration No. PY01 T 8686. He purchased the car by availing loan from Tata Finance Ltd. under HP agreement and, therefore, he was under obligation to insure his vehicle with the 1st opposite party. 2nd opposite party is the authorised agent of 1st opposite party, who arranged for taking the policy of insurance. The complainant's vehicle was insured with the 1st opposite party and the vehicle had valid insurance coverage from 10.00 hours on 30.8.2002 to the midnight of 29.8.2003. The complainant has been using his car for private purpose. At no point of time, the complainant used his car for hire or reward or carriage of goods. The car met with a road accident on 13.12.2002 at about 7.30 a.m. near Paramankeni Palam on East Coast Road. The car skidded on the road as a result of which it toppled and rolled down into a roadside pit and suffered heavy damages. One Kathiresan, who possessed a valid driving licence drove the said car and one Jeyanthi, who is the relative of the complainant was the same person travelling in the car at the time of the accident. The complainant sent his nephew viz., P. Velu to visit the accident spot. The said Velu visited the accident spot and lodged a complaint before G6 -Cheyyur P.S., Kanchipuram District. The police have also registered a case against the driver for an offence under Section 279, IPC. The complainant also informed the 1st opposite party about the fact of accident under the prescribed Intimation -cum -Preliminary Claim Form dated 19.12.2002. The 1st opposite party conducted survey of the damaged vehicle on 13.12.2002. The vehicle was taken from the accident spot to Chennai where the vehicle was inspected by Lanson, Chennai. The 1st opposite party appointed M/s. Vasu Associates, Chennai as the Investigator to probe into the accident. The investigator required the complainant to produce certain unnecessary documents like, fuel bill, toll bill, history of the car till date of accident, the number of free services utilised, dates of services along with the mileage clogged. The Investigator had also required the complainants to furnish unwarranted and unnecessary details like the complainant's arrival in India with copy of Passport, places visited by the complainant with his family members on pilgrimage tour with receipts and hotel bills. These particulars are trivial and they are in no way relevant for deciding the claim of the complainant. The complainant had personal discussion with the Investigator on the above requirement of particulars. Though the Investigator seemed to be satisfied with the manner of accident, the 1st opposite party by letter dated 2.6.2003 has informed their inability to admit the complainant's claim alleging that the vehicle had been under usage for excluded purpose in violation of General Exceptions 3(a). The rejection of the complainant's claim by the opposite party without assigning any valid reason would show that the opposite party has designed a plan to thwart the legitimate claim of the complainant. The act of the 1st opposite party in rejecting the complainant's claim amounts to deficiency in service. The complainant purchased the car by availing loan to the tune of Rs. six lakhs. The complainant has to pay Rs. 13,000 per month towards monthly instalments. As the 1st opposite party has neglected to pay the cost of the damages, the complainant has stopped payment of monthly instalments to the financier. In case, the Tata Finance Co. would charge any penal interest on the outstanding loan amount, it is only the 1st opposite party, who would be liable to pay the same. The complainant issued notice on 30.5.2003 calling upon them to pay the entire cost of repairs. The 1st opposite party did not choose to send any reply to the above notice. M/s. Lanson Toyota has estimated the tentative cost of the vehicle at Rs. 5,72,131. That apart, the complainant has incurred heavy expenditure by way of purchase of a new car. Due to the above act of the opposite parties, the complainant has undergone mental torture and agony. Therefore, the opposite parties are liable to compensate the complainant. The opposite parties may be directed in their capacity as the insurer and authorised agent, to pay the entire cost of repairs as charged by M/s. Lanson Toyota either to the complainant or directly to the company or in the alternative to replace the damaged car by a new car. The opposite parties may be directed to pay the entire penal charges on the outstanding loan amount and Rs. 50,000 as compensation for the deficiency in service and unfair trade practice. The opposite parties may be directed to pay Rs. 40,000 towards towing charges and another sum of Rs. 50,000 towards mental torture and agony.

(3.)THE case of the 1st opposite party is as follows:
The opposite party on receipt of the claim made by the complainant engaged the service of the Investigator viz. M/s. Vasu Associates. The Investigator on the basis of the letter given by the driver, Kathiresan stating that he had been to hospital enquired at PIMS Hospital and found that in the said accident, the said driver and one Marie Jose were injured and treated in the said PIMS Hospital. It was found that Marie Jose was the person travelled in the vehicle when it involved in the accident and she was carrying 76 units of blood in three ice boxes belonging to MMM Hospital. On coming to know about the same, the Investigator requested the Pondicherry Institute of Medical Sciences and MMM Hospital, Mogappair to clarify whether the vehicle involved in the alleged accident was used for transporting blood samples from MMM Hospital to Pondicherry Institute of Medical Sciences. MMM Hospital by letter dated 3.2.2003 informed the Investigator that the vehicle of the complainant had come into their premises at 5.05 hours on 13.12.2002 and left at 6.10 hours with one Mrs. Marry Jose. The Pondicherry Institute of Medical Sciences by letter dated 26.2.2003 informed the Investigator that the vehicle left PIMS at 2.30 a.m. on 13.12.2002 and the vehicle reported the MMM Hospital at 5.15 a.m. and left with Mrs. Marie Jose at 6.15 a.m. and after coming to know about the accident, the PIMS sent an ambulance to the accident spot and brought them there and except one empty box and one sachet, all other materials were recovered and Mrs. Marie Jose was put into the plaster for her fracture of leg. From the above facts, it is clear that the accident occurred on 13.12.2002 when the vehicle was used for transporting blood samples from MMM Hospital at Chennai to Pondicherry Institute of Medical Sciences. The complainant in order to make false claim had set up his relative, P. Velu to lodge a complaint with G -6, Cheyyur Police. As per the records of PIMS, only Mrs. Marie Jose got injured and PIMS had sent their ambulance to the accident spot and brought them to Pondicherry. When that being the case, the complaint given by P. Velu is false one. The opposite party on coming to know about the usage of vehicle through the Investigator, rightly repudiated the claim of the complainant.P. Velu, while giving the complaint before police had not stated that the occupant of the car is Jeyanthi and that she is related to the complainant. In the letter dated 14.12.2002 given by the driver, it is stated that the lone occupant of the vehicle was Mrs. Jeyanthi, the sister of the complainant. Whereas, in the subsequent letter dated 18.12.2002, he never stated about the relationship of Jeyanthi. The complainant has stated in the complaint that the said Jeyanthi is his relative and not chosen to give the nature of the relationship. During investigation, the said Jeyanthi had not disclosed that she is related to the complainant. It is clear that Jeyanthi was not the person, who was the occupant of the vehicle at the time of accident. The opposite party has found that the vehicle was used for commercial purpose in contravention of the General Exceptions. The opposite party denied the allegation that the vehicle was used for private purpose. During investigation, it was found that the car was used for carrying blood samples from MMM Hospital to PIMS. The averments in the complaint that because of the denial of the claim, the complainant is not able to pay the instalments are not true. The information gathered by the Investigator would prove that the vehicle was used only by the PIMS for carrying blood samples which is not permitted under the policy and, therefore, the claim was repudiated.

The 2nd opposite party was set ex parte.

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