PRESIDENT DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR

                                                         CONSUMER COMPLAINT NO.111/2023

Present-Dr. Ramakanta Satapathy, President,

  Sri. Sadananda Tripathy, Member,

Satyanaran Patel,

S/O- Debarchan Patel,

R/O of At/PO-Chandanimal, PS-Kuchinda.

Dist-Sambalpur-768222, Odisha,

Ph No. 9437353800, Email-skpatel.cml@gmail.com.   …………........Complainant

Vrs.

1. HDFC-ERGO General Insurance Company Limited

Registered & Corporate Office: 1^st Floor, HDFC House, Backbay Reclamation, H.T. Parekh Marg, Churchgate, Mumbai-400020.

2. Raghavendra M.

Senior Manager-MOD Claims, HDFC ERGO General Insurance Company Ltd. Unit No. 502,504,506, 5^th Floor, Mahatta Tower, B-1 Block, Community Centre, Janakpuri, New Delhi-110058 Mob-+919136044709.

•                  ….…...…….Opp. Parties

Counsels:-

1. For the Complainant         :- Self
2. For the O.P. No.1 & 2        :- Sri. S. Mahapatra, Adv.

Date of Filing:12.07.2023,Date of Hearing :19.02.2024, Date of Judgement : 15.04.2024

  Presented by Dr. Ramakanta Satapathy, PRESIDENT

1. The Complainant filed this complaint alleging delay and negligence in motor insurance claim, non-payment of full claim and consequential loss and damages. The brief facts of the complaint is that for private car No. OD 14L 1270. Maruti Suzuki Bolero the Complainant availed policy No. 23111004 62816401000 from the O.Ps for the period 30.06.2020 to 29.06.2021 having IDV Rs. 4,28,854/-. Due to road accident near under Bhasma Police Station, Sundargarh near Masnikani Tool gate vehicle was damaged and claim No. C 230020318219 dated 31.12.2021 made. The Complainant disputed:

Date of declaration of settlement as 11.05.2021.

Date of realisation of advance payment 22.11.2021.

And date of closure of claim 22.11.2021.

The O.Ps after 130 days of registering the claim on 31.12.2020 considered the claim as “TOTAL LOSS” on 11.05.2021. After 66 days of sanction of Rs. 2,30,000/- advance payment was released on 14.05.2021 only through cheque(SBI, Kuchinda released on 20.07.2021) The O.Ps have hidden information about salvage buyer and final assessment process, no compensation given pre-matured closure made and contradictory order passed by the O.Ps. No any satisfactory relief was passed by the insurance ombudsman.

Being aggrieved complaint has been filed.

2. The O.Ps in their reply submitted that the O.Ps received claim intimation on 31.12.2020. Immediately surveyor was deputed who reported total loss and the O.Ps were ready to settle the claim on total loss basis i.e. Rs. 2,55,854/- subject to mandatory deductions. The O.P. has arranged for preliminary auction of the vehicle and as on 05.10.2021, highest bid received from the wreck buyer to-wards the damaged vehicle was Rs. 1,72,000/-.

On the request of the Complainant as he wanted to retain the vehicle, the O.Ps paid Rs. 2,30,000/- to the financier, SBI loan account vide cheque No. 103813 to-wards settlement of loan and to obtain NOC.

Original IDV Rs. 4,28,854/-.

Payment made to Loan account Rs. 2,30,000/-.

Policy excess- Rs. 1,000/-.

Realizable Salvage Value Rs. 1,72,000/-.

To realize the salvage value of Rs. 1,72,000/- from scrap vehicle and process of remaining claim amount, the Complainant has not submitted the mandatory documents after giving several intimations. For non co-operation of the Complainant the O.P. closed the claim.

The Complainant has not affected R.C. cancellation. The Ombudsman dismissed the case and there is no deficiency on the part of the O.Ps.

3. Perused the documents filed by the Complainant and O.Ps.

Complainant filed:

1. Registration Certificate of Vehicle No. OD-14L 1270.
2. Policy No. 2311-1004 6281 6401-000.
3. Claim registration.
4. Total loss intimation letter dated 05.10.2021.
5. Final Assessment letter dated 22.11.2021.
6. Closure of claim letter dated 22.11.2021.

The O.Ps filed:

1. Policy No. 2311-1004 6281 6401-000.
2. Standard form for private car package policy.
3. Claim form dated 02.01.2021.
4. Surveyor report dated 19.11.2021.
5. Correspondences of the Complainant.
6. Correspondences of the O.Ps.
7. Awards dated 19.05.2023 of Ombudsman.
8. IRDAI circular dated 25.07.2019.

4. Perused the documents filed by both the parties. In the present case the main allegations of the Complainant is non-settlement of claim in time, Supression of the Salvage process and final assessment process.

It is the admitted case of both the parties that:

IDV of the vehicle Rs. 4,28,854.00.

Payment made to loan account Rs. 2,30,000/-.

Policy excess. Rs. 1000.00.

Realisation of Salvage Value- Rs. 1,72,000/-.

Claim made on 31.12.2020 vide claim No. C 230020318219.

Declared ‘total loss’ on 11.05.2021.

Payment released on 14.05.2021.

From mail letter dated 09.09.2021 of the Complainant it reveals that the Complainant expressed his inability to cancel the R.C. of the vehicle No. OD-14L-1270 and requested the O.P. to settle the claim without cancellation of R.C. vide letter dated 13.10.2021. The O.P. requested the Complainant to submit the following documents:

1. Final Consent Letter .
2. Aadhaar Card Copy.
3. Pass-port size photo.

Again on 20.10.2021 remainder letter was issued by the O.P. From mail dated 30.11.2021 it reveals that the Complainant ignored all the mails of the O.P. Ultimately auction was conducted on 04.10.2021 and Vijay Kumar Jaiswal was the highest bidder who accepted the highest price of Rs. 1,72,000/-. Total Participants were 83. The Complainant was informed vide letter dated 22.11.2021 the liability of insurer is Rs. 2,55,854/- and the wreck value of vehicle is Rs. 1,72,000/-. The Complainant was also informed to submit NOC from financier and to proceed for cancellation of registration. In the said letter payment made to financier Rs. 2,30,000/- has also been mentioned.

A person coming to the Commission should come with clean hand. Non submission of documents required by the insurer is latches of the O.P. who expressed his inability to submit cancellation of R.C. certificate. Further consent letter and no dues certificate of the Bank has not been submitted which is the cause of delay of the claim. Ultimately the O.P. issued letter dated 22.11.2021 declaring as “No claim”.

The Ombudsman has rightly observed and passed the order dated 19.05.2023.

This Commission is concerned with deficiency in service. The O.P. has followed due procedures for settlement of claim but only due to avoiding attitude of the Complainant, ultimately closed the claim. The delay is due to the Complainant for settlement of claim. Secondly due procedure has been followed for auction sale.

Taking into consideration the circumstances of the case the Complaint has no merit and accordingly dismissed against the O.P.

Order pronounced in the open couth on 15^th day of April 2024.

Supply free copies to the parties.