DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FARIDKOT
C. C. No. : 205 of 2018
Date of Institution: 19.12.2018
Date of Decision : 13.11.2019
Jatinder Singh, aged about 42 years son of Harbhajan Singh r/o House No. 117, Street No.1, Dashmesh Nagar, District Faridkot.
.........Complainant
Versus
- Bajaj Allianz General Insurance Company Limited, SCO No.146 and 147, 6th Floor, Feroze Gandhi Market, Faridkot through its Authorized Signatory.
- Bajaj Allianz General Insurance Company Limited, SCO No.156-159, 2nd Floor, Sector 9 C Chandigarh through its Authorized Signatory.
- Bajaj Allianz General Insurance Company Limited, Head Office GE Plaza, Airport Road, Yarewada, Pune-411006 through its Authorized Signatory.
.............OPs
Complaint under Section 12 of the
Consumer Protection Act, 1986.
Quorum: Sh. Ajit Aggarwal, President,
Smt. Param Pal Kaur, Member.
Present: Ms Harpreet Kaur, Ld Counsel for Complainant,
Sh Satish Jain, Ld Counsel for OPs-1 to 3,
ORDER
(Ajit Aggarwal, President)
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Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against OPs seeking directions to OPs to make payment of insurance claim with interest and for further directing OPs to pay Rs.1,00,000/- as compensation for deficiency in service and harassment alongwith litigation expenses of Rs.11,000/-.
2 Briefly stated, the case of the complainant is that complainant got insured his vehicle bearing registration no.PB-04-Y-4800 from OPs vide Insurance Policy No.OG-18-3260-1801-0000008 and during the subsistence of said insurance policy, vehicle of complainant met with an accident on 22.07.2018 at Kotkapura. Due intimation regarding same was given to OPs and on instructions of OPs, complainant got repaired his vehicle from Brar Automotive Muktsar and paid Rs.39,927/-to said agency, but vide letter dated 26.07.2018, OPs have wrongly and illegally repudiated the claim of complainant on the ground that complainant signed wrong declaration that he did not receive any benefit regarding the previous policy and complainant has wrongly got NCB on current policy. It is submitted that at the time purchasing the present policy, OPs got signatures of complainant on various blank documents without explaining their contents and now they are misusing said documents. At the time of purchasing the policy, OPs never asked him if he has taken insurance on previous policy and complainant also did
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not knew about it. OPs have wrongly repudiated the genuine claim of complainant on false and unexplained grounds which is altogether incorrect. All this act and conduct of OPs amounts to deficiency in service and has caused harassment and mental agony and tension to complainant. Complainant has prayed for directing the OPs to pay compensation for harassment alongwith litigation expenses besides the main relief. Hence, the complaint.
3 The counsel for complainant was heard with regard to admission of the complaint and vide order dated 2.01.2019, complaint was admitted and notice was ordered to be issued to the OPs.
4 On receipt of the notice, the OPs. filed written statement taking preliminary objections that complainant obtained online policy by providing details on web portal for getting insured his vehicle in question. Vehicle of complainant was insured with present policy on the basis of information and declaration given by complainant wherein he asserted that no own damage claim was experienced by him against previous insurance policy and at the time of purchasing policy in question, complainant has taken benefit of no claim bonus discount to the tune of 20%. Complainant mentioned in his declaration submitted to them that he did not raise any claim against his previous policy and he is entitled for 20% NCB, but he has taken the claim from the previous Insurance Company with which his vehicle was insured that clearly proves the fact that declaration given by complainant with regard to No Claim against
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previous policy is not correct and as per terms and conditions of present policy, answering OPs have rightly repudiated the claim of complainant on the basis of false declaration given by complainant. However, on merits, OPs have denied all the allegations of complainant being wrong and incorrect and asserted that complainant got insured his vehicle by playing fraud upon them and wrongly claim NCB and thus, he does not come under the purview of Consumer Protection Act. It is averred that complainant has manipulated the entire story of alleged accident. It is denied that they gave instructions to complainant for getting repaired his vehicle from Brar Automotive, Muktsar and it is also denied that complainant paid Rs.39,227/- on account of repair charges to said agency. Further averred that they have rightly repudiated the claim of complainant on the ground that he gave false declaration regarding not receiving benefit from his previous policy and obtained the present policy by not disclosing the real facts. It is reiterated that there is no deficiency in service on their part and denied all the other allegations of complainant being wrong and incorrect and prayed for dismissal of complaint with costs.
5 Parties were given proper opportunities to prove their respective case. Counsel for complainant tendered in evidence affidavit of complainant Ex.C-1/A and documents Ex C-1 to C-6 and then, closed their evidence.
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6 In order to rebut the evidence of the complainant, Counsel for OPs.1 and 3 tendered in evidence documents Ex OP-1, 3/1 to Ex OP-1, 3/13 and then, closed the evidence.
7 We have heard the ld counsel for complainant as well as OPs and have carefully gone through evidence and documents placed on record by respective parties.
8 From the careful perusal of evidence and documents placed on record and pleading made by parties in above discussion, it is observed that case of complainant is that insured vehicle of complainant met with an accident and got damaged. He duly intimated OPs and lodged claim with them but they wrongly repudiated the claim on false grounds. In reply, OPs admitted the insurance of said vehicle. It is also admitted that due intimation was given by complainant regarding said accident to OPs. There is also no denial by OP that they repudiated the claim of complainant. Main ground taken for repudiating the claim of complainant by OP is that complainant availed a no claim bonus of 20% based on declaration in proposal form and he wrongly declared No Claim Bonus Eligibility in proposal form though complainant had already availed claim under previous policy. Complainant has violated the terms and conditions of the policy in question and they have rightly repudiated the claim of complainant. As per OPs, they rejected claim of complainant only on the ground that at the time of purchase of present insurance policy, complainant suppressed the material facts and availed the benefit
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of NCB by stating that he had not lodged any claim in respect of his previous policy with previous insurer. But during the investigation, it became clear that he had already received the claim from the previous insurer, which amounts to breach of terms and conditions of the policy. Counsel for complainant argued that if the complainant did not disclose regarding lodging of claim with previous insurer, then in that case, the opposite party can verify this fact from the previous insurer within time and moreover, it is the duty of OPs to check whether insured has taken any insurance on previous policy or not at the time of issuing new policy to him and even OPs did not ask him anything regarding previous policy and they kept mum, through out the entire insurance period and when the complainant lodged claim in respect of accident of his vehicle, the opposite parties repudiated the claim on the ground that complainant had taken the benefit of No Claim Bonus and this denial and repudiation by OPs amounts to deficiency in service on their part. Moreover more or less they are entitled to recover the amount of NCB from the complainant, but they have no right to reject the claim of the complainant straightway.
9 Ld Counsel for complainant has placed reliance on 2016 (2) CPC 459, titled as National Insurance Company Ltd Vs Jagir Kaur, whereas Hon'ble National Commission, New Delhi held that Accident of Vehicle. Surveyor appointed - Loss assessed. False statement at time of obtaining of insurance policy alleged. Repudiation of Claim. Deficiency in service. District Forum dismissed complaint. State
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Commission allowed appeal. Hence Revision. Proposal form shows that respondent/complainant claimed no claim bonus while renewing policy and also while charging premium no claim bonus of 20% was allowed. Survey report which is on record assessed loss on net salvage basis for Rs.2,09,000/-. District Forum's order also records that respondent/complainant urged that as per survey report respondent /complainant entitled to amount of Rs.2,09,000/- and amount to be awarded to her. Therefore, Petitioner/Insurance Company directed to pay to respondent /complainant 75% of amount assessed by surveyor i.e. Rs.2,09,000/- that comes to Rs.156,750/- with 9% interest from date of filing of complaint with salvage being given to petitioner/insurance company. Hence, revision partly allowed. Further in case tiled as National Insurance Co. Ltd. Vs Harpreet Singh- 2016 (1) CPR 910, whereas our Hon'ble National Commission, New Delhi held that for reimbursement of damage to Truck caused due to accident. Repudiation of claim on ground that respondent complainant obtained No Claim Bonus by concealment of misrepresentation of fact. Where insured is unable to produce evidence regarding his No Claim Bonus entitlement, he may be permitted to give a declaration in support of his No Claim Bonus. In instant case, admittedly no communication was sent by the petitioner to the previous insurer within 21 days after granting the insurance cover to the insured. This obviously amounts to breach of tariff on the part of the petitioner insurance company and disentitle the insurance company to
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take shelter of the plea of misrepresentation of facts on the part of petitioner. Complainant on the basis of false declaration given to petitioner paid 25% less premium. Equity demands that bonus payable to complainant in respect of his insurance claim should be decreased by 25%. Directions issued to petitioner insurance company to pay to respondent complainant 75% of claimed amount with 9% interest. Revision petition partly allowed. So, as per law settled by Hon'ble National Commission, New Delhi, the opposite party cannot reject the claim of the complainant straightway. They are liable to pay the claim even if, it is presumed that the complainant has breached any term and condition of the policy and in that case, he is entitled for the claim on non standard basis. Repudiation of entire claim by opposite party amounts to deficiency in service and trade mal practice .
10 In the light of above discussion, evidence placed on record and case laws discussed above, the present complaint is hereby partly allowed and opposite party is directed to make payment of Rs.29,945.25 i.e. 75% of Rs.39,927/-to complainant on account of payment made by complainant for repair of his insured vehicle alongwith interest @ 9% per annum from 31.08.2018 i.e the date when opposite parties repudiated the claim of the complainant till final realization. Opposite parties are further directed to pay Rs.5,000/-(five thousand only) to complainant as consolidated compensation for harassment and mental agony suffered by him including litigation expenses. Compliance
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of the order be made within one month from the date of receipt of copy of this order, failing which, the complainant shall be entitled to proceed under section 25 & 27 of the Consumer Protection Act. Copy of the order be supplied to the parties free of costs. File be consigned to record room.
Announced in Open Forum
Dated : 13.11.2019
(Parampal Kaur) (Ajit Aggarwal)
Member President
