Delhi

North East

CC/65/2022

Sh Abhishesh Rajput - Complainant(s)

Versus

Bajaj Allianz General Insurance Co. Ltd. - Opp.Party(s)

01 May 2024

ORDER

           DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

                                                   Complaint Case No. 65/22

 

 

 

In the matter of:

 

		Sh. Abhishesh Rajput S/o Sh. Bharat Singh R/o Flat No. 1885, DDA Janta Flats, Near GTB Hospital, GTB Enclave, North East Delhi, Delhi-110093		Complainant
		Versus
	1.         2.	Bajaj Allianz General Insurance Co. Ltd. 93, Ashoka Bhawan, 6th Floor, Nehru Place, Delhi-110019   Bajaj Allianz General Insurance Co. Ltd. G E Plaza (Great Eastern Plaza) Airport Road, Opposite Gunjan Threatre, Pune, Maharastra 411006		Opposite Parties
			DATE OF INSTITUTION:         JUDGMENT RESERVED ON:                           DATE OF ORDER:		16.03.22 28.02.24 01.05.24

 

CORAM:

Surinder Kumar Sharma, President

Anil Kumar Bamba, Member

 

ORDER

Anil Kumar Bamba, Member

The Complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019.

Case of the Complainant           

1. The case of the Complainant as revealed from the record is the Complainant is the owner of vehicle bearing no. DL 1Z B 2155 covered by a comprehensive insurance policy (i.e. covering own damage of the owner as well as third party liability cover) of Bajaj Allainz General Insurance Company Ltd vide the renewed policy no. OG 19 1105 1803 00000041 effective from 19.04.18 to 18.04.19 for  an amount of Rs. 4,50,000/-. The said policy was renewed for the above said period over email on payment of renewal charges through credit card. The vehicle of Complainant was on a journey with four passengers on 07.11.18. Thereafter the vehicle of Complainant got hit by a speeding truck bearing no.      UP 72E 8194 and three passengers excluding driver died on the spot and driver also got grievously hurt. The accident was fatal that it crushed the whole vehicle. The FIR regarding the accident was registered at Police Station Kotwali City, District Pratapgarh, UP vide FIR no. 1067/2018. The Complainant also intimated to Opposite Party about the accident and raise the claim and Opposite Party  provide claim no. OC 19 130101803 000000516. The Opposite Party demanded for permit of vehicle, the Complainant supplied the same. The true copy is filed on record. The Opposite Party had also demanded for certain documents and Complainant supplied the same. The Complainant contacted Opposite Party for the reimbursement of the claim on regular intervals but same was delayed by Opposite Party on one pretext or the other. Thereafter Opposite Party stated that claim of Complainant would be settled once post mortem report of died passengers are supplied by Complainant.  It is stated that this demand of Opposite Parties are beyond the control and scope of the Complainant as it is merely impossible for him to get the post mortem report of the passengers who were travelling in his vehicle. It is stated that it is Opposite Party dishonest intensions to demand such reports in order to not reimburse the claim of the Complainant, on enquiry for the claim the Opposite Parties instantly replied the Complainant that his claim is invalid and is hence closed. Hence, this shows deficiency in service on behalf of Opposite Party. The Complainant sent legal notice dated 05.02.22 for reimbursement of claim but all in vain. The  Complainant had also filed extracts of order no. 7 of 22 of NCDRC regarding condonation of delay. The Complainant has prayed to reimburse the sum of      Rs. 4,50,000/- as the insured amount of vehicle and for the refund of the amount collected for renewal of the general insurance policy for the period 19.04.18 to 18.04.19 i.e. Rs. 20,087/- in total. The Complainant has also prayed to pay interest @ 18 % p.a. from the date of institution of the claim. Further, he prayed for the mental harassment and for Rs. 20,000/- at least for litigation expenses.

Case of the Opposite Party

2. The Opposite Party contested the case and filed written statement. The Opposite Party stated that the Opposite Party issued commercial vehicle package policy bearing no. OG 19 1105 1803 00000041 for the period from 19.04.18 to 18.04.19 to the Complainant for the car bearing no. DL 1ZB 2155 model Hyundai Xcent.
3. The Complainant has claimed that on 07.11.18 driver along with three passengers were travelling from delhi to pratapgarh, UP and at about 4.00 AM, a truck bearing no. UP 72E 8194 hit the car. Consequent to the accident the three passengers died and the driver of the car suffered grievous injuries. Eventually, an FIR was lodged on 07.11.18 vide FIR No. 1067/2018, at P.S Kotwali City, District Pratapgarh, U.P.
4. The Complainant raised the claim with the Opposite Party, pursuant to which vide letter dated 29.12.18 the Opposite Party sought the following documents for processing the claim of the Complainant and the information and documents asked were as follows:

1. Post mortem Report of Mr. Kamlesh, Lallu & Sandeep
2.  Medical Injury of Mr. Rahul
3.  FIR if lodged, vehicle releasing order technical inspection report from Police and driver confirmation on court papers i.e. charge sheet, bail documents
4.  Claim Form (Duly Filled & Singed)
5.  Copy of Registration Certificate along with original (for verification)
6.  Copy of driving license along with original for verification
7.  Copy of the policy along with original policy documents for verification
8.  Copy of the road permit

5. The Complainant did not provide the information sought from him and Opposite Party was left with no option but to close the aforesaid claim vide letter dated 05.01.19 in violation of the following condition: “Policy condition no. 1, Notice shall be given in writing to the company immediately upon the occurrence of any accident or loss or damage and in the event of any claim and thereafter the insured shall given all such information and assistance as the company shall require.”
6. That till date, despite multiple reminder and after nearly three years from the date of claimed incident the Opposite Party has not submitted Post Mortem Report of Mr. Kamlesh, Lallu & Sandeep, Medical Injury Report of Mr. Rahul and FIR if lodged, Vehicle releasing Order Technical Inspection Report from the Police and Driver confirmation on papers i.e. Charge Sheet, Bail Documents rendering the Opposite Party inept in processing the claim of Complainant. Therefore the Opposite Party has left no option but to close the aforesaid claim, due to non-cooperation in settlement of your claim and as the same amounted to violation of condition no. 1 of the policy. 
7. That without prejudice to the above contention, it is most respectfully submitted that as per the investigation conducted by the investigator, bottle of alcohol and glasses were found inside the car and same are evidenced in the photographs clicked by the investigator. It is submitted that the same amounts to violation of the terms and conditions of the policy as it clearly stipulates that “the company shall not be liable to make any payment in respect of any accidental loss or damage suffered whilst the insured or any person driving with the knowledge and consent of the insured is under the influence of intoxicating liquor or drugs’. The relevant condition is reproduced as per the conditions is reproduced hereunder:

“Now this policy witnesseth:

That subject to the terms exceptions and conditions contained herein or endorsed or expressed hereon

2. The company shall not be liable to make any payment in respect of

(c) any accidental loss or damage suffered whilst the insured or any person driving with the knowledge and consent of the insured is under the influence of intoxicating liquor or drugs.”

8. It is most respectfully submitted that as per the inspection report the driver of the insured vehicle at the time of accident was careless and grossly negligent. It is further submitted that the Opposite Party cannot be made liable for the careless and grossly negligent behaviour of the driver of the insured and further for the failure on the part of the insured who, as per the terms and conditions of the policy was required to take all reasonable steps to safeguard the vehicle insured from loss, but has miserably failed to do so. It is further submitted that in addition to the submissions made hereinabove as per the inspection report of the investigator one person namely. Mr. Anil Dubey was nearby the accident spot and made a video of the incident just after the accident had occurred and as per the video the accident had happened due to the carelessness of the driver of the insured.
9. It is most respectfully submitted that the driving the vehicle under the influence of intoxicating liquor or drugs also amounts to violation of the condition no.5 of the policy. It is most respectfully submitted that as per the terms and conditions of the policy the insured was to take all reasonable steps to safeguard the vehicle insured from any loss. The relevant condition is reproduced as per the conditions is reproduced hereunder:

5. The insured shall take all reasonable steps to safeguard the vehicle insured from loss or damage and to maintain it in efficient condition and the company shall have at all times free and full access to examine the vehicle insured or any part thereof or any driver or employee of the insured. In the event of any accident or breakdown, the vehicle insured shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle insured be driven before the necessary repairs are effected, any extension of the damage or any further damage to the vehicle shall be entirely at the insured’s own risk.

10. It is most respectfully submitted that the driver of the insured vehicle did not possess commercial license to drive the vehicle in question, which admittedly is a commercial vehicle and the insured vehicle, in question, at the time of alleged accident was being used for commercial purposes, the same has being confirmed by statement made by Mr. Rahul Singh.
11. The Opposite Party during the investigation further found that of claim filed by the Complainant found that the Complainant at the time issuance of insurance policy in question failed to disclose that insured vehicle was fitted with CNG but the premium for same was not paid. Since the fact of CNG fitment was concealed the same amounts to false or fraudulent statement or any suppression or concealment of fact. Moreover, the Registration Certificate of the insured vehicle reflects that the same is Petrol Model, therefore the CNG was retro-fitted in the vehicle. The Complainant had not paid insurance premium which is normally payable for CNG fitted vehicle. Therefore, it can be easily inferred that the offending vehicle had been fitted with CNG cylinder illegally and unauthorizedly. It is condition in the insurance policy that insured has to declare the factum of the CNG as the same has corresponding effect on the premium to be paid by insured. The terms and condition of every insurance policy stipulates that insurer has the right to deny claim on grounds of any false or fraudulent statement or any suppression or concealment of fact by the insured and as result of which, the policy shall also be cancelled and the claim shall be forfeited.  It is submitted that suppression or concealment of fact by the insured vitiates the insurance contract. The non-disclosure of relevant details and material facts is a ground to repudiate the claim since insurance contracts are contracts of utmost good faith.

Rejoinder to the written statement of Opposite Party

12. The Complainant filed rejoinder to the written statement of Opposite Party wherein the Complainant has denied the pleas raised by the Opposite Party and has reiterated the assertions made in the complaint.

Evidence of the Complainant

13. The Complainant in support of his complaint filed his affidavit wherein he has supported the averments made in the complaint.

Evidence of the Opposite Party

14. In order to prove its case, Opposite Party filed affidavit of Sh. Shyama Charan, Manager (Legal) of Opposite Party, wherein the averments made in the written statement of Opposite Party have been supported.

Arguments & Conclusion

15. We have heard the Ld. Counsels for parties. We have also perused the file and the written arguments filed by the parties. The case of the Complainant is that he is the owner of vehicle bearing no. DL 1Z B 2155 covered by an insurance policy of Opposite Party effective from 19.04.18 to 18.04.19 for an amount of   Rs. 4,50,000/-. The vehicle of Complainant was on a journey with four passengers on 07.11.18 and the vehicle of Complainant got hit by a speeding truck and three passengers excluding driver died on the spot and driver also got grievously hurt.  Further, the Complainant stated that the accident was fatal that it crushed the whole vehicle. The FIR regarding the accident was registered at Police Station Kotwali City, District Pratapgarh, UP vide FIR no. 1067/2018. The Complainant also intimated to Opposite Party about the accident and raise the claim and Opposite Party provide claim no. OC 19 130101803 000000516. The Opposite Party had also demanded for certain documents and Complainant supplied the same. The Complainant contacted Opposite Party for the reimbursement of the claim on regular intervals but same was delayed by Opposite Party on one pretext or the other. Thereafter Opposite Party stated that claim of Complainant would be settled once post mortem report of died passengers are supplied by Complainant.  It is stated that this demand of Opposite Parties are beyond the control and scope of the Complainant as it is merely impossible for him to get the post mortem report of the passengers who were travelling in his vehicle. It is stated that it is Opposite Party dishonest intensions to demand such reports in order to not reimburse the claim of the Complainant. Hence, this shows deficiency in service on behalf of Opposite Party.
16. On the other hand, the case of the Opposite Party is that it is admitted that Complainant’s car was insured with them for the period from 19.04.18 to 18.04.19. It is also admitted by the Opposite Party that they have received information regarding accident of the said vehicle and claim was lodged. After lodging the claim Opposite Party asked the Complainant vide letter dated 29.12.18 to supply following documents:

1. Post mortem Report of Mr. Kamlesh, Lallu & Sandeep

2. Medical Injury of Mr. Rahul

3. FIR if lodged, vehicle releasing order technical inspection report from Police and driver confirmation on court papers i.e. charge sheet, bail documents.

4. Claim Form (Duly Filled & Singed)

5. Copy of Registration Certificate along with original (for verification)

6. Copy of driving license along with original for verification

7. Copy of the policy along with original policy documents for verification

8. Copy of the road permit

17. Since Complainant failed to supply above mentioned documents they have closed claim vide letter dated 05.01.19.
18. After pursuing the record and evidence submitted by the Complainant he did not supply documents mentioned at S.No. 1, 2 & 6 and part of the S.No.3 i.e. vehicle releasing order technical inspection report from Police and Driver confirmation on court papers i.e. charge sheet, bail documents.
19. Since Complainant failed to supply required documents to the Opposite Party. In our considered opinion, there is no deficiency in service on the part of Opposite Party. Therefore, the complaint is dismissed.
20. Order announced on 01.05.24

Copy of this order be given to the parties free of cost.

File be consigned to Record Room.

 

(Anil Kumar Bamba)         Member

(Surinder Kumar Sharma) President