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Ankush Gupta filed a consumer case on 17 Jan 2023 against Bajaj Allianz General Insurance Company Limited in the Karnal Consumer Court. The case no is CC/581/2020 and the judgment uploaded on 20 Jan 2023.
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.
Complaint No. 581 of 2020
Date of instt.18.12.2020
Date of Decision 17.01.2023
Ankush Gupta son of Shri Dharm Pal Gupta, Huse no.876, Sector-13, Urban Estate, Karnal-132001, Haryana.
…….Complainant.
Versus
Bajaj Allianz General Insurance Company Limited (Claims Department, 156-159, 2nd floor, Sector 9C, Chandigarh.
…..Opposite Party.
Complaint u/s 35 of the Consumer Protection Act, 2019
Before Sh. Jaswant Singh……President.
Sh.Vineet Kaushik ………..Member
Dr. Rekha Chaudhary…..Member
Argued by: Shri Sanjay Kumar, representative of complainant.
Shri Atul Mittal, counsel for the OP.
(Jaswant Singh President)
ORDER:
The complainant has filed the present complaint u/s 35 of the Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant got insured his Hyundai i10 car bearing registration no.HR-24K-5276 with the OP, vide policy no.OG-20-9906-1801-00152798, valid from 14.04.2020 to 13.04.2021. On 19.07.2020 at about 8.00 p.m. uncle of complainant namely Sanjay Gupta was driving the car from his shop to home, where on his way back (near Mugal Canal, Karnal) the car hit a stone lying on the road (reason, being a car coming from opposite side with high beam made the vision unclear which led to the accident) and when his uncle stepped down the car and checked, there was an oil leakage visible from the car. He parked the car on the roadside. The car was checked by Hyundai dealership in Karnal and they informed that the policy in question did not cover the cashless benefit but the damage claim will be covered under the insurance policy and all the amount will be claimed by OP once the repair payment is made. The complainant toes his car to Samta Motors Private Limited on 22.07.2020 for repair. Complainant has spent Rs.31182/- on the repair of his car. Complainant filed the claim with the OPs for reimbursement of the said amount but OP did not pay the same and repudiated the claim of the complainant, vide letter dated 03.09.2020 on the false and frivolous ground. In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence this complaint.
2. On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi; jurisdiction as the policy in question was issued from Chandigarh where the OP is having its office. OP is having no branch office at Karnal and concealment of true and material facts. On merits, it is pleaded that the claim of the complainant was thoroughly processed by OP by way of appointment of Surveyor & Loss Assessor, who thoroughly investigated the claim of the complainant and submitted the detailed report dated 23.08.2020 and who assessed the loss to the tune of Rs.4152/-, vide report dated 23.08.2020 which was subject to the approval and terms and conditions of the insurance policy. In this regard letters were written to the complainant wherein that Damages to the vehicle are not correlated with cause of loss and not accidental nature. In this regard letters dated 08.08.2020 and 27.08.2020 was written to the complainant mentioning therein that since he has failed to provide satisfactory explanation to the queries raised in the aforesaid letters. The complainant failed to reply the said letters and the claim of the complainant was repudiated, vide letter dated 03.09.2020. It is further pleaded that cause of loss does not co-relate with description and the story of complainant is falsely concocted. It is further pleaded that complainant has not complied with the terms and conditions of the policy of insurance and he has failed to provide necessary evidence by way of documents which are essential to assess the loss. The loss highly been exaggerated. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.
3. Parties then led their respective evidence.
4. Learned counsel for complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of repudiation letter dated 03.09.2020 Ex.C1, copy of claim form Ex.C2, copy of insurance policy Ex.C3, copy of receipt of Shyam Crane Service Ex.C4, copy of RC Ex.C5, copy of Aadhar card Ex.C6, copy of invoice summary Ex.C7, copy of repair order Ex.C8, copy of diving licence Ex.C9 and closed the evidence on 12.05.2022 by suffering separate statement.
5. On the other hand, learned counsel for the OP has tendered into evidence affidavit of Saurav Khullar, Assistant Manager Ex.OW1/A, affidavit of Vikas Bhatowa, Surveyor and Loss Assessor Ex.OW2/A, copy of surveyor report Ex.OP1, copy of final survey report Ex.OP2, copy of repair estimate Ex.OP3, copy of claim Form Ex.OP4, copy of repudiation letter dated 03.09.2020 Ex.OP5, copy of insurance policy Ex.OP6, copy of letter and its reminders dated 27.08.2020, 08.08.2020 and 08.08.2020 written by OP to complainant Ex.OP7 to Ex.OP10 and closed the evidence on 21.10.2022 by suffering separate statement.
6. We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.
7. Learned counsel for complainant, while reiterating the contents of complaint, has vehemently argued that complainant got insured his Hyundai i10 car from the OP. On 19.07.2020, the said vehicle met with an accident and was badly damaged. Complainant took his vehicle to Samta Motors Private Limited and spent an amount of Rs.31182/- on its repair Complainant submitted his claim with the OP for reimbursement of the said amount but OP did not disburse the said amount to complainant and lastly prayed for allowing the complaint.
8. Per contra, learned counsel for OPs, while reiterating the contents of written version, has vehemently argued that on receipt of intimation from the complainant with regard the accident of the vehicle in question, OPs deputed a Surveyor and Loss Assessor, who investigated the matter and submitted his report dated 23.08.2020 and assessed the loss to the tune of Rs.4152/- OP wrote the letters dated 08.08.2020 and 27.08.2020 to the complainant mentioning therein that since he has failed to reply the said letters and the claim of the complainant was repudiated, vide letter dated 03.09.2020 and lastly prayed for dismissal of the complaint.
9. We have duly considered the rival contentions of the parties.
10. Admittedly, the vehicle in question met with an accident during the subsistence of the insurance policy. It is also admitted that the sum insured in the policy in question is Rs.1,39,486/-.
11. The claim of the complainant has been repudiated by the OPs, vide letter Ex.OP5 dated 03.09.2020 on the ground, which reproduced as under:-
(i) “You have deliberately removed the vehicle from the spot of accident without intimating to us and without our consent. Thus, you have deprived us an opportunity to ascertain the necessary facts related to the accident including without limitation, cause of loss, circumstances and quantum of loss required to decide admissibility of claim.
(ii) As per physical inspection of the vehicle and survey report confirms that the cause of loss as narrated by your goodself is not concurrent with the nature of damages seen on the vehicle which leads to misrepresentation of facts and violation of duties of utmost good faith by your goodself had lead to breach of insurance contact”.
Therefore, in the absence of any response from your side no other option except to repudiate the claim”.
12. The first plea taken by the OP is that complainant has removed the vehicle in question from the spot without the spot inspection and thus OP has been deprived from its right. Admittedly, the vehicle in question was removed by the complainant without spot inspection. Thus, complainant has violated the terms and conditions of the insurance policy. Moreover, complainant has failed to reply of the letters dated 08.08.2020 and 27.08.2020.
13. The next plea taken by the OPs is that the damages of the insured vehicle do not correlate with the case of accident. The onus to prove its case was lied upon the OPs. In support of its version OPs have placed on record affidavit of surveyor Ex.OW2/A in which it is mentioned that the insured vehicle was not correlating with the manner of accident as narrated by insured. There was no damage to front bumper. There is no impact on silencer pipe which is lower than gear case. There was no impact of RHS housing, no impact on lower mounting, only LHS gear case is broken and not a single impact on RHS case. There is no damage or impact to the bottom of sub frame which is just below gear housing. The said surveyor has also placed on file his report. Complainant has failed to rebut the said evidence product by the OP. Moreover, the alleged representative of complainant is not competent to pursue the present complaint. Hence, we are of the considered view that OP has rightly repudiated the claim of the complainant. Thus, we found no deficiency in service on the part of the OP while repudiating the claim of the complainant.
14. Thus, as a sequel to abovesaid discussion, present complaint is devoid of any merits and same deserves to be dismissed and same is hereby dismissed. No order as costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room, after due compliance.
Dated:17.01.2023.
President,
District Consumer Disputes
Redressal Commission, Karnal.
(Vineet Kaushik) (Dr. Rekha Chaudhary)
Member Member
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