Complaint No: 68 of 2019.

                                                                Date of Institution: 21.02.2019.

                                                                       Date of order: 31.10.2023.

Sandeep Kumar aged about 39 years S/o Sh. Darshan Lal resident of House No. 179, Sekhrian Mohalla I/s Kapoori Gate, Batala, District Gurdaspur.

                                                                                                                                                                 …..........Complainant.                                                                                                                                                                                                                                                                                                                                                                                                      

                                                                                 VERSUS

1.       Bajaj Allianz General Insurance Company Limited, registered office GE Plaza, Airport Road, Yerwada, Pune – 411006, through its Divisional Manager.

2.       Bajaj Allianz General Insurance Company Limited, 2nd Floor Satnam Complex, BMC Chowk, G.T. Road, Jalandhar, through its Branch Manager.

3.       Bajaj Allianz Insurance Company Limited, New Dharm Singh market, Batala, through its Branch Manager.

                                                                                                                                                                       ….Opposite parties.

                                          Complaint Under section 12 of the Consumer Protection Act.

Present: For the Complainant: Sh.Rahul Puri, Advocate.

               For the Opposite Parties: Sh.Sandeep Ohri, Advocate.  

Quorum: Sh.Lalit Mohan Dogra, President, Sh.Bhagwan Singh Matharu, Member.

ORDER

Lalit Mohan Dogra, President.

          Sandeep Kumar, Complainant (here-in-after referred to as complainant) has filed this complaint under section 12 of the Consumer Protection Act (here-in-after referred to as 'Act') against Bajaj Allianz Gen. Ins. Co. Ltd. Etc. (here-in-after referred to as 'opposite parties).

2.       Briefly stated, the case of the complainant is that the complainant is the owner of Hyundai i 10 Car bearing registration No.PB-06-K-1117. It is further pleaded that the Car was duly insured for the period from 13 November, 2018 to 12 November, 2019 for IDV of Rs.2,72,606/- with Bajaj Allianz General Insurance vide its Policy No.OG-19-1220-1801-00000140. It is further pleaded that as such the complainant falls in the definition of consumer. It is further pleaded that the above mentioned vehicle was insured through an agent serving in Bajaj alliance office situated at new Dharm Singh market, Batala. It is further pleaded that unfortunately, the vehicle met with an accident on 18.11.2018 and was severely damaged, after which the complainant promptly reported the matter to the OP’s but the OP’s did not pay any immediate attention, however after some delay the insurance company deputed a Surveyor on repeated requests by the complainant to access the loss. It is further pleaded that although the Surveyor accessed the loss in this case amounting to total loss of the vehicle insured (i.e. for a value of Rs.2,72,606/-) but the OP’s  went on with putting the matter pending on one or the other excuse and till date no payment has been made to the complainant. It is further pleaded that the vehicle was being driven by the complainant who is holding a valid Driving License issued by the competent authority and complainant was not plying the vehicle against the terms and condition of the insurance policy or in contravention of the insurance policy rules, nor there any intentional or willful delay on the part of the complainant in reporting the matter to the OP’s. It is further pleaded that the OP’s by not making payment of the insured amount for the loss suffered by the complainant on fake and baseless observations and  is trying to back out from his obligations with malafide intention and ulterior motive without any reason or rhyme. It is further pleaded that due to this illegal act and conduct of the opposite parties the complainant has suffered great loss and also suffered mental agony, Physical harassment and inconvenience. It is further pleaded that there is a clear cut deficiency in service on the part of the opposite parties.

          On this backdrop of facts, the complainant has alleged deficiency and unfair trade practice on the part of the opposite parties and prayed that necessary directions may kindly be issued to the opposite party No.1 to honour the claim of the complainant and make the payment of insured amount, qua the claim of the complainant in terms of the insurance policy alongwith interest @ 18% P.A. from the date of accident of the vehicle till actual realization. And It is further prayed that the compensation to the tune of Rs.50,000/- may also be awarded to the complainant besides the amount of claim on account mental agony, physical harassment and deficiency in service on the part of the opposite parties. Litigation expenses to the tune of Rs.22,000/- may also be awarded in favour of the complainant after accepting this complaint and Expenses to the tune of Rs.20,000/- on account of expenses incurred due to parking and towing charges may also be awarded to the complainant, in the interest of justice.

3.       Upon notice, the opposite parties appeared through counsel and contested the complaint and filing their written reply by taking the preliminary objections that the complainant has no cause of action to file the present complaint. It is further pleaded that there is no deficiency in service on the part of Insurance Co. It is pleaded that the claim has been filed by the complainant and the documents were submitted. It is further pleaded that surveyor has also been appointed who duly inspected the vehicle and submitted his report and after going through the documents and survey report, it has been observed that while obtaining the insurance policy for vehicle, the complainant had given a declaration that he has earned 20% NCB under the expiry policy as per declaration "I/We, the above named do hereby, to the best of my knowledge and belief, warrant the truth of the foregoing statements in every respect and agree that if I have made any false or fraudulent statement of there be any suppression or concealment, the policy shall be cancelled and the claim shall be forfeited". It is further pleaded that during the course of verification, it has been observed that there has been a claim under the previous policy and hence the complainant was not eligible for NCB under the current policy. It is further pleaded that he gave wrong declaration and which leads to breach of the insurance agreement. It is further pleaded that the letter dated 28.11.2018, 30.11.2018, 11.12.2018 and 26.12.2018 has been sent to the complainant in this regard and the claim has been repudiated vide letter dated 26.12.2018 as there is no response from the complainant side. It is further pleaded that even otherwise, if this Ld. Commission comes to the conclusion that there is any liability of the insurance co., then in that case the liability of the insurance co. is only as per survey report and in no case more than the amount assessed by the competent surveyor. It is further pleaded that as already stated the surveyor submitted the report after physically verifying each and every part of the damaged vehicle and submitted its report. It is further pleaded that net assessed amount as per survey report is Rs.2,18,055/-, but as already stated the claim has been repudiated and as such there is no liability of the insurance co.

          On merits, the opposite parties have reiterated their stand as taken in legal objections and denied all the averments of the complaint and there is no deficiency in service on the part of the opposite parties. In the end, the opposite parties prayed for dismissal of complaint with costs. 

4.       Learned counsel for the complainant has tendered into evidence affidavit of Sandeep Kumar, (Complainant) as Ex.CW-1/A alongwith other documents as Ex.C-1 to Ex.C-3.

5.       Learned counsel for the opposite parties has tendered into evidence affidavit of Sh. Jai Singh, (Senior Executive, Authorized Signatory of Bajaj Allianz Gen. Ins. Co. Ltd., Chandigarh) as Ex.OP-1to3/A alongwith other documents as Ex.OP-1to3/1 to Ex.OP-1to3/9.

6.       Rejoinder filed by the complainant.

7.       Written arguments not filed by both the parties.

8.       Ld counsel for the complainant has argued that  the complainant is the owner of Hyundai i 10 Car bearing registration No.PB-06-K-1117 and the Car was duly insured for the period from 13 November, 2018 to 12 November, 2019 for IDV of Rs.2,72,606/-. It is further argued that the vehicle of the complainant met with an accident on 18.11.2018 and was damaged, and on itimation being given the Surveyor accessed the loss as Rs.2,72,606/- but the OP’s  repudiated the claim on false and flimsy grounds and as such there is a clear cut deficiency in service on the part of the opposite parties.

9.       On the other hand ld counsel for the opposite parties Mr. Sandeep Ohri has vehemently argued that on receiving intimation surveyor was appointed who duly inspected the vehicle and submitted his report and after going through the documents and survey report it was observed that while obtaining the insurance policy for vehicle, the complainant had given a declaration that he has earned 20% NCB. It is argued by Mr. Ohri that during the course of verification, it has been observed that there has been a claim under the previous policy and hence the complainant was not eligible for NCB under the current policy and complainant gave wrong declaration and which leads to breach of the insurance agreement. It is further in arguments  that the letter dated 28.11.2018, 30.11.2018, 11.12.2018 and 26.12.2018 were sent to the complainant in this regard and the claim was repudiated vide letter dated 26.12.2018 as there is no response from the complainant side and as such complaint being false is liable to be dismissed.

10.     We have heard the counsel for the parties and have gone through the record.

11.     It is admitted fact that complainant is the owner of Hyundai i 10 Car bearing registration No.PB-06-K-1117. It is further admitted fact that the Car was duly insured for the period from 13 November, 2018 to 12 November, 2019 for IDV of Rs.2,72,606/- with Bajaj Allianz General Insurance vide its Policy No.OG-19-1220-1801-00000140. It is further admitted fact that the complainant falls in the definition of consumer as per the act. It is further admitted fact the vehicle owned by the complainant and insured with the OPs met with an accident on 18.11.2018 and was damaged. It is further admitted fact that the Surveyor accessed the loss in this case as Rs.2,18,055/-. It is further admitted fact that the claim lodged by the complainant has been repudiated by the opposite parties vide letter Ex.OP-1 to 3/4 with the reason that there has been a claim under the previous policy and hence the complainant was not eligible for NCB under the current policy. But perusal of the case file shows that although the opposite party has placed on  record previous policy of insurance Ex.OP- 1 to 3 /6 as per which the car was insured with ICICI Lombard under which the previous claim took place but we are of the view that it was duty of the opposite party to have verified the detail of previous policy at the time of issuance of the policy, as such since  opposite party failed to verify the same and accepted the premium from the complainant, as such opposite party  can not deny to pay the claim to the complainant on this ground later on. As for liability of the opposite party is concerned, the complainant has claimed that surveyor assessed the loss as Rs.2,72,606/- how ever perusal of the report of surveyor Ex.OP- 1 to 3/5 shows that  the  surveyor has assessed the total payable amount as Rs.2,18,055/- and complainant has not disputed the assessment arrived at by the surveyor and we also do not find any reason to depart from the report of the surveyor and as such we are of the view that on account of receiving of NO CLAIM BONUS under the policy by the complainant, the present dispute can be resolved by making payment in respect of the loss to the vehicle on NON STANDARD BASIS, i.e opposite party is directed to pay 85% of the amount of Rs.2,18,055/- i.e Rs.1,85,346/- to the complainant.

12.     Accordingly present compliant is partly allowed and opposite parties are directed to pay Rs.1,85,346/- in respect of claim lodged by complainant alongwith interest @ 9 % P.A. from the date of filing of present compliant till realization of the amount. Opposite parties are further directed to pay Rs.10,000/- to the complainant for mental tension, harassment, inconvenience and Rs.5000/- as  cost of litigation. Entire exercise shall be completed within 30 days from the receipt of copy of this order.

13.     The complaint could not be decided within the stipulated period due to heavy pendency of Court Cases, vacancies in the office and due to pandemic of Covid-19.

14.     Copy of the order be communicated to the parties free of charges. File be consigned.                                                                                                                                                               

            (Lalit Mohan Dogra)

                                                                                      President.  

Announced:                                                   (B.S.Matharu)

Oct. 31, 2023                                                        Member.

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