Haryana

Fatehabad

CC/114/2020

Sanjay Kumar - Complainant(s)

Versus

Bajaj Allianz General Insurance - Opp.Party(s)

Rajesh Gandhi

05 Dec 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION; FATEHABAD

          C.C.No.114 of 2020.               Date of Instt.:24.06.2020 Date of Order: 05.12.2023

Sanjay Kumar son of Devi Lal resident of Karanpura Tehsil Bhadra District Hanumangarh.

..Complainant.

          Versus

1.Manager, Bajaj Allianz General Insurance Company Block No.4,7^th Floor DLF Tower 15, Shivaji Marg, Delhi.

2.Manager, Avni Honda Gency, Fatehabad Road, Ratia District Fatehabad.

          ..Opposite parties.

Complaint under Section 12 of the Consumer Protection Act, 1986

Before:        Sh. Rajbir Singh, President.                                                               Smt.Harisha Mehta, Member.                                                             Sh.K.S.Nirania, Member

Present:       Sh.Rajesh Gandhi, Advocate for complainant.                                   Sh.U.K.Gera, Advocate for Op No.1.                                                   Sh.Amit Wadhera, Advocate for Op No.2.

ORDER

SH.RAJBIR SINGH, PRESIDENT;

                   Brief facts of the present complaint are that the complainant had purchased a motor cycle bearing registration No.RJ-49-SC0785 in January, 2016; that OP No.1 got the vehicle in insured vide policy No.OG-20-2202-1802-00014158  having validity from 17.06.2019 to 16.09.2020; that the vehicle complainant met with an accident on 06.08.2019 and regarding this a rapat was lodged in P.S.Ratia; that the motor cycle is still lying with Op No.2 where the inspection was conducted by the surveyor; that the complainant has already submitted all the relevant documents to the insurance company but despite that no claim  amount has been released to him; that the complainant visited the Ops many a times besides serving legal notice upon them but to no avail. The act and conduct of the Ops clearly amounts to deficiency in service on their part. In evidence, the complainant has tendered his affidavit and documents Annexure C1 to Annexure C8.

2.                          On notice, Ops appeared and filed their separate replies.  OP No.1 in its separate reply has submitted that the present compliant is not maintainable being filed by concealing the material facts from this Commission. It has been further submitted that the vehicle met with an accident on 06.08.2019 but the intimation was given to it on 06.09.2019 whereas the information to the police was given on 15.08.2019; that the DDR was registered after a delay of 9 days; that the complainant himself has violated the terms and conditions of the policy, therefore, the claim was rightly repudiated by the replying OP.

3.                          OP No.2 in its reply has taken preliminary objections such as time barred, jurisdiction, locus standi and suppression of material facts etc. It has been further submitted that the motor cycle question was purchased by the complainant from Manjhu Honda which is duly insured by Op No.1; that the vehicle in question is parked in the agency of the replying OP as the policy in question was not cash less, therefore, it was not repaired without the surveyor report and bills; that there is no deficiency in service and unfair trade practice on the part of the replying Op. In the end, prayer for dismissal of the complaint has been made. OPs in their evidence have tendered affidavits Ex.RW1/A, Ex.RW1/B and documents Annexure RW1/1 to Annexure RW1/11.

4.                          Heard. The counsel for the complainant reiterated the averments made in the complaint and prayed for its acceptance whereas the counsel for appearing OPs reiterated the averments made in the reply and prayed for its dismissal.

5.                          Undisputedly, the complainant is registered owner of motor cycle bearing registration No.RJ49-SC-0785 (Annexure C7) and the same was insured with Op No.1 (Annexure C3). The complainant has come with the plea that her vehicle met with an accident during the subsistence of the policy; therefore, it is the boundened duty of the insurance company to pay the loss suffered by her on account of damage of the vehicle but it has not been done by the insurance company. 

6.                          Learned counsel for the Op No.1 has stressed hard that the complainant himself has violated the condition no.1 of the policy as there is delay of 30 days in intimating the insurance company with regard to alleged accident therefore, the Op No.1 cannot be held liable for any liability on account of damage of the vehicle. 

7.                          GDD (Annexure C2) was registered on the statement of the complainant wherein it has been specifically mentioned that due to sudden appearance of dog, his vehicle got uncontrolled and further in the process of saving the dog, the vehicle fell into a dig. Learned counsel for the complainant has submitted that the delayed intimation, if any, was not intentional rather due to unavoidable circumstances.

8.                          The fact regarding delaying intimation is not disputed because the alleged accident had happened on 06.08.2019 and the intimation was given to the Op No.1 only on 06.09.2019.  Learned counsel for the Ops No.1 has mentioned that due to violation of condition No.1 of the policy, the claim was rightly rejected. The fact regarding accident of the insured vehicle during the subsistence of the policy is clearly established. Perusal of Annexure C2 i.e. GDD was recorded on 15.08.2019 i.e. 9 days later after the alleged accident which was occurred on 06.08.2019. Though there may be delayed in intimation but there is no justification for the Op for denying the claim of complainant in its entirety only for such violation of term and condition.  In this regard, reliance can be made to authority titled as United India Insurance Co. Ltd. Vs. Gian Singh reported in II(2006) CPJ page 83 (NC), wherein it has been held by Hon’ble National Commission that in case of violation of condition of policy as to nature of use of the vehicle, the claim ought to be settled on non-standard basis.  In the authority titled as Mohammad Ejaj Vs.UII, 2014(4) CLT page 161 (Hon’ble State Commission, Haryana), it has been held that Insurance Claim-Repudiation-On the ground that there was delay of 15 days in lodging the F.I.R. and 36 days in giving intimation to the Insurance Company-IRDA have given direction to the Insurance Companies not to reject genuine claims simply because of late registration of F.I.R. and late intimation to the Insurance Company-Held-IRDA is the controlling authority of all Insurance Companies and being a statutory body, is competent to frame guidelines and issue instructions to Insurance Companies which are binding upon them-Appeal accepted.  In the authority cited in 2016(2) CLT page 434 (Hon’ble State Commission, Haryana) titled as Future General India Insurance Co. Ltd. Vs. Satbir, where in the head-note, it is mentioned that Insurance claim-Theft of insured tractor-Prompt FIR-Delay of 66 days in intimation to insurance company-Held-In the Circular Ref:IRDA/HLTH/MISC/CIR/216/09/2011 dated September 20, 2011 issued by ‘IRDA’, it has been mentioned that genuine claims should not be rejected on account of delay in intimation, and that, the insurer’s decision to reject a claim must be based on “sound logic” and “valid grounds”-Insurance company is liable to indemnify the loss suffered by the complainant-Appeal dismissed. Hence, we are of the considered view that the claim in respect of vehicle in question should have been settled by the Ops No.1 & 2 on the basis of the guidelines of non-standard settlement. The fact regarding parking of damaged motor cycle at the workshop of Op No.2 is not disputed. The surveyor in the provisional survey report has mentioned as under:

Loss and Survey information
Date of Loss	15.08.2019	Intimate Date
Claim Registration Date	06.09.2019	Date of Survey Allotment	17.09.2019
Date of Survey	07.09.2019	Survey Report status	PSR Generated
Description of loss	Description: While driving, suddenly a dog came in front of IV, so to save it IV got unbalanced and fell down in pothole damages; Front and Back Side Location Chimo Fatehabad, Haryana.
Surveyor comments	The subject vehicle No.RJ49SC-0785 has been inspected at Avni Honda, Fatehabad on 07.09.2019 by in house surveyor but due to major loss, claim assigned to me on 17.09.2019 I inspected the vehicle on 18.09.2019 and have following observation; 1.Date of loss mentioned on the claim from and DD reported date 15.08.2019 is mentioned as 06.08.2019 2.Claim intimation done to insurer by insured on 06.09.2019 where he mentioned date of loss as 15.8.2019 3. There is delay intimation from insured end. 4.Claimed damages are old and rusted and not correlated with cause of loss 5.Insurer may asked the clarification for date of loss, alongwith injury details, spot photographs and any third party involve in accident if any, so I am submitting the independent report to insurer and insurer may take decision as per finding noted.

 

 Thereafter the surveyor in report (Annexure RW1/7) has assessed the net amount Rs.31602/- , therefore, the end of justice would be met if we settle the claim on non-standard basis.

9.                          Thus, in view of above discussion, we dispose off the   complaint and direct the Op No.1 to settle the claim of complainant on non-standard basis and to pay Rs.23701/- (in round figure) i.e. 75% of Rs.31602/- (amount assessed by the surveyor in Annexure RW1/7) with a further direction to make the payment to the Op No.2 after conducing final survey of the repaired motor cycle. The complainant is also directed to make the rest of the amount, if necessary, to the Op No.2 at the time of taking the delivery of the motor cycle after repairing the same by Op No.2. The OP No.2 is also directed to handover the vehicle in question to the complainant in a running and roadworthy condition within 15 days from the date of depositing of balance payment by the complainant, if necessary. The compliance of the awarded amount be made within a period of 30 days by the Ops No.1 & 2 after doing the needful by the complainant as per direction given above.

10.                        In default of compliance of this order, proceedings against respondents shall be initiated under Section 72 of Consumer Protection Act, 2019 as non-compliance of court order shall be punishable with imprisonment for a term which shall not be less than one month, but which may extend to three years, or with fine, which shall not be less than twenty five thousand rupees, but which may extend to one lakh rupees, or with both. A copy of this order be sent to the parties free of cost. File be consigned to the record room after due compliance.     

Announced in open Commission.                                                           Dated: 05.12.2023

                  

          (K.S.Nirania)               (Harisha Mehta)                     (Rajbir Singh)                      Member                                 Member                               President