Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 577
Instituted on : 08.11.2019
Decided on : 17.10.2023
Jasvir s/o Sh. Vijay Singh R/o H.No. 316 H.B.Colony, Sector-18, Faridabad at present Village-Titoli, Tehsil & District Rohtak.
.......................Complainant.
Vs.
- Bharti AXA General Insurance Co. Ltd. Now ICICI Lombard, 1st Floor, IDBI Bank Power House, Rohtak.
- ICICI Lombard GIC Mercantile House, 7th Floor, 15 Kasturba Gandhi Marg, Cannaught Place, New Delhi-11001. …………...Opposite parties.
COMPLAINT U/S 35 OF CONSUMER PROTECTION ACT,2019.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
DR. VIJENDER SINGH, MEMBER
Present: Sh. Jasvir Kundu, Advocate for complainant.
Sh. Gulshan Chawla, Advocate for Opposite party No. 2.
Opposite party no.1 given up.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case as per complainant are that he is registered owner of a Skoda Laura Car bearing registration no.HR-51AF-0276 which was insured from the opposite party no.1 vide policy no.S7057181 from 20.09.2018 to 19.09.2019. The IDV value of the said vehicle is Rs.5,00,000/-. It is further stated that on 13.03.2019, the vehicle of the complainant met with an accident and vehicle was badly damaged and complainant also suffered injuries and admitted in PGIMS, Rohtak. The complainant informed the officials of the opposite party no. 1 in this regard and on 14.03.2019 the vehicle was got surveyed by the surveyor of the company. he prepared the estimate report as total damage. Complainant submitted all the documents to opposite parties as desired by them and applied for insurance claim. Thereafter the officials of the opposite parties no. 1 & 2 repudiated the claim of the complainant by making false grounds that “This is a case of misrepresentation of facts as the material information was not disclosed to us at the time of the taking claim”. Whereas the complainant disclosed all the facts. But the opposite parties informed the complainant telephonically that this letter was recalled and again new surveyor will examine the vehicle and he will again submit new report to company and the claim will be disbursed as per company rule. But they again repudiated the claim on dated 04.11.2019. The complainant approached to the opposite parties officials and requested them to disburse the claim amount. After repeated requests the opposite parties did not disburse the claim amount. As such, there is deficiency in service on the part of opposite parties. Hence this complaint and it is prayed that opposite parties may kindly be directed to disburse the insurance claim amount of Rs.5,00,000/- alongwith interest @ 18% per annum from the date of incident till the date of actual realization, to pay Rs.1,00,000/- as compensation and Rs.11,000/- as litigation expenses to the complainant.
2. After registration of complaint, notices were issued to the opposite parties. Opposite party No.2 in its reply has submitted that: “The claim intimation was received in the office of answering opposite party on 15.03.2019 alleging the factum that vehicle in question had met with an accident on 13.03.2019. On receipt, opposite party registered the claim of the complainant and appointed an Independent surveyor M/s Magnum “Insurance Surveyors and loss assessors to assess the loss to the vehicle. The Independent surveyor assessed the loss to an amount of R.162087/- but the amount as assessed was not paid for the reason detailed above/below. That on getting the surveyor report, it became crystal clear that an Independent Surveyor M/s Magnum Insurance surveyors and loss assessors had given detailed observation confirming the factum that damages alleged to be sustained to insured vehicle does not commensurate with the cause of loss as mentioned by the insured in the claim form It is wrong and denied that vehicle in question has been a total loss, as alleged. Thus from above factual position it is clear that complainant misrepresented the facts for the purpose of taking claim from insurance company. That present case is of misrepresentation and concealment of the fact and breach of condition mentioned in the policy”. Thus the claim of the complainant has been repudiated and the same has been duly served upon the complainant. All the other contents of the complaint were stated to be wrong and denied and opposite party prayed for dismissal of complaint with costs. However, opposite party No.1 was given up by the complainant vide order dated 02.03.2021 of this Commission.
3. Ld. Counsel for the complainant in his evidence has tendered his affidavit Ex.CW1/A, documents Ex.C2 to Ex.C7 and also tendered documents Ex.C8 & Ex.C9 in additional evidence and closed his evidence on dated 21.04.2023.. Learned counsel for opposite party No. 2 tendered affidavit Ex. RW1/A, documents Ex.R1 to Ex.R4 and the evidence of opposite party was closed by the Court order dated 06.09.2022.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. In the present case, claim of the complainant has been repudiated by the opposite party vide its letter Ex.R4 dated 19.06.2019 on the ground that “As per report of surveyor this is a case of misrepresentation of facts as the material information was not disclosed to us at the time of taking claim”. We have perused the survey report Ex.R3, as per which the surveyor made some observations which are as under:- : “Damages sustained to insured vehicle not supports the cause of loss mentioned in the claim form by insured. The nature & symmetry of the damages are different as compare the cause of loss mentioned”. But to prove this fact neither any scientific reason has been given nor any document has been placed on record by the opposite party No.2. Photographs attached with the survey report Ex.R3 shows that vehicle is totally damaged. Complainant has placed on record copy of estimate Ex.C8 issued by Shakti Motors, Hissar Road, Rohtak dated 21.03.2017 amounting to Rs.1126131/-. To prove the incident, complainant has placed on record OPD card Ex.C2. As the estimate is more than the IDV of the vehicle. Hence the complainant is entitled for the loss on the total loss basis after deducting the salvage value, which we have assessed as Rs.80000/-. As per policy Ex.C6 the IDV of the vehicle is Rs.500000/-. Hence the complainant entitled for Rs.420000/-(Rs.500000/- less Rs.80000/-).
6. In view of the facts and circumstances of the case, we hereby allow the complaint and direct the opposite party No.2 to pay Rs.420000/-(Rupees four lac twenty thousand only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e.08.11.2019 till its realization and shall also pay a sum of Rs.5000/-(Rupees five thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant within one month from the date of decision. However, complainant is directed to send a letter to the RTO for cancellation of R.C.
8. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
17.10.2023
................................................
Nagender Singh Kadian, President
………………………………..
Tripti Pannu, Member.
………………………………..
Vijender Singh, Member.
