DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II

U.T. CHANDIGARH

Vikas Aggarwal, Prop. Of M/s Passim Medichem Agencies, Plot No.186, Industrial Area, Phase-2, Chandigarh.

                                                                                    ---Complainant

V E R S U S

Bharti Axa General Insurance Company Ltd., 1^st Floor, SCO No.350-352, Sector 34-A, Chandigarh, through Sh.Amit Parmar, Sr. Specialist Claims.

---Opposite Party

BEFORE:            SHRI LAKSHMAN SHARMA                    PRESIDENT

                        SMT. MADHU MUTNEJA                   MEMBER

                        SH.JASWINDER SINGH SIDHU            MEMBER

Argued By:            Sh.Maninder Arora, Advocate for the complainant

Sh.N.K.Malhotra, Advocate for the OP.

PER JASWINDER SINGH SIDHU, MEMBER

1]             Complainant (hereinafter referred to as CC for short) has filed the present complaint against the Opposite Party (hereinafter referred to as OP for short) on the ground that the CC is the proprietor of M/s Passim Medichem Agencies and owns a Car in the name of M/s Passim Medichem Agencies, having Regd. No.CH-03-U-1490 Model 2005.  That the CC got the insurance of the said car done through the OP for the period 03.12.2008 to 02.12.2009 and paid premium of R.9908/-. Copy of the Policy is Ann.C-1. 

                On the expiry of the previous policy, the same was renewed by the CC through the OP from 03.12.2009 to 02.12.2010 and paid a premium of Rs.9255.27Ps.  Copy of the same is Ann.C-2.

                Thereafter, the CC met with an accident while driving the said Car on 11.10.2010 and for the purpose of getting it repaired, took the vehicle to Emm Pee Motors Limited, Chandigarh (Authorised Agency of the Company).  The CC lodged the claim with the OP and submitted all the relevant documents with the OP for the settlement of the claim.  In the meanwhile, he got the car in question repaired.  When the CC went to take the delivery of the vehicle on 25.10.2010, he was informed that his claim was not settled by the OP.  In order to take the delivery of the vehicle, the CC had to pay Rs.41,686/- from his own pocket vide Receipt No.3232, dated 25.10.2010. 

                Aggrieved by the action of the OP, of not settling his rightful claim, CC prays for directions of this Forum asking OP to reimburse the claim/bill amount as per Ann.C-3 along with interest @18% p.a. from the date of payment of the bill and further Rs.50,000/- for physical & mental harassment along with litigation expense.

2]             On notice, OP filed their version along with a few annexures.

                The OP has taken preliminary objection citing a fact that as the amount claimed by the CC has already been paid to him, as per the terms & conditions of the policy, hence, the present complaint is totally vague, false and not sustainable in the eyes of law on the ground that the CC did not disclose any fact against the OP. 

                It is also mentioned in Para-2 (Page-2) of the reply that the OP has paid the amount and in view of the receipt of the same, dated 10.2.2011, the CC having appended his signatures Ann.R-2, there is no cause left with the CC to pursue with the present complaint. 

3]             Parties led their respective evidences.

4]             Having gone through the entire complaint and version of OPs and the evidence of the parties, we are of the considered view that the CC is successful in proving deficiency in service on the part of OP on the following grounds:-

i)      It is very much clear from the Letter of the OPs, dated 27.11.2010 sent under the signature of one Mr.Amit Pawar (Ann.C-4 Page-16) along with the Repudiation Letter of the claim of CC (Page-17), wherein it is clearly mentioned under the Column of Observations that:-

“A claim was reported in the above policy on 09/06/2010.

On perusing the documents and the proposal, it is observed that insured has declared about eligibility for 65% NCB.

The previous Insurer M/s Reliance Insurance Company Limited, confirmed claim in their expiring policy.

We have received written confirmation (email) from M/S Reliance Insurance Company Limited regarding their claim settlement.

The insured had tried to misrepresent the factual position and thereby became ineligible for NCB”

ii)        Further in the Column of Recommendations, it is mentioned that “..considering the above facts, it is recommended that claim is declined based on the above misrepresentation of facts by the Insured, which renders the policy void.”

iii)    It is a very surprising event that the CC having insured his vehicle in the previous policy, which too was done by the OP Company, but from the perusal of the previous Policy No.FPV/I0003485/91/12/ D19111,Account No.91000029 dated 03.12.2008, issued by OP Company, the CC did not claim any N.C. B. (No Claim Bonus) from the OP, whereas it is only in the present policy under question Policy No.FPV/I0003485/91/12/D19111,Account No.91000091  valid for the period 03.12.2009 to 02.12.2010, wherein 65% discount under N.C.B. was availed. Hence, the observations cited by the OP in their repudiation letter to the CC are defeated by their own documents. 

iv)    It is also interesting to note that the OP came forward with a written reply after a passage of nearly 7 months of having been served in a proper manner and that too after having paid the CC the amount of money claimed by him.  This fact is also reflected in their Reply.  But, OP has filed Ann.R-2, which according to them is the Receipt of claim money received by the CC.  On having gone through Ann.R-2, it is clearly evident that the CC has mentioned the fact with regard to the status of the present complaint to the OP and had also registered his Protest with the OPs pending decision of the Hon’ble Forum.  CC had also mentioned that he is ready to settle the matter with the OP if they come forward to compensate him with regard to the harassment suffered by him and expenses incurred on litigation. 

The OP has cleverly not cited this fact while submitting the written Reply.  As such, all the averments of the present complaint go unrebutted. 

v)     We also find that the CC has not breached any of the terms & conditions of the Policy, as alleged by the OP in their repudiation letter nor the OP has come forward with any cogent, reliable and trustworthy evidence, after having conducted investigations qua this fact, which could support their version. Thereafter having paid the claim amount to the CC on their own proves their admission of their fault. Hence the CC is successful in proving gross deficiency in service on the part of the OP.

5]             On the above observations, we allow this complaint and direct OP to pay interest on the amount of Rs.41,686/- @9% p.a. from 09.09.2010 (after considering 3 months processing time) till it was received by the CC i.e. upto 05.1.2011.  We also saddle OP with consolidated amount of compensation to the tune of Rs.10,000/- for causing harassment to the CC along with Rs.5000/- towards cost of litigation.

                This order be complied with by OP within 30 days from the date of receipt of its certified copy, failing which OP shall be liable to pay an interest @18% p.a. on the amount of compensation that stands against them after completion of 30 days, besides the cost of litigation

                Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room.

Announced

06.09.2011                                                           

   (LAKSHMAN SHARMA)

PRESIDENT

 (MADHU MUTNEJA)

MEMBER 

 (JASWINDER SINGH SIDHU)

MEMBER