Order by:

Sh.Amrinder Singh Sidhu,  President.

1.       The   complainant has filed the instant complaint under section 12 of  the Consumer Protection Act, 1986 (as amended upto date) on the allegations that Opposite Party No.3  is national bank and is having tie up with Opposite Parties No.1 and 2 to sell their general insurance policies to its customers and the complainant is customer of Opposite Party No.3 having saving bank account in his name. On the allurement of the officials of the Opposite Parties, the complainant purchased a policy for his vehicle bearing No. PB-29X-5243 bearing No.3380/01220504/000/01 valid for the period 23.10.2018 to 22.10.2019 and  the premium of Rs.24,177/- was deducted from the saving bank account of the complainant with Opposite Party No.3. Further alleges that during the policy period, the insured vehicle of the complainant met with an accident, and in this regard, the complainant informed the Opposite Parties and also lodged the claim with the Opposite Parties and thereafter as per the directions of the Opposite Parties, the insured vehicle was sent for repair to Preet Agro Industries, Nabha and the surveyor of the Opposite Parties prepared the estimated costs of repairs between Rs.90,000/- to Rs.1 lakh. As per the directions of the Opposite Parties, the complainant  got repaired his vehicle and also submitted the claim with the Opposite Parties, but at last, the Opposite Parties refused to make the payment of the claim under insurance.   As such, there is deficiency in service on the part of the Opposite Parties. Vide instant  complaint, the complainant has sought the following reliefs.

a)       To direct the Opposite Parties to pay the amount of Rs.71,050/- as costs of repairs of insured vehicle and also to pay Rs.50,000/- as compensation for loss of business and Rs.50,000/- on account of mental tension and agony alongwith litigation expenses and interest thereon till its realization. Hence, the present complaint is filed by the Complainant  for the redressal of  their grievances.

2.       On notice, Opposite Parties No.1 and 2 appeared through counsel and contested the complaint  by filing the written version taking preliminary objections therein inter alia that the present complaint is not maintainable; that there is no deficiency in service on the part of the Opposite Party.  Brief facts are that at the time of alleged accident, the vehicle in question was used for commercial purposes and there were 3 persons traveling in the insured vehicle including the driver as per the  documents and claim form submitted by the complainant, whereas the permitted seating capacity as per the RC  is only one person including driver, which is the serious violation of  the policy conditions pertaining to limitation as to use. Moreover, Parkash Singh alleged driver of the vehicle in question was holding the driving licence  for MCWG/LMV/Tractor only  and the said DL is not valid for commercial vehicle nor there was any endorsement for commercial vehicle in the said DL, but the insured vehicle at the time of alleged accident  was being plied as commercial vehicle, hence no claim is payable and the Opposite Parties No.1 and 2 repudiated the claim vide letter dated 19.01.2019. Not only this, Opposite Parties deputed Mahesh Chander Sharma Surveyor and loss assessor who collected the documents and assessed the loss and submitted his report on 29.12.2018 with the remarks for repudiation of claim of complainant, whereby he assessed the loss at Rs.58,791/- after applying  depreciation and other provisions as per the terms and conditions of the policy. However, if this District Consumer Commission o none reason or other held that the complainant is entitled for any relief then it is submitted that the complainant is not  entitled more than Rs.58,791/- as assessed by the surveyor after deducting excess and compulsory clause  and after deducting salvage value as per the policy terms and conditions and that too on non standard basis.    On merits, Opposite Parties No.1 and 2 took up the same and similar pleas as taken up by them in the preliminary objections and hence, it is prayed that the complaint of the complainant is liable to be dismissed against Opposite Parties.

3.       Opposite Party No.3 appeared through counsel and contested the complaint  by filing the written version taking preliminary objections therein inter alia that the present complaint is not maintainable  against the answering Opposite Party and that there is no deficiency in service on the part of the answering Opposite Party. This District Consumer Commission has no jurisdiction to try and decide the present complaint as per the provisions of the old Act as the present complain was filed on 28.08.2019 and new Amended Act was came into force on 20.07.2020 as the complainant insured the vehicle from Opposite Parties No.1 and 2 and policy was issued from the office  situated at Ludhiana. Hence, there is no deficiency in service on the part of the Opposite Party No.3. On merits, Opposite Party No.3 took up the same and similar pleas as taken up by them in the preliminary objections and hence, it is prayed that the complaint of the complainant is liable to be dismissed against Opposite Party No.3.

4.       In order to prove his case, the complainant has tendered into evidence  affidavit  of complainant Ex.C1 alongwith copies of documents Ex.C2 to Ex.C18 and closed the evidence.

5.       On the other hand, to rebut the evidence of the complainant, Opposite Parties No.1 and 2  tendered  into evidence affidavit of  Sh.Pardeep Pathak Ex.Ops1 & 2/1 alongwith copies of documents Ex.Ops1&2/2 to Ex.Ops1 & 2/8 and similarly, Opposite Party No.3 tendered into evidence the affidavit of Sh.Kashmiri Lal Ex.OP3/1. 

6.       We have heard the ld.counsel for the parties and also gone through the documents placed on record.

7.       During the course of arguments, ld.counsel for the Complainant as well as Opposite Parties have mainly reiterated the facts as narrated in the complaint as well as in the written statements respectively. We have perused the rival contentions of  the parties and also gone through the record on file. The main contention of the ld.counsel for the complainant is that during the policy period, the insured vehicle of the complainant met with an accident and he immediately informed the Opposite Parties and  they deputed  their surveyor for  the assessment of the loss and as per the directions of the Opposite Parties, the complainant got repaired his insured vehicle and spent Rs.71,050/-, copies of the bill of Preet Agro Industries Private Limited have been placed on record as Ex.C8 to Ex.C13, but  the Opposite Parties refused to make the payment of the claim under insurance.    On the other hand, ld.counsel for the Opposite Parties No.1 and 2 has  repelled the aforesaid contention of the ld.counsel for the complainant  on the ground that at the time of alleged accident, the vehicle in question was used for commercial purposes and there were 3 persons traveling in the insured vehicle including the driver as per the  documents and claim form submitted by the complainant, whereas the permitted seating capacity as per the RC  is only one person including driver, which is the serious violation of  the policy conditions pertaining to limitation as to use. Moreover, Parkash Singh alleged driver of the vehicle in question was holding the driving licence  for MCWG/LMV/Tractor only  and the said DL is not valid for commercial vehicle nor there was any endorsement for commercial vehicle in the said DL, but the insured vehicle at the time of alleged accident  was being plied as commercial vehicle, hence no claim is payable and the Opposite Parties No.1 and 2 repudiated the claim vide letter dated 19.01.2019 due to breach of the terms and conditions of the policy. However, we are of the view that even if the complainant has breached the terms and conditions of the policy in question, even then the  Insurance Company ought to have settled the claim of the complainant on “non standard basis” even if some of the conditions of the insurance policy are not adhered by the insured. In this regard, we are supported with judgment  in  case titled National Insurance Company Limited versus Kamal Singhal IV (2010)CPJ297 (NC) wherein the Hon'ble National Consumer Disputes Redressal Commission, New Delhi relying upon various decisions of the National Consumer Disputes Redressal Commission in the matter of (1) National Insurance Company Ltd. v. J. P. Leasing & Finance Pvt. Ltd. (RP No. 643/2005), (2) Punjab Chemical Agency v. National Insurance Company Ltd. (RP No. 2097/2009), (3) New India Assurance Co. Ltd. v. Bahrati Rajiv Bankar, (RP) No. 3294/2009) and (4) National Insurance Company Ltd. v. Jeetmal, (RP No.3366/2009) and also judgment of the Hon'ble Apex Court in the matter of Insurance Company Versus Nitin Khandewal IV (2008) CPJ 1(SC), held the  breach of condition of the policy was not germane and also held further that : “the appellant Insurance Company is liable to indemnify the owner of the vehicle when the insurer has obtained comprehensive policy to the loss caused to the insurer”. The Hon'ble Supreme Court has further held that; “even assuming that there was a breach of policy, the appellant Insurance Company ought to have settled the claim on “non-standard basis.” Hon'ble Apex Court in back drop of these features, in these cases, allowed 70% of the claim of the claimant on the “non-standard basis”. This view was again reiterated by the Hon'ble Apex Court in the matter of Amalendu Sahoo versus Oriental Insurance Company Limited. II(2010) CPJ 9(SC)=II (2010)SLT 672.  Hon'ble National Commission in the case National Insurance Company Limited versus Kamal Singhal referred to above relying upon the law laid down by the Hon'ble Supreme Court has held that;

“there being a long line of decisions on this score, we have no option but to uphold the finding of Fora below with modification that the claim be settled on 'non-standard' basis”, in terms of the guidelines issued by the Insurance Company. In case petitioner company fails to carry out the direction contained therein, the amount payable on 'non-standard' basis, shall carry interest @ 6% p.a from the date of expiry of six weeks till the date of actual payment”.

8.       In such a situation the repudiation made by Opposite Parties regarding genuine claim of the complainant appears to have been made without application of mind. It is usual with the insurance company to show all types of green pesters to the customer at the time of selling insurance policies, and when it comes to payment of the insurance claim, they invent all sort of excuses to deny the claim. In the facts of this case, ratio of the decision of Hon’ble Apex Court in case of Dharmendra Goel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation.  This ‘take it or leave it’, attitude is clearly unwarranted not only as being bad in law, but ethically indefensible.  It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. In similar set of facts the Hon’ble Punjab & Haryana High Court in case titled as New India Assurance Company Limited Vs. Smt.Usha Yadav & Others 2008(3) RCR (Civil) Page 111 went on to hold as under:-

“It seems that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy.The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5000/- for luxury litigation, being rich.

9.       Now come to the quantum of compensation. The complainant has claimed the repair charges of the insured vehicle amounting to Rs.71,050/- and in this regard, he has placed on record the  copies of bills Ex.C8 to Ex.C13  vide which he has paid the amount on account of repair charges. Hence, having  regard to the position of the law, as has been laid down, by the Hon'ble Apex Court in the various decisions referred to here-in-above and also the view expressed by the Hon'ble National Commission, we are of the considered view that in the present case the complainant, if not entitled for the entire amount of repair charges, the Insurance Company definitely ought to have settled the complainant's claim on 'non-standard basis”, which in the facts and circumstances taking the assistance of the view expressed by the Hon'ble Apex Court and also by the Hon'ble National Commission, we allow 70% of the assessed amount on 'non-standard' basis” of the repair bills amount.

10.     In view of the aforesaid facts and circumstances of the case,  we allow the complaint of the Complainant partly and direct the Opposite Parties No.1 and 2 to make the payment of Rs.49,735/- (Rupees forty nine thousands seven hundred thirty five only) i.e. 70% of the repair bill amount of Rs.71,050/- to the Complainant alongwith interest @ 8% per annum from the date of  filing the present complaint i.e. 28.08.2019  till its actual realization.  The complaint against Opposite Party No.3 stands dismissed. The compliance of this order be made by  Opposite Parties No.1 and 2  within 60 days from the date of receipt of this order, failing which the complainant  shall be at liberty to get the order enforced through the indulgence of this District Commission. Copies of the order be furnished to the parties free of cost. File be consigned to record room after compliance.

11.     Reason for delay in deciding the complaint.

          This complaint could not be decided within the prescribed period because the State Government has not appointed any of the Whole Time Members in this Commission for about 3 years i.e. w.e.f. 15.09.2018 till 27.08.2021 as well as due to pandemic of COVID-19.

Announced in Open Commission.

Dated:08.06.2022.