Punjab

Ludhiana

CC/19/156

Neha - Complainant(s)

Versus

Cholamandalam MS General Insurance Co.Ltd. - Opp.Party(s)

Kaunal B:ajaj Adv.

18 Jan 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No:156 dated 19.03.2019.                                                         Date of decision: 18.01.2024.

 

Neha Vats, aged about 34 years, Daughter of Sh. Vijay Kumar, Resident of H. No.463-C, Urban Estate, Phase-1, Dugri, Ludhiana.                                                                                                                         ..…Complainant

                                                Versus

1. Chola MS General Insurance, SCO 2463-2463, IInd Floor, Sector 22-C, Chandigarh.
2. Chola MS General Insurance, Dare House No.2, NSE Bose Road, Chennai-600001.
3. Mercedes Benz India Pvt. Ltd., E-3, MIDC Chakan-Phase-3, Chakan Industrial Area, Kuruli and Nighoje, Tal Khed, Pune-410501.
4. Joshi Autozone, Authorized Dealer Service Centre of Mercedes Benz India Pvt. Ltd., Grand Trunk Road, Jugiana, Ludhiana.                                                                                                       …..Opposite parties 

Complaint Under section 12 of the Consumer Protection Act, 1986.

QUORUM:

SH. SANJEEV BATRA, PRESIDENT

SH. JASWINDER SINGH, MEMBER

MS. MONIKA BHAGAT, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant             :         Sh. Kunal Gaurav Bajaj, Advocate.

For OP1 and OP2          :         Sh. Vyom Bansal, Advocate.

For OP3                         :         Complaint against OP3 not admitted vide order                                           dated 30.05.2019.

For OP4                         :         Exparte.

 

 

 

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                Briefly stated, the facts of the case are that the complainant being owner of the Mercedes Benz car bearing No.PB-13-AH-0046, manufactured by OP3 and OP4 is the dealer of the said car whereas OP1 and OP2 are the insurance providers. The complainant stated that she was looking and inquiring for the best suitable luxurious car for her and family members like BMW, Audi prevailing in the Indian market. OP4  represented themselves to be dealer of well renowned and best car manufacturer in the world who manufactures luxurious car suitable for Indian road and also represented that their services are hassle free and free from any encumbrances as well as they work for customer satisfaction. According to the complainant, she purchased one of the segment of said car on assurance of OP4 but after one year during periodic service of the vehicle, she marked her complainant to the Service Manager about starting problem of the engine and some noise from the engine when the ignition is on and also when the car is running on the road. Then the officers of OP4 assured her not to worry as the car is fully insured and under warranty period  and assured to resolve the issues. The complainant further stated that in the month of July 2017, the said car met with an accident at Underpass Bridge, Near Lodhi Club, BRS Nagar, Ludhiana as the stone was lying in between the water at the underpass road which struck with the car below which resulted in accident and chamber of the engine hit with the stone causing leakage of oil and engine of the car got seized. After the accident, the complainant called at OP4’s workshop and the damaged car was towed to the workshop on the same day. OP4 informed OP1 and OP2 who appointed Mr. Sanhil as Surveyor and Loss Assessor for inspection and to assess the loss of the damaged car and after inspection, he instructed OP4 to start repairing the damaged vehicle. OP4 assured the complainant to deliver the car shortly after its repair and paying nominal file charges. However, the car was covered under Dep Cap Cashless Policy from Bumper to Bumper and consumables by OP1 and OP2. The complainant regularly enquired about her car but inspite of repair of the vehicle, it was not delivered to the complainant. Rather OP4 handed over an Email conversation and forwarded the same on the Email ID of the complainant wherein it was stated that the loss is not payable as the same allegedly does not fall under the policy condition. The complainant further stated that OP1 and OP2 are escaping from their liability whereas the surveyor during inspection assessed the loss without her knowledge and even he never conveyed this to the complainant. Even the surveyor reported that the damage accrued to the car does not fall under the terms and conditions of the policy as the engine and gear box got damaged. The complainant further stated that till date no communication and revert was given by OP3 despite sending of Emails to OP1 to OP3. Her claim has been rejected arbitrarily, illegally and against the principles of natural justice which amounts to deficiency in service and unfair trade practice on the part of the OPs for which the OPs are liable to compensate the complainant. In the end, the complainant prayed for issuing directions to the OPs to replace/repair the Engine and Gear box and other repair charges of the car along with compensation of Rs.10,00,000/- and litigation expenses of Rs.51,000/-. 

2.                The complaint as against OP3 was not admitted vide order dated 30.05.2019.

3.                None turned up on behalf of OP4 despite service of notice through registered post dated 04.06.2019 and as such, OP4 was proceeded against exparte vide order dated 11.10.2019.

4.                Upon notice, OP1 and OP2 appeared and filed joint written statement and by taking preliminary objections assailed the complaint on the ground of maintainability, the complaint barred by limitation; the complainant being estopped by his own act and conduct; suppression of material facts; lack of cause of action etc.

                   Under the column of factual submissions, OP1 and OP2 stated that the vehicle of the complainant i.e. Mercedes Benz A 180 bearing No.PB-13AH-0046 was insured vide policy No.3362/01276922/000/00 Private Car Policy having validity from 01.11.2016 to 31.10.2017 by them. OP1 and OP2 further stated that a claim towards damage of the insured vehicle was intimated by the complainant, which was registered vide claim No.3362355985 and they appointed Mr. Sanhil Chhabra, Surveyor to survey the vehicle. Letters dated on 16.10.2017 and 24.10.2017 were written demanding certain documents but neither any reply nor any documents were supplied by the insured.  It was intimated to the insured in the said letters that the engine is not covered under the policy so as per policy terms and conditions engine is not allowed for Replacement. The claim was closed as No-Claim after not receiving any response from the complainant. As per surveyor report, the assessed net liability of the insurance company at Rs.3,85,303/- as admissible in the policy terms and conditions.

                   On merits, OP1 and OP2 reiterated the crux of averments made in the preliminary objections and factual submission. OP1 and OP2 have denied that there is any deficiency of service and has also prayed for dismissal of the complaint.

5.                In support of her claim, the complainant tendered her affidavit Ex. CA in which she reiterated the allegations and the claim of compensation as stated in the complaint. The complainant also tendered documents i.e. Ex. C1 is the copy of Aadhar card of the complainant, Ex. C2 is the copy of insurance cover note w.e.f. 01.11.2016 to 31.10.2017, Ex. C3 is the copy of insurance policy w.e.f. 01.11.2016 to 31.10.2017, Ex. C4 is the copy of RC bearing No.PB13-AH-0046, Ex. C5 is the copy of Email correspondence, Ex. C6 is the copy of letter dated 07.11.2017 written by the complainant, Ex. C7 and Ex. C8 are the copies of letters dated 16.10.2017 and 24.10.2017 respectively issued by OP1 and OP2 and closed the evidence.

6.                On the other hand, the counsel for OP1 and OP2 tendered affidavit Ex. RA of Sh. Pradeep Pathak, Deputy Manager Claims (Legal), Cholamandalam MS General Insurance Company Limited at SCO 2463-2464, First Floor, Sector 22C, Chandigarh as well as affidavit Ex. R4/A of Sh. Vikram, Insurance Surveyor & Loss Assessor along with documents i.e. Ex. R1 is the copy of insurance policy w.e.f. 01.11.2016 to 31.10.2017, Ex. R2 and Ex. R3 are the copies of letters dated 16.10.2017 and 24.10.2017 issued by OP1 and OP2, Ex. R4 is the copy of Motor Final Survey Report-Private and closed the evidence.

7.                We have heard the arguments of the counsel for the parties and also gone through the complaint, affidavit and annexed documents and written statement, affidavit and documents produced on record by both the parties.

8.                Undisputably, a vehicle make Mercedes Benz bearing registration No.PB-13-AH-0046 owned by the complainant met with an accident at Underpass Bridge, Near Lodhi Club, BRS Nagar, Ludhiana due to struck with a stone  lying in between the water at underpass road resulting in damage to engine of the vehicle. The said vehicle was insured with OP1 and OP2 vide insurance policy Ex. C3 = Ex. R1. As such, the complainant lodged a claim with OP1 and OP2, who appointed Mr. Sanhil Chhabra, Surveyor to survey the vehicle. The said surveyor  submitted Motor Final Survey Report-Private vide which he assessed the net liability of the insurer to be Rs.3,85,303.20. However, OP1 and OP2 demanded certain documents from the complainant vide letters dated 16.10.2017 and 24.10.2017 Ex. C7 = Ex. R2 and Ex. C8 = Ex. R3 otherwise his claim will be treated as “No Claim”. Admittedly, the complainant has not submitted the documents with OP1 and OP2.                

9.                Perusal of Ex. C7 = Ex. R2 and Ex. C8 = Ex. R3 shows that the insurance company had demanded the following documents from the complainant:-

i.        Bills of repair,

ii.       Photographs

iii.      Insured signature proof

 

 

It has been mentioned in the letters Ex. C7 = Ex. R2 and Ex. C8 = Ex. R3 that in case of non-supply of the documents, the claim file will be closed as ‘No claim’. A close examination of these letters reveals that these letters were issued after the receipt of the claim supported by certain documents and only the pending documents were requisitioned through these letters. Moreover, non-submission of the documents cannot be made a sole ground to close the claim of the complainant. The insurance companies are required to be more liberal in their approach without being too technical.

10.              In this regard, reference can be made to 2022(2) Apex Court Judgment 281 (SC) in case title Gurmel Singh Vs Branch Manager National Insurance Company Ltd. whereby it has been held by the Hon’ble Supreme Court of India that the insurance company has become too technical while settling the claim and has acted arbitrarily. The appellant has been asked to furnish the documents which were beyond the control of the appellant to procure and furnish. Once, there was a valid insurance on payment of huge sum by way of premium and the Truck was stolen, the insurance company ought not to have become too technical and ought not to have refused to settle the claim on non­submission of the duplicate certified copy of certificate of registration, which the appellant could not produce due to the circumstances beyond his control. In many cases, it is found that the insurance companies are refusing the claim on flimsy grounds and/or technical grounds. While settling the claims, the insurance company should not be too technical and ask for the documents, which the insured is not in a position to produce due to circumstances beyond his control.

Ex. R4 is the assessment summary in which the liability has been assessed as Rs.3,85,303.20. However, it was the duty of OP1 and OP2 to assess the loss even when the documents were submitted to them. Sh. Sanhil Chhabra, Surveyor vide his report Ex. R4 has given his report and has assessed the insurance company’s liability as Rs.3,85,303.20. The complainant has not controverted the facts mentioned in the written statement, so far as the surveyor report Ex. R4 is concerned as the complainant has neither filed any objections to controvert the averments made in the written statement.

11.              As a result of above discussion, the complaint is partly allowed with an order that OP1 and OP2 shall pay the claim of Rs.3,85,303.20 to the complainant as per survey report Ex. R4 along with interest @8% per annum from the date of filing of the complaint till date of actual payment. However, there shall be no order as to costs. The complaint as against OP4 is dismissed. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

12.              Due to huge pendency of cases, the complaint could not be decided within statutory period.

 

(Monika Bhagat)          (Jaswinder Singh)                     (Sanjeev Batra)

Member                         Member                                       President         

 

Announced in Open Commission.

Dated:18.01.2024.

Gobind Ram.