BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, KAITHAL.
Complaint no.322/16.
Date of instt.: 20.10.2016.
Date of Decision: 24.08.2017.
Rajesh Kumar son of Sh. Mange Ram, resident of Village Choushala, Tehsil Kalayat, Distt. Kaithal.
……….Complainant.
Versus
- Cholamandlam M.S.General Insurance Company Ltd., Dare House, 2nd Floor No.2, NSC Bose Road, Channei-60000IS.C.O.
- Cholamandlam M.S.General Insurance Company Ltd., S.C.O. No.103, Second Floor, Mugal Canal Market, Karan Complex Market, Mall Road, Karnal through its Branch Manager.
- Cholamandlam Investment and Finance Company Ltd., Karnal Road, Opposite Canal Colony, Kaithal, through its Branch Manager.
..……..Opposite Parties.
COMPLAINT UNDER SEC. 12 OF CONSUMER PROTECTION ACT, 1986.
Before: Sh. Jagmal Singh, President.
Sh. Rajbir Singh, Member.
Smt. Harisha Mehta, Member.
Present : Sh. Manoj Saharan, Advocate for complainant.
Sh. M.R.Miglani, Advocate for the opposite parties.
ORDER
(JAGMAL SINGH, PRESIDENT).
The complainant has filed the present complaint under Section 12 of Consumer Protection Act, 1986, with the averments that he got insured his Innova Car bearing registration No.HR-16P-4733 with the Ops vide policy No.3362/01199125/000/00 for the period w.e.f. 06.06.2016 to 05.06.2017. It is alleged that on 17.06.2016, the said car met with an accident and a case bearing FIR No.119 dt. 23.06.2016 under Sections 279, 337 and 338 IPC was got registered in P.S. Kalayat. Information regarding accident was given to the Op. It is further alleged that a surveyor was appointed by the Op and on the asking of surveyor, the complainant got repaired the said car and spent Rs.97,450/- on the repair of above-said car. It is further alleged that the complainant lodged the claim with the Ops and submitted all the necessary documents with the Ops but the Ops repudiated the claim of complainant vide letter dt. 16.08.2016. The said repudiation of claim is wrong and illegal. This way, the Ops are deficient in service. Hence, this complaint is filed.
2. Upon notice, the opposite parties appeared before this forum and filed reply raising preliminary objections with regard to maintainability; cause of action; locus-standi; non-joinder and mis-joinder of necessary parties; that this forum has got no jurisdiction to entertain and try the present complaint as the complainant got insured his vehicle from the Branch Office, Karnal; that the complainant did not inform the answering Op within time; that the claim of complainant was repudiated by the answering Ops on the ground that the complainant has violated the terms and conditions No.1 & 9 of the insurance policy. There is no deficiency in service on the part of answering Ops. On merits, the contents of complaint are denied and so, prayed for dismissal of complaint.
3. In support of his case, the complainant tendered in evidence affidavit Ex.CW1/A and documents Ex.C1 to Ex.C4 and closed evidence on 10.03.2017. On the other hand, the Ops tendered in evidence affidavit Ex.RW1/A and documents Ex.R1, Ex.R2 and Mark-R1 &Mark-R2 and closed evidence on 22.05.2017.
4. We have heard ld. counsel for both the parties and perused the case file carefully and minutely and have also gone through the evidence led by the parties.
5. Ld. counsel for the complainant reiterated all the points mentioned in the complaint. He argued that the complainant got insured the Innova Car in question with the Ops for the period w.e.f. 06.06.2016 to 05.06.2017. He further argued that on 17.06.2016, the said car met with an accident and a case bearing FIR No.119 dt. 23.06.2016 under Sections 279, 337 and 338 IPC was got registered in P.S. Kalayat. He further argued that the information regarding accident was given to the Op and a surveyor was appointed by the Op. He further argued that on the asking of surveyor, the complainant got repaired the said car and spent Rs.97,450/- on the repair of above-said car. He further argued that the complainant lodged the claim with the Ops and submitted all the necessary documents with the Ops but the Ops repudiated the claim of complainant vide letter dt. 16.08.2016. On the other hand, ld. counsel for the Ops argued that this forum has got no jurisdiction to entertain and try the present complaint as the complainant got insured his vehicle from the Branch Office, Karnal. He further argued that the complainant did not inform the Ops within time and the claim of complainant was repudiated by the Ops on the ground that the complainant has violated the terms and conditions No.1 & 9 of the insurance policy. Ld. counsel for the Ops submitted an authority cited in 2013(1) CPC paged 283 (NC) titled as Suresh Kumar Vs. NIC and copy of order dt. 20.02.2017 passed by Hon’ble National Commission in case titled as Rajesh Kumar Vs. NIC bearing revision petition No.3045 of 2015.
6. From the pleadings and evidence of the parties, it is not disputed that the complainant got insured the Innova Car in question with the Ops for the period w.e.f. 06.06.2016 to 05.06.2017 and on 17.06.2016, the said car met with an accident. It is also not disputed that a case bearing FIR No.119 dt. 23.06.2016 under Sections 279, 337 and 338 IPC was got registered in P.S. Kalayat. The dispute between the parties is that the Ops repudiated the claim vide letter dt. 16.08.2016, Mark-R2 on the ground that the accident took place on 23.06.2016, whereas intimation regarding accident was given to the Ops on 11.07.2016 and the complainant violated the terms and conditions of the insurance policy. But there would have been no justification for the Ops 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.
The above authorities are fully applicable to the facts of instant case, whereas the authorities submitted by ld. counsel for the Ops are not applicable to the facts of present case. Hence, we are of the considered view that the claim in respect of vehicle in question should have been settled by the Ops on the basis of the guidelines of non-standard settlement. Therefore, the Ops have wrongly repudiated the claim of complainant in toto.
7. In the present case, the surveyor namely Mr. Rajesh Kumar Sharma has assessed the loss of the damaged vehicle for a sum of Rs.69,090/-. Ld. counsel for the Ops has submitted the photo-copy of the same at the time of arguments. So, this report of surveyor is taken into consideration for deciding the compensation amount in the complaint. In this regard, we rely upon a judgment 2(2008) CPJ page 182 (NC), United India Insurance Co. Vs. Maya, wherein it has been held that a surveyor report should not be dismissed summarily as the surveyor is independent and qualified person under the relevant provisions of Insurance Act, 1938. In view of this authority, we are of the considered opinion that the complainant is entitled for 75% of the amount of loss assessed by the surveyor on the basis of non-standard.
8. Thus, in view of above discussion, we allow the complaint partly and direct the Ops to settle the claim of complainant on non-standard basis i.e. 75% of Rs.69,090/- (the assessed loss by the surveyor)= Rs.51,817.50 paise to the complainant. No order as to costs. Let the order be complied with within 30 days, failing which, the complainant shall be entitled interest @ 8% p.a. from the date of commencement of this order till its realization. A copy of this order be sent to both the parties free of costs. File be consigned to the record room after due compliance.
Announced.
Dt.24.08.2017.
(Jagmal Singh),
President.
(Harisha Mehta), (Rajbir Singh),
Member. Member.
