Haryana

StateCommission

A/650/2015

UNITED INDIA INSURANCE CO. - Complainant(s)

Versus

DARSHNA DEVI - Opp.Party(s)

P.S.SINI

15 Feb 2016

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No  :      650 of 2015

Date of Institution:      05.08.2015

Date of Decision :       15.02.2016

 

United India Insurance Company Limited, Regional Office SCO 123-124, Sector 17-B, Chandigarh through its duly constituted attorney Smt. Sunita Sharma, Deputy Manager.

                                      Appellant/Opposite party

Versus

Darshna Devi w/o Sh. Raghuvir Singh, Resident of Village & P.O. Lakhan Majra, Tehsil Meham, District Rohtak.

                                      Respondent/Complainant

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Shri B.M. Bedi, Judicial Member.

                            

Argued by:          Shri P.S. Saini, Advocate for appellant.

                             Shri Sikander Bakshi, Advocate for respondent.

 

                                                   O R D E R

 

B.M. BEDI, JUDICIAL MEMBER

 

United India Insurance Company Limited (for short ‘the Insurance Company’)-Opposite Party, is in appeal against the order dated July 2^nd, 2015, passed by District Consumer Disputes Redressal Forum, Rohtak (for short ‘the District Forum’) in Complaint No.349 of 2013.  

2.      Darshana Devi-Complainant (respondent herein) was the owner of vehicle, Mahindra Scorpio bearing Registration No.HR-46-C-0520. It was insured with the Insurance Company/appellant, w.e.f. 24.04.2011 to 23.04.2012, vide Insurance Policy Exhibit C-1, for Rs.6,75,000/-. The vehicle was damaged in an accident on 19.03.2012.  On being informed, the Insurance Company appointed surveyor who inspected the vehicle and assessed the loss at Rs.1,54,692/-. Claim being filed, the Insurance Company repudiated the same vide letter dated 05.09.2012 (Exhibit R-1) on the ground that during the period of previous policy, the complainant had availed insurable benefits but this fact was not disclosed while obtaining the instant policy and by giving wrong declaration wrongly availed No Claim Bonus (NCB) to the extent of 25%. Aggrieved by the repudiation of her claim, the complainant filed complaint under Section 12 of the Consumer Protection Act, 1986.

3.      The Insurance Company in its reply reiterated the fact stated in the repudiation letter and prayed for dismissal of the complaint.

4.      Vide impugned order, the District Forum accepted complaint directing the Insurance Company as under:-

“…..it is observed that the opposite party shall pay the insurance claim as assessed by the surveyor less NCB (Rs.154692/- less Rs.3949/-) i.e. to pay Rs.150743/- (Rupees one lac fifty thousand seven hundred forty three only) along with interest @ 9% p.a. from the date of filing the present complaint i.e. 04.09.2013 till its actual realization and shall also pay a sum of Rs.2500/- (Rupees two thousand five hundred only) as litigation expenses to the complainant maximum within one month from the date of decision failing which the awarded amount shall carry interest @ 12% p.a. from the date of decision. Complaint is disposed of accordingly.”

5.      It is not in dispute that the insured vehicle of the complainant was damaged in an accident and the surveyor of the Insurance Company had assessed the loss at Rs.1,54,692/-. The ground on which the claim was rejected was that the complainant had taken NCB at the time of obtaining the policy in question by giving false declaration.  

6.      To decide the controversy, the provisions of GR.27 of the Indian Motor Tariff need to be taken into consideration.  As per GR.27 of the M.V. Act, the Insurance Company is under an obligation to collect information from the previous Insurance Company with respect to the NCB by writing letter within 21 days from the date on which the complainant had obtained the policy. The relevant part of GR.27 of the Indian Motor Tariff reads as under:-

          “GR.27. No Claim Bonus

1. No Claim Bonus (NCB) can be earned only in the Own Damage section of Policies covering all classes of vehicles but not on Motor Trade Policies (Road Transit Risks/Road Risk/Internal Risks) and policies which cover only Fire and/or Theft Risks. For policies covering Liability with Fire and/or Theft Risks, the NCB will be applicable only on the Fire and/or Theft components of the premium. An insured becomes entitled to NCB only at the renewal of a policy after the expiry of full duration of 12 months.
2. No Claim Bonus, wherever applicable, will be as per the following table.

Xxx

3. xxx
4. xxx
5. xxx
6. In the event of the insured, transferring his insurance from one insurer to another insurer, the transferee insurer may allow the same rate of NCB which the insured would have received from the previous insurer. Evidence of the insured’s NCB entitlement either in the form of a renewal notice or a letter confirming the NCB entitlement from the previous insurer will be required for this purpose.

Where the insured is unable to produce such evidence of NCB entitlement from the previous insurer, the claimed NCB may be permitted after obtaining from the insured a declaration as per the following wording.

“I/We declare that the rate of NCB claimed by me/us is correct and that no claim as arisen in the expiring policy period (copy of the policy enclosed). I/we further undertake that if this declaration is found to be incorrect, all benefits under the policy in respect of Section 1 of the Policy will stand forfeited.”

Notwithstanding the above declaration, the insurer allowing the NCB will be obliged to write to the policy issuing office of the previous insurer by recorded delivery calling for confirmation of the entitlement and rate of NCB for the particular insured and the previous insurer shall be obliged to provide the information sought within 30 days of receipt of the letter of enquiry failing which the matter will be treated as a breach of Tariff on the part of the previous insurer. Failure of the insurer granting the NCB to write to the previous insurer within 21 days after granting the cover will also constitute a breach of the Tariff.”

7.      It is not in dispute that in this case the Insurance Policy (Exhibit C-1) was effective from 24.04.2011. The accident took place on March 19^th, 2012, that is, after about eleven months from the date of obtaining the policy. As per GR.27 of the Indian Motor Tariff, the insured can take benefit of ‘No Claim Bonus’ subject to producing evidence that he had not taken any claim during the period of previous policy. However, if the insured does not furnish any such evidence, the NCB can be permitted after obtaining declaration from the insured to the effect that no claim was taken by him during the subsistence of the previous policy and thereafter shall verify from the previous insurer by writing a letter within 21 days, failing which it will constitute a breach of the Tariff on the part of insurer and not insured.

8.      In the case in hand, learned counsel for the appellant/Insurance Company while assailing the order of the District Forum has referred to the declaration Exhibit R-3. A perusal of the declaration on Exhibit R-3, shows that it was given by Dasmesh and not by the complainant-Darshna Devi though the name of complainant figures on the first page of this document. There is no explanation on behalf of the Insurance Company in this regard. In this view of the matter the document relied upon by the Insurance Company is not helpful to it. No declaration given by claimant has been produced on record. By no stretch of imagination it can be said that false declaration was given by complainant-Darshna Devi. Besides, there is nothing on the record to show that the Insurance Company had verified from the previous insurer i.e. Bajaj Allianz General Insurance Company Limited. No certificate regarding verification of the NCB, allegedly taken by the claimant from Bajaj Allianz, has been produced on the record.  Thus, the Insurance Company wrongly repudiated complainant’s claim by taking false ground. No case for interference in the impugned order is made out.

9.      The appeal fails and is hereby dismissed.

10.    The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the complainant against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

Announced: 15.02.2016

(B.M. Bedi) Judicial Member

(Nawab Singh) President

 

CL