Chandigarh

StateCommission

A/6/2022

Tata AIG Insurance Company Ltd. - Complainant(s)

Versus

Diljot Singh - Opp.Party(s)

Rajneesh Malhotra & Vandana Malhotra Adv.

09 Feb 2022

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

TATA AIG General Insurance Co. Ltd. 2^nd Floor, SCO 232-234, Sector 34-A, Chandigarh through its Branch Manager.

Email ……Appellant/Opposite Party

V e r s u s

Diljot Singh aged about 28 years S/o Sh.Avtarjeet Singh R/o House No.890, Sector-7, Panchkula, Haryana.

…..Respondent/Complainant

BEFORE:              JUSTICE RAJ SHEKHAR ATTRI, PRESIDENT

                             MRS.PADMA PANDEY, MEMBER.

Present through Video Conferencing:-

                             Sh.Rajneesh Malhotra, Advocate for the appellant.

                             Sh.Harish Goyal, Advocate for the respondent.

JUSTICE RAJ SHEKHAR ATTRI, PRESIDENT

                   This appeal has been filed by the opposite party (in short the appellant), feeling aggrieved by the order dated 23.09.2021 passed by the District Consumer Disputes Redressal Commission-I, U.T., Chandigarh (in short the District Commission), whereby the consumer complaint bearing no.306 of 2020 filed by the complainant (in short the respondent) was partly allowed and the appellant was directed as under:-

 “.. In view of the above discussion, the present consumer complaint succeeds and the same is accordingly partly allowed. Opposite Party  directed as under :-

1. to pay ₹43,39,418/- to the complainant alongwith interest @ 9% per annum from the date of submission of claim..
2. to pay an amount of ₹1,00,000/- to the complainant as compensation for causing mental agony and harassment to him;
3. to pay ₹15,000/- to the complainant as costs of litigation.
4. The complainant shall return the remains of accidental vehicle to the Opposite Party along with all the necessary documentation work.

This order be complied with by the Opposite Party within thirty days from the date of receipt of its certified copy, failing which, it shall make the payment of the amounts mentioned at Sr.No.(i) & (ii) above, with interest @ 12% per annum from the date of this order, till realization, apart from compliance of direction at Sr.No.(iii) above..……”.

2.           It is the case of the complainant that he had purchased one old car make Audi A8 3.0 TDI QUATTRO Model 2012 bearing Registration No.HR-26-BT-0019 from M/s ASK Automotive Pvt. Ltd., Plot No.28, Sector 4, IMT, Manesar, Gurgaon, which he got transferred in his name on 01.06.2020. On making payment of premium amount of Rs.2,37,015/- to the opposite party, insurance of the said vehicle was also got transferred in his name, whereby, Insured Declared Value (in short the IDV) thereof was fixed @ Rs.43,39,418/-, under Zero Depreciation comprehensive Policy. As per the said policy, in case, in an accident the total retrieval value exceeds 75 per cent of the total cost of the vehicle, it was to be declared as total constructive loss. On 12.06.2020, the vehicle in question met with an accident, information whereof was given to the opposite party and claim was lodged thereafter. However, to his utter shock, the opposite party issued letter dated 06.07.2020, seeking the proof of purchase of the vehicle in question. Thereafter, he visited the office of the opposite party number of times with a request to settle his claim but to no avail. When legal notice dated  13.07.2020 (Annexure C-8) served upon the opposite party, in the matter, also did not yield any result, the complainant filed consumer complaint before the District Commission. 
3.           Upon notice, the opposite party put in appearance and filed written statement stating therein that vide letters dated 06.07.2020, 27.08.2020 and 11.9.2020, the company offered to settle the claim of the complainant on merits, as per terms and conditions of the policy; that the opposite party proposed to replace the damaged vehicle with the vehicle of same make and model and sought approval of the complainant; that the opposite party  called upon the complainant vide letter dated 06.07.2020 to provide purchase agreement with mode of payment (cash/cheque/DD) and necessary documents to complete STR-AML-KYC (Suspicious Transactions Report Anti Money Laundering-Know Your Customer) requirement as per the directions of Ministry of Finance but he failed to provide the same; and that since complicated questions of facts and law are involved in this complaint, as such, only the civil court has power to adjudicate it. Prayer was made to dismiss the complaint.
4.           In the rejoinder filed, the complainant reiterated all the averments made in the complaint and controverted those contained in written version of the opposite party.      
5.           The contesting parties led evidence by way of affidavits and documents before the District Commission.
6.           The District Commission after hearing the contesting parties and on going through the material available on record, partly allowed the consumer complaint in the manner stated above, against the appellant.
7.           Hence this appeal.         
8.           We have heard the Counsel for parties; gone through the material available on the record; and are of the considered opinion that this appeal deserves to be dismissed for the reasons to be recorded hereinafter.
9.           It is an admitted fact that after purchase of the vehicle in question, in the manner stated above, the respondent got the same insured from the appellant, valid for the period from 20.06.2019 to 19.06.2020. It is also not disputed that the IDV of the said vehicle was fixed at Rs.43,39,418/- and that during subsistence of the said insurance policy, accident took place on 12.06.2020 and the surveyor has come to the conclusion that it was a total loss [TL/constructive Total Loss (CTL)] case because the expenditure of repairs, if carried out, will exceed 75% of the cost thereof. It is coming out from term and conditions of the insurance policy in question, that it was agreed to between the parties that, in case of any accident of the vehicle in question, the IDV shall be treated as the Market Value throughout the policy period without any further depreciation for the purpose of Total Loss (TL/constructive Total Loss (CTL) Claims i.e. Rs.43,39,418/-, after retaining the salvage by the opposite party.
10.           During arguments, Counsel for the appellant took following objections:-
    1. that though as per condition no.3, the appellant was at liberty to either repair, reinstate or replace the vehicle or part thereof and/or its accessories or may pay in cash the amount of the loss or damage but the respondent was not ready for the same and insisted for payment of IDV;
    2. that despite making number of requests, the respondent failed to provide purchase agreement with mode of payment (cash/cheque/DD) and necessary documents to complete STR-AML-KYC (Suspicious Transactions Report Anti Money Laundering-Know Your Customer); and
    3. that the matter needs to be relegated to the civil court, as complicated questions of facts and law are involved therein.    
11.           First we will deal with the contention raised by Counsel for the appellant to the effect that as per condition no.3, the appellant was at liberty to either repair, reinstate or replace the vehicle or part thereof and/or its accessories or may pay in cash the amount of the loss or damage, it may be stated here that we have gone through the said condition (3 (a) of the said policy and found that it has been agreed by the appellant that the liability of the company shall not exceed the IDV of the vehicle as specified in the schedule less that value of wreck/salvage, over and above the fact that it was also having an option to repair, reinstate or replace the vehicle or part thereof and/or its accessories or may pay in cash the amount of the loss or damage. Plain reading of the said condition goes to reveal that it was not made a condition precedent that the company will only repair, reinstate or replace the vehicle or part thereof and/or its accessories, in case any accident took place and it is declared as total loss. Thus, once it was also mentioned in the said condition that the company may pay in cash the amount of loss or damage and its liability shall not exceed the IDV of the vehicle as specified in the schedule less the value of wreck, as such, the respondent was also at liberty to except the option either to get the IDV of the vehicle in question or to get the vehicle in question replaced with the same model/made, in case of total loss of the insured vehicle.

                   The appellant has failed to place on record any evidence to prove that the respondent was bound to get the insured vehicle repaired/replaced, in case, it met with an accident and declared as Total Loss (TL/constructive Total Loss (CTL) by the surveyor. Thus, in our considered opinion, the respondent was entitled for getting refund of the amount equal to the IDV of the vehicle in question i.e. Rs.43,39,418/-, as it was a case of total loss because of the accident aforesaid. By not making payment of the IDV amount to the respondent, despite the fact that the vehicle in question was declared by the surveyor, as total loss, the appellant was deficient in providing service and also adopted unfair trade practice. The District Commission was also right in holding so.

12.           Now coming to the next contention raised by Counsel for the appellant to the effect that since the respondent failed to provide purchase agreement with mode of payment (cash/cheque/DD) and necessary documents to complete STR-AML-KYC (Suspicious Transactions Report Anti Money Laundering-Know Your Customer), as such, his claim was not settled by the appellant, it may be stated here that we have also gone through the Circular regarding STR-AML-KYC (Suspicious Transactions Report Anti Money Laundering-Know Your Customer), whereupon reliance has been placed by the appellant and found that it has been issued by the Ministry of Finance, on 31.03.2006. The appellant has failed to convince this Commission as to why no efforts were made by it to complete STR-AML-KYC (Suspicious Transactions Report Anti Money Laundering-Know Your Customer), at the time of receipt of the premium and issuance of the insurance policy in question on 20.06.2019. It is not the case of the appellant that the aforesaid circular has been issued after the date of issuance of the policy in question. Furthermore, there is nothing on record to show that at the time of transfer of policy in question, in the name of the respondent or at any stage prior to issuance of the said policy, any such exercise was carried out by the appellant. Thus, in the present case, if the appellant preferred to ignore to complete STR-AML-KYC (Suspicious Transactions Report Anti Money Laundering-Know Your Customer) of the respondent, at the time of issuance of insurance policy, as such, now they cannot be allowed to defeat the claim of the respondent on this ground, especially, when his case of total loss was received by them for making payment of the IDV. The District Commission was also right in holding so.
13.           As far as contention raised by Counsel for the appellant to the effect that the matter needs to be relegated to the civil court, as complicated questions of facts and law are involved therein, it may be stated here that it is a simple case of deficiency in rendering service, negligence and adoption of unfair trade practice on the part of the appellant in not honouring the genuine claim of the respondent i.e. not making the payment of IDV to the tune of  Rs.43,39,418/-, as his vehicle had been declared total loss(TL/constructive Total Loss (CTL) by the surveyor, on account of the accident which took place during subsistence of the insurance policy in question.

                   The respondent paid huge amount towards premium aforesaid, to the appellant, with a view to secure himself financially, in case of any mis-happening/accident of the vehicle in question, but whenit came on the part of theappellant tohonour the claim, it tried to wriggle out of the same, by taking a hyper technical view, thereby causing him lot of mental agony, harassment and financial loss. It has been observed by this Commission that the insurance companies are interested only in obtaining  insurance premiums and when it came on them to  honour the claims, the  insured  are unnecessarily dragged into rounds of  litigation, which act needs to be deprecated. The District Commission was also right in holding so.

14.           In view of peculiar facts and circumstances of this case, we are of the considered opinion that the act and conduct of the appellant by not paying the amount of IDV of the vehicle in question, despite the fact that it was declared as total loss by the surveyor and on the other hand taking a hyper technical view, is not tenable and also amounts to deficiency in providing service, negligence and adoption of unfair trade practice, on its part. The District Commission was thus right in partly allowing the consumer complaint, in the manner stated above, which needs no interference of this Commission. Thus, the order impugned stands upheld. Resultantly, this appeal being devoid of merit is dismissed, with no order as to cost.
15.           Consequently, application bearing no.47 of 2022 filed alongwith this appeal, also stands dismissed having been rendered infructuous.   
16.           Certified copies of this order be sent to the parties, free of charge.
17.           The concerned file be consigned to Record Room, after completion.

Pronounced

09.02.2022

Sd/-

 [JUSTICE RAJ SHEKHAR ATTRI]

PRESIDENT

Sd/-

 (PADMA PANDEY)

          MEMBER

Rg.