BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,  PANCHKULA

Suresh Kumar aged 55 years, son of Sh.Murli Dhar resident of H.No.986, Sector-7, Panchkula.

                                                                           ….Complainant

Versus

1.     Edelweiss General Insurance Co. Ltd. through its Managing Director/Directors, 5^th Floor, Tower 3, Wing B, Kohinoor City Mall, Kohinoor City, Kirol Road, Kurla(W), Mumbai-400070.

        IInd Address

        Edelweiss House C.S.T. Road, Kalina Mumbai.

2.     Managing Director/Directors Edelweiss General Insurance Co. Ltd., 5^th Floor, Tower 3, Wing B, Kohinoor City Mall, Kohinoor City, Kirol Road, Kurla(W), Mumbai-400070.                                                                                                                                                                                                                          ..….Opposite Parties

COMPLAINT UNDER SECTION 35 OF THE CONSUMER PROTECTION ACT, 2019

Before:              Sh. Satpal, President.

Dr. Sushma Garg, Member.

Dr. Suman Singh, Member

For the Parties:   Complainant in person along with Sh. Naman, Advocate.  

                        None for the OPs No.1 & 2(Defence of OPs No.1 & 2                                 struck off vide order dated 06.01.2022).                

ORDER

(Satpal, President)

1.             The brief facts, as alleged, in the present complaint, are, that the complainant is the owner of the Honda City car bearing registration No.PB-65-AK-9071 issued by the Registering authority SAS Nagar, Mohali(Punjab), which is valid upto the year 2032. It is stated that the said car met with an accident on 09.08.2020, while it was being driven by the son of the complainant, namely, Sh.Raman Arora, during the validity period of insurance policy no. 950002502 issued by the opposite party(hereinafter referred to as OP), which was valid from 17.05.2020 to 16.05.2021. It is averred that the said Raman Arora, while driving the said insured car no.PB-65-AK-9071 on 09.08.200 at around 05:30 A.M. in the morning, noticed that a stray(street) dog had suddenly come in front of the car from his right hand side and in order to save the dog, he steered the car towards right side and also applied breaks, due to which, he lost control over the car and the car got over turned after hitting the divider. It is averred that the said incident occurred, when the car had reached Sector-12, Panchkula(Haryana);  no police report was lodged as no third party was involved in the accident;  the car was damaged to such an extent that it was towed to M/s Joshi Automobiles in Panchkula by Manjeet Recovery Service; the complainant informed the OP No.1 about the accident and lodged a claim with the OPs and all the relevant documents in respect of the claim were provided by the complainant and his son to the OPs. Despite the lodging of the claim, the OPs have failed to satisfy the claim of the complainant till date despite number of requests sent to the OPs vide emails.  It is stated that the OPs have been making one excuse or the other qua the settlement of the claim as lodged by the complainant despite the fact that the car in question had met with an accident, which was duly insured with the insurance company i.e. the OP No.1 on the date of the accident. It is stated that the vehicle in question has suffered a total loss. The Ops are not interested in settling the valid claim of the complainant and have been illegally insisting upon the submission of certain documents and are making lame excuses for not settling the claim. It is stated that the complainant was forced to bring back the vehicle from the workshop i.e. Joshi Automobiles since the Ops were not settling the claim of the complainant. It is stated that the complainant has now parked the damaged vehicle in front of his house. Due to the act and conduct of the OPs, the complainant has suffered financial loss and mental agony, physical harassment; hence the present complaint.

2.             Upon notice, the OPs have appeared through Sh. Vikas Kumar, Advocate, proxy counsel for Sh.Rahul Makkar, Advocate for Ops No.1 & 2 to contest the complaint; but they did not file the written statement despite availing several opportunities including the last opportunity. Therefore, the defence of OPs was ordered to be struck off by the Commission, vide its order dated 06.01.2022. However, the learned counsel on behalf of the Ops has placed on record the written arguments on 09.07.2024.          

3.             To prove the case, the complainant has tendered the affidavit as Annexure C-A along with documents Annexure C-1 to C-13 in evidence and closed the evidence by making a separate statement.

4.             On 21.08.2023, the learned counsel on behalf of the complainant has placed on record the affidavit of Sh.Gurkeerat Saggu, who was allegedly co-occupant in the car at the time of accident. Apart it, the photographs of the accidental vehicle were also submitted and the same were taken on record as Mark ‘A’ & ‘B’. On 14.12.2023, the learned counsel has also placed on record a letter on Harmony Honda letter Head(Mark ‘C’), wherein it was mentioned that car had sustained the total loss  amounting Rs. 6,14,976/-.

5.             We have heard the learned counsel for the complainant and gone through the record available on the file including the written arguments filed on behalf of the complainant and written arguments placed on record by the OPs counsel on 09.07.2024, minutely and carefully.

6.             During arguments, the learned counsel for the complainant, has reiterated the averments as made in the complaint as also in the affidavit(Annexure C-A) and contended that  the car bearing no.PB-65-AK-9071 had met with an accident on 09.08.2020 during the validity period of insurance policy no.950002502 and that all the required and relevant papers were provided to the surveyor as deputed/appointed by the insurance company(OP No.1) but the OPs, acting wrongly and in an illegal and invalid manner, have not settled the accident claim so far. It was argued that the Ops has been insisting on submission of unnecessary documents, which are not at all required for the settlement of the genuine accident claim and thus, prayed for acceptance of the complaint by grating the relief as claimed for in the complaint.

7.             The written statement was not filed by the Ops within the stipulated period; accordingly, their defence was struck off vide order dated 06.01.2022 by the Commission. However, the Ops through their counsel have placed written arguments on record on 09.07.2024, wherein certain preliminary objections have been taken disputing the maintainability of the complaint that no valid cause of action has accrued in favor of the complainant; the complainant has not approached the Commission with clean hands; the complainant does not qualify the ingredients of a valid complaint as envisaged under Section 2(6) of the Consumer Protection Act, 2019.

                On merits, it is submitted that certain documents and clarifications were asked by the surveyor /OPs from the complainant in view of the discrepancies and contradictions in the statement of Sh. Raman Arora, son of the complainant, and Sh.Ujjawal , friend of Sh. Raman Arora). It is submitted that the claim has neither been closed nor repudiated so far; thus, the complaint is pre-mature; hence, the complaint is liable to be dismissed.

                The pleas taken by the OPs vide preliminary submissions are rejected because no force and substance is found therein. The submissions made on merits shall be discussed in the following para of this order.

8.             Evidently, the car bearing no.PB-65-AK-9071, was insured by the OP’s vide insurance policy no.950002502 dated 14.05.2020, which was valid w.e.f. 17.05.2020 to 16.05.2021, when the alleged accident occurred on 09.08.2020 in the morning at 05:30 AM. in Sector-12, Panchkula. As per the email(Annexure C-13) sent by consolidated insurance management agency to the son of the complainant, at his email address i.e.

1. Itemised billing of mobile no.9780981100 for the period from 7^th August to 11^th August 2020.
2. Google time line of your friend Mr. Gurkeerat Saggu, co-occupant at the time of accident.

We will further inform you about the pending documents/information required after receiving above mentioned document/information.

                On 18.09.2020, Sh. Raman Arora(son of the complainant), who was allegedly driving the car at the time of accident, has sent an email, which for the sake of clarity and convenience, is reproduced as under:-

          I raman arora s/o suresh kumar resident of 986 sector-7, Panchkula, Haryana hereby declare that I met with the accident on 9^th of August early morning. I have provided you with every possible document which I have been asked for. I asked  my friend  for the Google maps but he told  me that he has  no history  of maps  and as per my call history  is concerned I am not able to visit to airtel office due to increase in covid-196 cases  in my area but if you can access them then you can. I furthermore, will never be/been a hurdle in your investigation and will assist  you always in every possible way but as per my friends are concerned, they feel like their privacy  is being  breached  so I cannot insist them over anything  which they feel like not sharing or providing but you can investigate  them on your behalf..

Regards

Raman Arora

9780981100

                On 22.09.2020, the above said reply as sent by Sh.Raman Arora, was sent by consolidated insurance management services to one person, namely, Swapnil Kadam of OP no.1. On 25.09.2020, said Swapnil Kadam, on behalf of the OP No.1, advised Sh.Raman Arora by sending  the email as under:- 

Dear Mr. Raman

As discussed, below mentioned process to obtain the call details record(itemized bill) from Airtel.

https://youtu.be.N5WN.1Nl0itQ

Please send the below mentioned SMS to 121

EPREBILL AUG

9.             From the above, it is abundantly  clear that the complainant  was rightly advised to seek the relevant information qua his location  and call details by sending the SMS to Airtel at the following address:-

https://youtu.be.N5WN.1Nl0itQ

10.            As per reply sent by Sh.Raman Arora(son of the complainant), vide his email(Annexure C-12(colly)) dated 18.09.2020, his  friend had declined to give his google time location and he i.e. Raman Arora himself has also not taken any positive steps in obtaining the call details from the Airtel qua his mobile no.9780981100 for the period from 07.8.2020 to 11.08.2020.

11.            We have perused the affidavit allegedly signed by the complainant, which is placed on record as Annexure C-3 and a bare perusal of the same i.e. the said affidavit(Annexure C-3) reveals that its certain columns qua certain important and material information like the place of accident, the date of accident and the name of the driver are blank. Further, as per email (Annexure C-12) and the statement made by Sh.Raman Arora, which is available on record as Annexure C-13 before the surveyor, Sh.Gurkrit saggu allegedly the friend of Sh. Raman Arora was travelling with him at the time of accident. Further, as per the said statement annexure C-13, Sh Ujjawal, friend of the Raman Arora, had reached at the site on the request of the Sh. Raman Arora made by him from his mobile no.9780981100 but we find not even an whisper of averments made in the entire complaint as well as affidavit of the complainant (Annexure C-A) that Sh.Gurkeerat Saggu was travelling with him at the time of alleged accident on 09.08.2020 and Sh.Ujjawal, friend of Sh. Raman Arora had come at the accident site on the request of Sh.Raman Arora, made through his mobile no. 9780981100 to arrange the recovery van. Thus, there were major and substantial discrepancies in the version of Sh. Raman Arora as well as the complainant and thus, the surveyor as well as the insurance company (OP No.1) were justified in seeking the call details of Sh.Raman Arora of his mobile no. 9780981100 w.e.f 07.08.020 to 11.08.2020 along with the google time line of his friend Sh.Gurkeerat Saggu, co-occupant of the car at the time of accident.

12.            Moreover, there is no police report qua the accident of the car in question. Furthermore, no MLR or any medical prescription slip/medical treatment showing any injury by the driver or Sh. Gurkrit Saggu(allegedly co-occupant of the car at the time of accident) is made available on record. It is not the case of the complainant that no injury was sustained by said persons in the said accident.

13.            Pertinently, the car in question had got heavily damaged, as per version of the complainant as well as  photos of car Mark ‘A’ & ‘B’ and loss estimate Mark ‘C’ amounting to Rs.6,14,976/-, as the same (car) had got overturned in the accident. It is totally unbelievable and incredible that no injury of any kind was not sustained by the driver or the co-occupant.

14.            However, the complainant has not placed on record any documentary evidence, much less cogent, adequate and proper qua any physical injury sustained in the accident for the reasons best known to him. In the absence of police report and MLR as also the fact that the serious contradictions and discrepancies were found in the statement of Sh.Raman Arora and the complainant as made by them before the surveyor/investigator, no fault can be found on the part of the surveyor/investigator as well as the insurance company(Ops) in seeking  the call details and location of the complainant and his friend vide email(Annexure C-12).

15.            As discussed above, we find no fault on the part surveyor/ investigator/OPs in seeking certain details from the complainant qua the accident in question in order to ascertain the actual nature of accident. Moreover, the claim has neither been closed nor repudiated by the OPs so far; thus, the complaint is not maintainable being pre-mature and, so, the same is disposed of accordingly. A copy of this order shall be forwarded, free of cost, to the parties to the complaint and file be consigned to record room after due compliance.

Announced on: 17.07.2024

 Dr.Suman Singh                Dr.Sushma Garg             Satpal               

                Member                          Member                        President

Note: Each and every page of this order has been duly signed by me.

                                         Satpal                       

                                       President