Haryana

Karnal

CC/565/2022

M/s Global Construction Company - Complainant(s)

Versus

Future Generali India Insurance Company Limited - Opp.Party(s)

Narinder Chaudhary

15 Jul 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No.565 of 2022

                                                        Date of instt.10.10.2022

                                                        Date of Decision:15.07.2024

 

M/s Global Construction Co. (a Regd. Partnership firm no.06AAQFG246AGIZA  having its office at house no.479, Sector-7, Urban Estate, Karnal) through its partner Shri Sahib Singh son of Shri Balbir Singh, resident of house no.473, Karan Vihar, near Vijeta Public School, District Karnal, Aadhar no.7004-3145-7838. Mobile no.99965-68000.

                                                 …….Complainant.

                                              Versus

 

1. Future Generali India Insurance Co. Ltd., unit no.G007, Ground floor, having its office at Golf Course Road, Sector-54, Gurugram, Haryana (Gurgaon) 122002
2. Mahindra Insurance Brokers, having office at P.P. Automobiles Pvt. Ltd. NH 119/4, K.M. Stone, opposite New World, G.T. Road, Karnal.

                                                              …..Opposite Parties.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.      

      Sh. Vineet Kaushik…….Member

              Ms. Sarvjeet Kaur…….Member

 

Argued by: Shri Narinder Chaudhary, counsel

for the complainant.

                Shri Karamveer Mandhan, counsel for the OP no.1.

                OP no.2 given up.

 

                     (Jaswant Singh, President)

ORDER:   

                

                The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant is the registered owner of Mahindra and Mahindra Balero Camper Gold VX 2WD bearing registration no.HR-05AX-4033, having ID of Rs.4,50,000/-. The said vehicle was insured by the complainant with the OP, vide policy no.MAH71966 for the period commencing from 10.02.2021 to 09.02.2022. The accident occurred on 15.12.2021 during the subsistence of the insurance policy. On 15.12.2021, at about 1.00 a.m., the said vehicle of the complainant was met with an accident and was badly damaged. Amarjeet Singh was driving the said vehicle and in the said accident, he sustained minor injuries, as such no report was lodged with the police regarding the accident. The driver of offending vehicle ran away from the spot and thereafter vehicle was brought to Ajamgarh by crane at Deep Auto Ajamgarh and after two days it was delivered at the agency. There was no fast track in the vehicle as the same was used for local purposes. Amanjeet Singh was driving the said vehicle at the time of accident and he was holding valid and effective driving licence. It is further alleged that OP no.1 appointed D.S.I.B. Insurance Surveyor and Loss Assessors Pvt. Ltd. to inspect and assess the said loss and All India Claims Assessors for investigation purposes. The statement of Amanjeet singh was recorded but inspite of the facts a false report to deprive the complainant of his right to claim compensation, it was stated that Amanjeet Singh confirmed that driver at the time of loss was Amrish Singh. Amanjeet Singh, who was driving his vehicle at the time of the accident confirmed in writing that vehicle at the time of accident was driven by him. It was the case of total loss, so the loss caused to the vehicle is the IDV value which is Rs.4,50,000/- as per the policy. The facts of total loss finds mentioned in the report of Deep Automobiles authorized dealer, Mahindra and Mahindra Ltd. at Ajamgarh. Complainant lodged the claim with the OPs and submitted all the required documents for settlement of the claim but OPs did not pay the claim amount and repudiated the claim of complainant on the false and frivolous ground. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

 2.            On notice, OP no.1 appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that as per claim form submitted by the complainant, at the time of accident Amanjeet Singh was driving the insured vehicle. However, during the investigation, it was revealed that Amrish Singh was driving the insured vehicle instead of Amanjeet singh which was also confirmed by Amanjeet in writing. Even after several requests of the OP no.1, the complainant failed to provide the driving license of Amrish Singh. Based on the said non-disclosure of the material facts the complainant is guilty of “Suppresio-veri” and suggestion-falsi”. Hence, the repudiation of the claim was justifiable. The OP no.1 issued a Moto Secure Insurance Policy in the name of M/s Global Construction Co. for a insured declared value of Rs.4,50,000/-, which was valid from 10.02.2021 to 09.02.2022. On 18.12.2021, complainant intimated the OP no.1 that insured vehicle met with an accident at around 1.00 a.m. while travelling to Nizamabad on its way for checking of the machine. During the said travel, an unknown vehicle came from the opposite side in order to overtake the insured vehicle by the other vehicle. It is further pleaded that On the same day, post intimation from the complainant, duly assigned investigator namely “All India Claims Assessors” and surveyor namely “Disb Insurance Surveyors and Loss Assessors Pvt. Ltd.” and on 21.12.2021, the said investigator visited workshop Deep Motors wherein they inspected the insured vehicle and collected the gate entry and found that the insured vehicle entered in the workshop on 18.12.2021. Further, the surveyor collected picture of the arrival of the damaged car in the workshop which was brought by crane. At the time of investigation, the investigator met with M/s Golbal Construction Company’s authorized person, Amrish Singh but Amanjeet Singh was not available on the surveyor’s visit date. The Surveyor collected Amrish Singh’s statement in written, wherein he stated that after the collusion with the vehicle, the insured vehicle of complainant got damaged and he also attained minor injury. Upon calling for medical records, he was unable to provide any medical documents to the OP no.1 in support of the statement regarding the said injury. During the investigation, the appointed investigator found that the complainant did not lodge any complaint/FIR with the visited local police station against the said accident of the insured vehicle which allegedly occurred on 15.12.2021, which create reasonable doubt, that complainant himself damaged the insured vehicle in order to claim the insured amount from the OP no.1. On 13.02.2022, the surveyor met the declared driver Mr. Amanjeet Singh and discussed the case wherein the complainant confessed in writing that at the time of accident, his junior supervisor, Mr. Amrish Singh was driving the insured vehicle and unfortunately, the insured vehicle met with an accident. Mr. Amanjeet Singh confessed the same in writing, that Amrish Singh got minor injury on his forehead and took medical help from the local chemist. It is relevant to state that Amrish Singh was not holding a valid driving licence. On 16.02.2022, the surveyor submitted OD intimation Referral summary with the OP no.1, wherein investigator observed that it is a case of implantation of driver’s name and the declared driver himself confessed in writing that Amrish Singh was driving the insured vehicle at the time of accident and he sustained minor injury on his forehead. After receiving the OD intimation Referral summary, the OP no.1 sent several letters dated 20.02.2022, 02.03.2022 and 10.03.2022 to the complainant company, wherein the OP no.1 asked for additional documents which included:

1. Copy of valid driving licence of Mr. Amrish Singh.
2. Clarification on mis-representing actual facts to the insurance company regarding driver at the time of accident.

It is further pleaded that complainant intentionally did not provide the required documents of the driver who was driving the insured vehicle at the time of accident to the OP no.1 in order to verify and indemnify the claim. In the instant case, OP no.1 has fulfilled his duty by bonafidely issued letters towards providing the correct driving license and vide the said letters, the OP no.1 specifically informed the complainant to provide the same. Inspite of repeated requests, complainant deliberately has failed to provide the requisite documents to OP no.1. By not providing the valid and effective driving licence of Amrish Singh amounts to violation of terms and conditions of the insurance policy. Thus, the claim of complainant was rightly repudiated by the OP. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             OP no.2 filed its separate written version raising preliminary objections with regard to maintainability; cause of action and mis-joinder and non-joinder of necessary party. On merits, it is pleaded that the complainant has alleged that vehicle bearing no.HR-05-AX-4033 is insured with OP. The complainant, without any proof or any evidence has made false averments regarding insurance of the vehicle. OP no.2 is not engaged in insurance business nor has issued any policy in capacity of insurance company and OP has no concern with the alleged accident. Infact, as per the insurance policy, the alleged vehicle has been alleged to be insured by OP no.1 and the accident claim for the present case has to be lodged with the said insurance company. As such, there is no cause of action has arisen against the OP no.2.

 4.            On 08.02.2023, OP no.2 has been given up by the learned counsel for the complainant being unnecessary party.

5.             Parties then led their respective evidence.

6.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of aadhar card Ex.C1, copy of partnership deed Ex.C2, copy of Details of Managing/authorized parters Sahab Singh Ex.C3, copy of RC Ex.C4, copy of letter of OP no.2 to complainant Ex.C5, copy of insurance policy Ex.C6, copy of statement of Amanjeet Singh Ex.C7 and Ex.C9, copy of total loss report Ex.C8, copy of letter to Global Construction Ex.C10, copy of repudiation letter dated 20.02.2022 Ex.C11, copy of driving licence of Amanjeet Singh Ex.C12, copy of RC Ex.C13 and closed the evidence on 29.08.2023 by suffering separate statement.

7.             On the other hand, learned counsel for the OP no.1 has tendered into evidence affidavit of Mohini Suryawanshi Ex.OP1/A, copy of policy schedule Ex.OP1, copy of claim form Ex.OP2, copy of statement of driver Amanjeet Singh Ex.OP3, copy of OD Intimation Referral Summary Ex.OP4, copy of repudiation letter dated 20.02.2022 Ex.OP5, copy of Final Survey Report Ex.OP6 and closed the evidence on 09.02.2024 by suffering separate statement.

8.             We have heard the learned counsel for the parties and perused the case file carefully and have also gone through the evidence led by the parties.

9.             Learned counsel for complainants, while reiterating the contents of the complaint, has vehemently argued that complainant got insured his vehicle with the OP no.1. On 15.12.2021 during the subsistence of the insurance policy, the said vehicle met with an accident and was badly damaged. At the time of accident Amarjeet Singh was driving the said vehicle and he was having valid and effective driving licence. OP no.1 appointed D.S.I.B. Insurance Surveyor and Loss Assessors Pvt. Ltd. to inspect and assess the said loss and All India Claims Assessors for investigation purposes. The complainant lodged the claim with the OP and submitted all the required documents for settlement of the claim but OP did not pay the claim amount and repudiated the claim of complainant on the false and frivolous ground and lastly prayed for allowing the complaint. Learned counsel for the complainant relied upon the case law titled as Karnavati Veneers Pvt. Ltd. Vs. New India Assurance Company Limited and othrs in civil appeal no.3893 of 2013, date of decision 09.02.2023 of Hon’ble Supreme Court.

10.           Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that during the investigation, it was revealed that Amrish Singh was driving the insured vehicle instead of Amanjeet Singh. The complainant failed to provide the driving license of Amrish Singh because said Amrish Singh was not holding a valid driving licence at the time of accident. OP sent letters dated 20.02.2022, 02.03.2022 and 10.03.2022 to the complainant company, wherein the OP has demanded the documents but inspite of that letters, complainant intentionally did not provide the driving licence of Amrish Singh. Thus, the claim of complainant was rightly repudiated by the OP and lastly prayed for dismissal of the complaint.

11.           We have duly considered the rival contentions of the parties.

12.           The claim of the complainant has been repudiated by the OP, vide repudiation letter Ex.C11/Ex.OP5 dated 20.02.2022 on the grounds, which are reproduced as under:-

“As you are aware that we had appointed Surveyor DISB Insurance Surveyors and Loss Assessors Pvt. Ltd. to inspect and assess the said loss and All India Claims Assessors for investigation purposes. Based on his observations, report, claim form, policy terms and conditions, documents submitted and the facts available we have the following observations.

1.    As per claim form submitted and claim intimation name of       driver at the time of loss was Mr. Amanjeet Singh.
2. As per investigation report Driver Mr. Amanjeet Singh confirmed that driver at the time of loss was Mr. Amrish Singh.

Hence, as per above facts, it seems that name of driver mentioned in claim form and intimation is not correct and tried to hide the facts which is misrepresentation of the facts to insurer and violation of policy term and condition.”

 

13.           The claim of the complainant has been repudiated by the OP on the abovesaid ground. The OP has alleged that at the time of accident Amanjeet Singh was driving the insured vehicle however during the investigation it was revealed that Amrish Singh was driving the insured vehicle. The onus to prove its version was relied upon the OP but OP has miserably failed to prove its version by leading any cogent and convincing evidence. The case of the OP based upon claim form Ex.OP2 and statement of Amanjeet Singh Ex.OP3. With regard to driving the vehicle in question at the time of accident allegedly taken by the OP has been specifically denied by the complainant and complainant has tendered the statement Ex.C7 of Amanjeet Singh in which he has stated that at that time he was driving the insured vehicle. To prove its version, the best witnesses were Amanjeet Singh and Amrish Singh but OP neither examined to them nor tendered their affidavits. Hence, the plea taken by the OP has no force.

14.           Further,  Hon’ble Punjab and Haryana High Court in case titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, has held as under:-

“It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy”.   

15.           Keeping in view that the ratio of the law laid down in aforesaid judgment, facts and circumstances of the present complaint, we are of the considered views that act of the OP while repudiating the claim of the complainant amounts to deficiency in service and unfair trade practice, which is otherwise proved as genuine one.

16.           As per the survey Ex.OP6 dated 11.03.2021, loss has been assessed by the surveyor of the OP to the tune of Rs.6,39,134/- but  as per insurance policy Ex.C6, the insured declared value (IDV) of the vehicle in question is Rs.4,50,000/-. Thus, the vehicle in question falls under the category of total loss. Hence, complainant is entitled for Rs.4,50,000/- alongwith interest, compensation for mental pain and agony and litigation expenses etc.

17.           In view of the above discussion, we allow the present complaint and direct the OP no.1 to pay Rs.4,50,000/- (Rs. four lakhs fifty thousand only) as IDV of the vehicle in question to the complainant alongwith interest @ 9% per annum from the date of denial of the claim i.e. 20.02.2022 till its realization. We further direct the OP no.1 to pay Rs.25,000/- to the complainant on account of mental agony and harassment and Rs.11,000/- for the litigation expenses. This order shall be complied within 45 days from the receipt of copy of this order. However, the complainant is also directed to complete all the formalities with regard to transfer/cancel of the RC of the vehicle in question and hand over the salvage of the vehicle in question to the OP.  The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:15.07.2024                                                                    

                                                                President,

                                                   District Consumer Disputes

                                                   Redressal Commission, Karnal.      

 

(Vineet Kaushik)        (Sarvjeet Kaur)    

                     Member                   Member