Haryana

Karnal

CC/686/2022

Naresh Kumar - Complainant(s)

Versus

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

V.K. Sharma

18 Jun 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                      Complaint No. 686 of 2022

                                                      Date of instt. 02.12.2022

                                                      Date of Decision:18.06.2024

 

Naresh Kumar son of Rishi Pal, resident of Sukhdev Colony, Ram Nagar, Karnal.

                                               …….Complainant.

                                              Versus

 

Future Generali India Insurance Company Limited 303-310, 3^rd Floor, Kailash Building, K.G. Marg, Cannaught Place, New Delhi.

 

…..Opposite Party.

       

Complaint Under section 35 of the Consumer Protection Act, 2019.

 

Before   Shri Jaswant Singh……President.

              Shri Vineet Kaushik…….Member

      Dr. Suman Singh….Member

  

 

Argued by:  Shri V.K.Sharma, counsel for the complainant.

                    Shri Naveen Sharma, counsel for the OP.

                    (Jaswant Singh, President)

 

ORDER: 

                        

                 The complainant has filed the present complaint Under section 35 of the Consumer Protection Act, against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant is registered owner of a Mahindra Bolero Pickup bearing registration No.HR45C-6902 which was purchased by the complainant on finance provided by Mahindra and Mahindra Financial Services Ltd. The complainant got the said vehicle insured from the OP and paid the premium. On 25.08.2022, complainant was driving the said vehicle at a moderate speed and suddenly a stray cow came in front of the vehicle and the driver lost his control and the vehicle struck against the railing resultantly, the vehicle was badly damaged. The vehicle was inspected by Er.Virender Kumar in New Citi Auto Mart, HUDA Market, Karnal and advised to get the same repaired and to deposit the repair bills to the OP. After the repair and on completion of all the formalities, the complainant approached the OP and submitted the relevant documents alongwith bill amounting to Rs.36684/- and after receiving the same, the official of OP assured that they will settle the claim but very surprisingly, the OP has repudiated the claim of the complainant without any reason and rhyme. In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability; jurisdiction; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that OP appointed a surveyor Er.Virender Kumar for assessment of claim. During the investigation and from the verification of documents, it was observed that the fitness certificate of the vehicle was expired on 28.11.2021 and the road tax was not paid after 30.09.2020. Te surveyor of P issued a letter dated 22.09.2022 for submission of registration certificate, cancelled cheque, fitness certificate, driving licence, estimate of repairs, repair bills within seven days but the complainant did not acknowledge the letter dated 22.09.2022 and again a reminder dated 15.10.2022 was issued to complainant to share the requested documents but the complainant did not provide the same, thus, the claim of the complainant was closed. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of RC Ex.C1, copy of insurance policy Ex.C2, copy of driving licence Ex.C3, copy of tax invoice Ex.C4, copy of fitness certificate Ex.C5, copy of tax receipt Ex.C6, copy of pollution certificate Ex.C7, copy of insurance policy Ex.C8 and copy of Aadhar Card Ex.C9 and closed the evidence on 05.06.2023 by suffering separate statement.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Mohini Suryawanshi Ex.OP1/A,  copy of authority letter Ex.OP1, copy of policy schedule Ex.OP2, copy of claim form Ex.OP3, copy of RC status Ex.OP4, copy of letter dated 15.10.2022 Ex.OP5, copy of letter dated 31.10.2022 Ex.OP6 and closed the evidence on 31.01.2024 by suffering separate statement.

6.             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.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got insured his vehicle with the OP. On 25.08.2022 the said vehicle met with an accident. In the said accident, the vehicle of complainant was badly damaged. The intimation regarding the said accident was given to the OP. On receipt of intimation, OP appointed a surveyor, who investigated the matter. All the necessary documents were submitted to the surveyor as well as to the investigator  of the OP by the complainant to settle the claim but OP closed the claim of complainant on the false and frivolous grounds and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued OP vide letters and its reminders dated 22.09.2022 and 15.10.2022 demanded certain documents from the complainant but complainant did not submit the same. Thus, the claim of complainant was rightly repudiated by the OP, vide its letter dated 31.10.2022 and lastly prayed for dismissal of the complaint.

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

10.           Admittedly, complainant got insured his vehicle with the OP. It is also admitted that the vehicle of complainant met with an accident during the subsistence of the insurance policy. It is also admitted that the insured declared value of the vehicle in question at that time was Rs.5,30,000/-.

11.           The claim of the complainant has been closed by the OP, vide letter Ex.OP6 dated 31.10.2022 on the grounds, which are reproduced as under:-

“Further to final reminder letter send on respectively, we would 22.09.2022 and 15.10.2022 hereby like to confirm that we have not received the following required documents/information called in aforementioned letter till date:

1. Fitness certificate of the vehicle.
2. Motor Driving Licence of the driver
3. Repair bill of the vehicle
4. Repair estimate
5. PAN/Aadhar Card/Election Voter card of the owner of vehicle.

As noted in the foregoing letter, documents were to be submitted in the stipulated time frame provided therein. Since we have not received the said documents within the stipulated time frame we construe that you are no longer interested in pursuing the captioned claim and accordingly the captioned claim is closed as “Nil Claim” on grounds of non compliance of documents.

Thus we regret our inability to consider the said claim due to reasons as mentioned above. We treat this as missed opportunity to serve you but reiterate our commitment to serve you in future.”

 

12.           Complainant has alleged that he had supplied required documents. The onus to prove his case was relied upon the complainant.  To prove his case complainant has placed on file, copy of RC Ex.C1, copy of insurance policy Ex.C2, copy of driving licence Ex.C3, copy of tax invoice Ex.C4, copy of fitness certificate Ex.C5, copy of tax receipt Ex.C6, copy of pollution certificate Ex.C7, copy of Aadhar Card Ex.C9. When complainant has placed on file the copies of said documents as to why he would have not submitted the same to the OP except the fitness certificate. The complainant in his evidence has placed on file copy of fitness certificate Ex.C5 and on perusal of the same it reveals that the complainant has applied for said fitness certificate on 22.03.2023 and the same has been valid from 27.03.2033 to 26.03.2025. The accident took place on 25.08.2022, meaning thereby that at the time of accident, the complainant was not having valid fitness certificate of the vehicle in question. As the complainant was not having valid fitness certificate at the time of accident, thus, he has violated the terms and conditions of the insurance policy. Moreover, for the sake of gravity, if it is presumed that complainant has violated the terms and conditions of the insurance policy, in that eventuality, the claim of the complainant cannot be repudiated in toto.  In this regard, we relied upon the case laws cited in Revision Petition no.1870 of 2015(NC) decided on 14.08.2018 titled as New India Assurance Co. Ltd. Versus Thirath Singh Brar and authority of our own Hon’ble State Commission in First Appeal no.717 of 2016 decided on 6.4.2017 titled as United India Insurance Company Limited and others Versus Anshul Bansal.  In both judgments it was held that in case of any breach of warranty/condition of the policy the insurer is liable to pay 75% of admissible claim on non-standard basis.

13.           Furthermore, now a days it has become a trend of insurance companies, they issue the policies by giving false assurances and while giving claim amount, they make such type of excuses. Thus, the repudiation of the claim of complainant is arbitrary and unjustified. In this regard, we place reliance on the judgment of Hon’ble Punjab and Haryana High Court 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”.

14.           Keeping in view the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, the act of the OP while repudiating the claim of the complainant amounts to deficiency in service and unfair trade practice, which is otherwise proved genuine one.

15.           To prove the fact that the complainant has spent Rs.36,684/- on repairing of his vehicle, he has placed on record copy of tax invoice Ex.C4 dated 05.09.2022, amounting to Rs.36,684/-, and the said document has neither denied nor rebutted by the OP.

16.           In view of the above discussion, we partly allow the present complaint and direct the OP to pay Rs.27,513/- (Rs.Twenty seven thousand five hundred and thirteen only)  i.e. 75%  of the repair amount to the complainant alongwith interest @ 9% per annum from the date of repudiation of the claim i.e. 31.10.2022 till its realization. We further direct the OP to pay Rs.5500/- to the complainant on account of mental agony and harassment suffered by him and Rs.5500/- for the litigation expenses. This order shall be complied within 45 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:18.06.2024                                                                    

                                                                President,

                                                    District Consumer Disputes

                                                    Redressal Commission, Karnal.

 

 (Vineet Kaushik)       (Dr. Suman Singh)

  Member                   Member