Complaint No: 37 of 2023.
Date of Institution: 07.02.2023.
Date of order: 11.09.2023
Naresh Bala Wife of Joginder Pal resident of Behrampur Road, Near Tagore Model School, Gurdaspur Tehsil and District Gurdaspur.
.....Complainant.
VERSUS
- Go Digit General Insurance Company Ltd., AK Empire, 1st Floor, BSF Chowk, Kirti Nagar, Ladhowali Road, Jalandhar, through its Manager. Pincode – 144001
- Go Digit General Insurance Company Ltd., Atlantis 95, 4th B Cross Road, Koramangla Industrial Layout, 5th Block, Bengaluru (Karnataka) -560095, through its Managing Director.
….Opposite parties.
Complaint U/s 35 of the Consumer Protection Act.
Present: For the Complainant: Sh.Kamaljit Suri, Advocate.
For the Opposite Parties: Sh.Sandeep Ohri, Advocate.
Quorum: Sh.Lalit Mohan Dogra President, Sh.Bhagwan Singh Matharu, Member.
ORDER
Lalit Mohan Dogra, President
Naresh Bala, Complainant (here-in-after referred to as complainant) has filed this complaint under section 35 of the Consumer Protection Act, (here-in-after referred to as 'Act') against Go Digit General Insurance Co. Ltd. Etc. (here-in-after referred to as 'opposite parties).
2. Briefly stated, the case of the complainant is that the complainant is registered owner of vehicle i.e. Motor cycle make Yamaha bearing Chassis No.MF1RG6728N0028505 Engine No.G3N4E0341818 Registration No.PB-06-BC-6672. It is submitted that the above said vehicle is fully insured with the OP’s Insurance Company through OP’s Vide Policy / Cover No.D075194383 valid from 06.09.2022 to midnight of 05.09.2023. It is further pleaded that the policy is comprehensive and covers all risks. It is further pleaded that as such complainant is consumer of the OP’s. It is further pleaded that Insured Declared Value of the above said vehicle is Rs.1,79,455/-. It is further submitted that on 13.10.2022, a relative of the complainant namely Anil Kumar son of Krishan Lal resident of village Bhola Tehsil Dina Nagar District Gurdaspur came to the house of complainant and took the above mentioned motor cycle. It is further pleaded that above said Anil Kumar is holding a valid driving license issued by the competent authority. It is further pleaded that at about 2.30 P.M. when above said Anil Kumar reached in middle of village Bhola - Paniar, all of sudden a stray dog came in front of the motor cycle and the driver of motor cycle in order to save the stray dog applied brakes of motor cycle, as a result of which the driver of the motor cycle lost his control and motor cycle fell on the road. It is further pleaded that due to this accident front side of the motor cycle was badly damaged and even driver of motor cycle also suffered injuries. It is further pleaded that this occurrence was also witnessed by Rishab son of Ashok Kumar resident of Village Bhola Tehsil and District Gurdaspur who was coming towards Gurdaspur at that time. It is further alleged that matter was reported to the OP’s immediately after the accident and the OP’s deputed Surveyor who visited the spot on the next day who inspected the motor cycle, klicked photographs of the motor cycle along with all relevant documents and advised the complainant to get the motor cycle repaired from the concerned agency i.e. D.K. Motors, Railway Road Mukerian District Hoshiarpur. It is further pleaded that above said Agency prepared estimate to the tune of Rs.48,995/-. It is further alleged that thereafter the complainant lodged her claim with the OP’s supported by all the requisite documents for payment on account of the loss suffered by her, but to the utter surprise of the complainant, the OP’s have repudiated the claim of the complainant vide letter dated 07.12.2022 with false and frivolous observations. It is further alleged that the observation raised by the OP’s are totally false, baseless and having no ring of truth in the same. It is further pleaded that complainant never concealed any fact from the OP’s and provided each and every information from time to time as and when asked by the OP’s. It is further pleaded that on account of nonpayment by the OP’s, the motor cycle of the complainant is lying unrepaired in the above mentioned agency. It is further pleaded that the complainant was not plying the vehicle / motor cycle against the terms and conditions of the Insurance policy or in contravention of the insurance policy rules, nor there was any delay on the part of complainant in reporting the matter to the OP’s. It is further alleged that the OP’s by not making payment of Rs.48,995/- on account of total loss of the vehicle to the complainant on fake and baseless observations and trying to back out from their obligations of making payment of the sum assured to the policy holder/ complainant with malafide intention and ulterior motive without any reason or rhyme. It is further pleaded that due to this illegal act and conduct of the opposite parties the complainant has suffered great loss and also suffered mental agony, Physical harassment and inconvenience, as such there is a clear cut deficiency in service on the part of the opposite parties.
On this backdrop of facts, the complainant has alleged deficiency and negligence in service and unfair trade practice on the part of the opposite parties and prayed that necessary directions may kindly be issued to the opposite parties to make the payment of Rs.48,995/- i.e. for the loss suffered by the complainant in this accident. It is further prayed that compensation to the tune of Rs.1,00,000/- may also be awarded to the complainant besides the amount in question on account mental agony, physical harassment and deficiency in service on the part of opposite parties. Litigation expenses to the tune of Rs.10,000/- may also be awarded in favor of the complainant after accepting this complaint in the interest of justice.
3. Upon notice, the opposite parties appeared through counsel and contested the complaint and filing their written reply by taking the preliminary objections that the complainant has no cause of action and locus standi to file the present complaint, that the insurance is a contract based on utmost good faith. It is further pleaded that complainant breached the said faith and fail to provide the true information and misrepresented the facts and due to which his claim has been repudiated. It is further pleaded that the insurance is a contract between two parties and both the parties bind with the terms and conditions of the policy and there is no deficiency in services on the part of insurance company / Opposite Parties. It is pleaded that the matter of the fact is that the policy was issued in favor of the complainant and the claim was lodged. It is further pleaded that investigation has been duly conducted and during investigation it has been come out that son of the complainant was travelling with driver, but as per driver statement he was alone and the statement given by both are contradictory. It is further pleaded that as confirmed by the complainant that her son doesn’t know driving, but as per his Instagram ID with snaps riding the vehicle are found uploaded. It is further pleaded that the spot verification was not done due to non-corporation and meeting with driver Anil and the son of the complainant namely Kanu Sharma required for further verification not done. It is further pleaded that the record of calls made after accident also required and other proofs like Google timeline / spot photo / police report / CCTV also required, but have not been provided. It is further pleaded that the letter dated 23.11.2022 has been duly sent in this regard and afterwards the letter dated 30.11.2022 has been sent, but no response from the complainant side and due to that the claim has been denied vide letter dated 07.12.2022 and afterwards the letter dated 21.12.2022 has also been sent. It is further pleaded that so the claim is not admissible as there is misrepresentation and no supporting evidence is submitting in support of admissibility of the claim as such there is no deficiency in the services on the part of the opposite parties.
On merits, the opposite parties have reiterated their stand as taken in legal objections and denied all the averments of the complaint and there is no deficiency in services on the part of the opposite parties. In the end, the opposite parties prayed for dismissal of complaint with costs.
4. Learned counsel for the complainant has tendered into evidence affidavits of Naresh Bala (Complainant) as Ex.CW-1/A, Rishab as Ex.CW-2/A and Anil Kumar as Ex.C-10 along with other documents as Ex.C-1 to Ex.C-9.
5. Learned counsel for the opposite parties has tendered into evidence affidavit of Aniruddha Kiran Kale, (Authorized Signatory, Go Digit General Insurance Company Ltd.) as Ex.OPW-1/A along with other documents as Ex.OP-1 to Ex.OP-5.
6. Rejoinder filed by the complainant.
7. Written arguments filed by the complainant but not filed by the opposite parties.
8. Counsel for the complainant has argued that motorcycle of the complainant met with an accident on 13.10.2022 when it was being driven by Anil Kumar but the opposite parties insurance company has repudiated the claim on the basis of legally unacceptable report of investigator which amounts to deficiency in service on the part of the opposite parties.
9. On the other hand counsel for the opposite parties has argued that after receiving intimation case was got investigated from the investigator who found that there was discrepancy in the statement given by alleged driver Anil Kumar and the insured. The investigator further found that son of complainant Kanu Sharma was found to be performing stunts while driving motorcycle on Instagram Account whereas the complainant had stated that her son does know driving of motorcycle. Further proofs like google timeline, spot photo, police report were not provided to investigator and CCTV and as such claim was repudiated by the insurance company.
10. We have heard the Ld. counsels for the parties and gone through the record. It is admitted fact that complainant is registered owner of motorcycle No.PB-06-BC-6672 which is also evident from copy of registration certificate (R.C.) Ex.C1. It is further admitted fact that the said motorcycle was comprehensively insured with the opposite parties vide policy of insurance Ex.C2. It is further admitted fact that during the continuation of the policy of insurance the motorcycle owned by the complainant met with an accident. It is further admitted fact that claim lodged by the complainant has been repudiated vide letter dated 07.12.2022 Ex.C4.
11. To prove the case complainant had placed on record copy of R.C. Ex.C1, policy of insurance Ex.C2, copy of letter regarding explanation of delay Ex.C3, copy of repudiation letter Ex.C4. Photographs of accidental motorcycle Ex.C5 and Ex.C6, estimate of repair Ex.C7, Driving licence of Anil Kumar Ex.C8 whereas on the other hand opposite parties have mainly relied upon the report of investigator Ex.OP-4 dated 08.11.2022.
12. We have gone through the report of the investigator wherein the investigator had found discrepancy in the statement given by driver Anil Kumar and the insured and has also given reason that the insured had stated in her statement that her son does know driving whereas on the Instagram Account he is found performing stunts. The report of the investigator states that the said motorcycle was being driven by Sh.Kanu Sharma at the time of accident and not Anil Kumar. Perusal of file shows that the opposite parties have not filed any affidavit of the said investigator and although the report is claimed to be signed by Amandeep Chief Investigating Officer but it is nowhere stated in the report as to whether said Amandeep himself investigated the case or had deputed some junior official to investigate the case. The report of the investigator Ex.OP-4 is not supported by any document and evidence and seems to have been prepared by the investigator on the basis of telephonic conversation without any investigation at the spot by sitting in his own office. The opposite parties had not even deputed any surveyor to assess the damage to the accidental motorcycle and the opposite parties have repudiated the claim by relying upon the report of the investigator only which seems to be unjustified. Report of the investigator is set aside having been based on conjectures and surmises. Since the complainant has fully proved her case through evidence and her duly sworn affidavit and affidavit of eye witness Sh.Rishab Ex.CW2/A. It is proved that at the time of accident on 13.10.2022 the motorcycle was driven by Anil Kumar who is none else but son-in-law of the complainant was driven the motorcycle and was having a valid driving licence. As such repudiation of claim by the opposite parties on false and flimsy grounds amounts to deficiency in service.
13. Accordingly, present complaint is partly allowed and opposite parties are directed to depute a surveyor and after assessment of loss settle and pay the claim of the complainant and also pay Rs.5,000/- for mental tension, harassment and cost of litigation to the complainant within 30 days from the receipt of copy of this order.
14. The complaint could not be decided within the stipulated period due to heavy pendency of Court Cases.
15. Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record room.
(Lalit Mohan Dogra)
President
Announced: (B.S.Matharu)
Sept, 11, 2023 Member
*YP*
