Chandigarh

DF-I

CC/608/2020

Mukesh Kumar - Complainant(s)

Versus

Go Digit General Insurance Ltd. - Opp.Party(s)

S.K. Manchanda

21 Feb 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-I,

U.T. CHANDIGARH

 

                    

Consumer Complaint No.	:	CC/608/2020
Date of Institution	:	22/12/2020
Date of Decision	:	21/02/2024

 

Mukesh Kumar S/o Suresh Kumar R/o H.No.28, Near Shivalik Garden Shanti Nagar, Manimajra, Chandigarh- 160101.

 

Versus

Complainant

 

1. Go Digit General Insurance Ltd., office address, 2nd and 3rd Floor, Ferozpur Road, Gurdev Nagar, Near Maharaja Regency, Ludhiana-141001.

 

2. Go Digit General Insurance Ltd., office address Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095.

 

Opposite Parties

CORAM :	PAWANJIT SINGH	PRESIDENT
	SURJEET KAUR	MEMBER
	SURESH KUMAR SARDANA	MEMBER

 

                                                

ARGUED BY	:	Sh.S.K.Manchanda, Advocate for Complainant.
	:	Sh.Rajesh Verma, Advocate for OPs.

 

Per Suresh Kumar Sardana, Member

1.      Averments are that the complainant is owner of vehicle number CH04F0108 make BMW X3 model 2008 and the same vehicle is insured by the OPs dated 19.08.2019 for the term period of 19.08.2019 to 19.08.2020 Annexure C-1. On fateful day of 09.12.2019, friend of complainant namely Mr. Parav Sharma S/o Mr. Mahesh Lal borrowed the car from complainant in the evening for visiting the hotels on Morni Road Panchkula for the purpose of booking venue for some family occasion and around 9:00 Pm when he was moving further after visiting the Red Wood Hotel, Morni Road Panchkula, suddenly the driver lost the control over the vehicle. Consequently, the said vehicle struck the roadside tree and resulted in damage of the vehicle. Mr.Arvind took the driver to General Hospital, Sec.6, Panchkula as the driver of the vehicle was under trauma, pains and internal injuries due to the fatal accident (Annexure C-2). The official of the workshop i.e. Sai Moto Corp, Sector S.A.S 82, Nagar, Mohali has intimated about the claim to the OPs through Helpline Number on next day morning i.e. 10.12.2019 regarding the accident and registered the claim. Subsequently, the OPs appointed the Surveyor namely Er.Sunil Dutt on 10.12.2019 and he has conducted the Survey of the damaged vehicle on the same day. Thereafter, the OPs have appointed the investigator on 11.12.2019 who has again conducted the Survey of the damaged vehicle to assess the cause, nature and extent of loss/damage and visited the spot of accident on 12.12.2019 along with the complainant and driver of the vehicle involved at the time of accident. Further, the investigating officer and one another forensic expert visited the workshop i.e. Sai Moto Corp, Sector 82, S.A.S Nagar Mohali on 14.12.2019 for assessment of the loss whereby the officials of the OPs dismantled the damaged vehicle in the absence of the complaint and Manager of the department of Body Shop of the Workshop. The OPs claims on its website that the company will make the payment to settle the claim within 30 days but failed to fulfill the commitment in the present case (Annexure C-3). The complainant has also raised his grievance through email on 01.02.2020 regarding non-updating the status of the claim and causing harassment by the various officials of the OPs and deliberately making false claims to delay the settlement of payment against the accident claim (Annexure C-4). The OPs sent a letter dated 10.02.2020 to the complainant wherein OPs raised various queries based on conjectures and surmises to deliberately delay the settlement of the claim and asked to submit documentary evidence despite the complainant already submitted all the relevant documents to the OPs (Annexure C-5). The complainant has made various telephonic calls to Mr.Ankush on 16.12.2019 and 17.01.2020 who was the Head of the claim settlement department for Tricity Chandigarh to know the status of the claim but the act and conduct of the officials of the OPs was such that he has not deliberately responded the phone calls. The complainant entitles for reimbursement of the claim of IDV amount and the damaged vehicle shall be treated as total loss in terms of the insurance contract. Hence, is the present consumer complaint.
2.     OPs contested the consumer complaint, filed their written reply and stated that in a previous claim involving the alleged insured Mukesh Kumar the make of the vehicle and spot of alleged accident in previous claim is similar with the case in hand. From the available facts it is safe to assume that the insured have same modus operandi in all the claims through which they are trying to make wrongful claim from the insurance company. Further it was confirmed by the previous owner of the alleged vehicle that he sold his vehicle for only 5 lakhs while our insured Mr. Mukesh kumar has claimed an IDV of Rs.13,80,000 and even after repeated request to submit documentary proof of purchase of vehicle, Payment transaction and bank statement has failed to provide the same even after repeated request by the investigator and this opposite company he has failed to provide the details, it is safe to conclude that the insured has misrepresented the facts material to this claim and also while procuring the policy coverage. All the relevant facts have been uncovered during investigation and the detailed investigation report has been submitted with the opposite insurance company on 03/02/2020 Annexure-5. It is further stated that, till today complainant has not given correct clarification as to exact cause of loss, place of loss and actual driver details. As such the OP has repudiated the claim by giving proper reasoning vide letter dated 19^th Feb 2020 Annexure-8. On these lines, the case is sought to be defended by the OPs.
3.     Rejoinder was filed and averments made in the consumer complaint were reiterated.
4.     Parties led evidence by way of affidavits and documents.
5.     We have heard the learned counsels for the parties and gone through the record of the case.
6.     The main grievance of the complainant is that inspite of having proper insurance cover for his vehicle, his legitimate accidental claim has been repudiated by the OPs. On perusal of policy, it is observed that the period of policy is 19.08.2019 to 19.08.2020 Annexure C-1 is valid policy. Complainant was having proper policy cover for his vehicle.
7.     On perusal of the Annexure C-8, which is a repudiation letter, it is observed that the claim has been rejected.

         “Please refer to your reported own damage claim under the above subject policy and our letter dated 8th Feb 2019 & email dated Tue 18-02-2020 16:30. However, you have failed to respond to the said communications and also fulfil the requirements for further processing of your claim till date.

         In view of the above we understand that you're not interested in pursuing your claim further and due to non-cooperation, your claim stands repudiated.”

         It is observed that the complainant has submitted replies to all the queries and it is also a fact that the surveyor has assessed a damage of Rs.1291329.90 which is more than the 75% of IDV of Rs.13,80,000/-. This report containing assessed loss is submitted by complainant by way of affidavit of a licensed insurance claim surveyor & loss assessor/investigator. As the net assessed amount on repairs basis is exceeding the prescribed limit i.e., 75% of IDV, hence, it is a case of total loss. Hence, we are of the view that the complainant is required to be paid the IDV of Rs.13,80,000/- minus the salvage of Rs.43919.90.

8.     In view of the above discussion, the present consumer complaint succeeds and the same is accordingly partly allowed. OPs are directed as under :-

1. to pay ₹13,36,080/- (IDV value minus salvage) to the complainant alongwith interest @ 9% per annum from the date of filing of this complaint onwards.
2. to pay an amount of ₹20,000/- to the complainant as compensation for causing mental agony and harassment to him.
3. to pay ₹10,000/- to the complainant as costs of litigation.

9.     This order be complied with by the OPs within 45 days from the date of receipt of its certified copy, failing which, they 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.
10.     Pending miscellaneous application, if any, also stands disposed of.
11.     Certified copies of this order be sent to the parties free of charge. The file be consigned.

			Sd/-
21/02/2024			[Pawanjit Singh]
Ls			President
			Sd/-
			[Surjeet Kaur]
			Member
			Sd/-
			[Suresh Kumar Sardana]
			Member