Punjab

Sangrur

CC/186/2023

Sukhjinder Singh - Complainant(s)

Versus

Grievance Redressal Cell Future Generali India Insurance Co. Ltd. - Opp.Party(s)

Sh. Sukhjinder Singh(In Person)

04 Jul 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SANGRUR .

          

                                                                         Complaint No. 186

 Instituted on:   22.05.2023

                                                                          Decided on  :   04.07.2024      

 

Sukhjinder Singh (Age-41) S/o Harbhajan Singh, H.No.92, Street No.6, Shivam Colony, District Sangrur-148001(Punjab).                                                                ….Complainant. 

                                          Versus

1. Grievance Redressal Office, Future Generali India Insurance Company Limited Registered and Corporate, Office Address, Embassy 24x7 Park, 801 and 802, 8^th Floor, L.B.S. Marg, Vikhroli-West Mumbai, Maharashra, 400083 Care Line:- 1800-220-233, 1860-500-3333, 022-67837800, Email: FGCARE@FURUREGENERALLIN
2. Grievance Redressal Office, Policy Bazaar Insurance Brokers Private Limited Infinity Tower Mindspace, 1-B, Zakeria RD, Behind Lakozy Toyota Showroom, Malad, Rajan Pada, Ekta Nagar, Malad West, Mumbai-400064(Maharashtra) Care Line:- 1800-258-5970

                                                                ...Opposite parties. 

QUORUM                                       

JOT NARANJAN SINGH GILL : PRESIDENT

SARITA GARG                          : MEMEBR

KANWALJEET SINGH              : MEMBER

 

For the complainant  : In Person              

For the Op.1             : Shri Amit Goyal, Adv.

For the Op.2             : Shri Saurav Garg, Adv.

 

 

ORDER BY

KANWALJEET SINGH, MEMBER

 

 

1. Complainant has alleged in the complaint that the complainant bought a car insurance policy no. PBX21179 and car bearing no. HR26-DX-5249 from Op.1. The policy was valid from 07.3.2023 to 06.03.2024 covering zero depreciation, end to end damage to the vehicle, death or injury to driver and damage to 3^rd party alongwith road side assistance benefits. Complainant paid premium of Rs. 11,422/-. On 27.3.2023, the car of the complainant met with a small accident on Delhi-Gurgaon Road near Rajokri due to heavy traffic jam as another car hit with the car of the complainant from back side and the car of the complainant got pushed forward and hit a bike moving slowly in front of it. The Car of the complainant bonnet, front left side light and rear bumper got damaged. Complainant filed a damage claim request through Op.1 to Maruti Suzuki Service Centre, Rohan Motors, Gurgaon. Op.1 appointed surveyor Sh. Ravi Grover, who did not inform about the damage survey. Complainant kept following with the surveyor for next 3 days but he did not respond and then complainant got to know that the claim is on hold due to fake no claim bonus (NCB). On the policy taken through i.e. Op.2 (Policy Bazaar). The Op.1 cannot proceed with the claim approval till NCB issue is resolved. Op refused to approve the claim of the complainant by saying that the complainant took fake NCB. Therefore the claim cannot be approved. The complainant communicated many mails with the Ops and Phone calls and other representations. Complainant requested that he did not take any NCB intentionally. Complainant received an email related to recovery of NCB on 29^th April. Ops knew since beginning that there is an incorrect NCB on the policy of complainant as per their own records. Ops intentionally wanted to delay the proceedings to reject the damage claim of the vehicle in question. The complainant proceeded to correct the NCB issue by paying the due amount of Rs. 1225/- to the Op.1 on 03.05.2023 and lastly prayed that the ops to get the damage vehicle claim approved and paid to get the car damages repaired of the complainant.
2. Upon notice, Ops appeared and filed written reply separately. Reply of Op.1 taking preliminary objections that complainant has concealed the material fact and not come to the Commission with clean hands. The complainant approached the Op.1for insuring his vehicle and Op.1 issued the policy no. PBX21179 regarding the car bearing no. HR26-DX-5249. The policy is valid from 07.3.2023 to 06.03.2024. Complainant intimated about the accident of the insured vehicle on 2.4.2023. Accident took place on 27.3.2023 near Delhi-Gurgaon Road. After scrutinizing the documents of the complainant, it was noticed that the complainant has availed 20% NCB in subjected policy from Op.1. Complainant had taken a claim from his previous policy no. PBR43578-00. During verification the claim status of the previous insurer, it has been confirmed by the Op.1 that there is a claim in previous insurance policy hence, as per terms and conditions complainant is entitled with 0% NCB. Complainant has intimated the Op.1 about the loss after delay of 7 days. Due to which Op.1 has lost its legitimate opportunity to investigate the loss and vehicle recovery. This is a violation of the condition no.1 of the terms and conditions of the policy.

Brief facts of the Case:

Op.1 issued the insurance policy no. PBX21179 with regard to the car bearing no. HR26-DX-5249. The policy was valid from 07.3.2023 to 06.03.2024. Complainant intimated about the accident of the insured vehicle on 2.4.2023. Accident took place on 27.3.2023 near Delhi-Gurgaon Road. Premium paid of Rs. 11,422/- by the complainant. Complainant submitted a claim form dated 02.4.2023 stating that the insured vehicle was damaged during the car accident, when a car bumped from behind and bike hit from front in a traffic jam on 27.3.2023. The complainant misrepresented the fact of previous policy claim to avail the NCB of 20% from OP.1. The Op.1 repudiated the claim vide letter dated 10.4.2023. The pleadings of the reply of Op.1 are similar to their respective preliminary submissions. So, there is no need to retreat the same to avoid repetition. The remaining allegations are denied by the Op.1 and lastly prayed that the complaint may kindly be dismissed.

3. Reply of Op.2 pleaded that the Op.2 is an intermediary between the service providers and customers. It is a platform where the service providers and customers meet and it markets insurances services provided by the company as per the terms and conditions. The complainant bought a vehicle insurance policy bearing no. PBX21179 through the website of Op.2. The insurance policy has been issued by the Op.1. Hence, the Op.1 is liable for all services mentioned in the policy. Op.1 has been informed by the Op.2 that the complainant has opted 20%, but was not eligible for any NCB, because he has taken a claim on his previous policy. On the basis of misrepresentation made by the complainant. So, the claim was rejected on 10.4.2023. The remaining allegations are denied by the Op.2 and lastly prayed that the complaint may kindly be dismissed.
4. Complainant has tendered in his evidence Ex.C-1 to Ex.C-8 and Ex.C-9 affidavit and closed the evidence. Similarly, Op.1 tendered into evidence Ex.Op.1/1 affidavit and Ex.Op1/2 to Ex.Op.1/6 and closed the evidence. Similarly, Op.2 tendered into evidence Ex.Op.2/1 to Op.2/3 and affidavit Ex.Op.2/4 and closed the evidence.
5. We had heard the complainant and learned counsel of opposite parties and gone through the record file carefully with the valuable assistance of the learned counsel for the parties. During arguments the contentions of the complainant and learned counsel of the opposite parties are similar to their respective pleadings. So, there is no need to reiterate the same to avoid repetition. “Now come to major controversy whether the complainant is liable for relief as claimed by him in his prayer or not”?
6. No doubt, it is admitted by Op.1 in reply of preliminary objections in para no.3 that Op.1insured the vehicle of complainant for the period from 7.3.2023 to 6.3.2024 bearing policy no. PBX21179. It is not disputed that the incident occurred on 27.3.2023. Complainant intimated the accident of the insured vehicle to the Op.1 on 02.4.2023 after 7 days of the loss. Op.1 lost the opportunity to investigate the loss. Complainant committed the violation of the terms and condition no. 1 of the policy. During verification, it has been confirmed that there is a claim in previous policy. Hence, complainant is entitled with 0% NCB. It is admitted by Op.1 in their reply on page no.7 that premium received of Rs. 11,422/- has shown of the insurance policy of the car in question. Further, on page no. 8 of reply in para no. 5 of Ops, Ops pleaded that complainant has intimated two days delay. In this context, the stand of Op.1 is in itself contradictory with regard to two days or 7 days delay for intimation received from complainant. It is writ large on the file from the perusal of Ex.C-5 emails communicated by the complainant qua the Ops regarding resolve the insurance claim issue. It transpire from the perusal of Ex.C-6(damaged car repair job sheet) dated 12.4.2023 prepared by the Rohan Motors Ltd., Gurgaon. In this job Sheet it has shown the estimate cost of repair mentioned as Rs. 18000/-.  The document Ex.C-7 & Ex.Op.1/5 dated 10.4.2023 are the same with regard to repudiation of the claim. We feel for proper adjudication of the case the vital document which is Ex.C-8 mail dated 3.5.2023, Op.1 communicated to the complainant that Payment for Rs. 1225/- is successful. “A Man can lie, but document can’t”. Per contra, Op.1 issued another mail dated 4.5.2023 (second page of Ex.C-8) to the complainant and consent has been given regarding received of payment issue concerned with the correct NCB and regularized the policy. In this juncture, we feel that the insurance policy of the car of the complainant was regularized by the Op.1 after received the payment of Rs. 1225/- as NCB correction of the insurance policy bearing no. PBX21179 vide mail dated 3.5.2023 of Ex.C8 page 3 we feel that the Principle of Estoppel is fully applicable qua the Op.1. It transpire from Ex.Op.1/4 “Motor Claim form” dated 2.4.2023 duly singed by the complainant. Op.1 also embossis their official stamp on the same. This Commission has the considered view that the document Ex.C-8 is the utmost important document to trace out the veracity of truth. Op.1 admitted this factum that the payment received on 3.5.2023 of Rs. 1225/-. “ The person who seeks equity must do equity.” However, Op.1 through mail dated 4.5.2023 admitted that Op.1 has already registered a request to correct the NCB and regularize the policy. This Commission has the considered view that Op.1 admitted this factum that they regularize the policy in question qua the complainant. We feel that “Admission is the best evidence”.
7. On the basis of pleadings of both the parties as well as documentary evidence led by them, this Commission has no hesitation to hold that the complainant is out rightly entitled for relief. We feel that the insurance company received huge amount by way of premium and issue  the insurance policy to the innocent consumers frequently. On the other hand, Civil Society Phenomenon is toward the insurance  Companies  are avoiding by one pretext  or another  to pay the liability of insurance claim to the aggrieved consumers, we feel that  an insurance contract is known as a contract of “ uberrima fides” based  on “ utmost good faith” which is fully applicable in the present complaint. The Consumer Commissions are duty bound to provide justice to the deserving consumers. The Consumer Commission redresses the grievances through justice to the innocent consumers, but the justice seems to be. We feel that the complainant is liable for relief. This is a fit case to redress the grievances of the complainant.
8. Resultantly, keeping in view the facts and peculiar circumstances of the present complaint in hand and with careful analysis of the evidence available on record, we partly allow the complaint of the complainant and direct the Op No.1 to make the payment of Rs. 18,000/-to the complainant.
9. This order be complied by Op No.1 within a period of 45 days from the date of receipt of order.
10. The complaint could not be decided within the statutory time period due to heavy pendency of cases.
11. Copy of this order be supplied to the parties free of cost as per rules. File be consigned to the records after its due compliance.   

                                Announced.

                                4 July, 2024.

 

 

( Kanwaljeet Singh)    (Sarita Garg)  (Jot Naranjan Singh Gill)

    Member                        Member                  President