Haryana

Karnal

178/2012

Brahmanand S/o Suraj Bhan - Complainant(s)

Versus

HDFC EGRO Gernal Insurance Company Limited - Opp.Party(s)

Sh. Ravinder Raheja

08 Jan 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.  

                                                          Complaint No.178 of 2012

                                                          Date of instt.: 30.03.2012

                                                          Date of decision: 8.01.2016

 

Brahmanand s/o Sh.Suraj Bhan r/o V& P.O Khandra tehsil  Matlauda district Karnal.

.                                                                               ……..Complainant.

                                      Vs.

1.H.D.F.C. ERGO General Insurance Company Limited, SCO No.237, IInd Floor, Sector 12 Market, Karnal through its Branch Manager.

2.H.D.F.C. ERGO General Insurance Company Limited Regd. office at Ramon House, H.T.Parekh  Marg, 169, Backbay Reclamation, Mumbai – 400020 through its General Manager.

                                                                           ……… Opposite Parties. 

 

                     Complaint U/s 12  of the Consumer

                     Protection Act.

 

Before          Sh.K.C.Sharma……….President.                

                   Sh.Anil Sharma…….Member.

 

Present:-        Sh.Ravinder Raheja Advocate for the Complainant.

                   Sh.Sanjeev Vohra Advocate for the Opposite Parties

ORDER:                 

     

                      This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986, on the averments that he got insured his  Maruti   Alto Car bearing registration No. HR-06U/0479 with the Opposite Party No.1, vide policy no.2311200139084500000 and Agent Code no.202081704687,  valid for the period of 27.9.2011 to 26.9.2012. The car met with an accident on 29.9.2011  with a  buggi (wheat straw  loaded buggi) in the area falling between villages Khandra and Assan Kalan. Intimation of the accident was given to the Opposite Party No.1. Spot inspection was done by the authorized surveyor   of the company namely Manmeet Singh  Makkar.  Thereafter, the car was brought to the workshop of  Vijay Motors, Sector 25, HUDA, Panipat, with the help of crane, for repairs.  An amount of Rs.95061/- was paid for repairs, vide cash memo dated 10.12.2011. Thereafter, claim was lodged with the Opposite Party no.1, but the same was not admitted. Ultimately, legal notice dated 3.1.2012 was got served  upon the  Opposite Parties. Thereafter, he received letter dated 26.12.2011 on 10.1.2012 from Manmeet Singh Makkar,  who demanded the copy of the previous insurance policy and photographs of the vehicle. Photograph was sent to the surveyor, but the old policy was not found despite best efforts. In this regard, the letter dated 25.1.2012 was sent to the surveyor.  On 27.1.2012, he received letter dated 20.1.2012 regarding repudiation of his claim. The order of repudiation of the claim is wrong, illegal and against the policy of insurance, which amounted to deficiency in services and as a result of that he suffered mental pain and harassment apart from financial loss.

 

2.                 Notice of the complaint was given to the Opposite Parties, who appeared and filed written statement controverting the claim of the complainant on various grounds. Objections have been raised that  the complainant has no cause of action to file the present complaint; that the complainant has not approached this Forum with clean hands and that there was no deficiency in services on the part of the Opposite Parties.

 

                   On merits, it has been submitted that claim lodged by the complainant was duly processed .  During course of claim processing, it was found that complainant had  produced forged policy papers of the previous insurance  to  show continuity of the policy and to avoid inspection of the  vehicle.  Due to such misrepresentation  of material facts by the complainant, his claim was repudiated and intimation thereof was given, vide letter dated 20.1.2012.

 

3.                 In evidence of the complainant, his affidavit Ex.CW1/A and documents Ex.C2 to Ex.C15 have been tendered.

 

4.                 On the other hand, in evidence of the Opposite parties,  affidavit of Sh.Abhishek Kushwaha , Assistant Manager Ex.O1 and documents Ex.O2 to Ex.O5 have been tendered.

 

5.                 We have appraised the evidence on record,  the material circumstances of the case and the arguments advanced by the learned Counsel for the parties.

 

6.                 There is no dispute between the parties that the car of the complainant was insured by the Opposite Party No.1 for the period of 27.9.2011 to 26.9.2012. As per the case of the complainant, the car met with an accident on 29.9.2012, but  no  Daily Diary Report or First Information Report was got recorded in the Police Station, regarding the said accident. However, the Opposite Parties have also not disputed the factum of accident and damages to the car. The claim of the complainant was repudiated by the  Opposite Parties on the ground that pre;vious insurance policy of Iffco Tokio General Insurance Company Limited produced by the complainant at the time of taking policy from the Opposite Parties, in order to show continuity and to avoid inspection of the vehicle, was found forged during investigation, which amounted to misrepresentation of material facts.

 

7.                 The learned counsel for the Opposite Parties laid much emphasis on the contention that in order to show continuity and to avoid physical inspection of the car, the complainant produced previous insurance policy allegedly issued by theIffco Tokio General Insurance Co .Limited, which on  verification was found to be forged. The said cover note bearing No. 71358482 , the copy of which is Ex.O4, was in fact issued by the Iffco Tokio General Insurance Company  Limited in respect of vehicle bearing registration No.HR-05U/1086  owned by one Jasbir Singh and the copy of the  original cover note is Ex.O3. In this way, the complainant  played fraud upon the Opposite Parties, misrepresented the facts and gave false declaration, which amounted to fundamental breach of contract of insurance. It has further been argued that facts and circumstances indicate that car might have met with an accident  prior to issuance of the insurance policy by the Opposite Parties and the complainant obtained the policy from the Opposite Parties by misrepresenting the  material fact and  produced forged document of previous policy in order to claim the  amount from the Opposite parties illegally.

 

8.                 The documents Ex.O2 and Ex.O3 indicate that the same are in respect of cover note No. 71358484.Ex.O2 is in respect of car of complainant bearing registration No. HR-06U-0479, whereas Ex.O3 is in respect of vehicle bearing registration No.HR-05U-1086 owned by one Jasbeer Singh. As per the version of the Opposite Parties Ex.O2 was produced by the complainant and on verification it was found that the same was forged, whereas Ex.O3 was the genuine  cover note. There is no documentary evidence of the Opposite Parties worth the name on record, which may show that Ex.O2 was produced by the complainant at the time of taking policy from the Opposite Parties. Had Ex.O2 been produced by the complainant at the time of taking the policy, then there was no need for the investigator/surveyor to ask the complainant to produce the document of the previous policy. No affidavit of the concerned agent, who had issued the cover note has been filed to prove that the complainant had produced before him  any previous insurance policy document  of some other insurance policy.  Moreover, Ex.C3 issued by the Opposite Parties also falsifies the version of the Opposite Parties, because in the said document there is no reference of any previous policy document produced by the complainant. If, the complainant had produced any previous insurance document, then certainly, policy number and the name of the previous insurer must have been mentioned in the cover note  as well as policy r issued by the Opposite Parties. If, there was any previous policy, the complainant could claim  benefit of No  Claim Bonus also, but  Ex.C3 shows that no such benefit was given to the complainant by the Opposite Parties. Thus, the Opposite Parties  have failed to prove that the complainant had produced previous policy documents of Iffco Tokio General Insurance company Limited for getting issued the policy from the Opposite Parties, in order to show the continuity and to avoid physical  inspection of his vehicle. In this way, no fraud or misrepresentation  by the complainant in obtaining the insurance policy is established. Therefore, the Opposite Parties could not  escape from their liability. Under such circumstances, repudiation of the claim by the Opposite Parties amounted to deficiency in services.

 

9.                 The complainant has claimed that he has spent Rs.95061/- on the repairs of the car and in this regard he has produced bill  Ex.C15 issued by Vijay Motors, Panipat.  However, the Opposite Parties have produced copy of the surveyor’s report Ex.O5, according to which  final liability of the Opposite Parties was assessed as Rs.66617/- after  making all necessary deductions as per terms and conditions of the insurance policy. It is settled proposition of law that report of surveyor of loss is an important document and is not to be brushed aside unless there is any material on record to doubt its correctness.  There is no material on record to doubt the genuineness of the report   prepared by the surveyor.  Accordingly, the Opposite Parties are held liable to pay the amount of Rs.66617/-.

 

10.               As a sequel to the foregoing discussion, we accept the present complaint and direct the Opposite Parties to make the payment of Rs.66617/- to the complainant. The complainant shall also be entitled for a sum of Rs.5500/- for the mental agony and harassment suffered by him and for the litigation expenses. The Opposite Parties shall make the compliance of this order within a period of thirty days from the date of receipt of the 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:11.01.2016

                                                                    (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.

 

Present:-        Sh.Ravinder Raheja Advocate for the Complainant.

                   Sh.Sanjeev Vohra Advocate for the Opposite Parties

                  

                   An application for additional evidence filed by the Opposite parties. No reply is proposed to be filed  by the complainant, therefore, the application for additional evidence filed by the Opposite parties is allowed. The report of surveyor produced by way of additional evidence is exhibited as Ex.O5.Arguments in part heard. For  remaining arguments, the case is adjourned to 8.1.2016

Announced
dated:30.12.2015

                                                                    (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.

 

Present:-        Sh.Ravinder Raheja Advocate for the Complainant.

                   Sh.Sanjeev Vohra Advocate for the Opposite Parties

                  

                   Arguments heard. Vide our separate order of the even date, the present  has been accepted. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced
dated:8.1.2016

                                                                    (K.C.Sharma)

                                                                   President,

                                                         District Consumer Disputes

                                                          Redressal Forum, Karnal.

            (Anil Sharma ) 

               Member.