Delhi

East Delhi

CC/903/2015

ASHOK KR - Complainant(s)

Versus

HDFC ERGO GEN. INS. - Opp.Party(s)

20 Nov 2017

ORDER

DISTRICT CONSUMER DISPUTE REDRESSAL FORUM (EAST)

GOVT. OF NCT OF DELHI

CONVENIENT SHOPPING CENTRE, FIRST FLOOR,

SAINI ENCLAVE, DELHI – 110 092

C.C. NO. 903/15

Shri Ashok Kumar Verma

46-6 B , East Azad Nagar

New Delhi – 110 051                                                               ….Complainant

Vs.

M/s. HDFC ERGO General Insurance Co. Ltd.

Ground Floor, Ambadeep Building

14, Kasturba Gandhi Marg

New Delhi – 110 001                                                                     ….Opponent

Date of Institution: 30.11.2015

Judgment Reserved on: 20.11.2017

Judgment Passed on: 22.11.2017

CORUM:

Sh. Sukhdev Singh (President)

Dr. P.N. Tiwari  (Member)

Ms. Harpreet Kaur Charya (Member)

Order By : Ms. Harpreet Kaur Charya (Member)

JUDGEMENT

            Jurisdiction of this forum has been invoked by the complainant, Shri Ashok Kumar Verma, against M/s. HDFC ERGO General Insurance Co. Ltd. (OP) with allegations of deficiency in services and unfair trade practice.

2.        Facts of the present complaint are that the complainant purchased online insurance policy for his car No. DL8C-U-4900 from                      M/s. HDFC ERGO General Insurance Co. Ltd. (OP) on 31.08.2014 by paying a premium of Rs. 9,072/- through credit card for the period 01.09.2014 to 31.08.2015.

            On 05.08.2015, the car of the complainant met with an accident.  The complainant produced his policy for accidental claim but he was shocked to know that his policy had expired.  On contacting the call centre of OP, he came to know that his policy was only for 11 months and not for 12 months. 

            It was stated that the complainant received the confirmation of the policy for a period of 12 months through e-mail dated 31.08.2014, but he never received the intimation about the change in the policy term.

            On continuous follow-ups, the complainant was informed that he had already taken claim from his previous insurance company i.e.      M/s. Bajaj Allianz due to which No Claim Bonus (NCB) cannot be given, thus OP adjusted the premium by reducing the term of the policy, which does not need any prior approval of consent of the client.   

            The complainant took the confirmation from M/s. Bajaj Allianz on 09.08.2015 that no claim was registered in the policy till 31.08.2014, but on 09.08.2015, OP finally refused to settle the claim of the complainant for Rs. 1,57,830/-. 

            On 26.09.2015, the complainant sent a legal notice to OP, but did not get any reply.  Hence, the complainant has prayed for directions to OP to pay the amount of claim of Rs. 1,57,830/- alongwith 18% interest and Rs. 30,000/- as legal expenses.    

            The complainant has annexed the copy of cover note, credit card statement as Annexure A-1 and Annexure A-2 respectively, copy of original insurance policy as Annexure A-3, email dated 31.08.2014, copy of email from M/s. Bajaj Allianz, copy of claim receipts/invoice & payment made by the complainant, copies of emails exchanged between OP and the complainant as Annexure A-4 and Annexure A-5, copy of legal notice alongwith postal and courier receipts as Annexure A-10 and Annexure A-11 respectively, with the complaint. 

3.        Notice of the present complaint was issued to OP.  WS on behalf of OP was filed where they took several pleas such as this Forum did not have territorial jurisdiction.   It was admitted that the vehicle bearing no. DL8C-U-4900 was insured with OP vide policy no. 23111000187980000000 valid from 01.09.2014 to 31.08.2015 for an IDV of Rs. 3,69,000/-. 

            At the time of issuing the policy, the complainant had declared that he was entitled for No Claim Bonus and OP issued the policy giving the benefit of 20% No Claim Bonus.  On confirmation from the previous insurance company, it was revealed that the complainant was not entitled for No Claim Bonus, therefore, a letter dated 23.09.2014 was written to the complainant to deposit Rs. 453/- as the amount of No Claim Bonus, otherwise the period of policy will be reduced pro-rata.  The complainant did not pay any heed to the said letter and did not pay the balance amount of Rs. 453/-, hence the policy period was reduced on pro-rata basis for one month and the fresh policy was from 01.09.2014 to 30.07.2015.

            It was further stated that the complainant did not lodge any claim for a sum of Rs. 1,57,830/- or for any other amount.  Other facts have also been denied. 

4.        In replication to the WS filed by OP, the complainant reiterated and reaffirmed the contents of the complaint and denied those of the WS.

5.        Evidence by way of affidavit was filed by the complainant where he deposed on oath the contents of the complaint and got exhibited copy of cover note (Ex.CW1/1), copy of credit card statement (Ex.CW1/2), copy of insurance policy (Ex.CW1/3), copy of email dated 31.08.2014 (Ex.CW1/4), copy of airway bill no. B991Q3232868 (Ex.CW1/5), copy of email from Bajaj Allianz (Ex.CW1/6), copy of claim receipt invoice and payment made by the complainant (Ex.CW1/7)(colly.), copy of emails (Ex.CW1/8)(colly.), copy of email sent by OP (Ex.CW1/8) and copy of legal notice alongwith postal receipts and delivery reports (Ex.CW1/10)(colly.)

            OP examined Shri Pankaj Kumar, Manager (Legal) of OP, who reiterated the contents of their reply. 

6.        We have heard Ld. Counsel for the complainant and have perused the material placed on record.  The complainant has stated that his claim was not settled by OP as there was no valid insurance policy        as on the date of accident.  The period of policy term was reduced to 11 months by OP due the reason that the complainant had failed to deposit the NCB benefit, thus, the period of policy was reduced on pro-rata basis,.  However, if we look into the email dated 12.08.2015, which has been addressed to st August 2014”.

            During the course of arguments, it was argued on behalf of the counsel for complainant that even if the premium was adjusted on     pro-rata basis then @ Rs. 26.09/per day the insurance company could have calculated the period of insurance.

            The complainant has placed on record the letter dated 23.09.2014 where the OP has requested to provide a certificate from the previous insurer on eligibility of NCB or alternatively requested to pay NCB of      Rs. 453/- within 15 days from the date of receipt of the letter, failing which the same will be adjusted with the policy period to the extent of premium received, which the complainant himself has placed on record, thus, letter seeking clarification for NCB and at the same time, has also annexed email dated 12.08.2015, thus, it implies that the complainant had neither complied with the requirement of giving NCB certificate nor he paid Rs. 453/-. 

            Therefore, when the complainant chose to ignore the letter dated 23.09.2014 of OP, he cannot allege deficiency in service and unfair trade practice on OPs.  Hence, his complaint deserves its dismissal and the same is dismissed.  There is no order as to cost.

Copy of the order be supplied to the parties as per rules.

File be consigned to Record Room.

(DR. P.N. TIWARI)                              (HARPREET KAUR CHARYA)

        Member                                                                        Member   

            (SUKHDEV SINGH)

                  President