Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 217.
Instituted on : 02.05.2019.
Decided on : 22.03.2021.
Ashwani Malik age 30 years, R/o H.N0.2574-A/10, Ram Gopal colony, Rohtak. .......................Complainant.
Vs.
- HDFC ERGO General Insurance Co. Ltd. Regd. & Corporate Office 1st floor, 165-166 Backbay Reclamation, H.T.Parekh Marg, Churchgate, Mumbaiu through its Manager.
- HDFC ERGO General Insurance Company Limited SCO No.124-125 Sector-8, Madhya Marg, Chandigarh-16008 through its Reegional Manager.
- HDFC ERGO General Insurance Company Limited, 1st Floor, Pizza Hut, Opp. Sessions Judge House, Near Ashoka Chowk, Delhi Road, Rohtak.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
MS.TRIPTI PANNU, MEMBER.
Present: Sh.Ashok Kadian & Sh. Jai Karan Khatri, Advocates for the
complainant.
Sh.Gulshan Chawla, Advocate for the opposite parties.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that complainant is registered owner of a Fiat Car bearing registration No.03KL-3778 and the same was insured with the opposite party vide policy no.231110037607500000 w.e.f. 14.11.2018 to 13.11.2019. the complainant had purchased the said car from Parul and R.C. and insurance was transferred in the name o0f complainant in January 2018 and after expiry of earlier insurance the new insurance was also issued in the name of complainant. The said car of the complainant met with an accident on dated 04.12.2018 near Jind Bye Pass Road, Rohtak and the vehicle was badly damaged. The complainant immediately informed the officials of the opposite party company and his vehicle was surveyed by the opposite party’s surveyor on 05.12.2018 and the surveyor disclosed that the vehicle cannot be repaired and is in total loss and vehicle was parked at a safe place. .The complainant submitted his claim to the opposite party and submitted all the required documents as asked by the respondents’ officials. But despite his repeated requests, the claim has not been disbursed by the opposite parties. Now the opposite parties has issued the claim rejection letter in the name of previous owner i.e. Mr. Parul whereas the complainant has already purchased the vehicle from said Parul in January 2018. Mrs. Parul has no concern with this matter and already sold this vehicle to complainant and insurance is also in the name of complainant. The act of opposite parties is illegal and amounts to deficiency in service. Hence this complaint and it is prayed that opposite parties may kindly be directed to disburse the insurance claim amount of Rs.350000/- alongwith alongwith interest, compensation and litigation expenses to the complainant as explained in relief clause.
2. After registration of complaint, notice was issued to the opposite parties. Opposite parties in their reply has submitted that after receiving the intimation ,about loss to the vehicle, the answering opposite party duly appointed surveyor, in order to assess the loss and damages sustained by the insured vehicle. That after minute inspection of the vehicle and after going through the facts and circumstances as presented by complainant, observed that the damages as claimed through the alleged accident are unrelated to the cause of accident as reported in the claim form. The damages do not commensurate with the case of loss as mentioned by the complainant in the claim form. As such the claim of the complainant was repudiated vide letter dated 06.02.2019. The letter dated 22.03.2019 as produced by the complainant for adjudication, was inadvertently issued automatically via system, as the policy earlier was in the name of the Parul. Thus, the same is nothing but an inadvertent error occurred due to system. Both the letters contains the ground of repudiation as misrepresentation of facts. Hence the claim of the complainant has been rightly repudiated. The complainant is not entitled for any relief and dismissal of complaint has been sought.
3. Ld. Counsel for the complainant in his evidence has tendered his affidavit Ex.CW1/A, Ex.CW2/A, documents Ex.C1 to Ex.C14 and closed his evidence on dated 03.12.2019 and also tendered document Ex.C15 in additional evidence and closed his evidence on dated 09.03.2021. On the other hand, ld. Counsel for the opposite parties in his evidence has tendered affidavit Ex.RW1/A, Ex.RW1/B, documents Ex.OP1/1 to Ex.OP1/5 and closed his evidence on dated 18.02.2021.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. In the present case, the claim of the complainant has been repudiated by the opposite parties vide their letter dated 06.02.2019 placed on record as Ex.OP1/4, addressed to the complainant on the ground that : “Damages were no co-relating with cause of loss narrated on claim form., 2). Severe damages sustained to the parts fitted in engine compartment like: High pressure pump, Rail pressure sensor, injectors engine cover, cowl. Top Grill, Cowl top Pannel, were not correlating with the cause of loss. Although there were large dents on the Hood but it was fitted on the engine compartment parts in case of internal parts damages, Hood would have totally crashed., 3). You stated in claim form that, insured vehicle hit in a trolly, This was frontial impact on the insured vehicle whereas after opening the Bonnet the surveyor found that engine parts were severely damages by vertical hammering. 4). Spot report/Police report not provided n such a major accident”. Later the claim was again repudiated vide letter dated 23.02.2019 issued in the name of Parul, placed on record as Ex.C10/Ex.OP1/5 on the ground that: “During survey it has been observed that the damages all parts claimed in the alleged accident are unrelated to the cause of accident as reported in the claim form. The damages do not commensurate with the cause of loss as mentioned by you in the claim form. These damages are multiple and accumulated in nature. Hence, it is a violation of the Motor Package policy Condition no.1 and also tantamount to misrepresentation of material facts”. Regarding issuing of the alleged letter in the name of Parul, it has been submitted by the opposite parties in their reply that the letter was inadvertently issued in the name of Parul being the previous owner of vehicle. Regarding the other plea that damages to all parts claimed in the alleged accident are unrelated to the cause of accident, opposite party has not placed on record any technical report to prove the same. Moreover no second opinion has been taken by the opposite party to prove the same. Merely, photocopy of photographs have been annexed with the surveyor report Ex.OP1/3 which does not prove that the loss was intentionally caused or that damages to all parts claimed in the alleged accident are unrelated to the cause of accident. On dated 09.03.2021, complainant also placed on record a pen drive in which two conversations of two persons are there. The time of the conversation is 10 minutes 4 seconds and another is 13 minutes 24 seconds. After hearing the conversations, it has come to our notice that the photographs have not been taken in Shrishti Hyundai by the surveyor/technical person of the insurance company. As per conversation, the photographs have been taken from Shrishti Hyundai Service Station. The photographs and statement were taken by one Vishal who is the person in the conversation placed on record. Meaning thereby the surveyor/technical person has not minutely examined the vehicle in question and the assessment was made on flimsy grounds by the insurance company or its surveyor. In this complaint, initially the claim was repudiated on 06.02.2019 and thereafter the representation was also made before the insurance company by the complainant on 13.02.2019 and again the claim has been repudiated by the insurance company on 22.03.2019 after addressing the previous owner of the vehicle in question. Hence the repudiation of claim on this ground is illegal and opposite parties are liable to pay the claim amount. The surveyor in his report Ex.P1/3 has assessed the loss amounting to Rs.289000/-. The IDV of the vehicle is Rs.350000/- and the vehicle in question is not repaired till date. Hence we hereby assess the value of scrap as Rs.60000/- and after deducting the alleged amount of scrap, the opposite party is liable to pay an amount of Rs.290000/- to the complainant with R.C.
6. In view of the facts and circumstances of the case we hereby allow the complaint and direct the opposite parties No.1 to 3 jointly and severally to pay a sum of Rs.290000/-(Rupees two lac ninety thousand only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 02.05.2019 till its realization and also to pay a sum of Rs.10000/-(Rupees ten thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant within one month from the date of decision.
7. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
22.03.2021.
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Nagender Singh Kadian, President
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Tripti Pannu, Member.
