Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 291
Instituted on : 18.06.2019
Decided on : 04.08.2022
Dinesh Kumar s/o Sh. Ari Chand R/o H.No. 1569/20, Chhotu Ram Nagar, Rohtak. ..............Complainant.
Vs.
- HDFC ERGO General Insurance Company Limited, Naraina Complex, Rohtak through its Manager.
- HDFC ERGO General Insurance Company Limited,1st Floor, HDFC House, 165-166 Backbay Reclamation, H.T.Parekh Marg, Mumbai-400020 through its Manager.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
Present: Shri Puneet Chahal, Advocate for the complainant.
Shri Gulshan Chawla, Advocate for the opposite parties.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case as per complainant are that the complainant is registered owner of vehicle No. HR-12V-9656 and had got the same insured with opposite parties vide Policy no.2311100364864700001 commenced from 13.10.2018 to 12.10.2019 for insured value of Rs.3,15,385/- under 0% depreciation scheme. On 06.01.2019, the complainant’s vehicle met with an accident and the same was badly damaged. The said incident was informed to the opposite party on time and opposite party appointed a surveyor namely Sh. Yogesh Jain and complainant deposited all the relevant documents alongwith insurance policy to the surveyor and filled the claim form. The surveyor thoroughly inspected the vehicle , took the photographs and signatures on plane papers and completed all his formalities. The surveyor assured the complainant to disburse the claim in his favour after repair of the vehicle. The complainant spent an amount of Rs.1,18,425/- on the repair of his vehicle. Complainant made repeated requests to the opposite parties to settle his claim but on 08.03.2019, he was shocked and surprised to receive a letter from the opposite parties regarding rejection of his genuine claim. Hence, there is deficiency in service on the part of opposite parties and it is prayed that opposite parties may kindly be directed to pay an amount of Rs.1,18,425/- alongwith interest at the rate of 18% p.a. from the date of accident till realization, Rs. 10,000/- as litigation charges and Rs.1,00,000/- as compensation on account of unnecessary harassment, economical loss etc. as explained in relief clause.
2. After registration of complaint, notices were issued to the opposite party. Opposite parties in their reply has submitted that the vehicle in question has suffered a loss on 06.01.2019 due to accident, as alleged by the complainant in the claim form. On the receipt of claim intimation, opposite party appointed an independent Surveyor to assess the loss qua the vehicle in question and the said claim was rightly rejected by the Surveyor with the observations that damages of the insured vehicle does not correlate with the cause of accident mentioned in the claim form and there was multiple damages on the vehicle. On receipt of Surveyor report, opposite party rightly repudiated the claim of the complainant vide letter dated 08.03.2019 duly served upon by the complainant. Opposite party also submitted that in case of own damage insurance claim the liability of the insurance company is limited to the extent of loss assessed by the IRDA licensed surveyor and hence without prejudice to other contention, it is submitted that the liability of the opposite party cannot exceed the liability as assessed by the Surveyor. Hence, there is no deficiency in service on the party of insurance company. All the other contents of the complaint were stated to be wrong and denied and opposite party prayed for dismissal of complaint with costs.
3. Ld. Counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, documents Ex.C-1 to Ex.C-8 and has closed his evidence on dated 04.11.2020. Ld. counsel for the opposite parties has tendered affidavits Ex.RW1/A and Ex. RW-2/A, documents Ex.R1 to Ex.R4 and closed his evidence on 17.11.2021.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. In the present complaint, the claim of the complainant has been repudiated by the insurance company vide letter dated 08.03.2019 placed on record as Ex.R4 on the ground 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 the complainant in the claim form. These damages are multiple and accumulated in nature.”
6. We have minutely perused the report Ex.R3 placed on record by the respondent insurance company. This report has been issued by Er. Yogesh Jain Surveyor and Loss Assessor dated 12.02.2019. As per Er.Yogesh Jain Surveyor & loss assessor, he inspected the vehicle of the complainant and the engine parts were dismantled by the repairer in his presence and he found rust upon the parts of the engine. After considering rust he came into the conclusion that the nature of accident of the vehicle is not co-relate with the cause of loss as mentioned in the claim form. As per survey report an estimate of Rs.89000/- has been given but the surveyor has assessed the loss of Rs.32919/- in his assessment. Most of the parts have been declined for replacement on the ground of cause of loss. The surveyor has not mentioned any specific reason that why the accident is not co related with the cause of loss. Merely an assumption has been made by the opposite parties because to prove the above mentioned objections, any authentic evidence is not placed on file. In fact the perusal of photographs attached with the report itself shows that complainant has suffered a huge loss in his vehicle. As per complainant he had spent an amount of Rs.118425/- on the repair of the vehicle and has placed on record copies of bills Ex.C5 to Ex.C8. The perusal of the policy Ex.C1 itself shows that the vehicle of the complainant is covered with Zero dep., Emergency Assistance, engine and gear box Protection alongwith cost of consumable items in addition to his comprehensive private car package policy and he paid for the same. In this way the complainant is entitled for the amount which he has spent on the repair of his vehicle without any deductions as the policy is a zero dep. policy and consumable items are also covered under the policy.
7. In view of the facts and circumstances of the case we hereby allow the complaint and direct the opposite party to pay Rs.118425/-(Rupees one lac eighteen thousand four hundred and twenty five only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 18.06.2019 till its realization and shall also pay 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.
8. 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:
04.08.2022
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Nagender Singh Kadian, President
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Tripti Pannu, Member.
