Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 358
Instituted on : 25.07.2019
Decided on : 05.03.2024
Mrs. Stella Porter d/o Mr. Edwin Porter and wife of Late Sh. Mohan Gaur resident of #1466/3, near Old Sabji Mandi, Pili Kothi, Rohtak(since deceased) through her legal representative:
Vikram Gaur(Age 44 years) son of Late Sh. Mohan Gaur resident of # 1466/3, near Old subji mandi Pili Kothi Rohtak.
……….………….Complainant.
Vs.
- Hdfc Ergo General Insurance Company Limited, Regd. Office : 1st Floor, HDFC House, 165/166, Backbay Reclamation HTP Parekh Marg, Mumbai-400020.
- Hdfc Ergo General Insurance Company Limited, The compliance and grievances cell, D-301 3rd Floor, Eastern Business District, LBS Marg, Bhandup(West), Mumbai-400078.
- Rajesh Vehicle Insurance and Finance(agent HDFC ERGO) HUDA Complex, Rohtak-124001.
...........……Respondent/opposite party.
COMPLAINT U/S 35 OF CONSUMER PROTECTION ACT.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
DR. VIJENDER SINGH, MEMBER
Present: Sh.G.K.Lalit Advocate for the complainant.
Sh.Gulshan Chawla, Advocate for the opposite party No.1 & 2.
Opposite party No.3 already exparte.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case as per the complainant are that she is registered owner of the car bearing regn. No.HR-12W-0251 Maruti Swift Dezire LDI and the same is insured with the opposite party no.1 vide policy No.231110036852760000 for the period 23.10.2018 to 22.10.2019 and the policy was done by respondent no.3. The vehicle of the complainant met with an accident on dated 16.01.2019 in the area of village Shaidpur, District Sonepat. The complainant lodged her claim with the company in the morning of 17.01.2019 and completed all the formalities and documentation was done within time and the total expenses for the repair came out to be Rs.60591/- to be paid by the insurance company. But despite completion of all the requisite formalities, the claim has not been passed by the opposite party and opposite party has harassed the complainant. Hence this complaint and it is prayed that opposite parties may kindly be directed to pay Rs.60591/- as claim amount alongwith interest @ 18% p.a. w.e.f. 17.01.2019 to till its actual realisation and cost of litigation to the complainant.
2. After registration of complaint, notices were issued to the opposite parties. Opposite party No.1 & 2 in their reply has submitted that the claim intimation regarding the loss to the vehicle on 16.01.2019 was received in the office of the answering opposite party on 17.01.2020 and on registration of the claim, claim no.C230018359337 was allocated to the informer. In view to check genuineness and to assess the loss amount under the terms and conditions an IRDA approved Independent surveyor was appointed and after getting the report, it became crystal clear that the damages detailed in the claim form does not commensurate with the cause of loss as mentioned by the insured in the claim form and the damages were multiple and accumulated in the nature. Moreover the vehicle in question had met with a loss on 16.01.2019 whereas intimation regarding the same has been given on 17.01.2019, after unexplained delay of 1 day. Hence in view of the terms and conditions of the policy, the claim of the complainant has been rightly repudiated vide letter dated 08.04.2019. It is further submitted that the Hon’ble Commission has no territorial jurisdiction to entertain and adjudicate the present complaint. There is no office of opposite party at Rohtak and policy in question has been issued from office at Mumbai. The vehicle in question met with accident at Sonepat-Haryana and no cause of action has arisen within territorial jurisdiction. All the other contents of the complaint were stated to be wrong and denied and opposite party No.1 & 2 prayed for dismissal of complaint with cost. However, notice sent to opposite party No.3 received back with the report of refusal and opposite party No.3 was proceeded against exparte vide order dated 12.09.2019 of this Commission.
3. Ld. counsel for complainant in his evidence has tendered affidavit Ex.CW1, documents Ex.C1 to Ex.C10 and closed his evidence on dated 09.02.2022. Ld. Counsel for opposite party has tendered affidavit Ex.RW1/A, documents Ex.R1 to Ex.R4 and closed his evidence on 08.12.2022.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. We have minutely perused the documents placed on record by both the parties. The claim of the complainant has been repudiated by the insurance company on the ground that the insurance company was intimated regarding the loss belatedly and further submitted that the complainant is misrepresenting the facts of the claim and wrong declaration has been given in the claim form. These damages are multiple and accumulated in nature, Hence it is violation of Motor Package Policy Condition No.1 and also tantamount to misrepresentation of material facts. The condition no.1 of the policy states that :
“Notice shall be given in writing to the company immediately upon the occurrence of any accidental loss or damage in the event of any claim and thereafter the insured shall give all such information and assistance as the company shall require”.
It is further submitted that misrepresentation of facts goes against the declaration given on the reverse side of the claim form which is as under:
"I/we the above named, do hereby, to the best of my/ our knowledge and belief warrant the truth of the forgoing statement in every respect and I/we agree if I/we have made or in any further declaration the company may require in respect of the said accident shall make any false or fraudulent statement or suppression or any suppression concealment, the policy shall be void and all rights to recover there under in respect of past or future accidents shall be forfeited."
It is further submitted that by not timely intimating answering respondent, complainant has violated term and conditions of the policy. So the claim of the complainant has been repudiated as no claim on the above mentioned ground. We have minutely perused the documents placed on record by both the parties. The insurance company submitted four documents alongwith affidavit Ex.RW1/A i.e. Ex.R1 insurance policy, Ex.R2 claim form, Ex.R3 no claim letter and Ex.R4 surveyor report. One more objection has been taken in the written statement that this Commission has no territorial jurisdiction to entertain and try the present complaint. We have minutely perused the cover note. The first page of package policy placed on record as Ex.C3. On the bottom of this page the seal of the agent of the insurance company has been affixed and address of the agent is of Rohtak. So this Commission has territorial jurisdiction to try and entertain the present case. In the present case date of accident is 16.10.2024 and the opposite party has taken the plea that there is delayed intimation in giving intimation to the opposite party. But opposite party as per its affidavit and written statement has stated that the intimation was given on the very next day. Hence there is no delay in giving intimation to the opposite party. Regarding the objection that detail mentioned in the claim form are not commensurate with the cause of loss as mentioned in the claim form filed by the complainant. In support of this contention, the respondent failed to place on record any technical or mechanical report that wrong facts have been mentioned in the claim form. So there is deficiency in service on the part of opposite party. As such opposite party No.1 & 2 are liable to pay the claim amount to the complainant. As per Ex.C3/Ex.R1, vehicle of the complainant was manufactured in the year of 2013. The policy in question is a private car package policy and the same is not a ‘nil depreciation policy’. . As per surveyor the complainant has suffered a loss of Rs.32093.31/- in the accident in question whereas the complainant(since deceased) has pleaded that she spent an amount of Rs.65091/- on the repair of the vehicle. As per our opinion the surveyor has assessed the claim after deducting the less excess clause and as per terms and conditions of the insurance policy. So the complainant is entitled for the amount of Rs.32093/- as assessed by the surveyor. However, at the time of arguments, an application for making the LR of complainant has been placed on file on the ground that the complainant Mrs.Stella Porter had died on 07.12.2023 and the applicant Vikram Gaur is the only legal heir of the complainant.
6. In view of the facts and circumstances of the case, we hereby allow the complaint and direct the opposite party No.1 & 2 to pay the amount of Rs.32093/-(Rupees thirty two thousand and ninety three only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 25.07.2019 till its realisation and shall also pay Rs.4000/-(Rupees four thousand only) as compensation on account of deficiency in service and Rs.4000/-(Rupees four thousand only) as litigation expenses to the L.R. of deceased/complainant namely Vikram Gaur son of 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:
05.03.2024.
........................................................
Nagender Singh Kadian, President
..........................................
Tripti Pannu, Member.
……………………………….
Vijender Singh, Member
