NCDRC

NCDRC

RP/685/2017

ANIL KUMAR - Complainant(s)

Versus

HDFC ERGO GENERAL INSURANCE CO. LTD. & ANR. - Opp.Party(s)

MR. NIKHIL JAIN

27 Apr 2018

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
REVISION PETITION NO. 685 OF 2017
 
(Against the Order dated 24/11/2016 in Appeal No. 1017/2016 of the State Commission Uttar Pradesh)
1. ANIL KUMAR
S/O UDAI VEER SHARMA, R/O 22 MAHENDRA NAGAR,PALI KHERA, SAUKH ROAD, NAI MANDI
MATHURA
U.P
...........Petitioner(s)
Versus 
1. HDFC ERGO GENERAL INSURANCE CO. LTD. & ANR.
FIFTH FLOOR,MEHTA TOWER,B-1 BLOCK COMMUNITY CENTRE,JANAKPURI
NEW DLEHI
2. HDFC ERGO GENERAL INSURANCE CO. LTD
NEAR BHAGAT HALWAI,ANJANA TALKIES,M.G ROAD,
AGRA
U.P
...........Respondent(s)

BEFORE: 
 HON'BLE MR. JUSTICE AJIT BHARIHOKE,PRESIDING MEMBER

For the Petitioner :
Mr. Nikhil Jain, Advocate
For the Respondent :
Ms. Suman Bagga, Advocate

Dated : 27 Apr 2018
ORDER

JUSTICE AJIT BHARIHOKE, PRESIDING MEMBER

This revision is directed against the order of the State Commission, U.P. dated 24.11.2016 in first appeal No.1017/2016 vide which the State Commission allowed the appeal preferred by the respondent/insurance company against the order of the District Forum and dismissed the complaint.

2.         Briefly put, facts relevant for the disposal of the revision petition are that the petitioner insured his truck No.RJ-05-GB-3385 with the respondent insurance company for the period 19th March, 2014 to 18th March, 2015 for a sum of Rs.17 lakhs. According to the petitioner/complainant, on 28.5.2014, the truck caught fire at around at around 10.30 pm while being driven through Yamuna Expressway. Necessary information was given to the concerned Authority on toll free number. On the receipt of information fire-brigade and the police visited the spot and extinguished the fire. The insured truck suffered damage due to fire. Necessary information was given to the respondent insurance company. The insurance company appointed a surveyor, namely, Innovative Insurance, Surveyors & Loss Accessors Pvt. Ltd.  It is the case of the complainant that above noted survey company appointed Sh. N M Kapoor as Surveyor to conduct spot survey and submit the report despite of the fact that Sh. N M Kapoor had already left Mathura and shifted to Chhattisgarh.  N M Kapoor, therefore, deputed job of survey to one Mr. A K Saxena who conducted survey. Before submitting his report,  A.K.Saxena contacted Lal Chand, Claim Manager of the opposite party and informed him that the claim of the complainant was correct.  Thereafter, the officials of the insurance company in collusion with A K Saxena with a view to defeat the right of the complainant got forged survey report prepared by A K Saxena on which A K Saxena put forged signatures of surveyor N M Kapoor.  It is also alleged that A K Saxena had demanded bribe of Rs.50,000/- from the complainant regarding which a telephonic complaint was made to the Claim Manager on 15.09.2014. 

3.         It is further alleged that despite of the fact that the  complainant contacted the Claim Manager, his claim was not settled.  Instead Claim Manager Lal Chand appointed Sh. Shashank Sharma for reassessment of the claim.  Shashank Sharma submitted his survey report in favour of the complainant but the insurance company by concealing that report repudiated the insurance claim on the basis of forged survey report.  Being aggrieved, the complainant filed consumer complaint in District Forum Agra.

4.         The opposite party on being served with the notice filed written statement denying the allegations made in the complaint.  It was denied that opposite party appointed M/s Innovative Insurance Surveyors & Loss Assessors Private Ltd. for conducting spot survey or that said company deputed N M Kapoor to conduct the survey to submit the report.  According to the opposite party, A K Saxena was appointed to conduct survey and assess the loss. However, on receipt of the complaint from the complainant that said surveyor  had asked for illegal gratification, the opposite party / insurance company appointed Zuber Ali Khan of Zuber Corporation to reinvestigate the matter and on the  basis of the report of Zuber Ali Khan, the insurance company did not accept the final survey report of A K Saxena and repudiated the claim. The opposite party also pleaded that complainant had history of similar past motor claim which raised suspicion and triggered further investigation into the claim.

5.         The District Forum on consideration of the pleadings and evidence allowed the claim and directed the opposite party / insurance company to pay to the complainant insured amount of Rs.17.00 lakhs with 6 % interest thereon from the date of filing of the complaint till the realization of the amount. Rs.10,000- was also granted as compensation for mental pain and agony.

6.         The opposite party not being satisfied with the order of the District Forum approached the State Commission in appeal.  The State Commission on re-appreciation of evidence came to the conclusion that repudiation of insurance claim by the respondent / insurance company was justified.  Consequently, the appeal was accepted, order of the District Forum was set aside and complaint was dismissed. This led to the filing of the revision petition.

7.         Learned counsel for the petitioner has contended that order of the State Commission is not sustainable as it is based on assumption that earlier also, the complainant had taken insurance claim for damage caused to truck due to fire, therefore, his claim under the instant complaint is false.  It is submitted that State Commission has failed to appreciate that A K Saxena, surveyor in  his report dated 05.06.2014 had opined that damages caused to the truck appears to be probable result of the fire accident, which stands fortified by the report of the fire brigade team which reached at the spot and extinguished the fire.  It is submitted that State Commission has committed a grave error by relying upon the report of the Zuber Ali Khan ignoring the fact that he conducted survey on 17.11.2014 i.e. after a long gap of almost eight months from the date of incident. 

8.         Learned counsel for the opposite party on the contrary has argued in support of the impugned order.

9.         I  have considered the rival contentions and perused the record.  The claim of the petitioner is on account of the alleged damage caused to the truck as its engine caught fire.  It is not in dispute that earlier also, the complainant had submitted and taken insurance claim in respect of damage caused to the truck because of fire caused due to fire circuit of the battery, the State Commission has taken a view that claim of the petitioner was suspect as it cannot be a sheer coincidence that truck of the complainant catches fire for one reason or the other time and again. In view of the aforesaid circumstances, the appointment of independent investigator after the receipt of survey report cannot be said to be unreasonable.  Zuber Ali Khan who is IRDA approved investigator in his report  has given detailed reason to conclude that fire was not caused by the short circuit in the battery but was result of arson and, a case of manipulated fire accident. The conclusion of the investigator are reproduced as under:

 “We have discussed with insured regarding IV engine inspection he said he is not available in station for three days, hence it is not possible for him to present during dismantling / inspection of IV engine.

            We  have requested insured to provide the written statement he said he will provide us the statement in details next day, however when we called him next day i.e. on dt. 18.11.2014, he said is not available in station for coming three days.

            We have visited Toll booth at Yamuna Express Way during the discussion with fire fighting team they informed us that during their visit to IV which is in flames nobody was present, neither insured nor the IV driver.

            Our scientific approach as per NFPA 921 Fire and explosive investigation, all developed hypothesis tested with collected data during our examining IV, failed to prove IV fire as accident fire.

            The fire pattern signs found on IV and our above interpretations establishes beyond any doubt the fire origin is not an accidental.

            The battery location altered by insured, 24 Volts battery kept inside the cabin which against the manufacturer specification and it is a violation of MV Act 52. 

            The accessibility to the IV engine limited even we tried to reach underneath of IV, hence much findings about the IV engine not mentioned in this report.

            We have collected the sample of debris near the engine bonnet, for testing the presence of hydrocarbons, but not sent to laboratory for testing assuming that hydrocarbons may not be present due to six month delay in collecting the sample.

            Considering above facts and findings, we are in the opinion that the fire origin is not from battery and it is not an accident fire.  The all signs found on IV lead to signs of Arson.  Hence insurer can process the claim subject to the policy terms and conditions.”

10.       I have carefully gone through the investigation report of Zuber Ali Khan, principal investigator carefully.  The report is well reasoned, therefore, the conclusion regarding the fire having been caused due to arson cannot be doubted.  The conclusion of arson in the report is further strengthened from the fact that earlier also, the complainant had taken similar insurance claim as to the damage caused to the truck due to fire.  It cannot be a sheer incidence that insured vehicle of the complainant catches fire time and again.  This circumstance goes against the claim of the  petitioner regarding accident fire and fortify the conclusion of the investigator.

11.       In view of the discussion above, I find no reason to interfere with the well reasoned order of the State Commission in exercise of the revisional jurisdiction, particularly when no jurisdictional error is pointed out in the revision petition.  Revision petition is accordingly dismissed.

 
......................J
AJIT BHARIHOKE
PRESIDING MEMBER

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