Haryana

Karnal

CC/8/2019

Nirmal Singh - Complainant(s)

Versus

HDFC Ergo General Insurance Company Limited - Opp.Party(s)

Navdeep Pal Singh

27 Feb 2020

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                          Complaint No. 08 of 2019

                                                          Date of instt.03.01.2019

                                                          Date of Decision 27.02.2020

 

Nirmal Singh, age 36 years son of Shri Jagmal Singh, resident of Ekta Vihar Colony, Panipat.

                                                 …….Complainant.

                                              Versus

 

HDFC Ergo General Insurance Co. Ltd. SCO 237, Second floor, Sector 12, Karnal, through its Branch Manager.

 

                                                                        …..Opposite Party.

 

           Complaint u/s 12 of the Consumer Protection Act. 

 

Before    Sh. Jaswant Singh……President. 

      Sh.Vineet Kaushik ………..Member

                Dr. Rekha Chaudhary…….Member

 

 Present:  Shri Navdeep Pal Advocate for complainant.

                   Shri Sanjeev Vohra Advocate for opposite party.

                                              

                   (Jaswant Singh President)

ORDER:                    

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that complainant got insured his vehicle Fluidic Verna 1.6 CRDI SX bearing registration no.HR-51-AS-9303 with the OP, vide policy no.2311201870704800000 for the period commencing from 10.08.2017 to 09.08.2018 under the companies policy titled as Private Car Comprehensive Policy. The insured declared value (IDV) of the vehicle is Rs.8,00,000/- and the complainant is holding a valid driving licence. On 22.07.2018 at about 2 p.m. the complainant was going in the said car from Karnal to Panipat and when he reached near Pucca-Pul, Madhuban then a tralla which was going ahead of the said car stopped suddenly because a stray cow had come in front of the said tralla and driver of the said tralla applied its breaks suddenly in order to save the said cow as a result of which car of the complainant dashed into the back of the said tralla and a car which was coming behind the car of the complainant hit in the back of car of the complainant due which car was badly damaged, and a DDR no.16 in this regard was lodged on 30.07.2018, in Police Station Madhuban, Karnal. The intimation regarding the said accident was made to the OP on the date of incident and as a result of which surveyor was appointed by the OP and requisite formalities were completed by the complainant and the necessary documents as demanded by the OP were submitted. The damaged was thoroughly inspected and necessary photographs were taken by the surveyor. The surveyor after going through the claim, insurance particulars, vehicle particulars, driver’s particulars, accident particulars, police report, third party’s particulars, cause and nature of accident, survey, estimate of repairs submitted a Motor (Final) Survey Report to the OP upon the basis of which the OP repudiated the claim of the complainant, vide letter dated 21.09.2018 on the false and flimsy ground. In this way there was deficiency in service on the part of the OP. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OP, who appeared and filed written version raising preliminary objections with regard to jurisdiction; cause of action and concealment of true and material facts. On merits, it is pleaded that the vehicle in question met with an accident on 27.07.2018 having policy number 2311201870704800000, valid from 10.08.2017 to 09.08.2018. After receiving the intimation regarding the said accident, OP appointed the surveyor duly authorized by the IRDA, in order to assess the loss and damage sustained by the insured vehicle and to further verify the genuineness of the facts of the alleged accident. Thereafter, the surveyor after minute inspection filed his survey report. During survey it has been observed by the surveyor that “the damages sustained by the vehicle were not co-relating with the cause of accident as narrated.” The surveyor further observed and opinioned that:

. There was no impact on front members but Air Bag were found deployed.

. While checking minutely, it was found that plastic covering of Air Bags was             

  deliberately cut and loss was aggravated.

. Outer damages were not matching with the cause stated as per claim form.

. Pattern of damages inside the engine compartment is also not symmetrical.      

  Vertical impacts were found on a few parts fitted in engine compartment.

. Front bumper was totally safe whereas condenser, which is situated behind      

  the bumper is damaged.

. Vertical impacts were found on battery, air clear, outer body, intake        

   manifold, injector turbo, Injector Oil cooler. As per the surveyors opinion,  

  these parts seems to be deliberately damaged by hammering on said parts.

. As per the cause of accident, the vehicle should have been damaged from     

   front side whereas during inspection under body damages were also notices.

. While scrutinizing the documents it was found that actual date of purchase

 was March 2012, whereas it was informed to us that date of purchase was

 15.08.2017, there was misrepresentation about the purchase date so that

 IDV could be enhanced.

By misrepresenting the false facts of the accident/loss/damage, the complainant himself had played the fraud upon the OP.  Hence the claim of the complainant was rightly repudiated on the ground of misrepresentation of facts and on the basis of survey report which states that the damages as claimed through the alleged accident are unrelated to the case of accident as reported in the claim form. There is no deficiency in service on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence his affidavit Ex.CW1/A and documents Ex.C1 to Ex.C12 ad closed the evidence on 10.06.2019.

4.             On the other hand, OP tendered into evidence affidavit of Shweta Pokhriyal Ex.RW1/A and documents Ex.R1 to Ex.R6 and closed the evidence on 08.01.2020.

5.             We have heard the learned counsel for both the parties and perused the case file carefully and have also gone through the evidence led by the parties.

6.             Admittedly, the vehicle in question met with an accident during the subsistence of the policy. The claim of the complainant was repudiated by the OP, vide repudiation letter Ex.C6 (Ex.R1) on the opinion of surveyor which reproduced as under:-

. There was no impact on front members but Air Bag were found deployed.

. While checking minutely, it was found that plastic covering of Air Bags was            

  deliberately cut and loss was aggravated.

. Outer damages were not matching with the cause stated as per claim form.

. Pattern of damages inside the engine compartment is also not symmetrical.     

  Vertical impacts were found on a few parts fitted in engine compartment.

. Front bumper was totally safe whereas condenser, which is situated behind     

  the bumper is damaged.

. Vertical impacts were found on battery, air clear, outer body, intake       

   manifold, injector turbo, Injector Oil cooler. As per the surveyors opinion, 

  these parts seems to be deliberately damaged by hammering on said parts.

. As per the cause of accident, the vehicle should have been damaged from    

 front side whereas during inspection under body damages were also   

  notices.

. While scrutinizing the documents it was found that actual date of purchase

 was March 2012, whereas it was informed to us that date of purchase was

 15.08.2017, there was misrepresentation about the purchase date so that

 IDV could be enhanced.

 

7.             The claim of the complainant has been repudiated by the OP on the abovementioned grounds. Thus, the onus heavily lies upon the OP to prove his case against the complainant by leading cogent, convincing and concrete evidence, for that the OP has failed to lead the same.

8.             Neither the surveyor who has surveyed the vehicle in question examined by the OP nor his affidavit has been tendered during the course of evidence in the present case.

9.             The accident took place on the National Highway near Pucca-Pul which is very busy place and there is no for possibility for deliberately damaging the vehicle in question by the complainant specifically when it is not a case of the OP that the vehicle in question was not surveyed at the spot.

10.            From the survey report Ex.R3 alongwith photographs placed by the OP, parts and accessory quotation Ex.C5 and photographs Ex.C7 to Ex.C12 placed by the complainant on record, it has been proved that accident was major on. Hence, grounds taken by the OPs in repudiation letter is not sustainable in the eyes of law.

11.            While repudiating the claim of the complainant, OP has also taken a ground that the actual date of purchase of the vehicle was March, 2012 whereas complainant has informed the OP that date of purchase was 15.08.2017 and there was misrepresentation about the purchase date so that IDV could be enhanced. This ground of the OP is vague as at the time of getting the vehicle insured, all documents relating to vehicle and vehicle is itself used to be inspected by the insurance company and only after that vehicle is got insured. It becomes a trend of the insurance companies to repudiate the genuine claim of the customer on the unjustified grounds.

12.            In case New India Assurance Company Limited Versus Smt. Usha Yadav & others 2008(3) R.C.R. (Civil) 111, the Hon’ble Punjab and Haryana High Court expressed its anguish and observed as follows:-

        “It seems that the Insurance Companies are only interested in earning the premiums, which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance Companies make the effected people to fight for getting their genuine claims. The insurance companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus, pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy.”

Keeping in view the ratio of the law laid down by the Hon’ble Punjab & Haryana High Court, facts and circumstances of the case, we are of the considered view that the act of the OP amounts to deficiency in service and unfair trade practice.

13.            As per the insurance policy Ex.C1 (Ex.R6) the IDV of the vehicle in question is Rs.8,00,000/- and as per Motor Survey Report Ex.R3, total loss assessed by the surveyor of the OP as Rs.8,26,264/-. Thus, complainant is entitled for the IDV of the vehicle i.e. Rs.8,00,000/- alongwith compensation and litigation expense.

14.            Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OP to pay Rs.8,00,000/- the insured declared value(IDV) of the vehicle in question with interest @ 9% per annum from the date of repudiation of the claim till its realization. We further direct the OP  to pay Rs.20,000/- to the complainant on account of mental agony and harassment suffered by him and  Rs.5500/- for the litigation expense. The complainant is also directed to transfer the vehicle in question in the name of OP and also deposit the salvage of the vehicle with OP.  This order shall be complied within 30 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:27.02.2020                                                                       

                                                                      President,

                                                              District Consumer Disputes

                                                               Redressal Forum, Karnal.      

 

 

         (Vineet Kaushik)         (Dr. Rekha Chaudhary)

            Member                         Member