Haryana

Karnal

CC/306/2018

Pramo Devi - Complainant(s)

Versus

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

Navdeep Pal Singh

01 Oct 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                          Complaint No. 306 of 2018

                                                          Date of instt.12.11.2018

                                                          Date of Decision 01.10.2019

 

Pramo Devi, age 48 years, wife of Shri Jai Chand, resident of 16A/27, Prem Nagar, near Durga Zym, Kakroi Road Sonepat, Haryana.

 

                                                …….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 Singh 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 bearing registration no.HR51AL-2050 from the OP, vide policy no.2311202048289900001 for the period commencing from 02.01.2018 to 01.01.2019 titled as Private Car Comprehensive Policy by paying premium amount of Rs.29,427/- and the value of the car was assessed as Rs.9,60,000/-(Insured declared value). Before issuing the policy all necessary documents as such R.C., Address proof etc. were thoroughly seen and photocopies of the same were provided to the OP and the car was also inspected. On 20.05.2018 the son of complainant namely Naveen (who is holding a valid driving licence, issued by Licensing Authority, Sonepat) was going from his house at Sonepat to Samalkha at the house of his maternal uncle (Mama) from Sonepat Bye-pass and when he reached near the fields of village Devdu, all of a sudden a massive fire broke in the engine due to short circuit and the son of the complainant came out of the car in order to save his life and thereafter telephonically informed fire brigade which came at the spot and stifled (stopped/control of the fire), however the vehicle was completely burnt and beyond repair/useless and in this regard a DDR was also lodged at Police Station Sadar Sonepat, on 22.05.2018 and as per the investigation done by the police qua the fire it was found that car caught fire on 20.5.2018 due to short circuit. The officials of the fire station, Sonepat also lodged entries in this regard in their daily dairy register wherein it has corroborated by them the vehicle has been completely burnt due to fire. A sum of Rs.50/- was also given to the fire department for the charges levied in this regard. Intimation regarding the said accident was given to the OP and as a result of which surveyor was appointed and requisite formalities were completed by the complainant and the necessary documents as demanded by the OP were submitted by the complainant and the damages were thoroughly inspected and necessary photographs were taken and the survey was conducted. OP kept on delaying the matter for about 4 months without any satisfactory and reasonable cause and ultimately on 26.09.2018 the OP declined the claim of the complainant on false, frivolous and fictitious grounds. In this there is 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 maintainability; cause of action; complainant is estopped by her own act and conduct; jurisdiction and concealment of true and material facts. On merits, it is pleaded that the claim under dispute relates to the alleged incident of fire to the Insured Vehicle. That the vehicle was insured under Private Car Comprehensive Policy having policy no.2311202048289900001, valid from 02.01.2018 to 01.01.2019 subject to the provision of IMT and policy conditions, which was never disputed by the insured. As alleged in the complaint, the insured vehicle caught fire on 20.05.2018 while his son namely Naveen was travelling from Sonepat to Samalkha. The alleged incident of fire was intimated to the OP on 22.05.2018. After the alleged accident was reported to the OP, the OP appointed an IRDA licensed Surveyor as mandated under section 64UM of the Insurance Act, 1938 in order to assess the loss and damages. Further, OP also appointed an investigator cum forensic expert in order to ascertain genuine cause of the fire. During the investigation and forensic analysis done by the expert it was found that the fire was not accidental in nature but was Incendiary. As per the investigation Report, the case and origin of fire was not accidental in nature. As per the report of the expert the fire did not broke out due to self ignition. The observation made by the Forensic expert in his support of remark are reproduced herein below:-

. The cause of fire is not accidental, fire dynamics present on the exterior and interior of the car is not in support of accidental fire.

.  It is the case of multi Origins, which will not occur in the accidental fire. The amount destruction of the solid metals, like steel and aluminium is not the result of accidental fire.

. The other indications like missing fuel tank clips, missing wheel nuts, bent of valve stem, corrosion on valve head, corrosion on cylinder head, pitting on cylinder head, cylinder liner rusting, rich combustion evidence on 02 sensor, are the perfect indicators that the subject car is engine is not operational prior to the fire.

It is further pleaded that the complainant has deliberately misrepresented the cause of fire to extract money from the OP. The claim filed by the complainant was not genuine and was filed with a malafide motive to enrich himself. The misrepresentation of facts material to the claim go against the declaration 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 pleaded that the liability of the OP is governed by the terms and conditions mentioned in the policy and this cover only those perils which are specifically mentioned under the policy. Section 1 of the policy terms and conditions provides for the scope of the liability of the OP. Section 1 of  the policy reproduced as under:

“The company will indemnify the insured against loss or damage to the vehicle insured hereunder and/or its accessories thereon

1. By fire explosion, self ignition or lightening 2. By burglary housebreaking or theft 3. By riot 4. By earthquake 5. By flood 6.By accidental 7. By malicious act 8. By terrorist activity 8. Whilst in 9. By landslide.

In the present case the fire was neither cause by self explosion, self ignition or lightening but it was an incendiary fire. Therefore, the claim of fire to the insured vehicle was beyond the scope of the policy and was rightly repudiated. 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 Ex.CW1/A and documents Ex.C1 to Ex.C8 and closed the evidence on 27.05.2019.

4.             On the other hand, OP tendered into evidence affidavit of Shweta Pokhriyal Ex.RW1/A, affidavit of Zuiber Ali Khan Ex.RW1/B, affidavit of Manmeet Singh Makkar Ex.RW1/C and documents Ex.R1 to Ex.R5 and closed the evidence on 16.09.2019.

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

6.             The case of the complainant, in brief, is that the complainant insured his vehicle from the OP, vide policy no.2311202048289900001 for the period commencing from 02.01.2018 to 01.01.2019 titled as Private Car Comprehensive Policy and the same was caught fire on 20.05.2018 when the son of complainant was going Sonepat to Samlakha. The intimation in this regard was sent to OP on the same day and demanded the claim but OP repudiated the claim of the complainant on the false and frivolous grounds.

7.             On the other hand, the case of the OP is that in the present complaint, the insured vehicle caught fire on 20.05.2018 while his son namely Naveen was travelling from Sonepat to Samalkha. The alleged incident of fire was intimated to the OP on 22.05.2018. After the alleged accident was reported to the OP, the OP appointed an IRDA licensed Surveyor in order to assess the loss and damages. Further, OP also appointed an investigator cum forensic expert in order to ascertain genuine cause of the fire. During the investigation and forensic analysis done by the expert it was found that the fire was not accidental in nature but was Incendiary. As per the investigation Report, the case and origin of fire was not accidental in nature. As per the report of the expert the fire did not broke out due to self ignition. The claim filed by the complainant was not genuine. The claim of fire to the insured vehicle was beyond the scope of the policy and was rightly repudiated.

8.             On 20.05.2018 the vehicle in question caught fire, on information fire brigade reached at the spot, however, the vehicle was completely burn. On 22.05.2018 DDR Ex.C3 was lodged at Police Station Sonepat. During the investigation done by the police qua the fire it was found that car caught fire due to short circuit, intimation regarding the incident was given to the OP and as result of which Surveyor was appointed. As per version of the complainant the necessary documents as demanded by the OP were submitted by the complainant and burnt vehicle were thoroughly inspected and necessary photographs were taken and survey was conducted. On 26.09.2018 the claim of the complainant was declined by the OP.

9.             The claim of the complainant has been repudiated, vide repudiation letter Ex.R1 by the OP on ground that the cause of the fire was not accident fire dynamics present on the exterior and interior of the car were not in support of accidental fire. It was the case of multi origins fire eruption, which will not occur in the accidental fire. The amount of destruction of the solid metals, like steel and aluminum was not the result of accident fire.  The other indications like missing fuel tank clips, missing wheel nuts, bent valve stem, corrosion on valve head, corrosion on cylinder head, pitting on cylinder head, cylinder liner rusting rich combustion evidence on 02 sensor, were the perfect indicators that the subject car engine was not operational prior to the fire. Wrong vehicle registration date was informed to enhance IDV.

10.            As per the version of the OP, the matter was referred to Forensic Expert for investigation and through investigation was carried out and found that cause of loss is not accidental in nature. The damages are not accidental in nature. As per Motor Survey Report Ex.R2, Pre-accident condition of the vehicle was satisfactory. The incident took place on 20.05.2018 at about 3.30 p.m. The surveyor of the OP inspected the vehicle first time on 26.05.2018. As per version of the OP they have intimated the accident on 22.05.2018. The vehicle was surveyed in M/s ASR Automobiles Sonepat. The burnt vehicle had been shifted in the workshop with the help of crane.

11.            The vehicle in question was inspected by Zuber Ali Khan and he submitted fire Origin & Cause (O&C) investigation report Ex.R3 dated 28.08.2018. The fire claim of the complainant has been repudiated by the OP on the basis of said report. As per report, the said Zuber Ali Khan, allegedly as Independent Forensic Consultant stated in his affidavit Ex.RW1/B, he has examined the vehicle at the workshop on 19.07.2018 i.e. after 2 months (20.5.2018) of the accident. As per report there were missing fuel tank clips, missing wheel nuts, bent of valve stem, corrosion of valve head, corrosion on cylinder head, pitting on cylinder head etc. etc.

12.            The vehicle in question was inspected by the surveyor of OP after expiry of two months of accident, the said vehicle had been shifted in the workshop through crane. The possibility of missing the part in the way and in the workshop cannot be ruled out. Moreover, Zuber Ali Khan stated to be a independent Forensic Consultant has not produced any certificate in this regard.

13.            Second plea of the OP is that at the time of insured the vehicle in question, the wrong vehicle registration date was informed by the complainant to enhance IDV. As per Registration Certificate Ex.C5 manufacturer year of vehicle is 2010 and in the insurance cover note Ex.C1/Ex.R4 manufacturer year also shown as 2010. Moreover, at the time of insurance the any vehicle the same was done after verification of the reinvestigation concrete and other document. So, there is no force in the plea taken by the OP. As per insurance cover note Ex.C1/Ex.R4 the IDV value of the vehicle in question is Rs.9,60,000/-. It is admitted facts that vehicle in question has been totally burnt/damaged and now not roadworthy. Thus, in view of the above discussion, we are of the confirmed view that act of the OP amounts to deficiency in service and unfair trade practice.

14.            Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OP to pay Rs.9,60,000/- as insured amount to the complainant with interest @ 9% per annum from the date of repudiation of the claim till its realization subject to furnishing of subrogation letter, transfer of ownership of vehicle, indemnity bond and undertaking by the complainant within 15 days in the name of OP. We further direct the OP to pay Rs.25,000/- to the complainant towards compensation for mental and physical harassment and to pay Rs.11,000/- as litigations expenses. This order shall be complied with within 30 days from the date of receipt of the 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:01.10.2019                                                                       

                                                                  President,

                                                           District Consumer Disputes

                                                           Redressal Forum, Karnal.

               

        (Vineet Kaushik)          (Dr. Rekha Chaudhary)

            Member                               Member