Haryana

Karnal

CC/13/2021

Raman Kumar - Complainant(s)

Versus

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

Mange Ram Sangwan

05 Oct 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                        Complaint No. 13 of 2021

                                                        Date of instt.11.01.2021

                                                        Date of Decision: 05.10.2023

 

Raman Kumar son of Shri Janardhan Sharma, resident of village Isho-Pur Tehsil Jagadhri, District Yamuna Nagar.

 

                                                                        …….Complainant.

                                              Versus

 

1. HDFC Ergo General Insurance Company Ltd. through its Branch Manager SCO no.237, 2^nd floor Sector-12, opposite mini secretariat, Karnal.

 

2. HDFC Ergo General Insurance Company Ltd. through its Senior Manager 1^st floor 165-166 BackBay Reclamation H.T. Parekh Marg ChruchGate Mumbai-400020.

 

                                                                      …..Opposite Parties.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.       

              Sh. Vineet Kaushik…….Member

              Dr. Rekha Chaudhary……Member

          

 Argued by: Shri M.R. Sangwan counsel for complainant.

                    Shri Sanjeev Vohra, counsel for the OPs.

 

                    (Jaswant Singh, President)

ORDER:  

                The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019, against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant is registered owner of car Skoda Laura L and K 2.0 TDI model 2009, bearing registration no.HR 51 AF-5963. The said vehicle has been insured by complainant with the OPs, vide policy no.2311100295210300000, valid from 31.03.2018 to 30.03.2019 and the insured declared value of the vehicle is Rs.7,07,327/-. OPs received the premium of Rs.26008 with basic own damage, personal cover for owner driver of Rs.20000/-. On 26.02.2019, complainant was going from Yamuna Nagar to Delhi and in the way near Namaste Chowk, Karnal, the said vehicle met with an accident. In the said accident, the vehicle of complainant was totally damaged. The matter was reported to the local police, the police registered the DDR no.21 dated 26.02.2019. The intimation in this regard was also sent to OPs and on the instruction of the OPs, the vehicle was picked from the place of accident and was parked in the authorized parking of authorized service centre Sidak Automibiles Tepla Ambala with the help of Baga Crane Service Karnal, on dated 27.02.2019. OPs appointed a surveyor, complainant submitted all the concerned documents with claim form to the surveyor of the OPs as well as to the OPs and the claim of the complainant was registered, vide claim no.C-230018427413, showing the inspection date of vehicle as 06.03.2019. The claim of the complainant has not been settled till 17.05.2019 and a letter was issued to complainant on 17.05.2019 alleging “wrong information of registration on RC, wrong information about the RTO location and wrong date of purchase has been provided”. Complainant visited the office of OPs and requested to remove these type of irrelevant allegation and requested that when complainant had submitted all the concerned documents  i.e. RC, DL, insurance policy, DDR, medical report and other concerned documents to OPs, then why they are harassing him leveling such type of allegations. Again the claim of complainant had not been settled till 01.12.2020, so on 01.12.2020, complainant had sent a registered notice to OPs, but till today neither the reply to the notice has been sent nor the claim of the complainant has been settled till today and orally it has been told to the complainant that file of complainant has been closed with remarks no claim. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

2.             On notice, OPs appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that complainant purchased the policy in question from the OPs.  It is further pleaded that the said policy was purchased by the complainant through on-line portal, i.e. from policy Bazaar. The policy in question was purchased from policy Bazaar and therefore all the documents were submitted to the said entity. The OPs had issued the policy in good faith relying on all the information provided by the web Aggregator i.e. policy Bazaar and further which might have been provided by the complainant to the web aggregator at the time of policy procurement. It is further pleaded that the insured vehicle met with an accident on 26.02.2019 and the same was intimated to the OPs on 04.03.2019 i.e. after delay of almost 5-6 days and moreover the said delay has no reasonable justification. It is further pleaded on receipt of the claim intimation, OP appointed an IRDA licensed surveyor, Manmeet Singh Makkar, as mandated under section 64UM of the Insurance Act, 1938 for verification and assessment of damages. The surveyor after minute inspection filed his survey report, with the observations that damages of the insured vehicle does not correlate with the cause of accident mentioned in the claim form and there were multiple damages on the vehicle. During the processing of claim when the documents of the complainant were being reviews, the following discrepancies were observed:-

1. Discrepancy in date of registration. As per RC, the vehicle was registered on 23.10.2009, however, when the policy was purchased, the date of registration was misrepresented as 31.12.2011, which ultimately affected the IDV of vehicle.
2. Discrepancy in RTO location: As per RC, the correct RTO for the insured vehicle was Jagadhari, however, the same information was also misrepresented as RTO, Mumbai.
3. Discrepancy in purchase date of the vehicle: As per vehicle RC vehicle manufacture year is 06/2019 and registration date is 23.10.2009 but provided purchase date was 31.12.2014.

It is further pleaded that by misrepresenting the false facts of the accident/loss/damage, the complainant himself had played the fraud upon the OPs. It is further pleaded 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. There is no deficiency in service and unfair trade practice on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of registration certificate, copy of insurance policy Ex.C2, copy of crane service receipt Ex.C3, copy of DDR no.21 dated 26.02.2019 Ex.C4, copy of OPD slip dated 20.02.2019 Ex.C5, copy of legal notice dated 01.12.2020 Ex.C6, postal receipts Ex.C7 and Ex.C8, acknowledgement Ex.C9 and closed the evidence on 29.03.2022 by suffering separate statement.

5.             On the other hand, learned counsel for the OPs has tendered into evidence affidavit of Manoj Kumar Prajapat, Manager Ex.RW1/A, copy of claim form Ex.R1, copy of survey report Ex.R2, copy of letters dated 17.05.2019 and 23.05.2019 Ex.R3 and Ex.R4, copy of insurance policy Ex.R5 and closed the evidence on 16.05.2023 by suffering separate statement.

6.             In additional evidence, OPs has tendered affidavit Ashok Kumar Surveyor Ex.RW2/A and survey report Ex.R6 and closed its additional evidence on 08.08.2023 by suffering separate statement.

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

8.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got his vehicle insured with the OPs. On 26.02.2019, the vehicle of complainant met with an accident and in the said accident, the vehicle  was totally damaged. A DDR no.21 dated 26.02.2019 got lodged in this regard. The intimation was also sent to OPs. On receipt of intimation, OPs appointed a surveyor to assess the loss. Complainant submitted all the required documents with claim form to the OPs. The claim of the complainant has not been settled by the OPs despite repeated requests and visits of the OPs and prayed for allowing the complaint.

9.             Per contra, learned counsel for the OPs, while reiterating the contents of written version, has vehemently argued that the insured vehicle met with an accident on 26.02.2019 and the same was intimated to the OPs on 04.03.2019 i.e. after delay of almost 5-6 days. On receipt of the claim intimation, OP appointed an IRDA licensed surveyor, Manmeet Singh Makkar, for verification and assessment of damages. The surveyor has submitted his report with the OPs with the observations that damages of the insured vehicle does not correlate with the cause of accident mentioned in the claim form and there were multiple damages on the vehicle. During the processing of claim so many discrepancies were observed. He further argued that complainant neither submitted the required documents nor cooperate the investigator. Thus, the claim of the complainant was rightly repudiated by the OPs and lastly prayed for dismissal of the complaint.

10.           We have duly considered the rival contentions of the parties.

11.           Admittedly, complainant got his vehicle insured with the OPs. It is also admitted that the insured declared value of the vehicle in question is Rs. 7,07,327/-

 12.          The claim of the complainant has been denied by the OPs, vide letter Ex.R4 dated 23.04.2019 on the grounds, which are reproduced as under:-

1.  Wrong information about the date of registration on RC is 23.10.2009, but provided date of registration was 31.12.2011.
2.  Wrong information about the RTO location was given. It was    informed that RTO was Mumbai whereas actual RTO as per RC is Jagadhari.
3. Why purchase date was provided wrongly. As per vehicle RC vehicle manufacturing year is 06/2009 and registration date is 23.10.2009 but provided purchase date was 31.12.2014.

We may also apprise you that misrepresentation of facts, material to the claim goes against the declaration on the revere side of the claim form.

In the light of the above, we regret to inform your that we would not be able to honour our liability for the abovesaid loss and are repudiating the above claim as No Claim.

13.           The OPs have also alleged that as per RC vehicle manufacturing year is 06/2009 and registration date is 23.10.2009, but complainant had provided the date of registration as 31.12.2011 and complainant had provided the purchased date as 31.12.2014.In this regard, generally, the vehicle got insured by the insurance companies on the inspection of vehicle, checking the registration certificate of the vehicle and other documents like previously insurance policy etc. It is not possible that the OPs had insured the vehicle without inspection of the vehicle, checking the registration certificate of the vehicle and other documents like previously policy etc.  The allegations raised by the OPs are irrelevant and there is no legal hitch to decide the claim of complainant in the guise of the alleged grounds. Hence plea taken by the OPs has no force.

14.            Further,  Hon’ble Punjab and Haryana High Court in case titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, has held as under:-

“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”.

15.           Keeping in view the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, we are of the considered view that act of the OP while repudiating the claim of the complainant amounts to deficiency in service.

16.           The complainant only placed on file copy of registration certificate of vehicle in question Ex.C1, copy of insurance policy Ex.C2, copy of cash/credit memo of Rs.3500/- Ex.C3, copy of DDR Ex.C4, copy of OPD slip Ex.C5 and copy of legal notice Ex.C6 and except these documents there is nothing on the file to prove that vehicle of complainant was become totally damaged. Rather, OPs have placed on file survey report Ex.R2 dated 12.06.2019. As per survey report, the net loss assessed by the surveyor as Rs.2,50,855/-. Hence, the report of the surveyor will prevail and complainant is entitled for the loss as assessed by the surveyor.  In this regard we are relying upon the authority 2(2008) CPJ paged 182 (NC), United India Insurance Co. Vs. Maya, wherein it has been held that a surveyor report should not be dismissed summarily as the surveyor is independent and qualified person under the relevant provision of Insurance Act, 1938. In view of this authority as well as the facts and circumstances of the case, we are of the considered view that the OPs are liable to pay the loss assessed by the surveyor alongwith interest, compensation for mental agony and harassment and litigation expenses.

17.           In view of the above discussion, we partly allow the present complaint and direct the OPs to pay Rs.2,50,855/- (Rs. two lakhs fifty thousand eight hundred fifty five only) alongwith interest @ 9% per annum from the date of repudiating the claim i.e. 23.05.2019 till its realization. We further direct the OPs to pay Rs.20,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.11,000/- for the litigation expenses. This order shall be complied within 45 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:05.10.2023                                 

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

(Vineet Kaushik)        (Dr. Rekha Chaudhary)

                          Member                      Member