Haryana

Karnal

CC/356/2018

Veena Rani - Complainant(s)

Versus

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

Sandeep Kalyan

04 Feb 2020

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                          Complaint No. 356 of 2018

                                                          Date of instt.18.12.2018

                                                          Date of Decision 04.02.2020.

 

Veena Rani aged about 45 years wife of Shri Dharamvir Singh resident of village Phoosgarh Tehsil and District Karnal through her special power of attorney Shri Dheeraj son of Dharamvir resident of Phoosgarh Tehsil and District Karnal. Aadhaar no.58252542 3044. Mobile no.9467673003.

 

                                                 …….Complainant.

                                              Versus

 

1. HDFC-ERGO General Insurance Company Limited SCO 237, 2^nd floor, Sector 12, Karnal through its Branch Manager.

2.  Rahul Pam Private Limited, Adjoining Sudhanshu Ji Maharaj Ashram opposite Himalaya Cold Storage, G.T. Road, Karnal through its owner.

 

                                                                         …..Opposite Parties.

 

           Complaint u/s 12 of the Consumer Protection Act. 

 

Before    Sh. Jaswant Singh……President. 

                Sh. Vineet Kaushik……Member   

                Dr. Rekha Chaudhary…….Member

 

 Present:  Shri Sandeep Kalyan Advocate for complainant.

                   Shri Sanjeev Vohra Advocate for OP no.1.

                   Shri Rahul Bali Advocate for OP no.2.

                 

                   (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 has go abroad for a long time and as such she herself is not able to appear and proceed with this complaint of her own and as such she has appointed his son Shri Dheeraj as his special power of attorney to file the present complaint. The complainant is the registered owner of XCENT car bearing registration no.HR-05AS-0808 and he got the same insured with the OP no.1 at the asking of the OP no.2 as the OP no.2 asked complainant that he is having tie up with the OP no.1 and in case of any damage or accident, he will repair the same and payment will be collected from the OP no.1 as it is cashless policy. The OP no.1 after inspection assessed the value of said vehicle as Rs.4,77,000/- and charged an amount of Rs.17,377/- as premium of said vehicle. OP no.1 issued insurance policy no.23112020194123900000, which was valid from 26.04.2018 to 25.04.2019.  On 26.04.2018 the son of complainant namely Dheeraj was driving the said car and on that day the car was met with accident in the area of police station Basti Dodhwal District Ludhiana, Punjab qua which an FIR no.170 dated 27.04.2018 was registered by the police. Said accident was caused by driver of the motorcycle no.PB-10EV-9920 who was driving his vehicle in a very rash and negligent manner. After this accident the complainant intimated the OPs about the said accident and OP no.1 got inspected the said vehicle from its authorized surveyor. The OP no.1 told the complainant to get the said vehicle repaired from OP no.2 and entire payment will be paid to him by OP no.2. However, OP no.1 got completed certain formalities from the complainant and lodged the claim of the complainant vide claim no.C230018062077. The complainant took his vehicle at the workshop of the OP no.2 for its repairing and OP no.2 prepared estimate of repairing of said vehicle as Rs.430517/-. Thereafter, complainant visited the OP no.2 for getting his vehicle and then OP no.2 stated that his estimate has not yet been approved by OP no.1 and it would costs about one week more and advised complainant to wait for one week more. The complainant agreed for same. Thereafter, complainant received a letter dated 25.06.2018 from the OP no.1, vide which the claim of the complainant has been repudiated by taking excuse of condition no.4 of  the policy. In which it is stated that the vehicle was left unattended without proper precautions. On receiving of the said letter complainant contacted the OPs so many times and requested that at the time of accident several peoples gathered there and were bent upon to kill the son of the complainant and at that time it was his prime duty to save his life and not to keep the vehicle at another safe place as such he has to run from spot. But OPs did not pay any heed to the request of the complainant. In this way there was deficiency in service on the part of the OPs. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OPs, OP no.1 appeared and field written version raising preliminary objections with regard to complaint is premature; cause of action and concealment of true and material facts. On merits, it is pleaded that the claim of the complainant was closed by the OPs on the ground of non-submission of the requisite documents i.e. Mechanical report from the police station after release of the vehicle, detail of injury or death of third party & claim detail in previous policy,” as sought by the OP. The complainant even after various repeated requests and reminders letters failed to submit the requisite documents. In absence of the requisite documents the OPs were not able to decide the claim on merits and therefore the same was closed and not repudiated. It is further pleaded that the complainant has overlooked the closure letter send by the OP, by considering the same as repudiation letter, and thus filed the present complaint. It is further pleaded that the closure letter mentioned the fact that company is not liable to pay the damages which happened against the rear side damages, as the damages to rear side happened, due to the fault of the complainant, as after the vehicle actual met with the accident from the front side with a bike, thereafter, the vehicle was left unattended at the spot of accident. The vehicle was left unattended due to which the vehicle was dashed by another vehicle from rear side. However, the complainant in order to gain the sympathy of the court, presented the concocted story. It is further pleaded that the complainant intimated about loss to the OP alleging that the insured vehicle met with an accident, soon after intimation the claim was processed, and the OP duly appointed an IRDAI approved and licensed surveyor, in order to assess the loss and damages sustained by the insured vehicle. The OP also simultaneously appointed an independent investigator in order to verify the genuineness of the facts of the alleged accident. Thereafter, requests were made vide letter dated 25.06.2018 to the complainant for submission of documents, for the purpose of verification and processing of the claim of the complainant, however the complainant failed to provide the requisite documents. There is no deficiency in service on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             OP no.2 filed his separate written version raising preliminary objections with regard to mis-joinder and non-joinder of necessary parties; maintainability; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that as per submissions put forwarded in the FIR, it was the fault of driver of car bearing registration no.HR-05-AS-0808, which resulted into accident. It is further pleaded that the official of the OP no.1 had duly issued a letter dated 25.06.2018, which is self explanatory and the relevant portion of the same reads as under:-

        “Also claim sent for investigation in which it has been confirmed by you that after accident of your vehicle with biker from front side. The vehicle was left unattended at the spot of accident. After few hours of accident, a truck hit over your vehicle from rear side. For this we would like to bring policy condition no.4 or your information.”

        “Moreover, in view of above, we would not able to honor the liability for rear side damages. Only front side damages which were happened due to hit of biker can be covered as per policy terms and conditions.”

It is further pleaded that OP no.2 has no concern with regard to repudiation of claim. There is no deficiency in service on the part of the OP no.2. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

4.             Complainant tendered into evidence his affidavit Ex.CW1/A and documents Ex.C1 to Ex.C8 and closed the evidence on 13.09.2019.

5.             On the other hand, OP no.1 tendered into evidence affidavit of Shweta Pokhriyal Ex.RW1/A and documents Ex.R1 to Ex.R9 and closed the evidence on 03.01.2020.

6.             On the other hand, OP no.2 tendered into evidence affidavit of Pankar Dhiman Ex.OP2/A and document Ex.OP2/B and closed the evidence on 03.01.2020.

7.             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.

8.             The case of the complainant, in brief, is that he got insured his vehicle bearing registration no. no.HR-05AS-0808 with OP no.1, vide policy no.23112020194123900000, which was valid from 26.04.2018 to 25.04.2019.  On 26.04.2018        the vehicle of the complainant met with an accident and in this regard complainant registered FIR no.170 dated 27.04.2018 in the concerned police station. Thereafter, complainant intimated OP regarding the said accident and lodged her claim with the OP no.1 but OP no.1 failed to settle the claim of the complainant.

9.             On the other hand, the case of OP no.1, in brief, is that the claim of the complainant was closed on the ground of non-submission of the requisite documents i.e. Mechanical report from the police station after release of the vehicle, detail of injury or death of third party & claim detail in previous policy,” Further, the vehicle was left unattended by the complainant due to which the vehicle was dashed by another vehicle from rear side.

10.            The case of the OP no.2, in brief, is that OP no.2 has no concern with regard to repudiation of claim.

11.            Admittedly, the vehicle in question met with an accident during the subsistence of the policy. An FIR Ex.C5 got lodged by the driver of the motorcycle against the driver of the insured vehicle. The claim of the complainant has been closed by the OPs, vide letter Ex.C4/Ex.R1 on the following grounds:-

i)       Mechanical report from the police station after release of the vehicle;

ii)      Detail of injury or death of third party.

iii)     Claim detail in previous policy.

iv)     The vehicle in question left by the complainant unattended.

12.            At the time of accident the vehicle in question was driven by Dheeraj who is son of the complainant. It is not the case of the OP that Dheeraj was not having a valid driving licence. It is admitted that the FIR (Ex.C5) (translation thereof is Ex.R6) was lodged against Dheeraj Kumar by Sahul Misra.

13.            As per the version of the complainant when his vehicle met with an accident many people gathered there for causing injury to him, therefore, in order to save him, he ran away from the spot. Due to that, the vehicle has to left unattended by the complainant which is beyond his control.

14.            With regard to remaining queries, the OP can easily collect the same from the concerned quarters. As per the recommendation given in Ex.R8 by investigators of the OP, they do not find any misrepresentation of facts on the part of the insured.

15.            In view of the above facts and circumstances of the case, we are of the considered view that when the investigators of the OP specifically observed that there is no misrepresentation of the facts on the part of the insured, then claim of the complainant cannot be closed, same otherwise proved as genuine. Thus the act of the OP no.1 while closing the claim of the complainant amounts to deficiency in service. The IDV of the vehicle in question is Rs.4,77,000/-. Surveyor of the OP no.1 Shri B.B. Chawla assessed the loss, vide report Ex.R7 as Rs.3,42,985/-. So, the complainant is entitled for the 3,42,985/-.

16.            Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OP no.1 to pay Rs.3,42,985/- to the complainant with interest @ 9% per annum from the date of closing of the claim till its realization. We further direct the OP no.1 to pay Rs.20,000/- to the complainant on account of mental agony and harassment and Rs.5500/- towards the litigation expenses. This order shall be complied with 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:04.02.2020                                                                       

                                                                  President,

                                                           District Consumer Disputes

                                                           Redressal Forum, Karnal.

 (Vineet Kaushik)    (Dr. Rekha Chaudhary)

    Member                  Member