Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 436
Instituted on : 02.09.2019
Decided on : 23.02.2023
Anil son of sh. Jagbir Singh resident of village Behlba Tehsil Meham Distt. Rohtak. .
...................Complainant.
Vs.
- HDFC ERGO General Insurance Com. Ltd. Office at office at 1st Floor, 165-166. Backbay, Reclamation HT Parek Marg, Church Gate, Mumbai, through its Manager.
- HDFC ERGO General Insurance Company Ltd. office at Business Park, 6th Floor, Andheri kurla, Mumbai400059, through its Manager.
- HDFC ERGO General Insurance Company Ltd. office at 2nd Entrance Delhi Bye pass, Rohtak, opposite sector-1, Rohtak-124001, through its Managing / Authorized signatory/ Principal officer.
- Sunny Goel, Surveyor and Loss Assessor, HDFC ERGO, General Insurance Company Ltd., Rohtak.
....……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR.TRIPTI PANNU, MEMBER.
DR. VIJENDER SINGH, MEMBER.
Present: Sh.Devender Singh, Advocate for the complainant.
Sh.Gulshan Chawla, Advocate for opposite party No.1 to 3.
Opposite party No.4 exparte.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case, as per the complainant are that he got insured his vehicle bearing registration no.HR-32J-8731 with HDFC ERGO General Insurance Company Ltd. at Rohtak vide policy no. 2311100331848500002 for the period from 13.07.2018 to 12.07.2019 and 1DV value of same as per insurance policy is Rs.7,00,000/-. That on 15.12.2018 aforesaid vehicle of the complainant met with an accident near Jind bye pass, Rohtak caused by some unknown vehicle and in this accident this vehicle suffered total damage. The complainant duly intimated to the respondents about the damage suffered to the said vehicle within time. Opposite party deputed surveyor Mr. Suny Goel for survey who inspected the said damage vehicle and submitted his report. Complainant submitted all the documents as required by the surveyor and submitted his claim form with the opposite parties. But the respondents issued letter dated 08.04.2019 vide which respondents in an illegal and arbitrary manner has treated the claim of the complainant as ‘No claim’. The complainant after receiving the said letter time and again contacted to the respondents and requested to withdraw the said letter and to settle and disburse the claim amount on total loss basis of said vehicle but respondents refused to accede the request of complainant. The act of opposite parties is illegal and amounts to deficiency in service. Hence this complaint and it is prayed that opposite parties may kindly be directed to pay Rs.7,00,000/- as claim amount of said damaged vehicles along with interest @ 18% p.a. from the date of accident till realization to the complainant and also to pay Rs. 25,000/- as compensation on account of deficiency service and Rs.11000/- as litigation expenses to the complainant.
2. After registration of complaint, notice was issued to the opposite parties. Opposite parties No.1 to 3 appeared and filed their reply. In preliminary objections they have submitted that the claim of the complainant was repudiated on the ground of misrepresentation of facts, as it was apprised from the report of surveyor that the damages as claimed through the alleged accident are unrelated to the cause of accident as reported in the claim form. The damages do not commensurate with the cause of loss as mentioned by the complainant in the claim form. On merits it is submitted that the complainant in regard to the own damage claim of insured vehicle has alleged that the vehicle in question has suffered a loss on 15/12/2018, stating that "an oncoming truck hit into insured car & insured car got unbalanced and got overturned thus the insured car got damaged.". That on the receipt of the claim intimation, answering opposite party appointed an IRDA approved surveyor, namely Sunny Goel, to assess the loss qua the vehicle in question. Thereafter, the surveyor after minute inspection filed his survey report, with the observations that damages of the insured vehicle do not correlate with the cause of accident mentioned in the claim form. That based upon the report submitted by Independent Surveyor, answering opposite party has rightly repudiated the claim of the complainant vide letter dated 08/04/2019, duly served upon by the complainant. There is no deficiency in service on the part of opposite parties. All the other contents of the complaint were stated to be wrong & denied and opposite parties prayed for dismissal of complaint with costs.
3. However, opposite party No.4 did not appear despite service and as such opposite party No.4 was proceeded against exparte vide order dated 25.10.2019 of this Commission.
4. Ld. Counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, and document Ex.C1 to Ex. C12 and has closed his evidence on dated 02.11.2021. Ld. counsel for the opposite party No.1 to 3 has tendered affidavit Ex.RW1/A, Ex.RW2/A and document Ex.R1 to Ex.R4 and closed his evidence on 01.09.2022.
5. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
6. We have minutely perused the documents. As per document Ex.C8, the surveyor Sunny Goel demanded some documents from the complainant which are as under: 1. DMS Estimates with Exact parts rates, 2. Claim form duly filled & signed., 3. Verified copy of RC & Driving license., 4. Previous policy of your vehicle., 5. Please confirm how many occupants were in the car at the time of accident., 6. Any detail of injuries if to anybody. 7. Any FIR or DD?, 8.Spot photos if any. As per complainant he has already submitted all the required documents with the insurance company. After considering the documents, survey report and other relevant documents, insurance company rejected the claim of the complainant as ‘No Claim’ and informed the complainant vide letter dated 08.04.2019 which is placed on record by the complainant as Ex.C9.
7. We have minutely perused the documents as well as Ex.C9. No technical report or any photographs have been placed on record by the insurance company to prove the fact that damages of the insured vehicle do not correlate with the cause of accident. The surveyor failed to establish that why the damages are not co-related with the cause of accident as mentioned in the claim form. The surveyor has only considered the accident with truck only and has not considered the impact on the vehicle, when the same got imbalanced and overturned. The surveyor also failed to place on record the photographs of the place of accident as well as the photographs of damaged vehicle before this Commission. Hence the stand taken by the opposite party is wrong and opposite parties are liable to pay the claim amount. Complainant has placed on record copy of estimate of repair Ex.C7 amounting to Rs.1001930/- . We have minutely perused the survey report. As per surveyor he has assessed the estimated loss in the vehicle as Rs.965530/- and thereafter the final liability has been assessed as Rs.560560/-. After considering both the amounts, we came into the conclusion that vehicle comes under the category of total loss. Hence repudiation of claim by the opposite parties is illegal and amounts to deficiency in service. As such opposite party no.1 to 3 are liable to pay the claim amount as per IDV of the vehicle Rs.700000/- after deducting the salvage value, which we have assessed as Rs.50000/- i.e. to pay Rs.650000/-(Rs.700000/- less Rs.50000/-).
8. In view of the facts and circumstances of the case we hereby allow the complaint and direct the opposite party No.1 to 3 to pay the amount of Rs.650000/-(Rupees six lac fifty thousand only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 02.09.2019 till its realization and also to pay Rs.5000/-(Rupees five thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant within one month from the date of decision. However complainant is directed to move an application to the Registration Authority for cancellation of RC within 15 days.
9. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
23.02.2023.
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Nagender Singh Kadian, President
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Tripti Pannu, Member.
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Vijender Singh, Member
