Complainant Sukhdev Singh has filed the present complaint against opposite parties (for short O.P.) U/S 12 of the Consumer Protection Act, 1986 with a prayer that opposite party may be ordered to make full insured amount of Rs.9,55,831.28 paisa qua his claim immediately in terms of the insurance policy alongwith interest @ 18% P.A. from the date of accident of the vehicle till actual realization. Opposite parties be also directed to pay Rs.50,000/- as compensation on account of mental agony, physical harassment and deficiency in service on their part alongwith Rs.3000/- as litigation expenses.

2.     The case of the complainant in brief is that he is the owner of vehicle i.e. Car Model Renault, Duster RXL (O) bearing registration No.PB-03-T-AB-4595, Chassis No.MEEHSRAW5D9038157, Engine No.EO 42245. He had purchased the abovesaid vehicle on 7.12.2013 and on the same time the vehicle was allotted Temporary Registration Number as PB-03-(T)-AB-4595. The vehicle was insured with the opposite parties through opposite party no.3 vide policy cover Note No.2311200631804200001 valid from 7.12.2013 to 6.12.2014. The Insured’s Declared Value of the vehicle was Rs.10,72,550/-. On 5.9.2014, the aforesaid vehicle met with an accident and was totally damaged. The opposite parties were duly informed in this respect and they deputed their surveyor who visited the spot and assessed the loss to the vehicle to the tune of Rs.9,55,831.28 i.e. total loss vide Surveyor report dated 18.10.2014.  At the time of accident the vehicle was registered in his name and the same was being driven by a person having valid driving license issued by the competent authority. He was not plying the vehicle against the terms and conditions of the Insurance Policy rules nor there any intentional or willful delay on his part in reporting the matter to the opposite parties. Thereafter, he lodged his claim with the opposite parties with all the requisite documents for payment but the opposite party no.2 has repudiated his claim as “NO CLAIM” on the basis of fake and baseless observations vide letter dated 31.12.2014. A registered A.D. notice dated 7.2.2015 was also served upon the opposite party no.1 & 2 but despite the service of notice, they did not pay any heed in the matter. Hence this complaint.

3.      On notice, opposite parties appeared through their counsel and filed their joint contested written statement taking the preliminary objections that the complaint is arising out of insurance policy No.2311200631804200001 valid from 7.12.2013 to 6.12.2014. The policy was issued subject to its terms and condition with which both the parties are bound. The complaint is liable to be dismissed as there is an intentional concealment of material facts by the complainant in order to get insurance claim. The complainant has also tried to bring wrong facts before this Hon’ble Forum with an ill intention to get undue benefit of insurance. The claim is in respect of Own Damage claim arising out of accident of insured vehicle which allegedly met with an accident on 5.9.2014. However to the contrary it has been established after investigation that the actual date of accident was 4.8.2014 when the vehicle was unregistered. The vehicle was permanently registered on 8.8.2014 i.e. after the accident and then claim was lodged with the opposite party on 11.11.2014 stating date of loss as 5.9.2014. Hence the complaint is made on the basis of wrong facts and thus is liable to be dismissed with costs. On merits, it has been alleged among other things that during the investigation it comes into the light that the vehicle was not registered at the time of accident which is the breach of Section 39 of Motor Vehicle Act. The complainant was plying with vehicle against the terms and conditions of the policy and against the provisions of the Motor Vehicle Act and even the timely intimation has not been given. The alleged loss took place on 5.9.2014, but the intimation has been given on 11.11.2014 which is the breach of condition no.1 of the insurance policy. So the claim has been rightly repudiated vide letter dated 31 December 2014. All other averments made in the complaint has been vehemently denied and lastly prayed that the complaint may be dismissed with costs.

4.         Complainant tendered into evidence his own affidavit Ex.CW-I/A, along with the other documents exhibited as Ex. C1 to Ex.C11 and closed the evidence.

5.     On the other hand, counsel for the opposite parties tendered into evidence affidavit of Sh.Pankaj Kumar Manager Legal Ex.OP1, alongwith the other documents Ex.OP2 to Ex.OP11 and closed the evidence

6.       We have duly heard the learned counsels for both the sides on the points of law and have also thoroughly examined the records with requisite care & caution on the points of fact, as placed before us. We find that the OP insurers disallowed/closed the impugned Car Accident Insurance Claim (as “No Claim”) vides repudiation letter Ex.C5/ Ex.OP2/OP5 dated 31.12.2014 for of the two reasons addressed therein as No. 1: Delay of 66 days in intimating the ‘accidental-loss’ to the OP insurers reading as: During survey it was observed that there was delay of 66 days in intimating the claims. The loss happened on 05.09.2014 and the intimation has been given to insurer on 11/11/2014; and, that amounted to violation of the condition (1) of the policy in question. No. 2: The insured vehicle was not registered at the time of accident reading as: There was delay in intimation so the claim was sent for investigation. During investigation, it came to light that the vehicle was not registered at the time of accident; which is a violation of section 39 of the Motor Vehicles Act’ 1988. The OP insurers have however failed to produce any cogent evidence to prove the above two alleged violations. Neither, the information advice of the accident nor its insurance claim has been produced in evidence to prove the allegedly delayed receipt on 11.11.2014. The allegation of non-compliance/ violation of section 39 of the Motor Vehicles Act’ 1988 i.e., non-registration of vehicle as on date of accident (05.09.2014) gets duly negated by the Temporary Certificate of Registration Ex.C1 of 07.12.2013 and Certificate of Registration (Ex.C2/Ex.OP6) of 08.08.2014. It is not proved/placed on records that the temporary registration was not extendable/extended beyond 06.01.2014 and moreover the OP insurers have accepted the date of accident as 05.09.2014 in the Repudiation letter Ex.C5/ Ex.OP2/OP5 of 31.12.2014. Although, the OP insurers have alleged in the ‘written reply’ that the accident occurred on 04.08.2014 (and not on 05.09.2014) but in the absence of supporting cum cogent evidence its legal value shall be that of a ‘bald-statement’ only. The OP affidavit Ex.OP1 neatly circumvents ‘deposing’ the date of accident at 04.08.2014 and rightly so in the absence of any evidence on record. Of course, the Motor (Final) Survey Report Ex.OP3 of 21.12.2014 mentions the date of accident as: 04.08.2014 but again lacks the supporting evidence and that may be the precise reason of acceptance of 05.09.2014 (by the OP insurers) as the ‘date’ in the Repudiation letter Ex.C5/ Ex.OP2/OP5 of 31.12.2014. Further, we find that during the course of arguments, the learned counsel for the OP Insurers filed an application for producing additional evidence by way of Surveyor’s affidavit along with photographs of the accidented Car (as provided by the complainant) and the same was allowed in the interest of justice since the complainant also did not raise any objections. However, we again find here that in the absence of the requisite evidence and/or disclosure of the source of information (Ex.OP12) the Surveyor’s deposition of ‘date of accident’ as 04.08.2014 is left out ‘merely’ as a bald statement. Further, Ex.OP13 to OP17 the print-outs (copies of the accidented vehicle) in the absence of any attestation/ authorization/ authentication (even the complainant’s signatures etc) do not even identify the accidented vehicle what to say of the evidence of the date of accident etc. Lastly, we find that the accidented vehicle was comprehensively insured Ex.C3/Ex.OP7 with the OP insurers for an IDV of Rs.1,072,550/- and the Repair Estimates dated 18.10.2014 by the authorized Car- Work shop namely: Padam Cars Pvt. Ltd., item-wise sum up the loss at Rs.9,55,831.28 P and the same being more than the 75% of the IDV falls under the Total Loss claim-category. Under the circumstances, the OP insurers are liable to settle/ pay the impugned claim at the full IDV besides being guilty of ‘unfair trade practices’ amounting to ‘deficiency in service’.     Finally, we hold the OP insurers guilty of infringement of complainant’s consumer rights through ‘unfair trade practice’ amounting to ‘deficiency in service’ and that makes them liable to an adverse award under the Act.

7.       In the light of the all above, we partly allow the present complaint and thus ORDER the OP insurers to pay the impugned Claim in question to its full IDV in terms of the related Policy to the complainant besides to pay him Rs.10,000/- as compensation (inclusive of cost of litigation) within 30 days of the receipt of the copy of these orders otherwise the full awarded amount shall attract interest @ 9% PA form the date of filing of the complaint till actual payment.  

8.       Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record.

                          (Naveen Puri)

                                                                                             President      

ANNOUNCED:                                                             (Jagdeep Kaur)

November 17, 2015                                                                 Member

*MK*