DISTRICT CONSUMER DISPUTES REDRESSAL FORUM II
Udyog Sadan, C 22 & 23, Qutub Institutional Area
(Behind Qutub Hotel), New Delhi 110016.
Case No.111/2011
Dr. H. N. Aggarwal
S 222, Greater Kailash II,
New Delhi 110048 ….Complainant
Versus
HDFC ERGO General Insurance Company
6th Floor, Leela Business Park
Andheri ( East), Mumbai 400059
Also at
C 302, 3rd , Floor, Ansal Plaza
Hudco Place, Andrews Ganj
New Delhi 49 ….Opposite Party
Date of Institution 17.03.2011 Date of Order 25.03.2017
Coram
Sh. N.K. Goel, President
Ms. Naina Bakshi, Member
O R D E R
Ms. Naina Bakshi, Member
Brief facts of the case are that the Complainant, the owner of Car Skoda Octiva bearing registration No.DL7CE 4656, got it insured from the OP company vide policy No. VP00587795000100 and the policy was valid w.e.f. 15.03.2010 to 14.03.2011. On 19.09.2010 his son was returning home while coming down the Flyover Near Moolchand where there was quite a bit of water logging on the road. He drove the car carefully and suddenly an auto rickshaw came to the extreme right by cutting right infront of him and he had to break and stop the car. The engine was shut down and did not start. The incident was immediately reported to the customer care of the OP vide claim /reference No. 391365. Official of the OP instructed him to leave the car with authorised dealer /garage for repair. Accordingly the car was towed from the spot to the “Silver Stone Motors Pvt. Ltd.” at Okhla by Baba Cranes and he had to spend Rs.850/ towards towing charges. It is submitted that he submitted “Motor Claim Form” alongwith repair estimates and other required documents to the OP. After several requests the OP deputed a surveyor who inspected the car and assured him that the claim amount will be reimbursed within two weeks and got his signature on some ‘unfiled’ documents including “satisfaction voucher” cum “motor loss voucher.” He has relied on an email dated 04.10.10 sent by him to the OP in this regard. He received a letter dated 21.10.2010 from the OP thereby showing its inability to reimburse the claim without any reasonable cause. Therefore, he had to pay Rs. 70106/ towards the repairing charges to the Silverstone Motors Pvt. Ltd. vide invoice No. 036360 dated 4.11.2010. He was also deprived from using the vehicle for a long time. On 10.12.2010 he sent a legal notice to the OP which was received by the OP but the OP neither made the payment nor replied to the legal notice. Hence, pleading deficiency in service on part of the OP, the Complainant has filed the present complaint to award compensation towards the bills, mental and physical agonies etc. which occurred due to arbitrary management, negligent conduct and deficiency in service on the part of the OP and to pay Rs. 140866/ towards compensation and all other charges besides Rs.20,000/ for this litigation.
OP in the written statement inter alia has stated that the independent surveyor appointed for the purpose of assessing the loss has held that the damage to the engine of the insured vehicle was due to hydrostatic locking and the same was not caused by any accident or external force and hence the alleged loss to the insured vehicle was beyond the scope of insurance cover. The insured vehicle never met with any accident at any point of time. The independent surveyor carried out the survey on 8.10.2010 and conveyed to the workshop about inadmissibility of the claim and liability of the OP being restricted to charges for flushing and cleaning of engine of the insured vehicle . It is stated as under
“ In any case, the insured vehicle was not damaged either by fire explosion/self ignition/lighting or by burglary/ house breaking/theft or by riot/strike or by earthquake (fire or shock damaged) or by flood/typhoon hurricane/storm/ tempest/ inundation cyclone/hailstorm/frost (while parked) or by accidental external means or by malicious act or by terrorist activity or by landside/rockslide or whilst in transit by road/rail/inland waterway/lift/ elevator or air and as such the alleged damage is not covered by insurance policy.”
It is submitted that the OP has complied with its obligations under the contract and has not rendered deficient service. The OP has prayed for dismissal of the complaint.
The complainant has filed a rejoinder/replication to the written statement of the OP and stated that as per the following terms of policy the claim of the complainant is covered under the Insurance policy
“What you are covered For
Own damages to the insured vehicle caused by –
. Accidental external means
. Burglary/house breaking /theft
. Fire explosion/self ignition/lightning
. Terrorism , riots, strike or malicious act
. Transit by road, rail, inland waterway, air lift.
. Earthquake, flood, storm, landslide, rockslide
WHAT YOU ARE NOT COVERED FOR
. General again, wear and tear.
. Loss /damage outside India
. Mechanical or electrical breakdown, failure.
. Damage of tyres and tubes, unless damaged during an
Accident (for cars)
. Depreciation, any consequential, loss
. Loss or damage to lamps, tyres, tubes, mudguards, bonnets, sides parts, Bumpers, and paint works.( applicable to all commercial vehicle excluding Taxes for hire or reward).
. Damage by a person driving under the influence of liquor or drugs.
. Loss/damage attributable to war, munity, nuclear risk.
. Compulsory deductible (amount deductable from each and every claim under.”
Hence, according to him, his claim is maintainable. He has reiterated the averments made in the complaint.
Complainant has filed his own affidavit in evidence while affidavit of Sh. Pramanpreet Singh Gujral, Manager has been filed in evidence on behalf of the OP.
Written arguments have been filed on behalf of the parties.
We have heard the oral arguments on behalf of the parties.
We have gone through the file very carefully.
We straightway come to the question, whether the refusal to give the claim amount to the complainant by the OP was justified? If so, whether the complainant is not entitled to any relief?.
Vide letter dated 21.10.2010 (copy Ex. I) the OP repudiated the claim for the following reason
“There is no external impact either to the vehicle or to the engine from outside.
Engine can not be impacted merely coming in to contact with water and damage if any, can be attributed to either mechanical failure or trying to run the engine when it is still in contact with the water.
When vehicle stops on the water logged road, efforts to start the vehicle is the well known source to cause damages to engine. The obvious course is known to be not to try to start the engine, with/out total cleaning the water from inside engine and inspection by an expert technician, thus your extension of damages to the engine if any cannot be considered as per condition no. 4 of policy.”
In his report (copy Ex. OP1) the surveyor has observed as follows
“ Particulars Of Loss/Damages
ON THE RECEIPT OF ADVICES FROM THE INSURERS OFFICE FOR THE SURVEY & ASSESSMENT OF LOSS TO SAID ACCIDENTAL VEHICLE I, THE UNDERSIGNED HAD INSPECTED THE SAME CAREFULLY ARRANGING NECESSARY PHOTOGRAPHS. AT THE TIME OF SURVEY WE OBSERVED THAT THE DAMAGES TO ENGINE OF THE INSURED’S VEHICLE ARE DUE TO HYDROSTATIC LOCKING.
OBSERVATION
In my opinion, the liability of the insurer is restricted up to flushing of engine and the cleaning of vehicle. Accordingly, we have assessed the loss for flushing & cleaning of engine”
There is not an iota of evidence on the record which may even remotely suggest that the car in question had come to a sudden halt due to appearance of an auto rickshaw from the right side and its coming infront of the car in question. Therefore, the obvious result is that the car in question had stopped because of water logging on the road. The same is not covered under the category of “flood” “self ignition” or “transit by road”. The term “transit by road”, in our considered opinion, can only mean transportation of a vehicle from one place to another place any other means of transport. If we do not give this interpretation to the said term, the other terms viz. “inland” “waterway” and “ air lift” shall be rendered nugatory. Mere logging of water on the road for sometime does not amount to flood. In the motor claim form (copy Annexure E Ex. E) the column “details of the Accident and Damage to the insured vehicle” has been left blank. Thus, the claim raised by the Complainant becomes more suspicious and not near to the truth. Hence, we hold that the Complainant has failed to prove any deficiency in service on the part of the OP. Accordingly, we dismiss the complaint with no order as to costs.
Let a copy of this order be sent to the parties as per regulation 21 of the Consumer Protection Regulations. Thereafter file be consigned to record room.
Announced on 25.03.17.
