Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 390.
Instituted on : 10.07.2017.
Decided on : 24.01.2019.
Priya daughter of Sh. Pardeep Kumar, House No. 311/6, Mandir Wali Gali, Quila Road, Rohtak.
………..Complainant.
Vs.
HDFC ERGO General Insurance Company Limited, Customer Service, 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (E), Mumbai-400059.
Regd. Office: Ist Floor, 165-166, Backbay Reclamation, H.T. Parekh Marg, Churchgate, Mumbai-400059.
……….Opposite party.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
SH. VED PAL, MEMBER.
SMT. SAROJ BALA BOHRA, MEMBER.
Present: Ms. Shashi Aggarwal, Advocate for the complainant.
Sh. Gulshan Chawla, Advocate for opposite party.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that the complainant is a registered owner of a scooter of Honda-Activa model bearing registration No. HR-12W-6331, and the same was got insured through Two Wheeler Package Policy No. 2312100167748000000 with the OP company taken by the complainant online on 08.01.2017 through Policy Bazaar Insurance Web Aggregators Pvt. Ltd for the period 11.01.2017 to 10.01.2018. That on 11.01.2017, complainant’s brother took parked the vehicle in the street, where it got extensively damaged due to collision by the two bulls fighting there. After that the matter was immediately reported to the OP and the vehicle was surveyed by the surveyor of OP. The report was got lodged on 30.01.2017 in Police Station Civil Lines, Rohtak vide NCR No.0032/2017. The complainant lodged the claim with opposite party and also got the vehicle repaired on her own from the authorized service dealer at Rohtak who charged Rs. 22,536/- on account of repair vide invoice dated 07.02.2017. But the claim was repudiated as ‘No Claim’ vide letter dated 23.01.2017 of the OP on the ground that the damages claimed in the alleged accident are unrelated to the cause of accident as reported in the claim form. A legal notice was sent to the OP in this regard, but no response has been received. Hence this complaint and it is prayed that the OP may kindly be directed to pay Rs.22,536/- on account of loss alongwith interest @ 18% p.a. from the date of loss till payment and damages of Rs. 50,000/- with costs.
2. After registration of complaint, notice was issued to the opposite party. Opposite party in its reply submitted that the complainant intimated about loss to the OP on 11.01.2017, whereas the insured vehicle met with an accident on 12.01.2017(dates wrongly mentioned as the date of loss is 11.01.2017 and date of intimation is 12.01.2017) i.e. after the delay of 1 day. As per the policy terms and conditions, Condition No. 1, the intimation about the incident is to be given “Immediately”. But, the complainant has violated the policy terms and conditions. But on information, OP processed the claim of the complainant. The complainant submitted a claim form, in which reasons for loss/damage caused to the vehicle as “Hit by some on the spot area”. However, later on a DDR dated 30.01.2017, was submitted wherein the reason stated for the loss/damage was mentioned as “Two bulls were fighting and thus the vehicle was damaged’. That both the reasons, as regards to the loss of the vehicle prima facie contradictory to each other and hence happening of the damage to the vehicle in itself is in dispute. As per surveyor’s report, the damages do not commensurate with the cause of loss as mention by the complainant in the claim form. That keeping in view the above mentioned facts, the claim of the complainant was repudiated as per the policy terms and conditions through vide letter dated 23.01.2017, which was duly intimated to the complainant and lastly prayed for dismissal of the complaint.
3. Ld. counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, documents Ex.C1 to Ex.C8 and has closed his evidence on dated 24.01.2018. Ld. counsel for the OP has tendered affidavit Ex.RW1/A and documents Ex.R1 & Ex.R6 and closed his evidence on dated 07.09.2018.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. After going through the file and hearing the parties it is observed that the claim of the complainant has been repudiated by the opposite party on the ground that: “During survey it has been observed that the damages claimed in 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 complainant in the claim form”. In this regard it is observed that as per complaint, affidavit and NCR report filed by the complainant, the cause of accident is due to collision by the two bulls fighting there and the claim form filed by the OP is merely a photocopy and it is not proved that the same was filled by the complainant herself. Hence the claim of the complainant has been repudiated on flimsy grounds. As such complainant is entitled for the claim amount as per the survey report Ex.R5 amounting to Rs.20500/-.
6. In view of the facts and circumstances of the case, we hereby allow the complaint and it is directed that opposite party shall pay the amount of Rs.20500/-(Rupees twenty thousand and five hundred only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 10.07.2017 till its realization and also to pay a sum of Rs.3000/-(Rupees three thousand only) as compensation and litigation expenses to the complainant within one month from the date of decision.
7. Copy of this order be supplied to both the parties free of costs.
8. File be consigned to the record room after due compliance.
Announced in open court:
24.01.2018.
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Nagender Singh Kadian, President
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Ved Pal Hooda, Member.
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Saroj Bala Bohra, Member.
