Haryana

Fatehabad

CC/394/2019

Anit Kumar - Complainant(s)

Versus

HDFC Ergo General Insurance - Opp.Party(s)

Yogesh Gupta

22 Sep 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION; FATEHABAD

          C.C.No.394 of 2019.               Date of Instt.:12.09.2019 Date of Order: 22.09.2023

Anit Kumar son of Chhaju Ram resident of village Bhodia Bishnoin, Tehsil Mandi Adampur District Hisar.

..Complainant.

          Versus

1.HDFC ERGO General Insurance Company  Limited registered office-Unit No.502,504, 506, 5^th Floor Mahatta Tower, B-1 Block, Community
Centre, Janak Puri, New Delhi-110058 through its Managing Director.

2.HDFC ERGO General Insurance Co.Ltd.SCO 237, 2^nd Floor, Sector 12, Karnal 132001 State Haryana.

3.Indora Maruti Service Station, Maruti Authorized Service Station, Sirsa Road, Fatehabad, 125050.

          ..Opposite party.  

Complaint under Section 12 of the Consumer Protection Act, 1986

Before:        Sh. Rajbir Singh, President.                                                               Smt.Harisha Mehta, Member.                                                             Sh.K.S.Nirania, Member

Present:       Sh.Yogesh Gupta, Advocate for complainant.                                    Sh.U.K.Gera, Advocate for the Ops No.1 & 2.                                     Sh.Pankaj Bansal, Advocate for Op No.3.

ORDER

SH.RAJBIR SINGH, PRESIDENT;

                   By way of this complaint, the complainant has submitted that he is owner of vehicle Car bearing registration No.HR20AC/3825 which was insured with OP No.1 vide policy No.2311 2018 8680 9200 001 having validity for the period 31.08.2017 to 30.08.2018; that on 22.06.2018 the vehicle in question met with an accident; that on 23.06.2018 the complainant intimated about the accident to the insurance company; that the surveyor inspected the vehicle  in the presence of complainant; that the Op no.3 had issued the estimated bill of Rs.34287/- and its labour as Rs.15,000/-; that the complainant got the vehicle repaired from Op no.3 by spending a sum of Rs.21525/- for parts and Rs.12862/- as labour charges; that now the Op No.3, vide letter dated 13.08.2018,  is demanding the repair charges from the complainant has the Ops No.1 & 2 have repudiated the claim. The act and conduct of the OPs clearly amounts to deficiency in service. In evidence, the complainant has tendered his affidavit Annexure C1 alongwith documents Annexure C2 to Annexure C12.

2.                          On notice, Ops appeared and filed their separate replies. Ops No.1 & 2 in their joint reply have submitted that the claim under the policy was rightly repudiated vide letter dated 13.08.2019 because the surveyor, inspected by the replying Ops, in its report has opined that the damages to the insured vehicle do not correlated with the cause of accident; that the complainant himself has played fraud upon the Ops and has filed the present compliant by misrepresenting the facts. The observations made by the surveyor in his report are as under:

1.Bolts of Lhs head light and upper member were found in open condition.

2. Hose clip was found answering open.

3.Damages on vehicle were found aggravated to enhance insurance company liability.

4.Damage to the radiator was not co-relating with the cause of loss as narrated on claim form.

There is no deficiency in service on the part of answering OPs. In the end, prayer for dismissing the complaint has been made.  

3.                          OP No.3 in its reply has submitted that it had repaired the damaged vehicle of the complainant and neither the complainant nor the Ops No.1 & 2 have paid the cost of parts to the tune of Rs.21525/- with labour charges to the tune of Rs.12862/- to replying Op, therefore, there is no deficiency in service on the part of Op No.2. In the end, prayer for dismissal of the complaint has been made by denying the other allegations mentioned in the complaint. In evidence, the Ops have tendered affidavit of Sh.Vivek Yadav, Ex.RW1/A, affidavit of Sh.Naresh Kumar, Proprietor Ex.RW3/A with documents Ex.RW1/A to Ex.RW1/3, Annexure 3A to Annexure 3D.

 

4.                          Heard. The counsel for the complainant reiterated the averments made in the complaint and prayed for its acceptance whereas the counsel for OPs reiterated the averments made in the replies and prayed for its dismissal.

5.                          The complainant has come with the plea that his vehicle met with an accident during the subsistence of the policy; therefore, it is the boundened duty of the Ops to pay the loss suffered by him on account of damage of the vehicle but the Op did not do so.  

6.                          Admittedly, surveyor was appointed by the Ops No.1 & 2 on getting the intimation qua the damage of the insured vehicle whose report has been placed on the case file as Annexure RW1/3. Perusal of said report reveals that the surveyor had assessed the net payable loss to the tune of Rs.22094/-. Though the Ops No.1 & 2 have taken specific plea that the damages to the insured vehicle do not commensurate with the loss detailed notified to the company, therefore, the claim was not payable and thus, it was rightly repudiated vide letter dated 13.08.2018.

7.                          The Ops No.1 & 2 have placed the report of the surveyor on the case file as Annexure RW1/3. Perusal of this report reveals that the surveyor had assessed the net payable loss to the tune of Rs.22094/- but in the column of remarks the surveyor has mentioned that As HO Technical Team Instructions, the claim is not payable. Kindly treat the claim accordingly.  As per Ops No.1 & 2, the claim was repudiated vide letter dated 13.08.2018 on the ground that the actual damages does not commensurate with the loss detailed notified to the company.  If we read the remarks of the surveyor made in its report Annexure RW1/3 together with the repudiation letter dated 13.08.2018 one thing becomes clear that the Ops No.1 & 2 had already repudiated the claim and the surveyor has just acted as per the directions/order of the insurance company, therefore, we have no hitch to reach at the conclusion that the Ops No.1 & 2 have wrongly and illegally repudiated the claim by raising unnecessary plea that the damaged to the vehicle do not  correlate to the accident. Accordingly, this plea is hereby rejected.

8.                          It is proved on the case file that the damaged to the vehicle occurred during the currency of the policy for which the insurance company had received the premium, therefore, it is the duty of the insurance company to indemnify the loss as assessed by the surveyor in this report as it is a settled proposition of law that Surveyor is the best person to assess the loss and his report cannot be brushed aside, being important piece of evidence, unless there is cogent and convincing evidence.  In this regard we rely upon a judgment titled as United India Insurance Co. Vs. Maya, CPJ 2008 (2) page (NC) page 182  wherein it has been held that a surveyor report should not be dismissed summarily as the surveyor is an independent and qualified person under the relevant provisions of Insurance Act, 1938.   Further, in the present matter, the surveyor in his report has clearly mentioned net loss to the vehicle to the tune of Rs.22094/-. Therefore,  we are of the considered opinion that the end of justice would met if we direct the Ops No.1 & 2  to make the payment of Rs.22094/- to the Op No.3 as it has repaired the damaged insured vehicle .

 9.                         Keeping in view the above facts and circumstances, the present complaint is partly allowed and the Ops No.1 & 2 are hereby directed to make the payment of Rs. 22094/- (as per the report of surveyor Annexure RW1/3) to the OP No.3 directly.  Since the complainant himself has alleged that the a sum of Rs.34387/- has been spent on the repairing of the vehicle in question (Rs.21525/- amount of the parts and Rs.12682/- amount of labour charges), therefore, the complainant is directed to make the remaining amount of Rs.12293/- (Rs.34387 – 21525= 12293) to the Op No.3 within 45 days of the passing of this order, failing which the amount would carry 9 % interest from the date of repair i.e. 02.07.2018 till its realization. We also direct the Ops No.1 & 2 to pay Rs.11,000/- in lump sum for mental agony, harassment and litigation expenses to the complainant. Compliance of this order be made within 45 days failing which the awarded amount would carry 9 % interest from the date of filing of the complaint till its realization.

10.                        In default of compliance of this order, proceedings against respondents shall be initiated under Section 72 of Consumer Protection Act, 2019 as non-compliance of court order shall be punishable with imprisonment for a term which shall not be less than one month, but which may extend to three years, or with fine, which shall not be less than twenty five thousand rupees, but which may extend to one lakh rupees, or with both. A copy of this order be sent to the parties free of cost. File be consigned to the record room after due compliance.     

Announced in open Commission.                                                           Dated: 22.09.2023

                  

          (K.S.Nirania)               (Harisha Mehta)                     (Rajbir Singh)                      Member                                 Member                               President