Chandigarh

DF-II

CC/559/2014

Prem Kaur - Complainant(s)

Versus

HDFC Ergo - Opp.Party(s)

Sh.Ranadeep Singh Pandher Adv.

16 Oct 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II, U.T. CHANDIGARH

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Consumer Complaint  No	:	559 of 2014
Date  of  Institution	:	03.11.2014
Date   of   Decision	:	16.10.2015

 

 

 

 

 

Prem Kaur, Proprietor M/s Shringar Diamonds, H.No.64, Sector 17, Panchkula, Haryana. 

 

             …..Complainant

Versus

 

1]  HDFC Ergo, SCO No.124-125, Sector 8, Chandigarh, through its Manager.

 

2]  The Manager, Pioneer Toyota, EM Pee Motors Ltd., Plot No.71, Industrial Area, Phase-I, Panchkula 134109

 

….. Opposite Parties

 

BEFORE:  SH.RAJAN DEWAN                 PRESIDENT

         SH.JASWINDER SINGH SIDHU       MEMBER

         MRS.PRITI MALHOTRA             MEMBER

 

 

For complainant(s)      :     Sh.R.S.Pandher, Advocate.

 

For Opposite Party(s)   :     Sh.Gaurav Bhardwaj, Adv. for OP-1.

 

Sh.S.R.Bansal, Adv. for OP -2

 

 

PER JASWINDER SINGH SIDHU, MEMBER

 

 

          As per the case, the complainant got her Toyota Fortuner Car bearing Regd. No.CH-01-AE-0787 insured from Opposite Party No.1 vide insurance cover Ann.C-2 valid from 12.11.2013 to 11.11.2014.  It is averred that the complainant is using the said car for the personal use.  Unfortunately, the said vehicle met with an accident on 20.9.2014 at around 12.15 P.M. with another vehicle.  Sh.Parminder Singh son of the complainant called toll free number of Opposite Party No.1 Insurance Company and got the claim registered and the official of Opposite Party No.1 told Sh.Parminder Singh to send the vehicle to Opposite Party No.2.  Accordingly, the vehicle was taken to Opposite Party No.2 where it was inspected by the surveyor.  However, when the Opposite Party No.1 was contacted to supply the claim registration number, it was told that no claim has been registered against the policy and that the policy had already lapsed in August due to some faulty NCB benefit in the premium.  The matter was also taken up with Opposite Party No.1 through e-mail, but it was not replied.  It is pleaded that before the occurrence of the said accident on 20.9.2014, the complainant has never been informed regarding lapse/termination of insurance policy and the premium of Rs.25,493/- paid by the complainant too was not refunded, in case the policy has been declared lapsed/terminated.  Even the Surveyor Surinder Goyal too did not inform the complainant regarding lapse of insurance policy. The complainant also sent notice to Opposite Party No.1 for payment of amount of repair raised by Opposite Party No.2 (Ann.C-5), but it was not replied.  Ultimately, the complainant made the payment of Rs.1,76,069/- to Opposite Party No.2 and took the delivery of her car (Ann.C-7). Alleging the said act of Opposite Party No.1 as gross deficiency in service, hence this compliant has been filed. 

 

2]       The Opposite Party No.1 has filed the reply stating therein that the insurance of the vehicle is matter of record, but the period of insurance, as alleged, is incorrect and denied (Ann.A and A/1).  It is stated that neither any intimation regarding the alleged loss was ever given by the complainant nor by Opposite Party No.2 nor any claim was registered under the policy. It is submitted that answering Opposite Party had requested the complainant to provide a certificate from the previous insurer on eligibility of NCB or alternatively to pay the NCB amount of Rs.6432.95, so that the coverage for the normal period could be provided, but the complainant did nothing.  It is also stated that the insurance policy was never cancelled but the period of coverage was reduced till 13.8.2014 as the complainant had not paid the NCB amount nor produced the required certificate (Ann.B). It is pleaded that the complaint is not maintainable as the vehicle in question was insured in the name of M/s Shringar Diamonds, Panchkula, whereas the present complaint has been filed by Prem Kaur being the proprietor and no proof of proprietorship of M/s Shringar Diamonds has been placed on record. It is also pleaded that the complainant is not entitled to get any amount from answering Opposite Party. Rest of the allegations have been denied with a prayer to dismiss the complaint.

         The Opposite Party No.2 (EM Pee Motors) has also filed reply stating therein that no relief is claimed against the answering Opposite Party, hence complaint be dismissed qua it.  It is admitted that the answering Opposite Party has repaired and delivered the vehicle to the complainant. Rest of the allegations have been denied being not related to Opposite Party No.2 and it is prayed that the compliant qua Opposite Party No.2 be dismissed.

 

4]       Parties led evidence in support of their contentions.

 

5]       We have heard the ld.Counsel for the parties and have also perused the record.

 

6]       The complainant, who is the owner of vehicle Toyota Fortuner bearing Regd. No.CH-01-AE-0787 and the same was got insured on 11.11.2013 from Opposite Party No.1 by paying a premium of Rs.25,493/- and during the currency of the policy, the vehicle in question met with an accident on 20.9.2014 and suffered extensive damages. The Opposite Party NO.1 was duly intimated and the vehicle was moved to the premises of Opposite Party NO.2 for necessary repairs.  The complainant claims that even after his repeated requests, no information with regard to settlement of the claim was forthcoming, whereas she was informed that her policy had lapsed in the month of August for the reasons of some No Claim Bonus (NCB) and as such, the vehicle at the time of accident was not covered under any policy.  The complainant in the meanwhile paid an amount of Rs.1,79,069/- to Opposite Party No.2 against the bill for repairs and got the vehicle released.  The complainant claims that while making receiving the payments, Opposite Party NO.2 appended its note on the bill itself declaring that no amount has been paid by Opposite Party No.1 towards the settlement of claim of the complainant (Ann.P-7).

 

7]       The complainant has neither alleged any deficiency in service against Opposite Party No.2 nor any relief has been sought against it.  The Opposite Party No.2 has been impleaded as a necessary party only to substantiate her claim with regard to the merits of the complaint.

 

8]       The Opposite Party No.1 while contesting the claim of the complainant has come up with a defense that the complainant while proposing for the policy cover of her vehicle, has falsely sought No Claim Bonus, whereas she had already availed a claim from her previous insurance company and the same was not disclosed while claiming NO Claim Bonus and therefore, the Opposite Party No.1 while adjusting the premium amount paid had reduced the policy period on pro-rata basis upto 13.8.2014.  A copy of the policy issued after such adjustment, is annexed as Annexure A-1. The Opposite Party NO.1 has also claimed that the complainant was duly intimated about such change through a letter dated 13.5.2014 (Ann.A) declaring that an amount of Rs.6,432.95P be paid within 15 days or else the policy period would be adjusted to the extent of premium already paid.  Therefore, as per the version of the Opposite Party No.1, the complainant having failed to pay the outstanding premium amount and the vehicle having met with an accident on 20.9.2014 was not covered under the policy Ann.A-1, which had expired on 13.8.2014.  Thus, the claim of the complainant was not processed and there is no deficiency in service on the part of Opposite Party No.1. 

 

9]       We have perused the documents placed on record by the parties and are of the view that the Opposite Party NO.1 while accepting the proposal for the issuance of the insurance policy of the vehicle of the complainant on 11.11.2013 vide Ann.P-3 preferred to issue the policy document Ann.P-2 with the condition of zero depreciation as well as a No Claim Bonus of 35%.  It is also observed that there was no demand or desire of the complainant to claim a no claim bonus as there is no declaration to that effect is found signed by her as is necessary as mandated under GR 27 of IMT Indian Motor Tariff.  It is also evident that the complainant has not proposed for any NO claim Bonus which was voluntarily offered to her by the Opposite Party No.1 to the extent of 35%.  The Opposite Party NO.1 had also failed to seek the details of the previous insurance policy from the complainant before processing the proposal Annexure P-3. Such an act of the Opposite Party No.1 is clearly against the provisions of GR 27 of IMT and the officials of Opposite Party No.1 failed to adhere to the statutory norms applicable.   Such an act of Opposite Party NO.1 amounts to deficiency in service on its part.

 

10]      The Opposite Party No.1 has categorically accepted that the claim of the complainant was received at its end and the case was not processed as it had reduced the coverage period of the policy for nearly three months for non-payment of the extra premium amount demanded by it vide its letter dated 13.5.2014 (Ann.A).  The Opposite Party NO.1 has not placed on record any proof of the dispatch of this letter (Ann.A) from its office nor the proof of its delivery at the end of the complainant, on account of which any fault could be attributed towards the complainant for having failed to respond to this letter.  It is also necessary to mention here that though the demand period for the remaining premium amount had expired on 25^th May, 2014 i.e. 15 days from 13.5.2014, but after having raised another policy Ann.A-1, the Opposite Party NO.1 failed to deliver the same at the address of the complainant.  There is no proof of dispatch of Ann.A-1 nor any acknowledgment of its receipt by the complainant.  Therefore, in the absence of any trustworthy evidence, we are compelled to presume that these two documents, were deliberately not sent to the complainant and the complainant was not in the knowledge of such a unilateral decision of modification of her insurance policy, was put to a disadvantage of remaining without an insurance cover.

 

11]      It is necessary to mention here that the Opposite Party No.1 even though had preferred to modify the insurance policy, which was initially issued for a period of one year, but it had failed to cooked any provision, rules or regulation of the insurance act or its insurance policy under which it was free to make such unilateral changes.  The Opposite Party NO.1 while making such changes has even after against the spirit of contract that it had entered into on 12.11.2013 with the complainant at the time of issuance of the policy Ann.P-2. In the absence of any legal provision, the action of Opposite Party NO.1 is illegal and an unfair trade practice on its part.

 

12]      We are of the considered opinion that even though there has been acts of omission on the part of Opposite Party No.1, but still in order to keep the policy intact for a complete duration of 12 months, the complainant was to pay Rs.6432.95P towards the 35% of NCB.  We also feel that if the complainant was duly intimated, she would have certainly not objected to such payment.  Therefore, the Opposite Party NO.1 is certainly entitled to claim this amount from the complainant.

 

13]      It is also observed that Opposite Party No.1 failed to appoint a Surveyor or a Loss Assessor after having received a due intimation about the loss to the vehicle of the complainant.  It is necessary to quote here that the provisions of IRDA Protection of Policyholder’s Interest Regulation, 2002, the Opposite Party NO.1 was duty bound to appoint a Surveyor /Loss Assessor within 72 hrs. of the receipt of intimation of loss, therefore, the Opposite Party No.1 has also acted contrary to the aforementioned regulations of IRDA, which also tantamounts to deficiency in service on its part. 

        

14]      In the light of above observations, we are of the concerted view that the Opposite Party No.1 is found deficient in rendering proper service to the complainant. Hence, the present complaint of the Complainant is allowed qua Opposite Party No.1 and dismissed against Opposite Party No.2. The Opposite party No.1 is directed as under:-

[a] To pay an amount of Rs..1,69,636/- (i.e. Rs.1,76,069 - Rs.6432.95 P), to the complainant being the cost of repair of the vehicle in question less the premium amount demanded;

 

[b] To pay an amount of Rs.10,000/- to the complainant as consolidated amount of compensation for causing mental agony and harassment on account of deficiency in service;

 

[c] To pay litigation expenses to the tune of Rs.7,000/-

 

         The above said order shall be complied within 45 days of its receipt by the Opposite Party No.1; thereafter, it shall be liable to pay an interest @18% per annum on the amount mentioned in sub-para [a] & [b] above, from the date of occurrence of loss i.e. 20.9.2014 till it is paid, apart from paying litigation expenses.

 

         The certified copy of this order be sent to the parties free of charge, after which the file be consigned.

 

Announced

16^th October, 2015                                                                

                                                                        Sd/-

 (RAJAN DEWAN)

PRESIDENT

 

Sd/-

 (JASWINDER SINGH SIDHU)

MEMBER

 

 

Sd/-

(PRITI MALHOTRA)

MEMBER

Om                                                                                                                        

 

 

DISTRICT FORUM – II

CONSUMER COMPLAINT NO.559 OF 2014

PRESENT:   None   Dated the 16th day of October, 2015

O R D E R                        Vide our detailed order of even date, recorded separately, the complaint has been allowed against  Opposite Party No.1 and dismissed qua Opposite Party No.2                    After compliance, file be consigned to record room.

 

(Priti Malhotra)	(Rajan Dewan)	(Jaswinder Singh Sidhu)
Member	President	Member