CONSUMER DISPUTES REDRESSAL COMMISSION – X

GOVERNMENT OF N.C.T. OF DELHI

  Udyog Sadan, C – 22 & 23, Institutional Area

          (Behind Qutub Hotel)

   New Delhi – 110016

    Case No.262/21

Rajat Kumar S/o

Sh. Ramesh Kumar

R/o Sector-D, Pocket-2

Flat No.2471, Near Chhatarpur Metro Station

Vasant Kunj, Delhi-110070                           …..COMPLAINANT

Vs.

HDFC Ergo General

Insurance Company Pvt. Ltd,

Ground Floor, Eros Tower

Opp. Nehru Place Metro Station

Nehru Place, New Delhi-110019                         .…..RESPONDENTS

Date of Institution-22.10.2021

            Date of Order-12.01.2024

                                                O R D E R

RITU GARODIA-MEMBER

1. The complaint pertains to deficiency in part of the OP in repudiating the claim of the complainant.

2. The facts as stated in complaint are that the complainant purchased a vehicle model SKODA SUPERB, bearing registration number DL8CAY8975, in September, 2019, financed by HDFC bank with EMI of Rs.41,418/- to be paid in five years.

3.  The vehicle was initially insured with United India Insurance Company for one year. Thereafter, the vehicle was insured with OP, HDFC General Insurance, from 28.09.2020 to 27.09.2021 vide policy No.2311203626427500000 with an IDV of Rs.24,22,000/-. The complainant highlights the inclusion of additional benefit on the said policy i.e. “return to invoices”. 

4. On 24.03.2021, the complainant’s friend, Bhupendra Yadav, borrowed the vehicle in question.  On 26.03.2021 at about 10 p.m., the said Bhupendra Yadav visited the Café, Skyline at Satya Niketan.  He left for hotel Key Club around 12.30 p.m.  He returned back to the parked vehicle around 5.00 a.m. and found the said vehicle missing. He called the Police at 100 number. The police authority visited the place of the incident and recorded the complaint.  FIR was duly registered on the same day.

5. The complainant informed OP telephonically and received a claim No.C230020450628.  He received a call from agent of OP on 30.03.2021 who provided a list of documents to be submitted.

6. The complainant wrote to OP on 07.05.2021 as he had received no response for his claim. The complainant received a reply from OP informing him that his claim is under process.  He was further informed that due to increase in Covid-19 cases and lock-down, the office of OP is closed.

7. On 22.6.2021, Mr. Bhupesh Chauhan, OP’s investigator visited the complainant and handed over a list of documents.  The complainant received an email dated 20.07.2021 from OP demanding a list of documents.  The complainant responded vide email dated 05.08.2021 stating that most of these document are post approval documents and shall be submitted once the claim has been approved. 

8. OP has also demanded the tower location of his and his friend’s mobile phone on 27.07.2021. Various emails were exchanged between the parties.  The complainant prays for refund of Rs.27,66,321/- alongwith interest @14%, Rs.2,00,000/- for mental agony and pain and Rs.2,50,000/- for payment of litigation.

9. OP in its reply submits that the vehicle of complainant was insured from 28.09.2020 to 27.09.2021 for IDV of Rs.24,22,000/-.  OP vide letter dated 14.04.2021 demanded the following documents: 
1. Original claim form, spot verification, Original FIR, Original Registration Certificate, 100 Report, Vehicle particular, Service Record, Original insurance policy, previous insurance policy.  Statement of insured and last user, his DL, purchase invoice, financial account, ITR.
2. Letter to RTO regarding safe custody of vehicle
3. Loan Account statement and non-repossession letter from financer.
4. RTO form 26,28, 29, 30 duly signed
5. Cancelled Cheque
6. Indemnity letter
7. Untrace Report U/s 173 of CRPC certified and accepted by court.

  10.   On 22.06.2021, OP-1 again demanded the above mentioned documents.  On 04.09.2021, OP demanded the following documents:

1. Tower location of you and your friend’s mobile phone from the service provider, value of vehicle declared in your IT Return, Bill of Club visited, Financial Account, ITR/Form 16 for last 2 years.
2. NOC and form 35 signed by financer
3. RTO forms 26, 28, 29, 30 duly signed.
4. Cancelled Cheque
5. Indemnity letter
6. Untrace Report U/s 173 of CRPC certified and accepted by court.

  11.   OP submits that despite repeated reminders, the complainant has failed to   provide above mentioned documents.  OP closed the claim vide letter dated 25.11.2021 for non-submission of documents.

  12.  The complainant in its rejoinder submits that he had send the following documents to Mr. Bhupesh, Executive cum Investigator on 30.03.2021:

1. Copy of FIR
2. Copy of RC
3. Copy of the Insurance
4. Copy of Voter ID
5. Copy of Pan Card
6. Photographs

13. On 22.06.2021, the following documents were handed over to Mr. Bhupesh: 
1.  
2.  
3.  
4.  
5.  
6.  
7.  
8.  
9.  
10.  
11. vehicle.

14. On 30.06.2021, the following documents were handed over -

1. Tax invoices
2. RTO Registration Slip.

15. On 05.07.2021, an untraceable report was sent to Mr. Bhupesh.  On 06.07.2021, ITR and Car Service Report were handed over to Mr. Bhupesh. On 15.07.2021, ID of two neighbours as witness were handed over. On 19.07.2021, payment of bill /slip of the hotel and bank statement was sent.

16. On 18.08.2021, following documents were supplied to another executive of OP, Mr. Rajat Kumar Pandey:

1. Photographs of the Club
2. Videography of the club
3. Payment slip of the Hotel/Club
4. Bank statement pertaining to payment in Hotel

17. On 13.09.2021, nine documents were sent to email of OP :

1. Registration payment slip
2. ITR Form 3C (B)
3. ITRs of 2018-19 and 2019-20
4. Non traceable report
5. Temporary number certificate
6. Fortuner service bill
7. Payment of club slip.

18. On 22.09.2021, the complainant sent the following documents:

1. Proof of hotel visit i.e. the video
2. Photograph of friends (with date)
3. Slip of the hotel payment
4. Audio recording with the customer care service center executive of JIO from the registered mobile number (clarifying that the company does not provide the mobile location.)

19. On 27.09.2021 the complainant sent the following documents :

1. Mobile location
2. Bills of visited club

20. The complainant submitted evidence by way of affidavit as under :

1. Copy of Registered Certificate is exhibited as Ex. CW Mark-1/1.
2. Copy of insurance of the vehicle is exhibited as Ex. CW Mark-1/2.
3. Copy of FIR is exhibited as Ex. CW Mark-1/3.
4. Copy of letter dated 07.05.2021 is exhibited as Ex. CW Mark-1/4.
5. Copy of mail dated 07.05.2021 is exhibited as Ex. CW Mark-1/5.
6. Copy of letter dated 27.07.2021 of OP is exhibited as Ex. CW     
7.  
7. Copy of reply letter dated 05.08.2021 is exhibited as Ex. CW
8.  
8. Copy of letter dated 11.08.2021 is exhibited as Ex. CW Mark-1/8.
9. Copy of letter dated 12.08.2021 is exhibited as Ex. CW Mark-1/9.
10. Copy of letter dated 16.08.2021of OP is exhibited as Ex. CW Mark-1/10.
11. Copy of letter dated 04.09.2021 of OP is exhibited as Ex. CW Mark-1/11.
12. Copy of letter dated 13.09.2021 is exhibited as Ex. CW Mark-1/12.
13. Copy of letter dated 14.09.2021 is exhibited as Ex. CW Mark-1/13.
14. Copy of letter dated 22.09.2021 from OP is exhibited as Ex. CW Mark-1/14.
15. Copy of letter dated 22.09.2021 to OP is exhibited as Ex. CW Mark-1/15.
16. Copy of letter dated 27.09.2021 from OP is exhibited as Ex. CW Mark-1/16.
17. Copy of legal notice dated 01.10.2021 is exhibited as Ex. CW Mark-1/17.

21. The OP  submitted evidence by way of affidavit as under :

1. Copy of insurance policy is exhibited as Exhibit RW-1.
2. Copy of letter dated 14.04.2021 is exhibited as Exhibit RW-2.
3. Copy of letter dated 22.06.2021 is exhibited as Exhibit RW-3.
4. Copy of letter dated 04.09.2021 is exhibited as Exhibit RW-4.
5. Copy of letter dated 25.11.2021 is exhibited as Exhibit RW-5.

22. This Commission has considered the pleadings and documents on record.  It is admitted by both the parties that the vehicle of complainant was insured from 28.09.2020 to 27.09.2021 for IDV of Rs.24,22,000/-. The car was reported stolen on 27.03.2021, and a FIR was promptly registered on the same day. OP was informed of the incident through a telephonic communication. The complainant asserts that copies of the FIR, RC, insurance policy, photographs, PAN Card, and Voter ID were submitted to OP's investigator, Mr. Bhupesh, on 30.03.2021. It is noteworthy that the OP has not contested or denied this submission.
23. Top of Form
24. Bottom of Form

23. The complainant vide an email dated 07.05.2021 requested OP to process his claim.  The complainant states in the email that the claim was registered on OP’s helpline number on the same day.  He received the following message-
24.  

24. OP acknowledged the complainant's email on the same day in a response email. Subsequently, the complainant sent repeated reminders on 05.08.2021 and 11.08.2021.

25. OP vide letter dated 22.06.2021 demanded the following documents:
26.  

Meeting with you (sic).  Original Claim Form, Spot Verification, Original Registration Certificate, 100 report or received copy of first intimation to 1. Police, Vehicle Particulars, Service record of vehicle.  Original insurance Policy, Original Previous Insurance Policy, Statement of occurrence of both insured & last user.  Driving License Copy of Last User, Original vehicle purchase invoice.  Financial account, ITR/Form 16 for last 3 years, Bank account statement of last one year.  Current photographs, address proof & ID proof, Endorsement for original documents in F.I.R.  If stolen with insured vehicle, Id of Witness, 2. Proof of existence between dates of Policy inception & Date of Theft.

2. Letter to RTO for keeping the vehicle registration file in safe custody duly Acknowledged by RTO with stamp.

3. Updated Vehicle Loan Account Statement (If Hypothecated), Letter from Financer for confirmation of Non-Repossession the vehicle (if hypothecated).

4. RTO forms No.26, 28, 29, 30 duly signed (4 copies each) (Post Approval).

26. OP vide letter dated 04.09.2021 asked for the following documents : 
27.  

1. Tower Location of your and your friend’s mobile phone from the service provider, Value of vehicle declared in your IT Return, Bill of Club visited, Financial Account, ITR/Form 16 for last 2 years (2018-19, 2019-20). Registration Slip, Service Record of Fortuner.
2. NOC & Form 35, duly signed by the Financer & the Owner, Loan Foreclosure letter from financier.
3.  RTO forms No.26, 28, 29, 30 duly signed (4 copies each) (Post Approval).
4.  Cancelled cheque & NEFT mandate form (Post approval)
5.  Letter of Indemnity cum Subrogation duly Notarized with copy of Witness ID proof (Post Approval).
6. Un-traced Report U/s 173 CRPC Certified and Accepted by Court.

Please note.Ever since intimating the claim till today you have not produced the above mention documents and it seems that you are not interested in pursuing the claim.

27. Complainant vide email dated 13.09.2021 replied to the queries as follow:

“I again received a letter on 4^th of this mnth for my claim reminder (where as per hdfc ergo 6 documents are pending)

A: tower location of your and your friends mobile phone from service provider

Reply: I already explained this on my last month mail to you (interaction reference umber I 47126523)

B: value of vehicle declare in your it return

REPLY- already provided to your investigator namely Mr.Bhupesh

C: Bill of club visited

REPLY- already provided the payment method and ac statement of that transaction to your investigative agent namely bhupesh and also to Mr rajat pandy, moreover I provided the video and photos of that night of club where time clear mention.

D-financial statement and itr of last 2 year’s

REPLY- already provided to your investigator namely Mr. Bhupesh.

F: registration slip

REPLY- already provided to your investigator namely Mr. Bhupesh.

E: service record fortuner

REPLY- already provided to your investigator namely Mr. Bhupesh.

2- NOC and form 35

Reply-these are post approval documents

3-Rto form (26,28,29,30)

Reply-these are post approval documents

4- cancel cheque and NEFT form

Reply-these are post approval documents

5.  letter of indemnity

Reply-these are post approval documents

6.Untraceable report accepted by the court

REPLY:  Already provided to your investigator namely bhupesh.

28. OP, in an email dated 22.09.21, mentioned that it had received the service bill but had not received the mobile location and bills of the club visited.

29. On the same date, the complainant responded, explaining that obtaining tower location information is not possible without involvement from the court or police. Despite this explanation, OP, in an email dated 27.09.2021, reiterated the request for the same documents.
30. Top of Form
31. Bottom of Form

30. OP vide letter 25.11.2021 again asked for the following documents: 
1.  
2.  
3.  

4.   Cancelled cheque & NEFT mandate form (Post approval)

31. Complainant has filed receipt dated 27.03.2021 at 1.34 a.m.  of Aone Bar Private Limited, Chanakya Puri wherein Rs.50,000/- paid through ICICI Bank. 

32. From the sequence of mail exchanged between the parties, OP has asked numerous documents like claim farm, FIR, registration certificate etc. which has been provided by the complainant to OP.

33. In the latest communication from OP dated 25.11.2021, they have again requested the tower location and the bill from the club. It is important to note that the bill had already been furnished to OP, as documented in the letter dated 13.09.2021. A copy of the payment made towards the mentioned bill on 27.03.2021 at 1.34 a.m. has been provided as evidence. OP has not provided any clarification regarding the necessity of the tower location, making it challenging for the complainant to comprehend the request.

34. The second set of documents requested pertains to the loan closure, including a letter from the financier, NOC, and Form 35. It is emphasized that these documents can only be supplied once the loan has been successfully foreclosed.

35. The third, fourth, and fifth documents were sought by OP explicitly stating that these will be required post-approval, acknowledging that these documents are necessary only after sanction of the insurance claim.

36. Hon’ble Supreme Court in Gurnel Singh V/s Branch Manager, National Insurance Co. 2022/INSC/619, MANU/SC/0702/2022 has observed as follows:

“Para 4. 1.

In the present case, the insurance company has become tootechnicalwhilesettlingtheclaimandhasacted arbitrarily. The appellant has been asked to furnish the documents which were beyond the control of the appellant to procure and furnish. Once, there was a valid insurance on payment of huge sum by way of premium and the Truck wasstolen,theinsurancecompanyoughtnottohave become too technical and ought not to have refused to settletheclaimonnon­submissionoftheduplicate certifiedcopyofcertificateofregistration,whichthe appellantcouldnotproduceduetothecircumstances beyond his control. In many cases, it is found that the insurancecompaniesarerefusingtheclaimonflimsy groundsand/ortechnicalgrounds.Whilesettlingthe claims, the insurance company should not be too technical and ask for the documents, which the insured is not in a positiontoproduceduetocircumstancesbeyondhis control.”

37. Hon’ble National Commission in Branch Manager, New India Assurance Co. V/s Anoj Kumar Sahay MANU/CF/0807/2023 has also observed:

9 .The OP/insurance Company has argued that delay in finalization of report by the Surveyor was due to Complainant not submitting all the required documents. In this regard, relevant para of order of District Forum is reproduced below: "We have carefully heard the submissions made on behalf of both the sides and have gone through all the materials available on record. It appears to be an admitted position that the claim of the Complainant has not been settled as yet by the O.P. Annexure 11 to the Complaint petition is a document which shows that the documents mentioned therein were received by the O.P. or 04/02/2009. The existence and genuineness of this document has not been disputed by the O.P. Even the report of Surveyor dated 17/09/2009 produced before this Forum on behalf of the O.P. on 11/04/2014 indicates that the Surveyor had looked into as many as 13 documents. Under above said circumstances of the case it can be inferred that O.P. did not settle the claim of the Complainant. This issue accordingly stands decided in favour of the Complainant and against the O.P."

State Commission has further observed

"7. The Complainant also proved the receipt dated 04.02.2009, and therefore, it cannot be accepted that the relevant documents were not furnished by the complainant."

In the aforementioned case, National Commission has upheld   the orders passed by District & State Commission.

38. In the light of discussion above, we conclude that OP is culpable of a deficiency in service by persistently requesting the same set of documents. Moreover, we find OP guilty of engaging in an unfair trade practice by demanding irrelevant documents such as the tower location of a mobile phone, a matter beyond the control of the complainant. Additionally, we hold OP accountable for a deficiency in service for rejecting the claim based on the alleged non-submission of documents. Therefore, we direct OP to:
39. Top of Form

1. To pay Rs.24,22,000/-(IDV of the vehicle) along with interest @8% from the date of theft till payment.
2. To pay Rs.30,000/- towards compensation for mental harassment
3. To pay Rs.10,000/- towards litigation expenses.

39. File to be consigned to record room.  Orders to be uploaded and complied with within 30 days of the date of order.