Delhi

North East

CC/73/2021

Mr. Rohan Sharma - Complainant(s)

Versus

ICICI Lombard General Insurance Co. Ltd. - Opp.Party(s)

25 Oct 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

Complaint Case No. 73/21

 

 

 

In the matter of:

 

		Sh. Rohan Sharma S/o Sh. Dinesh Kumar Sharma R/o (Present Local Address 15/11, Upper Ground Floor (right side) west Patel Nagar, New Delhi 110008		Complainant
		Versus
	1.           2.	The Manager/ Director ICICI Lombard General Insurance Co. Ltd. Ist Floor, Unit No. 101, Station Box at, Dilshad Garden Metro station Mall, Dilshad Garden Delhi 110095   The Manager/ Director ICICI Lombard General Insurance Co. Ltd. ICICI Lombard House, 414, Veer Savarkar Marg, Near Siddhi Vinayak Temple, Prabhadevi, Mumbai 400025		Opposite Parties
			DATE OF INSTITUTION:         JUDGMENT RESERVED ON:                           DATE OF ORDER:		19.04.21 19.09.24 25.10.24

 

CORAM:

Surinder Kumar Sharma, President

Ms. Adarsh Nain, Member

ORDER

Surinder Kumar Sharma, President

The Complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019.

 

Case of the Complainant                                                                 

1. The case of the Complainant as revealed from the record is that Complainant purchased a car insurance policy No. 3001/HI-11165968/00/B00 in his name valid from 16.06.20 to 15.06.21 from Opposite Party company and paid premium of Rs. 15,204/-. Complainant stated that Opposite Party paid to Hyundai workshop the company who repaired the car Rs. 30,727/- only against total payment of Rs. 98,661/-. The Opposite Party made a short payment ofRs. 67,934/- and forced the Complainant to pay Rs. 42,934/- vide receipt no. 1223WS-BANK/2021/6016 dated 16.12.20 and also adjusted Rs. 25,000/- paid by Complainant in advance vide receipt no. 1223BS/CA/2021/328 dated 26.10.20. Complainant has made the payment as Opposite Parties made short payment to Hyundai workshop Rs. 67,934/- against cashless policy taken by Complainant with comprehensive insurance along with extra rider for “Engine Protect Plus”. Complainant states that he is also entitled to claim for the damage incurred by the engine as a result of the accidental damage.The Opposite Parties have repudiated the claim for the Engine Repair on false pretext. Complainant stated that when the policy is with comprehensive cover and also “engine Protect Plus” with extra premium Opposite Party company cannot repudiated the claim with malafide and unwanted tactics e.g. engine/gear box damage not payable due to heating/coolant (leakaged due to radiator damage) by mail dated 28.12.20. Complainant stated that even after repeated mails to Opposite Parties they did not make payment to Hyundai workshop and Complainant had to pay the said amount in spite of having cashless policy. Complainant had also sent legal notice to Opposite Parties vide speed post but of no use. Opposite Party company has repudiated claim of Complainant by email dated 28.12.20 and not refunded the claim amount. Hence, this shows deficiency in service on behalf of Opposite Party.  The Complainant has prayed that the Opposite Party company may be directed to pay back Rs. 67,934/- plus @ 12 p.a. interest from the date of amount was received. Complainant also prayed for Rs. 50,000/- as legal expenses.

Case of the Opposite Party No.1

2. The Opposite Party No.1 contested the case and filed written statement. It is stated that there is no deficiency of service on the part of Opposite Party. It is stated that the Complainant intimated the incident to it and the Opposite Party appointed a surveyor to assess the damage caused to the vehicle. On the basis of the report of the surveyor, the Opposite Party had partly allowed the claim of the Complainant. The amount of Rs. 67,934/- as claimed by the Complainant was not paid as the same was not allowed by the surveyor. It is stated that the complaint is without any merit and prayed that the same may be dismissed.

 

 

Rejoinder to the written statement of Opposite Party No.1

3. The Complainant filedrejoinder to the written statement of Opposite Partywherein the Complainant has denied the pleas raised by the Opposite Partyand has reiterated the assertion made in the complaint.

Evidence of the Complainant

4. The Complainant in support of his complaint filed his affidavit wherein he has supported the averments made in the complaint.

Evidence of the Opposite Party No.1

5. Opposite Party failed to file evidence despite grant of opportunities. Therefore Opposite Party evidence was closed vide order dated 25.08.23.

Arguments & Conclusion

6. We have heard the Ld. Counsels for the parties. We have also perused the file and the written arguments filed by the Complainant. The case of the Complainant is that his vehicle was insured by the Opposite Party. His case is that damage was caused to his car. The insurance policy was a cashless policy and was having “Engine Protect Plus” (with extra premium). His case is that the Opposite Party did not make the complete payment and it made a short payment of Rs. 67,934/-. The case of the Complainant is that this amounts to deficiency of service. On the other hand, the case of the Opposite Party is that this payment was not allowed by the surveyor and for this reason the amount of Rs. 67,934/- was not paid.  However, the Opposite Party did not lead any evidence to show that payment was not made as the same was not allowed by the surveyor. There is no evidence to show that the surveyor did not allow the said payment or that why it was not allowed by the surveyor. Therefore the plea taken by the Opposite Party cannot be believed.
7. In view of the above discussion, it is proved that there is deficiency of service on the part of Opposite Party No.1. The complaint is allowed. The Opposite Party No.1 is directed to pay an amount of Rs. 67,934/- to the Complainant along with interest @ 9 % p.a. from the date of filing the complaint till recovery. The Opposite Party No.1 is further directed to pay Rs. 15,000/- on account of mental harassment and Rs. 15,000/- towards litigation expenses to the Complainant with interest @ 9 % p.a. from the date of this order till recovery.
8. Order announced on 25.10.24.

Copy of this order be given to the parties free of cost.

File be consigned to Record Room.

 

(Adarsh Nain)      Member

(Surinder Kumar Sharma) President