Haryana

Karnal

CC/318/2022

Rattan Singh - Complainant(s)

Versus

ICICI Lombard General Insurance Company Limited - Opp.Party(s)

Mange Ram Sangwan

26 Jul 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No. 318 of 2022

                                                        Date of instt.31.05.2022

                                                        Date of Decision:26.07.2024

 

Rattan Singh son of Shri Jai Singh, resident of 73 VPO  Nalvi Khurd Tehsil and District Karnal.

 

                                                                        …….Complainant.                                             Versus

 

1. ICICI Lombard General Insurance Co. Ltd. through its Sr. Manager Registered office at: ICICI Lombard house no.414, Veer Savarkar Marg, near Sidhi Vinayak Temple, Prabhadevi, Mumbai-400025.

 

2. ICICI Lombard General Insurance Co. Ltd. through its Senior Manager Branch office at Karnal, SCO no.3, Second floor Sector-8 HUDA Market Karnal.

                                                                 …..Opposite Parties.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

Before   Shri Jaswant Singh……President.     

      Shri Vineet Kaushik…….Member

      Ms. Sarvjeet Kaur…..Member

 

 Argued by: Shri M.R. Sangwan, counsel for the complainant.

                    Shri A.K. Vohra, counsel for the OPs.

               

                     (Jaswant Singh, President)

ORDER:  

 

                The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant is registered owner of Audi Car bearing registration no.HR-05X 0036, which was insured by the OPs, vide policy no.3001/205224894/00/B00 commenced from 14.09.2020 to 13.09.2021, with the Insured Declare Value of Rs.14,22,670/-. On 27.02.2021, the said vehicle met with an accident at about 8 p.m. near Alpha City Gate on Indri Road, Karnal and suddenly the vehicle caught fire and was totally burnt. Complainant had immediately called fire brigade office, fire brigade came at the spot and tried to extinguish the fire, but the vehicle had totally damaged in fire. The DDR no.025 dated 27.02.2021 was got recorded in Police Station, Sadar, Karnal. The intimation was also given to the OPs.. On receipt of intimation, OPs appointed an surveyor, who had inspected the vehicle. Complainant lodged the claim with the OPs and submitted all the required documents for settlement of the claim. Thereafter, complainant requested the OPs several times for settlement of the claim but OPs did not pay any heed to the request of complainant and lastly repudiated the claim of the complainant, vide repudiation letter dated 17.02.2022 on the ground that “Misrepresentation of Facts.” Then complainant sent a legal notice dated 27.02.2021 to the OPs but it also did not yield any result. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

2.             On notice, OPs appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that on receipt of intimation regarding the incident, OPs appointed M/s Perfect Investigators Surveyor and Claim Investigators, Shri Vaibhav Bhushan Kaushik Surveyor Loss Assessor and Valuer who submitted their detailed report, besides the aforesaid, the OPs also assigned the case to the fire Forensic and Investigation and the case was registered at Bombay Forensic Mumbai and the said authority submitted their report on 07.05.2021. It is further pleaded that the claim of the complainant was duly processed, considered on merits and the same was not found payable and repudiated the same, vide letter dated 17.02.2022 on the ground that “Misrepresentation of facts (cause of loss not justified with existing damages on vehicle and try to hide material facts about loss). Claimed damages are not due to any external impact, not due to natural causes, not due to self-ignition cause, not due to electrical short circuit, but due to sabotage cause, on an account of human intervention and loss is not covered under the policy.” Moreover, OPs assigned claim no.MOT10811474 to the Fire Forensic & Investigation and thereof. The case was registered at Bombay Forensic, Mumbai on 13.04.2021. The agency carries out fire forensic and field investigation of the incident of fire to determine the source, origin and cause of fire and circumstances thereof. Based on the conducted hydrocarbon testing analysis of the relevant burnt debris samples, revealed that there is presence of residual hydrocarbon in the sample no.04 and 05 together. The hydrocarbon residue observed in the sample mentioned above are traces of accelerant fuel which is highly ignitable. The hydrocarbon found in the sample no.04 and 05 together which was collected from the passenger and rear portion area, where there is no possibility to get the presence/produce of such accelerant material in the passenger and rear portion area. The presence of hydrocarbon in the passenger and rear portion area evidence that the fire did not occur due to electrical short circuit, it would have occurred/accelerated on an account of human intervention only. Further, it is observed that the insured’s said vehicle found old and outdated/expired model, insured is the fifth owner of the vehicle, market value is less as compared to the IDV, so here is less possibility to sell for better price and insurance is for better IDV. It is further pleaded that based on the fire pattern forensic analysis, it is observed that the fire is multiple point origin of fire and it originated separately in the engine and rear portion of the insured’s vehicle. As per insured statement, he saw fire from bonnet portion of the vehicle. But as per the fire pattern forensic analysis, fire originated separately in front and rear portion of the vehicle. Hence, the explanation of the insured is not correlating with the fire forensic analysis. It is further pleaded that the complainant has not supplied the copy of previous insurance of the car in question to the surveyor. The insurance is based on utmost good faith and both the parties are bound by the terms and conditions of the contract of insurance. The liability of the insurance company-OPs has to be within the four corners of the contract of insurance alone. There is no deficiency in service and unfair trade practice on the part of the OPs.  The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.  

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of DDR dated 27.02.2021 Ex.C1, copy of legal notice dated 30.03.2021 Ex.C2, copy of insurance policy Ex.C3, copy of fire brigade report dated 03.03.2021 Ex.C4, copy of letter dated 03.09.2021 Ex.C5, copy of repudiation letter dated 17.02.2022 Ex.C6, copy of OPD slip dated 03.03.2022 Ex.C7 and closed the evidence on 20.03.2023 by suffering separate statement.

5.             On the other hand, learned counsel for the OPs has tendered into evidence affidavit of Sonu Rathi Ex.OP1/A, affidavit of Gopi Ralkar Ex.OP2/A, affidavit of Shubham Grover Ex.OP3/A,  copy of insurance policy Ex.O1, copy of Bombay Forensic Report  dated 07.05.21021 Ex.O2, copy of Perfect Investigator Report Ex.O3, copy of report of V.B. Kaushik Ex.O4, copy of letter dated 03.09.2021 Ex.O5, copy of repudiation letter dated 17.02.2022 Ex.O6 and closed the evidence on 05.01.2024 by suffering separate statement.

6.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got his vehicle insured with the OP. On 27.02.2021, the said vehicle met with an accident and caught fire and was totally burnt. A DDR no.025 dated 27.02.2021 was got recorded in Police Station, Sadar, Karnal. The intimation was also given to the OPs. Complainant lodged the claim with the OPs and submitted all the required documents for settlement of the claim. But despite repeated requests, OPs did not pay the claim and lastly repudiated the claim of the complainant, on the false and frivolous grounds and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OPs, while reiterating the contents of written version, has vehemently argued that on receipt of intimation regarding the incident, OP appointed a surveyor to investigate the matter and after inspection surveyor submitted his detailed report to the OPs. The OPs have also assigned the case to the Fire Forensic and Investigation, the said authority submitted their report on 07.05.2021. The claim of the complainant was  not found payable and rightly repudiated the same, vide letter dated 17.02.2022 on the ground of“Misrepresentation of facts.” He further argued that the vehicle in question was found old one and outdated/expired model. The market value is less as compared to the Insured Declared Value (IDV), so here is possibility to sell for better price and insurance is for better Insured Declared Value and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, the vehicle in question was burnt during the subsistence of insurance policy. It is also admitted that the insured declared value (IDV) of the vehicle in question is Rs.14,22,670/-.

11.           The claim of the complainant has been repudiated by the OPs, vide repudiation letter Ex.C6/O6 dated 17.02.2022 on the grounds, which are reproduced as under:-

“This is with reference to the claim no.MOT10811474 filed with us for the policy no.3001/205224894/00/B00. We have perused the documents submitted by you and regret to inform you that your claim cannot be settled for the following reason:

. “Misrepresentation of facts (causes of loss and justified with existing damages on vehicle and try to hide material facts about loss). Claimed damages are not due to any external impact, not due to natural causes, not due to self-ignition cause, not due to electrical short circuit, but due to sabotage cause, on an account of human intervention and loss is not covered under this policy.”,

 

12.           The claim of the complainant has been repudiated on the abovesaid grounds. The onus to prove its version was relied upon the OPs. To prove its version, OPs relied upon Motor Fire Forensic Report Ex.O2 dated 07.05.2021. The relevant portion of the Root Cause of Fire Analysis of the said report is reproduced as under:-

Following are the aspects of root cause of the fire which we have analysed in this case.

1. No Natural Cause:

1. We have not observed any evidence related to lighting strike or any other natural calamity cause.

2. No Self-Ignition Cause (Explosion or Implosion):

1. We have not observed any self-ignition cause of fire and no such material observed at the place where the fire originated.
2. We have not observed any explosive implosive type of material that could have caused the self-ignition.

3. No Electrical Short Circuit/cause

1. We have conducted the inspection of whole wiring where we have not found any beading formation or short circuit interpretation and we have not found any evidence relating to the same.

4. Sabotage Cause:

1. Based on the fire pattern forensic analysis, it is observed that the fire is multiple point origin of fire and it originated separately in the engine and rear portion of the Insured’s vehicle.
2. As per the insured’s statement, he saw fire from bonnet portion of the vehicle. Hence, the explanation of the insured is not correlating with the fire forensic analysis.
3. Based on the conducted hydrocarbon testing analysis of the relevant burnt debris samples, revealed that there is presence of residual hydrocarbon in the sample no.04 and 05 together.
4. It is observed that the insured’s said vehicle found old and outdated/expired model, insured is fifth owner of the vehicle, market value is less as compared to the IDV value, so there is less possibility to sell for better price and insurance is for better IDV.
5. Insured is non-cooperative to provide the documentary requirements.

(E) No Any Other Cause

1.     We have not observed any evidence related to the any other cause of the origin of fire in this case exclude sabotage cause.

 13.          From the above report, it has been proved that the hydrocarbon was found from rear portion area, where there was no possibility to get the presence of such accelerant material from the rear portion area. The presence of hydrocarbon from the rear portion of the vehicle proved that the fire was occurred due to human intervention. The possibility of self fire to the vehicle by the complainant cannot be ruled out as the vehicle was of old model, however, the insured declared value of the vehicle was more than the market value of the vehicle.

14.           Further, the Surveyor Loss Assessor and Valuer of the OPs has in his report Ex.O4  has recommended the claim for repudiate under misrepresentation of facts, as per investigation report Ex.O3 hydrocarbons detected in ash samples collected from vehicle. The said surveyor has not assessed any loss in his report.

15.           Neither complainant nor OPs have placed on file any surveyor report to ascertain the loss of vehicle in question. From the observations given in the Motor Fire Forensic Report Ex.O2 dated 07.05.2021, Perfect Investigation Report Ex.O3 and surveyor report Ex.O4, we are of the considered view that the claim of the complainant has rightly been repudiated.

16.           Keeping in view the abovesaid discussion, facts and circumstances of the case, the present complaint is devoid of merit and deserves to be dismissed and same is hereby dismissed. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:26.07.2024                                                                     

                                                           President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

 (Vineet Kaushik)       (Sarvjeet Kaur)

                          Member                          Member