Punjab

Sangrur

CC/533/2021

Sh. Ajmer Singh - Complainant(s)

Versus

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

Sh. Ashish Kumar

15 Jan 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SANGRUR .

 

                                                                         Complaint No. 533

 Instituted on:   27.04.2021

                                                                         Decided on:     15.01.2024

Ajmer Singh aged about 45 years son of Gurcharan Singh, resident of Village Bhelolpur, Tehsil Samrala, District Ludhiana.

                                                         …. Complainant 

                                                 Versus

1.     ICICI LOMBARD GENERAL INSURANCE CO. LTD. TF 1-5, Third Floor, 88, The Mall, Ludhiana, Punjab (141001) through its Branch Manager.

2.     ICICI LOMBARD GENERAL INSURANCE CO. LTD. SCO 26, 1^st Floor, Kaula Park, Above Harman Hotel, Sangrur Punjab 148001 through its Branch Manager.

3.     Max Autos (Authorised dealer of Maruti Suzuki) Dhuri Road, Sangrur through its Authorised Signatory.

                                                        ..Opposite parties

 

For the complainant    :       Shri Ashish Kumar Adv.

For the OP 1&2         :       Shri Sanjeev Goyal, Adv.

For the OP No.3         :       Exparte.

Quorum                                           

Jot Naranjan Singh Gill, President

Sarita Garg, Member

                        Kanwaljeet Singh, Member

 

ORDER

JOT NARANJAN SINGH GILL, PRESIDENT:

 

1.             Complainant has preferred the present complaint against the opposite parties on the ground that he availed services of the OP number 1 and 2 by getting insured his Maruti Vitara Breeza ZDI+ car bearing registration number PB-10-GT-0140 from OP number 1 and 2 for Rs.6,66,652/- by paying the requisite premium of Rs.27,735/- and the OP number 1 and 2 issued policy bearing number 3001/MI-08721733/00/000 which was valid for the period from 12.03.2020 to 11.03.2021. Further case of complainant is that on 26.6.2020 the complainant went to meet his maternal aunt at Village Kakra, Tehsil Bhawanigarh  and in the evening the cousin of complainant namely Manjeet Singh with his permission took the said car for some personal work to Samana and on the way when he reached near Balad Kalan, then suddenly a stray animal came on the road and in this process of saving the stray animal, the car in question met with an accident and got badly damaged. Intimation of accident was given to the OP number 1 and 2 and Op number 1 and 2 appointed surveyor, who inspected the car at the workshop of OP number 3. The OP number 3 got prepared the estimate to the tune of Rs.3,98,000/- for the repair of the vehicle. Thereafter the surveyor took all the documents from the complainant for releasing the claim amount, but nothing was done. Thus, alleging deficiency in service on the part of the OPs, the complainant has prayed that the OPs be directed to release the claim amount of Rs.3,98,000/- alongwith interest @ 18% per annum from the date of accident till realisation and further claimed compensation and litigation expenses.

2.             In reply filed by OPs number 1 and 2, preliminary objections are taken up on the grounds that the complaint is false, frivolous, vague and vexatious in nature and has been made to injure the interest and reputation of the OPs, that the complainant has not come to this Commission with clean hands and that the complainant has filed the complaint with malafide intention and that the complaint is devoid of any material facts and has been filed merely to harass the OPs.  On merits, it is admitted that that the complainant got insured the vehicle in question for the period from 12.3.2020 to 11.3.2021 for an amount of Rs.6,66,652/-. It is admitted that the OPs received the intimation regarding the loss caused to the vehicle of complainant and after getting the information regarding the accident, the OPs allotted claim number MOT10003433 and appointed surveyor and loss assessor for assessing the loss caused to the vehicle of the complainant.  The surveyor inspected the damaged vehicle at the workshop of OP number 3. The complainant submitted the estimate for Rs.3,98,059/- for repairing of the vehicle. The said estimate was on the higher side. The OPs appointed investigator to investigate the genuineness of the claim and during investigation, it was found that the complainant has stated wrong facts with regard to date of loss and manner of accident as alleged. It has been further averred that the claimed damages are not matching with the loss description and date mentioned in the claim form. The complainant was asked to explain the discrepancies but the complainant did not reply the same and consequently the claim of the complainant was repudiated vide letter dated 28.8.2020 as per terms and conditions of the policy.  The other allegations levelled in the complaint have been denied. Lastly, OP number 1 and 2 have prayed for dismissal of the complaint with costs.

3.             Record shows that the OP number 3 was proceeded against exparte on 22.09.2021.

4.             The learned counsel for the complainant has produced Ex.C-1 to Ex.C-6 copies of documents and affidavit and closed evidence. On the other hand, the learned counsel for OP number 1 and 2 has produced Ex.OP1&2/1 to Ex.OP1&2/3 copies of documents and affidavit and closed evidence.

5.             We have gone through the pleadings put in by  the parties along with their supporting documents with their valuable assistance. 

6.             The learned counsel for the complainant has argued that the complainant availed services of the OP number 1 and 2 by getting insured his car in question from OP number 1 and 2 for Rs.6,66,652/- by paying the requisite premium of Rs.27,735/- and the policy was valid for the period from 12.03.2020 to 11.03.2021, a copy of which on record is Ex.C-2. Further the learned counsel for complainant has argued that on 26.6.2020 the car in question suddenly met with an accident, intimation of which was given to the OP number 1 and 2 and the OP number 1 and 2 appointed the surveyor, but the claim was denied on the ground that the claim is on the very higher side and further argued that the loss claimed is not matching with the loss description. It is argued that the repudiation of the claim vide letter dated 28.8.2020 is also said to be wrong. Lastly, the learned counsel for the complainant has prayed for acceptance of the complaint.

7.             On the other hand, the learned counsel for the OP number 1 and 2 has contended vehemently that after receipt of the intimation, they appointed surveyor and loss assessor for assessing the loss caused to the vehicle of the complainant.  The surveyor inspected the damaged vehicle at the workshop of OP number 3 and estimate for Rs.3,98,059/- for repairing of the vehicle submitted by the complainant is said to be on the higher side. The OPs appointed investigator to investigate the genuineness of the claim and during investigation, it was found that the complainant has stated wrong facts with regard to date of loss and manner of accident as alleged in the complaint. It has been further argued that the claimed damage is not matching with the loss description and date mentioned in the claim form. The complainant was asked to explain the discrepancies but the complainant did not reply the same and consequently the claim of the complainant was repudiated vide letter dated 28.8.2020 as per terms and conditions of the policy.

8.             At the outset, it is an admitted fact between the parties that the vehicle of the complainant was insured with the OP number 1 and 2  and the loss/damage of the vehicle during the subsistence of the insurance policy is also not disputed.   In the present case, the OPs have repudiated the claim of the complainant on the ground that the claim is on the higher side and the claimed damages are not matching with the loss description and date mentioned in the claim form. Ex.C-2 is the copy of the insurance policy which shows that the vehicle in question is insured comprehensively with OP number 1 for Rs.6,66,652/-. Ex.C-5 is the copy of estimate of loss to the tune of Rs.3,98,059/- and the complainant has sought this amount to be paid by OP number 1 being the insurance amount for the loss caused to the vehicle in the accident. On the other hand, the learned counsel for OPs number 1 and 2 has contended that the claim of the complainant has rightly been repudiated vide letter dated 28.8.2020 Ex.OP1&2/3 on the ground of misrepresentation of facts causes & date of loss not justified with existing damages on vehicle and try to hide material facts about loss. Claimed damages not matching with loss description and date mentioned in the claim form and try to hide the material facts.  But we are unable to go with this contention of the learned counsel for the OPs number 1 and 2.  First of all, we may mention that if this was so ground for the repudiation of the claim of the complainant, then what were the actual facts which the complainant tried to hide from the OPs and from where the OPs number 1 and 2 came to know about the hiding of facts by the complainant, which were in the mind of OP number 1 and 2 has not been established on record by them. It is made clear that OP number 1 and 2 have neither produced the survey report and investigation report on record nor produced any other document to show about the facts hide by the complainant. The OPs  number 1 and 2 further have not produced any cogent document to show that there was mismatch of the damages reported by the complainant in the accident. Even the Ops number 1 and 2 have not produced any affidavit of the surveyor who reported the above said facts about the claim being on the higher side. Even OPs number 1 and 2 did not place claim form on record.  As such, we are of the considered opinion that we will go with the estimate produced by the complainant because the OP number 1 and 2 have concealed even the survey report from this Commission. There is no explanation from the side of the OPs number 1 and 2 that why they did not produce the copy of survey report on record and what was the reason which prevented the OPs number 1 and 2 to produce it on record, which may be helpful to this Commission for just decision of the case.

9.             Now, coming to the quantum of compensation payable to the complainant on account of loss in accident. We may mention that the complainant has produced on record the copy of estimate Ex.C-5 issued by OP number 3, who is authorised dealer of the manufacturer to the tune of Rs.3,98,059/-, as such, we may go with this estimate because the estimate has been issued by the approved dealer of the manufacturer.

10.            In view of our above discussion, we allow the complaint and direct OPs number 1 and 2 to pay to the complainant an amount of Rs.3,98,059/- being the claim amount. We further direct that if the OPs number 1 and 2 failed to pay the above said ordered amount within the period of sixty days, then they will be liable to pay interest @ 7% per annum from the date of filing of the present complaint i.e. 27.04.2021 till its realisation in full. We further direct them to pay to the complainant an amount of Rs.5000/- as compensation for mental tension, agony and harassment and an amount of Rs.5000/- as litigation expenses. This order shall be complied with by OPs number 1 and 2 within a period of sixty days of receipt of copy of this order.

11.            The complaint could not be decided within the statutory time period due to heavy pendency of cases.

12.            Copy of this order be supplied to the parties free of cost. File be consigned to the records after its due compliance. 

                             Pronounced.

                             January 15, 2024.