The titled Complainant Sh. Guriqbal Singh (Aadhar 8074 7836 4753), aggrieved at the inordinate-delay cum non-settlement of his Car-Accident Insurance-Claim sans assignment of any valid reason, has filed the present complaint against the titled opposite parties (namely: ICICI Lombard Gen. Insurance Co. Ltd & the Surveyor) seeking release of full amount of his Car Repair Bill of Rs.19,28,974/- with interest @ 18% PA besides a sum of Rs.5.0 Lac as compensation etc., in the interest of justice. 

2.        The complainant has been the owner of the BMW-X3X-Drive 20-D Luxury-Line Car Model 2019 - R.C. # PB-08-EE-3636 (Ex.C1) and insured comprehensively with the OP insurers @ an IDV (Insured Depreciated Value) Rs.20,38,750/- Policy # 3001/208278424/00/000 (Ex.C2) valid up to w.e.f. 06.11.2020 to 05.11.2021. Somehow, the said Car met with Road-side Accident on 23.10.2021 as recorded vide DDR # 11 on 25.10.2021 (Ex.C3) at Sri-Hargobindpur Police Station. The accident-damaged Car was towed to the authorized Repair Workshop at Jalandhar who prepared the repair estimates @ Rs.19,28,974/- (Ex.C4) that was duly lodged with the OP1 insurers vide the Accident Repair Claim MOT11546479 duly supported by requisite documents etc. The OP insurers deputed the Surveyor Nishant Gupta (the OP3) and the Investigator Inderjit Singh who both visited the accident-ed Car (parked at the Jalandhar Workshop) and also the accident-site to assess/investigate the loss/damage etc. and filed their respective reports to the principals (the OP insurers).       

3.       Thereafter, the complainant has been in regular liaison-contact with all the OP-s to get his claim-settlement expedited/to get the damaged Car repaired expeditiously so as to avoid Taxi Cab hiring @ Rs.2,500/- per day and Workshop Car-Parking @ Rs.500/- per day (Ex.C5). However, the OP insurers offered claim-settlement @ Rs.15 Lac verbally and also in writing vide letter of 23.02.2022 (Ex.C6) on replacement basis. The complainant refused the Rs.15 Lac offer to serve Legal Notice (Ex.C7 to Ex.C10) on 08.04.2022 requisitioning full accident-claim besides Rs 1.05 Lac as compensation to which the OP insurers replied vide letter of 30.04.2022 (Ex.C11) accusing 'misrepresentation' of facts by the complainant causing non-settlement of the claim. Thereafter, the complainant re-mailed his claim-notice to the OP insurers who replied that the claim-amount stood paid on 30.04.2022 (Ex.C12) vide the cheque # CMS 2571781039, that however did never reach, him.                       

4.       Lastly, the complainant has filed the present complaint duly supported by Affidavit (Ex.CW1/A) along with other evidentiary documents (Ex.C1 to Ex.C12) as well as rejoinder and written arguments etc. praying for the above sought-in relief(s).                  

5.       The titled OP 3 Surveyor was given-up by the complainant during the course of the proceedings from the array of opposite parties. The titled opposite party insurers, in response to the commission’s summons/notice appeared through their counsel and filed the written statement/reply stating therein preliminary as well as other objections (on merits, as well) as: That the present complaint is not maintainable since the complainant has neither any 'cause of action' nor any 'locus-standee' to file the present complaint since the accepted policy-terms (Ex.OP1,2,4/3) of the insurance-contract do bind both the parties. Further, there has been no deficiency on the OP part as the Surveyor had filed his final report (Ex.OP1,2,4/1) on 27.03.2022 for Rs.14.20 Lac and in light of the same, the claim was settled on replacement basis and on 30.04.2022 the related letter (Ex.OP1,2,4/2) was issued to him; even otherwise the OP liability has been limited by the Surveyor Report capped by the policy's IDV (Insured Depreciated Value). On merits, the OP insurers have denied most of the contents and pleadings as put forth in the complaint addressing these as matter of records or incorrect and repeating the objections including the one that W/shop Repair Estimates of Rs.19,28,974/- are incorrect/wrong and based upon their Surveyor Report the claim was settled on replacement basis i.e. the insurer may at its own option repair, reinstate or replace the vehicle and/or its parts/accessories etc and may pay in cash the amount of loss/damage and its liability shall not exceed that amount; to which the complainant had not replied; and lastly the OP insurers have sought dismissal of the present complaint with costs, by filing the exhibited documents (Ex.OP1,2,4/1 to Ex.1,2,4/3) along with the duly Sworn-in Affidavit Ex.OP1,2,4W/A by Sh.Diviyam Suri its Legal Manager in evidence. 

6.       We have duly heard the learned counsels for both the sides, on points of law, and have also thoroughly examined the records with requisite care and caution on the points of fact, as placed before us. We are also inclined to examine the inference it’s ‘scope n spread’ on account of some documents ignored to be produced/not-produced during the course of the present proceedings.               

7.       We observe that the OP insurers' prime objection/pleading favoring its claim settlement on replacement basis has been that the complainant had not responded to the same and had stuck firmly till last to the W/shop Estimates of Rs 19,28,974/-. We observe that the complainant has got his Model 2019 Car insured from the OP insurers since its purchase sans any claim and the last policy cover has been valid up to 05.11.2021 and there has been no understanding/agreement/consent etc of the claim settlement on the said replacement basis and the Surveyor as well as the investigator had not recommended the same and the Surveyor has not filed his affidavit/basis of estimates @ Rs.14.20 Lac and in the absence of these the W/shop estimates of Rs.19,28,974/- shall get precedence. 

8.       We thus discard the OP insurers' above pleadings/arguments, being in total contravention of the laws of natural justice. We are of the considered opinion at the face of the evidenced-facts as available on the records that there’s have been an unfair display of its superior/dominant position by the OP Insurers in settling the accident-claim that they have been legally bound to honor of course up to the IDV level; and as such the impugned ‘non-settlement’ on the OP1 insurer's part of the insurance-claim, in question, had been unwarranted, arbitrary and unfair; neither in accordance with the provisions of the statutory law nor in conformity with the sanctity of natural justice, equity and good conscience. Further, it has violated with impunity the preferred statutory consumer rights of the young complainant causing him much physical harassment, mental agony and financial loss in his routine peaceful life. Lastly, we hold the insurers guilty of statutory misconduct amounting to ‘unfair trade practices/deficiency in service’ and thus liable to an adverse award under the provisions of the governing statute. However, the OP insurers in order to pay the impugned claim shall be at liberty to procure certified copies of the requisite document(s), if any, from the records of the present complaint, in accordance with the prescribed rules.   

9.       In the light of the all above, we order the opposite party insurers to pay the impugned claim @ it's full amount of Rs.19,28,974/- with interest @ 6% PA from the date of complaint till realization besides Rs.20,000/- in lump sum as cost cum compensation within 45 days of receipt of the certified copy of these orders otherwise the aggregated award amount shall attract an additional interest @ 3% PA from the date of the orders till realization, in full. The complainant may apply for statutory indulgence of this commission, in accordance with the provisions of law, in case of non-compliance at the OP Insurers' end. The W/shop Parking Fee payable if any, shall be negotiated/paid by the OP insurers. 

10.      The complaint could not be decided within the stipulated period due to heavy pendency of Court Cases, vacancies in the office and due to pandemic of Covid-19.

11.      Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record. 

                                                               (Naveen Puri)

                                                                    President.

ANNOUNCED:                                    (B.S.Matharu)

DEC. 14, 2022.                                            Member.

YP.