Punjab

Faridkot

CC/15/106

Mohan Lal - Complainant(s)

Versus

ICICI Lombard General Insurance - Opp.Party(s)

Amit Mittal

26 Feb 2016

ORDER

 DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FARIDKOT

 

Complaint No. :      106

Date of Institution:  14.08.2015

Date of Decision :   26.02.2016

 

Mohan Lal Mittal s/o Shadi Ram c/o Mohan Lal  & sons, Old Factory Road, Kotkapura, Tehsil Kotkapura District Faridkot.

...Complainant

Versus

1. ICICI Lombard General Insurance Company Limited through its Managing Director/Authorized Person, ICICI Lombard House, 414, Veer Savarkar Marg, Near Siddhi Vinayak Temple, Prabhadevi, Mumbai-400025.

2. Pankaj Motors, through its Managing Director/Authorized Person, Talwandi Bye-pass, Faridkot.

3. Pankaj Motors, through its Managing Director/Authorized Person, Head Office, Moga.

4. Hira Automobiles, through its Managing Director/Authorized person, Malout Road, Sri Muktsar Sahib.

   .....Opposite Parties

Complaint under Section 12 of the

Consumer Protection Act, 1986.

 

 

Quorum: Sh. Ajit Aggarwal, President,

               Smt Parampal Kaur, Member,

               Sh P Singla, Member.

 

Present: Sh Amit Mittal, Ld Counsel for complainant,

         Sh Neeraj Maheshwary, Ld Counsel for OP-1,

         Sh Atul Gupta, Ld Counsel for OP-2 & 3,

         Sh Pardeep Kumar on behalf of OP-4.

 

(Ajit Aggarwal, President)

                               Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against OPs seeking directions to OPs to make payment of insurance claim of Rs.3,90,784/-and for further directing OPs to pay Rs. 4,00,000/- as compensation for harassment, inconvenience, mental agony besides litigation expenses of Rs 1,10,000/-.

2                                        Briefly stated, the case of the complainant is that complainant owns a Swift Dezire Car bearing registration no. PB-05E-0043 registered with DTO, Ferozepur, manufacture by Maruti Suzuki and OP-2 to 4 are authorized dealers of Maruti Suzuki and complainant got insured his car with OP-1 through OP-2 and 3, who issued him cover note alongwith his seal and signature and at the time of issuance of cover note, they assured him that in the event of damages up to 50% and OP-1 would pay him full declaration value of Rs3,90,784/-to complainant and moreover,OP-2&3took responsibility for same from OP-1 on behalf of OP-1. It is contended that on 11.03.2014 at about 12.00-12.30 midnight, the said car of complainant met with an accident and complainant sent his car to OP-4, who is authorized dealer of Maruti Suzuki for making estimate of the damaged car. Op-2 to 4 gave intimation regarding it to OP-1 and complainant also supplied copy of RC and other relevant documents as demanded by them.OP-4 made estimate of Rs 2,72,000/-for the loss and OP-4 duly supplied the same to OP-1 and OP-4 also intimated complainant that complainant is entitled to entire declaration value of Rs 3,90,784/-. On 4.08.15, complainant received a letter dt 20.06.2015from Op-1, vide which claim of complainant was rejected due to the fact that vehicle was not registered on the date of loss (Vehicle was used on Public road/place without having been registered or the registration has not remained valid thereby failing to comply with section 39 or section 43 of M V Act. It is further contended that car of complainant is registered from the District Transport Office, Ferozepur for the last many years and even earlier, said car of complainant met with an accident on 13.05.2012 and OP-1 gave insurance claim to complainant. Complainant had supplied the copy of RC and OP-1 had made payment of entire insurance claim. Thereafter, complainant sent registered letter to Op-1 on 4.08.2015, wherein requested that there is no misrepresentation of facts and at the time of accident, his car was registered with D.T.O, Ferozepur, but till now, they have not made payment of genuine claim of complainant, which amounts to deficiency in service and trade mal practice on the part of Ops and it has caused harassment and mental agony to complainant for which he has prayed for directions to Ops to pay Rs 4,00,000/-as compensation alongwith litigation expenses of Rs 1,10,000/- besides the main relief of insurance claim of Rs 3,90,784/-. Hence, the  present complaint.

3                             The counsel for complainant was heard with regard to admission of the complaint and vide order dated 9.09.2015, complaint was admitted and notice was ordered to be issued to the opposite party.

4                                 Op-1 filed written statement taking preliminary objections that complicated questions of law and facts are involved in this case, which cannot be decided in summary proceedings and therefore, complaint is not maintainable in this Forum. Complainant has concealed the material fact that vehicle is repairable with loss assessed by IRDA approved Surveyor at Rs 89,820/-only whereas complainant remained adamant to get the loss on total loss basis i.e at IDV of Rs 3,90,784/-, which is not payable at all. Op-1 has prayed for directing complainant to get the vehicle repaired and submit the bills of repair to them so that loss assessed by Surveyor may be released. It is averred that complainant is not the consumer of OP-1 and he has no locus standi to file the present complaint. However, on merits, OP-1 has denied all the allegations levelled by complainant being wrong and incorrect and asserted that there is no deficiency in service on the part of answering OP. It is averred that insurance is strictly subject to terms and conditions of Policy and it is denied that they would pay full IDV i.e Rs 3,90,784/-. It is also denied if OP-2 and 3 took responsibility for claiming the same from OP-1 and also denied that estimate of Rs 2,72,000/-was made. It is asserted that estimate is based on guess work and is not binding on the rights of OP-1. Op-1 got assessed the loss from M r Pawan Kumar Garg Surveyor and assessed the loss to the tune of Rs 89,820/-after applying depreciation and other provisions as per terms and conditions of the Policy, IMT, age of vehicle and nature of parts and submitted Survey Report dt 18.06.2015. Moreover, it is settled law that Survey Report is an important document and has to be accepted unless there are cogent reasons for rejecting the same. However, it appears that the repudiation letter was inadvertently issued presuming that the vehicle was not registered. All the other allegations levelled by complainant are denied being wrong and incorrect and it is reiterated that there is no deficiency in service or unfair trade practice on the part of answering OPs. The allegations with regard to relief sought too were refuted with a prayer that complaint deserves to be dismissed with costs.

5                                 On receipt of the notice, the opposite party-4 filed written statement taking preliminary objections that there is no deficiency in service on the part of OP. It is averred that after accident, said vehicle was got repaired from OP-4 and before starting repairs, insurance policy, driving license of driver, FIR number was made available to them by complainant and due intimation regarding this fact was given to OP-1. Vehicle was repaired on directions of complainant and OP-1 and same is ready since 30.05.2015. the amount of Rs 1,30,247/-is due towards complainant, but same is not paid to answering OP either by complainant or by OP-1. Op-4 has no objection in delivering the possession of car to complainant subject to payment of amount of Rs.1,30,247/-is due towards complainant. It is averred that complainant has no cause of action to file the present complaint and he has no locus standi to file it. However, on merits, OP-4 has denied all the allegations levelled by complainant being wrong and incorrect and reiterated that there is no deficiency in service on the part of OP-4.

6                                         OP-2 and 3 appeared in the Forum through Counsel, but despite availing several opportunities, they did not file reply and therefore, defence of OP-2 and 3 was struck off vide order dt 21.12.2015.

7                                        Parties were given proper opportunities to prove their respective case. The complainant tendered in evidence his affidavit Ex.C-1, C-2, affidavit of Ishan Mittal as Ex C-3 and documents Ex C-4  to C-13 and then, closed his evidence.

8                          In order to rebut the evidence of the complainant, OP-1 tendered in evidence, affidavit of Meenu Sharma, as Ex OP-1/1, affidavit of Pawan Kumar Garg as Ex Op-1/6 and documents Ex OP-/2 to OP-1/5 and then, closed the same.

  9                                         OP-4 tendered in evidence affidavit of Shavinder Pal Singh Warriach as Ex OP-4/1 and documents Ex OP-4/2 to OP- 4 /3and then, closed the same on behalf of OP-4.

10                                         Ld Counsel for complainant argued that the complainant owned a Swift Desire Car bearing Registration No. PB-05 E 0043 registered with District Transport Office, Ferozepur. Copy of the RC is Ex C-12. The above said car of the complainant is insured with OP-1 through OP-2 and 3. The copies of insurance covers are Ex C-6 to 8. At the time of issuance of insurance policy, the OPs assured complainant that in the event of accident of car and damage up to 50%, the OPs would pay full insurance value of the vehicle to the complainant. On 11.03.2014, the said car of complainant met with an accident. He duly informed OP-1 regarding it and sent his car to OP-4 for making estimate of the damage and to repair it. The OP-2 to 4 also duly gave intimation to OP-1 within time regarding the accident and damage caused to the car of complainant.  The complainant supplied all the requisite documents alongwith record and copy of RC as demanded by OPs to them. After the inspection of car, Op-4 estimated the loss to the vehicle for about Rs.2,72,000/-which is more than 50% of the insured value. The OP-4 duly intimated regarding it to OP-1 and assured complainant that he is entitled for entire insured value of the vehicle as loss is more than 50% of assured value but OPs did not pay the insurance claim of the complainant, rather on 4.08.2015, the complainant received a letter dt 26.06.2016 from OP-1 stating that the claim of the complainant has been repudiated due to mis-representation of facts that vehicle was not registered at the time of said accident. The copy of letter is Ex C-9. They repudiated the claim of complainant on false and frivolous grounds. The vehicle in question of the complainant is duly registered with District Transport Office, Ferozepur from the very beginning. The complainant also got verification of the registration from the DTO, Ferozepur and the copy of verification is Ex C-4. Moreover, earlier, the car in question met with an accident on 13.05.2012 and at that time, OP-1 duly gave insurance claim of the car to the complainant. After receiving the letter from OP-1, complainant sent reply to it through registered post stating all the facts alongwith copy of RC and Verification Report but till today, OPs have not paid the claim amount to the complainant. He visited the office of OPs many times but they put off the matter on one pretext or the other and now, they have flatly refused to make payment of amount. These acts of OPs amount to deficiency in service on their part, which caused great mental tension, harassment and financial loss to the complainant. He prayed that OPs may be directed to pay the full insurance value of the vehicle i.e Rs.3,90,784/- alongwith interest, compensation and                                 litigation expenses.

11                             To controvert the arguments of complainant, ld counsel for OP-1 argued that complainant has no cause of action and locus standi to file the present complainant. He is not the consumer of OP-1 and there is no deficiency in service and trade mal practice on their part. However, they admitted that the vehicle in question was insured with them but the insurance was strictly subject to the terms and conditions of the Policy. It is wrong that OPs assured complainant that in case of any accident or damage to the car more than 50%, the OPs would pay full insurance value to him. It is further wrong that OP-2 and 3 took any responsibility regarding it. It is settled law that in case of any loss it is to be assessed as per report of Surveyor and payment has to be made accordingly. He admitted that car of complainant met with an accident and intimation regarding it was given to OP-1 but it is wrong that OP-4 made the estimate of Rs 2,72,000/-. Even estimate is based on guess work and is not binding on the rights of OP-1. On the intimation, the OP-1 duly got assessed the loss from Pawan Kumar Garg, who conducted survey and assessed the loss to the tune of Rs89,820/- after applying depreciation and other provisions as per terms and conditions of the Policy. The Survey Report is Ex OP-1/1. It is settled law that Survey Report is an important document and has to be accepted except there is any cogent reason for rejecting the same. Complainant cannot claim anything more than the loss assessed by the Surveyor. As the vehicle of complainant was repairable and loss assessed by Surveyor is Rs 89,820/- only so, complainant is not entitled to get loss on total loss basis and entire insurance value is not payable at all. Complainant may be directed to get the vehicle repaired and submit the bill of repair to OP-1, so that the loss assessed by Surveyor may be released. He submitted that repudiation letter dt 26.06.2015 was wrongly and inadvertently issued to complainant stating that vehicle was not registered at the time of accident. OP-1 are ready to release the claim of Rs 89,820/-, which is assessed by Surveyor after submitting the bill of repair of car, but in any case, the complainant is not entitled to get the entire insured value on the basis of total loss. There is no deficiency in service and trade mal practice on the part of OP-1 and complainant has filed false and frivolous complaint and present complaint may be dismissed.

12                                          Ld Counsel for OP-4 argued that present complaint is not maintainable against them as complainant has no cause of action and locus standi to file the complaint against them. However, they admitted that vehicle in question met with an accident and same was brought to them for repair and same was repaired by OP-4. Before starting the repair, all the documents like Driving License, FIR regarding accident and copy of RC were submitted to OP-4, who duly gave information regarding it to OP-1 and submitted documents supplied by complainant to them and on the instructions of OP-1 and complainant, the OP-4 repaired the vehicle of complainant and same is ready since 30.05.2015 and an amount of Rs 1,30,247/- is due towards repair charges of the vehicle and same is not paid to OP-4 till today either by OP-1 or complainant and no communication has been received by OP-4 regarding it form OP-1 or complainant so far. They never tendered amount of repair to OP-4. OP-4 has no objection to deliver the vehicle to complainant subject to payment of Rs 1,30,247/-either by OP-1 or complainant. it is wrong that OP-4 gave any assurance to complainant that he is entitled for the full insurance value instead of loss assessed by the Surveyor. As they have nothing to do with the insurance claim of complainant, it is only between complainant and OP-1. The Op-4 is entitled to claim the bill of repair of vehicle in question. They are unnecessarily impleaded as party to this complaint and present complaint may be dismissed against OP-4.

13                                   We have heard the ld counsel for complainant as well as OPs and have duly gone through the record available on the file.

14                                              The case of the complainant is that he is the owner of a car, which was duly insured with OP-1 and this vehicle was registered with District Transport Office, Ferozepur. His car met with an accident on 11.03.2014. He duly informed regarding it to OP-1 and he brought his car to the workshop of OP-4 for repair, who assessed estimate loss to the tune of Rs 2,72,000/-. He averred that at the time of issuance of insurance policy, OP-1 assured him that in case of any accident or damage up to 50%, in that case, he would be entitled for full insured value i.e Rs3,90,784/- as the loss estimated by OP-4 was more than 50% of insured value and he is entitled for full insurance value, but vide letter dt 26.06.2015, OP-1 wrongly and illegally repudiated his claim on false grounds that his vehicle was not registered at the time of accident, whereas his vehicle was already registered with the office of DTO, Ferozepur. He claimed that OP-1 may be directed to pay the entire insurance value of the vehicle to him alongwith compensation. In reply OP-1 admitted that the vehicle in question was insured but they denied that they ever assured                        complainant that in case of any loss or damage of more than 50%, complainant is entitled for full insurance value of vehicle. They argued that on the intimation of loss, they duly informed Surveyor to assess the loss, who assessed the loss to the tune of Rs 89,820/- and the complainant is only entitled for this amount as insurance claim of his vehicle and not entitled for total insurance value. Regarding the letter dt 26.06.2015, for repudiating the claim of complainant, they stated that it was issued inadvertently presuming that vehicle was not registered at the time of accident.

15                            We have gone through the file, documents and evidence brought on file by the parties. It is settled law that for assessing the insurance claim, the Survey Report is an important document and has to be accepted unless there are cogent reasons for rejecting the same. So, the complainant cannot claim the entire insured value of the vehicle by setting aside the Survey Report. Therefore, in these circumstances, complainant is only entitled for the amount which is assessed by the Surveyor in his report i.e the amount of Rs 89,820/-. However, OP-1 is in default of repudiating the insurance claim of complainant wrongly and illegally on the false and frivolous grounds that vehicle in question was not registered at the time of accident, whereas complainant duly submitted all the requisite documents alongwith copy of Registration Certificate (RC) and also Verification Report of the RC from District Transport Office, Ferozepur to OPs. This act of OP-1 amounts to deficiency in service and trade mal practice on their part. Hence, present complaint in hand is hereby allowed. Op-1 is ordered to pay Rs 89,820/-to complainant as insurance claim of his vehicle as assessed by Surveyor alongwith interest at the rate of 12 % per anum from 26.06.2015 when they repudiated the claim of complainant till final realization. OP-4 is directed to deliver the possession of vehicle in question to complainant on receiving the repair charges of Rs.1,30,247/-from him. OP-1 is further directed to pay Rs.20,000/-as compensation for harassment and mental agony suffered by complainant and Rs.3,000/-as litigation expenses to complainant within one month of receipt of the copy of the order failing which, complainant shall be entitled to proceed under Section 25 and 27 of the Consumer Protection Act. Copy of order be given to parties free of cost under rules. File be consigned to record room.

Announced in Open Forum

Dated : 26.02.2016                 

 

     Member            Member                   President

                      (P Singla)         (Parampal Kaur)      (Ajit Aggarwal)