Punjab

Faridkot

CC/20/158

Sukhvir Singh Brar - Complainant(s)

Versus

ICICI Lombard General Insurance - Opp.Party(s)

Jaswant Singh

26 Apr 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, FARIDKOT

 

Complaint No. :        158 of 2020

Date of Institution :    06.10.2020

Date of Decision :      26.04.2023

Sukhvir Singh Brar aged about 62 years, son of Mohinder Singh resident of Danewalia Street, New Harindra Nagar, Faridkot, District Faridkot.

....Complainant

Versus

1. ICICI Lombard General Insurance Company Limited, Plot No.149, 4^th Floor, The Statement Industrial Area, Chandigarh-16002, through its Manager.
2. ICICI Lombard General Insurance Company Ltd. 2^nd Floor, KK Tower, SCO-31, District Shopping Centre Ranjit Avenue, Amritsar-143001, Punjab through its Manager.

..............OPs

Complaint under Section 35 of the

Consumer Protection Act, 2019.

 

Quorum: Smt Priti Malhotra, President,

                Smt Param Pal Kaur, Member,

                Sh Vishav Kant Garg, Member.

 

Present: Sh Jaswant Singh, Ld Counsel for Complainant,

              Sh Neeraj Maheshwary, Ld Counsel for OPs,

 

 

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ORDER

(Priti Malhotra,  President)

                         Complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against OPs seeking directions to them to release the claim amount of Rs.39,000/- as refund value of his insurance policy alongwith interest and has also prayed for directions to Ops to pay Rs.40,000/- as compensation for harassment and mental agony suffered by him besides litigation expenses of Rs.12,000/-.

2                 Briefly stated, the case of the complainant is that he got insured his car bearing no, PB04Z-8686 with OPs against policy no. 3001/HI-11115573/00/000 valid from 04.03.2020 to 03.03.2021 and during the subsistence of said policy, vehicle of complainant met with an accident on 29.06.2020 at Kotkapura Road, Farikdot  by striking with a stray animal. In said accident, bumper and some other parts of the car were damaged and complainant got repaired his vehicle from Brar Automotive, Muktsar and spent Rs.39,000/-as repair charges. Immediate intimation regarding said accident was also given to OPs and bill for repair charges was also sent to OPs alongwith all other

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requisite documents, but till today, OPs have not made payment of Insurance Claim to complainant. Complainant made several requests to OPs to make payment of his genuine insurance claim but they did nothing to redress his grievance. It is alleged that all this amounts to deficiency in service and trade mal practice on the part of Ops and it has caused huge harassment and mental agony for which he has prayed for directions to OPs to pay Rs.39,000/-on account of repair charges paid by him for repair of his car and has also prayed for directions to Ops to pay Rs.40,000/- as compensation for harassment and mental agony suffered by him besides litigation expenses of Rs.12,000/-. Hence, the  present complaint.

3                               The counsel for complainant was heard with regard to admission of the complaint and vide order dated 13.10.2020, complaint was admitted and notice was ordered to be issued to the opposite parties.

4                             On receipt of notice, OPs appeared in this Commission through counsel and filed written statement taking preliminary objections that complainant has no locus standi to file the

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present complaint as no cause of action arises against answering OP. Complainant does not fall within the definition of ‘consumer’ and he has violated the terms and conditions of the policy and thus, OP is not liable to pay any claim to him. Moreover, intricate questions of law and facts requiring voluminous evidence are involved in present case that cannot be decided by way of summary procedure of this Commission. Complainant has concealed the material facts from this Commission that he has availed 25% no claim bonus while procuring the policy in question by stating that there was no claim against previous policy though he got claim from previous insurer and therefore, vide letter dated 16.07.2020, claim of complainant was repudiated. OP has denied all the allegations of complainant being wrong and incorrect but admitted before the Commission that complainant purchased the policy in question from them which was valid for the period from 04.03.2020 to 03.03.2021. It is also admitted that complainant duly informed them regarding said accident and Surveyor appointed by them assessed loss to the tune of Rs.38,887/-as per Survey Report dated 07.06.2020. It is reiterated that there is no

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deficiency in service on the part of OPs. Prayer for dismissal of complaint with costs is made.

5                                         Proper opportunities were given to complainant as well as OP to lead evidence to prove their respective case. Ld   counsel for complainant tendered in evidence, affidavit of complainant as Ex C-1, documents Ex C-2 to C-10 and then, closed the evidence.

6                                      To controvert the allegations of complainant, ld counsel for OP also tendered in evidence affidavit of Aditya Pandey Ex OP-1, documents Ex OP-2 to Ex OP-5, affidavit of Manish Kumar, Surveyor Ex OP-6 and then also closed the same on behalf of Ops.

7                        We have heard the arguments advanced by ld counsel for complainant as well OP and have very carefully gone through and perused the affidavits & documents placed on record filed by respective parties.

 

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8                                     From the careful perusal of record placed on file and arguments advanced by the counsel for complainant and OP, it is observed that there is no dispute regarding purchase of policy in question by complainant from OPs and it is also not denied that accident occurred during subsistence of present policy. Complainant lodged claim with OPs, who got conducted spot survey, inspected the vehicle and assessed the loss but thereafter, OPs repudiated the same on the ground that complainant has availed no claim bonus while procuring the policy in question. We are not convinced with the arguments addressed by the ld counsel for OPs as they have not placed on record any document regarding receiving of no claim bonus by the complainant from his previous insurer. Moreover, it was the duty of Insurance Company to verify such facts at the time of issuance of policy and now, in the absence of any cogent evidence in this regard, so, in our considered opinion, repudiation of claim by OPs is unjustifiable. It is transpired that despite repeated requests for clearing the genuine claim of complainant, OPs did nothing to make payment of claim, which amounts to deficiency in service on the part of OPs. From the careful perusal of documents placed on record by

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complainant party, it is crystal clear that OPs have failed to clear the genuine insurance claim of complainant and did not redress the grievance of complainant. On the other hand complainant has produced sufficient and cogent evidence to prove his pleadings. All the documents furnished before the Commission by complainant are fully authentic and are beyond any doubt.

9                              Ld Counsel for complainant has relied upon 2009 (3) CLT 417 wherein it is held that Survey Report is an important documents and it has to be accepted unless there are cogent reasons for rejecting the same. Moreover, Hon’ble National Commission in case of Narinder Kumar Joshi Vs Reliance General Insurance Company Ltd 2017 CPJ 366 (NC) has observed that the insurance claim is to be settled on the basis of Surveyor Report unless legitimate reasons are pointed out for not accepting the surveyor report. Similarly in case of Sri Venkateshwar Sindikat Vs Oriental Insurance Company Ltd and another, II CPJ 1 (SC), Hon’ble Supreme Court of India has observed that the surveyors were

 

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appointed under statutory provisions and they are linked between insurer and insured when question of settlement of loss or damage arises. The report of surveyor could become base for settlement of claim by the insurer in respect of loss suffered by the insured. Plea taken by OPs that complainant availed no claim bonus, without producing any cogent evidence, does not absolve them from their liability to pay the genuine claim of insured.

10                          In the light of above discussion, this Commission is of considered opinion that there is deficiency in service on the part of OPs in not making payment of insurance claim of damaged vehicle to him. Had OPs paid sufficient attention to redress the grievance of complainant at initial stage and had they initiated appropriate & effective steps to clear his claim amount as per survey report, case of complainant would have been different or there would have been no complaint at all. Complainant has succeeded in proving his case and therefore, complaint in hand is hereby partly allowed. OPs are  hereby directed to make payment of insurance claim  amount of Rs.38,887/- as per survey report dated 07.06.2020 Ex OP-4 given by Surveyor

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alongwith interest at the rate of 8% per anum from the date of institution of complaint till final realization. OP is further directed to pay Rs.5,000/-as compositing compensation on account of harassment and mental agony suffered by complainant and for litigation expenses. Compliance of this order be made within 45 days from the date of receipt of copy of this order, failing which complainant shall be entitled to proceed as per Consumer Protection Act. Copy of the order be supplied to parties free of cost as per rules. File be consigned to record room.

Announced in Commission :

Dated: 26.04.2023

 

Member                   Member                    President

(Vishav Kant Garg) (Param Pal Kaur)     (Priti Malhotra)