Punjab

Faridkot

CC/15/133

Jaswinder Singh - Complainant(s)

Versus

ICICI Lombard Insurance co. - Opp.Party(s)

B.R.Watts

27 May 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FARIDKOT

 

Complaint No. :      133

Date of Institution:  15.09.2015

Date of Decision :   27.05.2016

 

Jaswinder Singh s/o Sh Gurdeep Singh r/o village Phide Kalan, Post Office Wander Jatana, District Faridkot.

...Complainant

Versus

Managing Director/Manager, ICICI Lombard Insurance Company Limited, ICICI Lombard House, 414, Savajar Marg, Near Siddhi Vinayak Temple, Prabhadev, Mumbai-400015.

.....Opposite Party

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 B R Watts, Ld Counsel for complainant,

              Sh Neeraj Maheshwary, Ld Counsel for OPs,

         

(Ajit Aggarwal, President)

                               Present complaint is filed under Section 12 of the Consumer Protection Act, 1986 against OPs seeking directions to OPs to make payment of insurance claim of Rs.48,635/-and for further directing OPs to pay Rs. 40,000/- as compensation for harassment, inconvenience, mental agony besides litigation expenses of Rs.10,000/-.

2                                Briefly stated, the case of the complainant is that complainant owns a Maruti Ritz car bearing Registration no.PB-30K-0143 and the said car was fully insured with OP vide Policy No. 3001/ MI-01073476/00/000 package policy private vehicle issued on 31.01.2013 and valid from 31.01.2013 to 30.01.2014. Certificate of insurance is attached. On 29.07.2013, the car of complainant was turned and fell into fields due to sudden drop of hub of front wheel. Claim was duly lodged with OPs, who appointed a Surveyor namely Davinder Singh Sandhu to check the car. He made detailed report and also received a bill of Rs2150/- and sent the Survey Report dt 28.10.2013 with detail of the accident to OPs. The complainant duly submitted all the requisite documents alongwith bills etc to Surveyor. The complainant paid Rs.48,635/-for repair of his vehicle, but OPs did not pay any claim to complainant as per report of Surveyor. In this way, there is clear cut deficiency in service on the part of Ops. Previously, the complainant filed complaint regarding his insurance claim before this Forum and in that complaint, ld counsel for OPs gave statement that complainant has not filed any claim regarding the accident in question and as such, the complaint is premature and if the claim is filed, the Insurance Company shall decide the same. On it, the complainant withdrew his complaint on 6.02.2015. This Forum directed OPs to clear the claim within 45 days and also permitted complainant that if he does not get claim, he was at liberty to file the fresh complaint on same cause of action. On 13.03.2015, complainant again submitted fresh claim alongwith necessary documents and copy of order of this Forum but Ops did not send any reply even after the lapse of 45 days. Notice alongwith claim form was also sent to Ops, but they did not decide the claim of complainant which amounts to deficiency in service and trade mal practice on their part. The OPs may be directed to make payment of insurance claim of complainant alongwith compensation and litigation expenses. Hence, the present complaint.

3                           The counsel for complainant was heard with regard to admission of the complaint and vide order dated 30.09.2015, complaint was admitted and notice was ordered to be issued to the opposite party.

4                      OP 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 and documents from this Forum and OPs and they have no documentary proof of submission of any alleged claim. Claim of the complainant is premature and moreover, complainant is not the consumer of answering OP and he has no locus standi to file the present complaint. However, on merits, OP 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 further averred that during the pendency of present complaint, the OPs deputed Surveyor, who conducted survey and after deducting depreciation assessed loss to the tune of Rs16,411/-. It is asserted that as per record, no regular claim has been lodged by complainant with OPs. If any claim had been intimated with OPs, claim number would definitely have allotted. It is totally denied that same number as that of previous claim was allotted as alleged by complainant. It is also denied that complainant is entitled for Rs.48,635/-as claim. 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                                Parties were given proper opportunities to prove their respective case. The complainant tendered in evidence his affidavit Ex.C-1 and documents Ex C-2 to C-19 and then, closed his evidence.

6                             In order to rebut the evidence of the complainant, OP tendered in evidence, affidavit of Meenu Sharma, as Ex OP-1, affidavit of Ranjit Singh as Ex OP-2 and documents Ex OP-3 to OP-4 and then, closed the same.

7                                          Ld Counsel for complainant vehementally argued that complainant owns a Maruti Ritz car which was insured with OP against Insurance Policy issued on 31.01.2013, valid from 31.01.2013 to 30.01.2014. On 29.07.2013, the car of complainant was turned and fell into fields due to sudden drop of hub of front wheel and then complainant duly lodged claim with OPs, who appointed a Surveyor  to check the car. Surveyor made detailed report and also received a bill of Rs2150/- and sent the Survey Report dt 28.10.2013 with detail of the accident to OPs. The complainant submitted all the requisite documents alongwith bills etc to Surveyor. The complainant paid Rs.48,635/-for repair of his vehicle, but OPs did not pay any claim to complainant as per report of Surveyor. In amounts to deficiency in service on the part of Ops. It is further contended that previously, the complainant filed complaint regarding his insurance claim before this Forum and in that complaint, ld counsel for OPs gave statement that complainant has not filed any claim regarding the said accident and as such, the complaint is premature and if the claim is filed, the Insurance Company shall decide the same. On it, the complainant withdrew his complaint on 6.02.2015 and this Forum directed OPs to clear the claim within 45 days and also permitted complainant that if he does not get claim, he was at liberty to file the fresh complaint on same cause of action. On 13.03.2015, complainant again submitted fresh claim alongwith necessary documents and copy of order of this Forum but Opposite Party did not send any reply even after the lapse of period of 45 days. Notice alongwith claim form was also sent to OP, but Opposite Party did not decide                                                            the claim of complainant which amounts to deficiency in service and trade mal practice on their part. This act of Ops has caused huge harassment to complainant and made his suffer mental agony. Prayer for accepting the complaint is made. Ld counsel for complainant has stressed on documents Ex C-1 to 19.

8                                To controvert the allegations of ld counsel for complainant, ld counsel for OPs asserted that complicated questions of law and facts are involved in present case, which cannot be decided in summary proceedings and therefore, it is not maintainable in this Forum. It is averred that complainant has concealed the material fact and documents from this Forum and OPs and they have no documentary proof of submission of any alleged claim and moreover, claim of the complainant is premature and complainant is not the consumer of answering OP and he has no locus standi to file the present complaint. All the allegations levelled by complainant are denied being wrong and incorrect and asserted that there is no deficiency in service on the part of answering OP. It is further averred that during the pendency of present complaint, the OPs deputed Surveyor, who conducted survey and after deducting depreciation assessed loss to the tune of Rs16,411/-, which have already been paid by OP to complainant on 18.03.2016 during the pendency of this complaint in the Forum. It is asserted that as per record, no regular claim has been lodged by complainant with OPs. If any claim had been intimated with OPs, claim number would definitely have been allotted. It is totally denied that same number as that of previous claim was allotted as alleged by complainant. It is also denied that complainant is entitled for Rs.48,635/-as claim. All the other allegations have been denied being wrong and incorrect and prayer for dismissal of complaint is made.       

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

10                              The case of the complainant is that he is the owner of car which was insured with OP. During the insurance period, the car of the complainant met with an accident and complainant gave due information regarding same to OP, who appointed Surveyor to assess the loss to the vehicle. The Surveyor checked and assessed the loss of the vehicle and sent his Survey Report to OP, but they did not pay the insurance claim to complainant, which amounts to deficiency in service and trade mal practice on the part of OP. In reply, OP submitted that complainant is not entitled for any claim as he has not lodged any claim with OP regarding the loss to vehicle and did not submit any document with them. The complainant is required to submit the claim form alongwith necessary documents to process his claim.

11                              Ld Counsel for complainant argued that he duly gave intimation regarding the accident to OP and OP appointed a Surveyor to assess the loss to the vehicle. The Surveyor Davinder Singh Sandhu duly inspected the vehicle, assessed the loss and submitted his Survey Report Ex C-2 and thus, OPs can not deny that the complainant did not give intimation to them regarding accident. However, in the previous complaint filed by complainant regarding the same cause of action, OPs took same stand and on the direction of this Forum, the complainant filed afresh claim with OP and as per directions of this Forum, OPs had to decide the claim within 45 days, but OPs have failed to decide the claim of complainant within stipulated period. They are only making lame excuses to avoid their liability to pay insurance claim to the complainant.

12                        We have thoroughly gone through the file, evidence on record and arguments addressed by the parties. It is observed that only plea of the OPs is that the complainant did not inform them about said accident and never lodged any claim with them for the loss to his vehicle. The complainant produced Sh Davinder Singh Sandhu the Surveyor and Loss Assessor in this Forum who appeared as CW-1 and produced copy of Survey Report dt 28.10.2013, which was conducted by him on the instructions of OP on 6.08.2013 and inspected and assessed the loss to the vehicle of complainant. He sent his detailed Survey Report alongwith bills, photographs and other documents to OPs. He specifically deposed that he conducted the Survey on the instructions of OP. Now, after it, it does not lie in the mouth of OP that complainant never intimated them regarding the alleged accident when Surveyor conducted the survey on their instructions and how they can escape from their liability. Moreover, the complainant produced claim form and letter dt 13.03.2015 sent by them alongwith necessary documents to OP after withdrawal of his previous complaint with directions of this Forum to decide the claim of complainant within 45 days. Now, in their fresh reply, they have again taken previous stand that complainant has not lodged any claim with them. We find no force in the stand of OP and we are of considered opinion that Opposite Party is intentionally avoiding payment of insurance claim of complainant, which amounts to deficiency in service and trade mal practice on their part. We are fully convinced with the arguments of complainant. Hence, complaint in hand is hereby allowed with directions to OP to pay Rs.39,000/- as claim for the loss of his vehicle as assessed by Surveyor Davinder Singh Sandhu vide his Survey Report dt 28.10.2013 Ex C-2  alongwith interest at the rate of 9 % per anum from 28.10.2013 the date of Survey Report till final realization minus Rs.16,411/- already paid by OP to complainant on 18.03.2016 during the pendency of this complaint in the Forum. Opposite Party is further directed to pay Rs10,000/-to complainant for harassment and mental agony suffered by him besides Rs3,000/-as litigation expenses 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 : 27.05.2016                 

  Member            Member                   President

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