CONSUMER DISPUTES REDRESSAL FORUM – X
GOVERNMENT OF N.C.T. OF DELHI
Udyog Sadan, C – 22 & 23, Institutional Area
(Behind Qutub Hotel)
New Delhi – 110 016
Case No.301/2006
SH. INDERJEET SINGH
S/O SH. NANNU MAL
R/O A-140, DR. AMBEDKAR NAGAR COLONY,
ANDHERIA MORE,
CHATTERPUR, NEW DELHI
…………. COMPLAINANT
VS.
M/S ICICI LOMBARD GENERAL INS. COMPNAY LTD.,
BIRLA TOWERS, 5TH FLOOR, 25 BARAKHAMBA ROAD,
NEW DELHI-110001
ISSUING OFFICE
A-ONE MOTORS MIRKANA ENGINEERING PVT. LTD.,
A-19, MOHAN CO-OPERATIVE INDUSTRIAL ESTATE,
MATHURA ROAD,
NEW DELHI
…………..RESPONDENT
Date of Order:05.11.2015
O R D E R
A.S. Yadav – President
It is not in dispute that complainant is the registered owner of Indica DLE car bearing registration number DL-3CU-4851 and the said car was duly insured with OP-1 vide cover note PA-216241 for a period of one year from 19.12.2004 to 18.12.2005 for IDV of Rs.2,40,331/-. It is not in dispute that on 09.01.2005 the aforesaid car met with an accident and for that a FIR No.13/2005 u/s 279/337/304A was lodged on 01.09.2005 in P.S. Tabru, District, Gurgaon, Haryana.
The case of the complainant is that he lodged claim with OP-1 and OP-2 but they failed to settle the claim amount till date. It is further stated in the complaint that complainant met OP-1 and OP-2 number of times in this regard but they always misled the complainant. At last on 26.9.2005 complaint sent a legal demand notice through his counsel which was duly served upon OPs. Since the claim was not settled hence this complaint has been filed.
OPs in the written statement took the plea that complainant failed to inform OP about the factum of the alleged accident and as such OP-1 did not find in its record any claim against the subject policy. It is further submitted that as per the terms and conditions of the policy there is a procedure for making claim which prescribed as follows:-
- Make a call to our call centre to get the advice on the next course of action. Provide the call centre with detailed information.
- Inform police in case the accident involves any other person’s bodily injury, property, terrorism, malicious act etc in such a case, collect details such as same, contact numbers, address etc.
- Get a repair estimate from the tied up garage and fill up the claim form. The garage will be advised by us to start repairs.
It is denied that the branch office of OP-1 is at A-one Motors, Mirkana Engineering Pvt. Ltd. It is stated that complainant has not disclosed from which branch office of OP-1, complaint purchased the subject insurance policy. In nutshell the case of the OP is that no claim was ever lodged in respect of the accident in question with OP-1.
We have heard Ld. Counsel for parties and carefully perused the record. Ld. Counsel for OP has drawn our attention to the terms and conditions of policy which provides that in case of accident, notice is to be given in writing to the company immediately upon the occurrence of any accidental loss or damage in the event of any claim. So far as terms and conditions of the insurance policy is concerned, it is settled law that insurance is a contract between the parties which entails that even the terms and conditions are to be got signed from the insured. In this case only a cover note was sent to the complaint and terms and conditions were never got signed or intimated to complainant. It is submitted by the Ld counsel for OP-1 that no notice was given ever in writing to the OP-1.
Complainant has specifically stated in the complaint that the claim was lodged with the insurance company. It is significant to note that immediately after the accident the vehicle in question was taken by the complaint to A-one Motors and they have assessed that the car was completely damaged. It is significant to note that complainant has specifically stated in his affidavit that he has visited the office of OP-1 and OP-2 number of times and they assured that the claim will be settled. There is no reason to disbelieve the complainant.
Assuming for the sake of arguments that the claim was not lodged with OP-1, complainant has specifically mentioned in the legal notice that the claim of aforesaid damage was lodged with OP-1 and OP-2 and he met authorized agent M/s Hema Joshi number of times in this regard but of no avail.
In para 5 of the complaint, the complainant has specifically stated that complaint has sent legal notice to OPs on 26.9.2005 which was duly served on OPs. In the reply OP has not specifically denied that it has not received the aforesaid notice. Complaint has filed on record the copy of the UPC receipt by which the notice was sent.
OP-1 did not reply that notice stating that they have never received any claim from the complainant or that M/s Hema Joshi was not their authorized agent and M/s Hema Joshi has never intimated to them about this accident.
It is settled law that if before filing a complaint a legal notice is sent to OP and the same is not replied then the contents of the notice are deemed to have been admitted.
The complainant has taken comprehensive policy in respect of his car. It is not in dispute that the car met with an accident on 09.01.2005. For that the information was immediately given to the police and FIR was lodged. Complainant has specifically stated that insurance policy was taken through Ms Hema Joshi, authorized agent of OP-1 based at A-one Motors. Complainant has proved that the car was taken to A-one Motors after the accident. It is proved that M/s A-one Motors has given the repot that the car was completely damaged. So far as terms and conditions of the policy that the claim to be lodged in writing is concerned, the same was not informed to the complaint even otherwise the complainant specifically stated that he has filed an application for the aforesaid claim with OPs. It is clear cut case of deficiency in service on the part of OP-1.
The complainant is entitled for refund of Rs.2,40,331/- alongwith interest @ 10% p.a. from date of filing of the complaint. Complainant is also entitled for compensation of Rs.5,000/- as well as Rs.5,000/- for litigation expenses.
Let the order be complied within one month of the receipt thereof. The complaint stands disposed of accordingly.
Copy of order be sent to the parties, free of cost, and thereafter file be consigned to record room.
(D.R. TAMTA) (A.S YADAV)
MEMBER PRESIDENT
