Haryana

Ambala

CC/30/2017

Ajay Sehgal - Complainant(s)

Versus

Iffco Tokio Gen Inss Co. - Opp.Party(s)

Vikas Rathi

19 Apr 2018

ORDER

BEFORE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMBALA.

 

                                        Complaint No.30 of 2017.

                                        Date of institution:-23.01.2017.

                                        Date of decision: - 19.04.2018.

Ajay Sehgal s/o Krishan Lal resident of House No.187, Ram Nagar, aged about …..years Ambala City.

 

                                                           ...Complainant.

Versus

1.IFFCO TOKIO GENERAL INSURANCE COMPANY  Iffco House, 3^rd Floor 34 Nehru Place New Delhi 110019 through its General Manager.

2.IFFCO TOKO GENERAL INSURANCE COMPANY Ltd SCO 2^nd Floor Above Dena Bank, Punjabi Mohalla Ambala Cantt. through its Branch Manager.

 

                                                            …Opposite parties.

 

Complaint under section 12 of

 

 

Before:     Sh. Dina Nath Arora, President.

                Sh. Pushpender Kumar, Member.        

                    Ms. Anamika Gupta, Member.        

         

               

Present: -  Sh.Manish Kashyap,  Advocate for complainant.

                Sh.Mohinder Bindal, Advocate for opposite parties.

       

Order

                In nutshell, the facts of the complaint are that the complainant is owner of Tata Safari Dicor 2.2 VTT bearing registration No.HR01-AB-3761 and the same was got insured with OPs vide policy No.87874692 having validity from 30.05.2014 to midnight 29.05.2015 and the Ops have charged the premium to the tune of Rs.21688/-. The policy was covering all the claims of expenses and losses if occurs during the currency year. On 29.03.2015 complainant alongwith his friend Harpreet Singh went to Morni District Panchkula and in the evening while returning from Morni, the tyre of the vehicle got punctured and while repairing the punctured tyre when the mechanic removed the jack the stone of from the tyre got skidded and car fell into the ditches and got totally damaged. The complainant reported the matter to PP Morni vide DDR No.16 of 01.04.2015. Thereafter the complainant approached the Op No.2 and deposited the requisite documents. In the investigation it has come that the car was totally damaged but despite assurance the Ops lingered on the matter on one pretext or the other. On 26.02.2016 the complainant was called by OP No.2 and on its asking furnished the affidavit with regard of claim of Rs.4,88,000/- but despite assurance the OPs did not release/clear the amount of claim. The complainant visited the OPs and also submitted all the requisite documents but despite that the OPs did not make the payment of compensation. The act and conduct of the OPs clearly amounts to deficiency in service on their part. In evidence the complainant has tendered affidavit Annexure CA and documents Annexure C1 to Annexure C3.

2.                     On notice Ops appeared and filed their joint reply wherein several preliminary objections such as maintainability, jurisdiction and concealment of material facts etc. have been taken. It has been submitted that a claim was reported by the complainant with regard to accidental loss to insured vehicle i.e. car Tata Safari Décor bearing registration No.HR-01AB-3761. Thereafter a surveyor was deputed who in his report recommended the settlement of loss for Rs.4,88,000/- on net of salvage basis as consented by the complainant but since then the complainant had failed to comply with the required information and documents, therefore, the claim could not be finalized. Moreover, after scrutinizing the whole facts, situation, record and evidence the OPs were compelled to close the reported claim as no claim due to non compliance as per terms and conditions of the policy. There is no deficiency in service on the part of Ops. Other contentions have been controverted and prayer for dismissal of the claim has been made. In evidence, the OPs have tendered affidavits Annexure RA, Annexure RB and Annexure RC and documents Annexure R1 to Annexure R9.

3.             We have heard learned counsel for the parties and gone through the case file very carefully.

4.             Learned counsel for the complainant has argued that the complainant is owner of Tata Safari Dicor 2.2 VTT bearing registration No.HR01-AB-3761 and the same was got insured with OPs vide policy No.87874692 having validity from 30.05.2014 to midnight 29.05.2015 and the Ops have charged the premium to the tune of Rs.21688/-. The policy was covering all the claims of expenses and losses if occurs during the currency year. It has been further argued that on 29.03.2015 the complainant alongwith his friend Harpreet Singh went to Morni District Panchkula and in the evening while returning from Morni, the tyre of the vehicle got punctured and while repairing the punctured tyre when the mechanic removed the jack the stone of from the tyre got skidded and car fell into the ditches and got totally damaged. The complainant reported the matter to PP Morni vide DDR No.16 of 01.04.2015. Thereafter the complainant approached the Op No.2 and deposited the requisite documents. In the investigation it has come that the car was totally damaged but despite assurance the Ops lingered on the matter on one pretext or the other. On 26.02.2016 the complainant was called by OP No.2 and on its asking furnished the affidavit with regard of claim of Rs.4,88,000/- but despite assurance the OPs did not release/clear the amount of claim. The complainant visited the OPs and also submitted all the requisite documents but despite that the OPs did not make the payment of compensation. Lastly prayer for acceptance of the complaint has been made.

                        On the other hand learned counsel for the OPs has argued that accidental loss to insured vehicle i.e. car Tata Safari Décor bearing registration No.HR-01AB-3761 was lodged with them and after that a surveyor was deputed who in his report recommended the settlement of loss for Rs.4,88,000/- on net of salvage basis as consented by the complainant but since then the complainant had failed to comply with the required information and documents, therefore, the claim could not be finalized. Moreover, after scrutinizing the whole facts, situation, record and evidence the OPs were compelled to close the reported claim as no claim due to non compliance as per terms and conditions of the policy. There is no deficiency in service on the part of Ops. Prayer for dismissal of the complaint has been made.

5.             Undisputedly, the vehicle of the complainant was insured with the Ops and the same suffered loss during the currency of the policy in question. It is not disputed that the surveyor was deputed and after inspecting the vehicle in question he had assessed the total payable amount to the tune of Rs.4,88,000/-  in his report Annexure R1. The OPs have come with the plea that the complainant has not supplied the requisite documents as per the terms and conditions of the policy, therefore, the claim of the complainant was reported as No claim. The counsel of the OP has taken the another plea that claim is not also  not payable because Investigator recorded the statement of the complainant and his neighbour who was with him at the time of incident. They have given the contradictory statement with each other about the incident. We have pursued the statement of complainant as Annexure R-6 and Annexure R-8. There is no major contradiction in their statement. Plea of the OPs that the complainant had intentionally and deliberately concealed and suppressed the material fact is not tenable.

It is worthwhile to mention here that the insurers’ decision to reject a claim shall be based on sound logic and valid grounds. The insurance company is not supposed to earn profit in the shape of premium from the customers because it has legal responsibility to indemnify the loss if occurs during the currency year. In the present case undisputedly the loss has been occurred during the subsistence of the policy and the surveyor in his report has also assessed the vehicle as total loss and opined net payable loss as Rs.4,88,000/- in Annexure R1. Rejection of claims on purely technical grounds in a mechanical fashion will result in policy holders losing confidence in the insurance industry, giving rise to excessive litigation. In the present case it appears that that insurance company is bent upon to reject the claim in this way or that way. Undisputedly, in the present case the surveyor was appointed by the insurance company who after physical verification gave his report and the same is placed on the case file as Annexure R1. Perusal of this very document reveals that the surveyor had assessed the net liability of insurer to the tune of Rs.488,000/-. Since the surveyor appointed by the insurance himself has coincided the damage to the vehicle with accident and this fact also finds support from the DDR No.16 dated 01.04.2015.  It is a settled proposition of law that Surveyor is the best person to assess the loss and his report cannot be brushed aside unless there is cogent and convincing evidence. In the instant case also, no credible evidence has been produced on the basis of which Surveyor’s report could be dis-believed.

5.                     Keeping in view the above facts and circumstances of the case it is held that the insurance company has wrongly withheld the claim of the complainant on the ground that complainant has not supplied the requisite documents as per terms and conditions of the policy, therefore, the present complaint deserves acceptance. Accordingly, we allow the present complaint against OPs with cost which is assessed as Rs.5,000/-. The OPs are further directed to comply with the following direction within thirty days of the receipt of copy of the order:-

1. To pay a sum of Rs. 4,88,000/- (as assessed by the surveyor in his report Annexure R1) to the complainant alongwith with simple interest @ 9% per annum from the date of filing of complaint till actual realization after keeping the salvage by the OPs. The complainant is directed to complete all the formalities accrues after receiving the salvage by the insurance company.

 

 Copy of the order be sent to the parties concerned, free of costs, as per rules. File after due compliance be consigned to record room.

 

Announced on: 19.04.2018

 

 

                                                               

PUSHPENDER KUMAR      ANAMIKA GUPTA        D.N. ARORA MEMBER                                MEMBER                        PRESIDENT