Haryana

Ambala

CC/136/2017

Vinod Kumar - Complainant(s)

Versus

Iffco Tokio Gen Insurance Co Ltd. - Opp.Party(s)

Gourav Raj

06 Jul 2018

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM AMBALA

 

 

                                                          Complaint case no.        : 136 of 2017

                                                          Date of Institution         : 11.05.2017

                                                          Date of decision   : 06.07.2018

 

 

Vinod Kumar son of Sh. Sumer  Chand, resident of Ward No.1, Naveen Colony, Naraingarh, Tehsil Naraingarh, District Ambala.

 

     ……. Complainant.

Vs.

 

IFFCO TOKIO, General Insurance Company Limited, IFFCO Sadan, C1 District Centre, Saket, New Delhi-110017 through its Manager/ Authorised person.

 

 

  ….….Opposite Party.

 

Before:        Sh. D.N. Arora, President.

                   Sh. Pushpender Kumar, Member.             

                    

 

Present:       Sh. Rajesh Malik, counsel for the complainant.

                   Sh. Mohinder Bindal, counsel for the OP.

 

 

ORDER:

In nutshell, brief facts of the present complaint is that the complainant is the owner of vehicle Eicher 10.59 bearing registration No. HR-37C-8799 and the above said vehicle was also insured with the OP and OP issued Policy No.93339718 valid  from 23.07.2015 to 22.07.2016 and the complainant also paid premium of Rs. 21,671.95 to the OP. The above said policy was a comprehensive policy cover all risk and damages and theft etc. On 20.07.2016 the vehicle in question was being driven by Subhash Chand s/o Rajender Singh, R/o Village  Kandalwala, Tehsil Nahan(H.P.) and suddenly a cow came on the road and the driver to avoid the said cow turned the vehicle towards right side and the vehicle in question struck  against a standing truck and in the said accident the vehicle in question was badly damaged. The matter was also reported to the policy of P.S. Kala Amb and a DDR No.029 dated 25.07.2016 was also registered regarding the accident. Thereafter, the complainant also reported the matter regarding accident to the OP and damage caused to the vehicle in question. The OP deputed the Surveyor and inspected the vehicle in question and took the photographers and the Surveyor suggested the complainant to get the vehicle repaired and submitted the bills with the OP company and the OP will reimburse the amount to the complainant. Thereafter, the complainant got the vehicle in question repaired from Rajiv Motors, Mani Majra, Chandigarh and spent about Rs. 1,70,000/- for the repair from his own pocket. The complainant submitted all the bills of repair etc. alongwith all other relevant documents and completed all the formalities but the OP has not settled the claim or the claimant inspite of repeated visits and requests and even the claimant sent various letters to the OP. The complainant also served a registered AD legal notice dated 12.12.2016 upon the OP. There is certainly deficiency in service on the part of the OP. Hence, the present complaint.

2.                Upon notice, OP appeared through counsel and tendered written statement raising preliminary objections qua complaint is not maintainable, not come with clean hands, no jurisdiction.  On merits, OP stated that the complainant himself who is responsible for the non-payment of his claim with regard to the damages caused to the truck bearing registration no.HR-37C-8799 in the accident dated 20.07.2016. As a matter of fact the  reported claim with regard to the loss caused to said truck of th ecomplainant was duly entertained immediately and on IRDA approved surveyor Mr. Kamal Kumar Kangra was deputed  to assess the loss and to give his fact finding report. Said surveyor immediately contacted  the complainant and inspected  the vehicle in question and discussed the matter with him in detail and obtained  the estimate of repair, claim form, police report etc. During the survey proceedings and related papers, the surveyor  doubted the driver who was name by the insured in claim papers and police report so to substantiate and establish  the identity of actual driver, he requested the insured to give the medical/treatment papers of the alleged driver since the person  who was driving  the truck in question at the time of accident had also suffered injuries being blood found at the seat of driver  and moreover, from the position of said truck  and loss, it was apparent and evident that the driver must have suffered the injuries in the said  accident particularly when it is mentioned that the cleaner had suffered head injuries. The identity of a driver is very crucial and important for the disposal of any motor claim as per law.Although, the complainant gave his request and undertaking for the settlement of his claim for Rs. 90000/- as per assessment made by the surveyor vide his report dated 29.07.2017, but inspite of repeated oral requests and letters dated 20.02.2017, 02.03.2017 and 15.03.2017, the complainant ignored the same and failed to comply. Ultimately, the OP being finding no other alternative, held the claim of the complainant as no claim. But the complainant did not respond but in order to put undue pressure filed this present false and frivolous complaint. Therefore, there is no deficiency in service on the part of the Op and prayed for dismissal the present complaint.

3.                To prove his version complainant tendered his affidavits as Annexure C/A, C/B, C/C & C/D with documents as annexure C/1 to C/8 and close his evidence. On the other hand, Counsel for the OP tendered affidavits as Annexure R/A & R/B with documents as Annexure R/1 to R/7 and closed his evidence.

4.                            We have heard learned counsels for both the parties and carefully gone through the case file. Admittedly that the complainant has purchased the vehicle policy from the OP after paying the premium Rs. 21671.95/- for the period 23.07.2015 to 22.07.2016. It is proved on the file that vehicle in question met with an accident on 20.07.2016 and DDR No.9 dated 25.07.2016 was got registered in P.S. Kala Amb. As per the version of the complainant that he has reported the matter to the OP and insurance company has deputed the surveyor and after survey of the vehicle, the complainant got the repaired the vehicle after spending the amount of Rs. 1,70,000/-. The complainant further stated that he has submitted the claim to the OP but they have wrongly withheld claim of the complainant.

On the other hand, the OP has closed the claim of the complainant that complainant has failed to give the treatment record of the driver as required just to establish the identity of the actual person at the driving seat at the time of accident. The Op has further taken the plea that at the time of survey of the vehicle, the surveyor has observed that the person who was driving the vehicle at the time of accident, he suffered injuries being blood found at the seat of the driver and moreover, from the position of the said truck it was apparent and evident that the driver must have suffered injuries in the said accident whenever the cleaner of the vehicle has suffered head injuries and the identity of the driver  is very crucial and treatment record of the driver is important for disposal of the claim.

5.                          We have gone through the surveyor report Annexure R-4, the surveyor has not recorded the statement of any witnesses on the spot nor he mentioned the above said facts that seat of the driver has been changed and driver did not suffered any injuries. The surveyor has only mentioned in his report that the medical record of person driver at the time of accident is required and the surveyor has not verified the facts regarding identity of the driver, rather surveyor has mentioned in his affidavit that truck might had driven by son of insured Mr. Rajat Goyal who suffered serious injuries in the accident and might be some other person but surveyor has not mentioned the above said fact in his report. Meaning thereby the surveyor is helping the insurance company/OP to deprive the complainant to take the benefit of insurance claim and he has also tried to fill-up the lacuna at the instance of the OP. Hence, the above said version of the OP is not sustainable. Whenever, it is proved on the record that the vehicle in question got damaged in accident. It is not disputed that the claimant has given the consent letter to the OP for paying the surveyor amount as assessed by the surveyor  amounting Rs. 90,000/- as per Annexure R-6 but OP has failed to pay the above said amount to the complainant. So, we are view that Op has wrongly withheld the claim of the complainant and we hold that it is a great deficiency on the part of the OP for not paying the genuine claim to the complainant. Accordingly, the present complaint deserves to be accepted and same is hereby allowed with cost which assessed Rs. 5000/- and .Op is directed to comply with the following direction within thirty days from receipt of copy of the order:-

1. The OP is directed to pay the surveyor amount as per Annexure R-4 amounting Rs. 90,000/- along with interest @ 9% from the date of filing of the complaint till its realization  
2. Cost of proceedings as assessed above Rs. 5000/-.

 

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:06.07.2018                                       (D.N. ARORA)

                                                                                    PRESIDENT

 

 

                                                                                           (PUSHPINDER KUMAR)

                                                                                      MEMBER