DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BARNALA, PUNJAB.
Complaint Case No: CC/15/2023
Date of Institution: 10.02.2023
Date of Decision: 16.09.2024
Amarjit Singh aged about 36 years son of Rajinder Singh, resident of Near Ramgaria Gurudwara Sahib Road, Phatak, Near Opp. Jass Diary, Tehsil and District Barnala.
…Complainant
Versus
1. IFFCO Tokio General Insurance Company Limited, 5-C/1, Ground Floors, Sheetal Complex, Rajbaha Road, Patiala-147001, District Patiala through its Manager.
2. Maruti Insurance Broking Private Limited, 01, Nelson Mandela Road, Vasant Kunj, New Delhi-1100070, through its Manager/Authorized Signatory.
…Opposite Parties
Complaint Under Section 35 of the Consumer Protection Act, 2019.
Present: Sh. P.S. Kaushal Adv counsel for complainant.
Sh. D.S. Sran Adv counsel for opposite party No. 1.
Sh. Varun Singla Adv counsel for opposite party No. 2.
Quorum.-
1. Sh. Ashish Kumar Grover: President
2. Smt. Urmila Kumari: Member
(ORDER BY ASHISH KUMAR GROVER PRESIDENT):
The complainant has filed the present complaint under Section 35 of the Consumer Protection Act 2019 against IFFCO Tokio General Insurance Company Limited, 5-C/1, Ground Floors, Sheetal Complex, Rajbaha Road, Patiala-147001, District Patiala through its Manager & others (in short the opposite parties).
2. The facts leading to the present complaint are that the complainant is the registered owner of Car Maruti S-Presso VXI having registration No. PB-19-S-8143. It is alleged that the complainant got his car insured from opposite party No. 1 through opposite party No. 2 and paid premium of Rs. 7,763/- including tax, having policy No. 12710999 for the period from 11.10.2021 to 10.10.2022. It is further alleged that at the time of receiving premium from complainant opposite party No. 1 had assured complainant that it is a cashless policy and complainant would not be required to pay any amount to get his said car repaired except a compulsory deductible of Rs. 1000/-. It is further alleged that the car of complainant met with an accident on 25.05.2022 and intimation qua this fact was given to opposite parties by complainant by lodging his claim and complainant parked his car at opposite parties authorized dealer namely Max Autos, Mansa Road, Barnala but complainant was asked to pay the repair charges there in advance qua which complainant number of times contacted opposite parties through emails but opposite parties neither repudiate the claim of complainant nor started the repair work of car of complainant and the car of complainant is still parked there unrepaired since 25.07.2022, which caused great mental harassment and pecuniary loss to complainant for an amount of Rs.1,00,000/-, as complainant is forced to hire private as well as public transport. The complainant sent a legal notice dated 30.12.2022 through his counsel but of no use. As such, the act of opposite parties for not providing services to complainant falls within the definition of deficiency of service and unfair trade practice on the part of opposite parties. Hence, the present complaint is filed for seeking the following reliefs.-
- The opposite party may be directed to get started the repair work of car on cashless basis and to pay a sum of Rs. 100,000/- on account of pecuniary loss.
- To pay Rs. 50,000/- as compensation as physical and mental pain, agony and harassment alongwith interest @ 18% per annum and Rs. 20,000/- as litigation expenses.
3. Upon notice of this complaint, the opposite party No. 1 appeared and filed written version by taking preliminary objections interalia on the grounds that the present complaint is not maintainable before this Commission. It is alleged that the claim in question of the complainant was closed by the answering opposite party as the complainant failed to fulfill the requirement of insurer of fulfilling the necessary documents to enable them conclude the reported claim under the terms and conditions of the insurance policy. The opposite party not denied to settle the claim of the complainant on merit as per terms and conditions of the insurance policy, but was not able to process the same for want of completion of claim formalities on the part of complainant as per various letters dated 21.01.2023 & 31.01.2023 and thus the claim was closed under non-compliance vide letter dated 07.03.2023 after giving ample opportunities to the insured. The present complaint is frivolous and not tenable at law and hence deserves to be dismissed with costs.
4. On merits, it is submitted that Car Maruti S-Presso VXI registration No, PB-19-S-8143 was insured by the answering opposite party for the period of 11.10.2021 to 10.10.2022 vide policy No 12710999 under Motor Insurance Policy as detailed in the Policy Schedule and all the conditions under the Policy Were fully understood by the Complainant/ Insured before taking the policy and he had thoroughly read the Policy Wordings. It is alleged that a claim was reported by the insured on 25.07.2022 for loss dated 28.02.2022 for damage to the insured vehicle and the claim was registered vide Claim No. 37Q49236. Thereafter, the Insurance Company appointed IRDA licensed and independent Surveyor/ Loss Assessor namely Er. Rajesh Aggarwal to conduct the survey of the loss to the vehicle. The surveyor surveyed the vehicle on very same day of intimation of claim and collected few documents such as claim form, copy of FIR, copy of insurance policy & copy of DL & RC etc. Since as contents of FIR suggested that the driver Mr. Amarjeet Singh was under drinking condition when the vehicle was met with an accident. The surveyor asked to insured to submit his MLR and police final investigation report to process the claim further and a letter dated 21.01.2023 was sent by the appointed surveyor to the Insured whereby documents required for claim processing were demanded such as MLR report of driver of insured vehicle and Final Investigation report of Police authority & Copy of Court Challan but the insured not provided the demanded documents. It is alleged that the opposite party also sent the Reminder Letter dated 31.01.2023 to Amarjit Singh but the insured not respond to insurance company as well and after that a letter dated 07.03.2023 sent by the Insurance Company to the insured intimating him about Closure of the claim due to no response from the insured side. It is further alleged that hence the file was closed under non-compliance of documents. All other allegations of the complaint are denied and prayed for the dismissal of complaint.
5. The opposite party No. 2 filed separate written version by taking preliminary objections on the grounds that the present complaint is wholly misconceived and unsustainable in the eyes of law. It is alleged that the allegations as made by the complainant in the instant complaint are mere bald averments without any shred of paper filed to substantiate them against the opposite party No. 2. The complainant has intentionally and deliberately concealed material facts from this Commission and has filed a vexatious and misleading complaint to obtain unjustly gains. It is noteworthy that there exists no privity of contract between the complainant and the answering opposite party as the opposite party No. 2 is neither insured the vehicle in question nor received any premium or consideration in its name. It is further alleged that the complainant has impleaded opposite party No. 2 without any reason, cause of action and/or justification.
6. On merits, it is specifically denied that answering opposite party inspected the vehicle of the complainant before insuring the same and further specifically denied that it issued cover note to the complainant after receiving the premium amount. It is submitted that opposite party No. 2 qua insurance broker mainly acts as a facilitator of motor insurance products offered by various Insurance Companies. It is submitted that the vehicle in question has been insured by Iffco Tokio General Insurance Co. Ltd." in lieu of premium charged from the complainant and same can be corroborated from the copy of insurance policy submitted by complainant along with his plaint. It is submitted that decision for repudiation or approving the insurance claim rests with the insurance company only i.e. opposite party No.1 and not with the broking entity, that is, answering opposite party. So, there is no deficiency in service or unfair trade practice on its part. All other allegations of the complaint are denied and prayed for the dismissal of complaint.
7. The complainant filed rejoinder to the written version of opposite party No. 1 vide which he denied the averments of version.
8. Ld. Counsel for complainant on 9.10.2023 has suffered the statement that I do not want to file any rejoinder against the version of opposite party No.2.
9. To prove the case the complainant tendered into evidence copy of RC Ex.C-1, copy of policy Ex.C-2, copy of legal notice Ex.C-3, postal receipts Ex.C-4 & Ex.C-5, affidavit of complainant as Ex.C-6, copy of FIR Ex.C-7 (containing 5 pages) and closed the evidence.
10. The opposite party No. 1 tendered into evidence copy of policy schedule with wording as Ex.OP1/l (containing 4 pages), copy of letter dated 21.01.2023 as Ex.OP1/2, copy of reminder letter dated 31.01.2023 as Ex.OP1/3, copy of closure letter dated 07.03.2023 as Ex.OP1/4, copy of surveyor report (containing 15 pages) as Ex.OP1/5, affidavit of Gurvinder Kaur as Ex.OP1/6, affidavit of Er.Rajesh Aggarwal as Ex.OP1/7 and closed the evidence.
11. The opposite party No. 2 tendered into evidence affidavit of Rohit Sachdev Ex.O.P2/1, copy of registration of licence renewal certificate from 2.2.2021 to 1.2.2024 Ex.O.P2/2, copy of registration of licence renewal certificate from 2.2.2018 to 1.2.2021 Ex.O.P2/3 and closed the evidence.
12. We have heard the learned counsel for the parties and have gone through the record on the file.
13. The insurance and accident in the present case has been admitted by the opposite party No. 1. The opposite party No. 1 closed the claim of the complainant vide letter dated 7.3.2023 Ex.O.P1/4 in which the opposite party No. 1 mentioned that the required documents has not been supplied by the complainant i.e. MLR report, Final Investigation report of Police authority & copy of Court Challan. Ld. Counsel for opposite party No. 1 argued that as per contents of FIR the driver Amarjit Singh was under drinking condition at the time of accident. The Surveyor asked to submit the MLR report and final investigation report of police to process the claim, but the complainant failed to supply the said documents. Therefore, the claim of the complainant was closed as no claim under condition No. 1 of the conditions attached to the policy which states as under “Notice shall be given to the Company immediately upon the occurrence of any accidental loss or damage in the event of any claim and therefore the insured shall give all such information and assistance as the Company shall required”. Ld. Counsel for the complainant argued that the complainant has supplied all the documents to the opposite party No. 1. Ld. Counsel for the opposite party No. 1 further argued that as per purview of the motor insurance policy, the insurance company is not be liable to make any payment in respect of any accidental loss or damage suffered whilst the insured or any person driving with the knowledge and consent of the insured is under the influence of intoxicating liquor or drugs and as per FIR the complainant was under the influence of liquor. The complainant has produced the copy of FIR as Ex.C-7. The FIR was got registered against the unknown person on the statement of injured Rajinder Singh son of Jagtar Singh resident of Street No. 9, Patti Road, Barnala in which it was got stated by the injured in the said FIR that the driver was under the influence of liquor at the time of alleged accident. The injured further alleged that the driver was caught by the persons gathered at the spot. The injured further alleged that due to serious injuries some unknown persons had taken the injured to the Civil Hospital, Barnala. We have gone through the entire evidence produced by the opposite parties. The opposite parties failed to produce any cogent evidence to prove that the complainant Amarjit Singh was under the influence of liquor at the time of alleged accident. The Insurance Companies in routine appointed the investigator to investigate the matter. The documents claimed by the Surveyor of the Insurance Company can easily be procured to decide the claim of the complainant. Merely statement of injured has not established that the driver Amarjit Singh was under the influence of liquor as he himself stated while registering the FIR that he was seriously injured due to the accident and it is further established that the FIR No. 228 of dated 25.5.2022 was got registered against the unknown persons. Ld. Counsel for the complainant argued that the vehicle in question still parked unrepaired since 25.7.2022 and the complainant claimed that opposite parties may be directed to start the repair on cashless basis. We have gone through the entire evidence produced by the complainant but the complainant has failed to produce any evidence to prove the loss of the complainant. But the opposite party No. 1 has produced the Surveyor report as Ex.O.P1/5 in which the Er. Rajesh Aggarwal Surveyor & Loss Assessor has assessed the loss of Rs. 88,819/- of the vehicle in question bearing registration No. PB-19S-8143. From the above said Surveyor/Loss Assessor report it is established that the vehicle in question was met with an accident and the vehicle was seriously damaged.
14. From the facts and evidence on the file it is established that the vehicle of the complainant was damaged in the accident and the complainant suffered loss due to said accident and the opposite party No. 1 has failed to settle the claim of the complainant. The closure of claim submitted by the complainant vide letter dated 7.3.2023 Ex.O.P1/4 was not reasonable and unjustified. Therefore, there is clear cut deficiency in service and unfair trade practice on the part of the opposite party No. 1.
15. In view of the above discussion, the present complaint is partly allowed against the opposite party No. 1 and the opposite party No. 1 is directed to pay an amount of Rs. 88,819/- as assessed by Surveyor alongwith interest @ 7% per annum from the date of filing the present complaint till its actual realization to the complainant. The opposite party No. 1 is further directed to pay Rs. 10,000/- on account of compensation for causing mental torture, agony and harassment suffered by the complainant and Rs. 5,000/- as litigation expenses to the complainant. Compliance of this order be made within the period of 45 days from the date of the receipt of the copy of this order. Copy of the order be supplied to the parties free of costs. File be consigned to the records after its due compliance.
ANNOUNCED IN THE OPEN COMMISSION:
16h Day of September, 2024
(Ashish Kumar Grover)
President
(Urmila Kumari)
Member
