Delhi

North East

CC/95/2021

Ashish Goyal - Complainant(s)

Versus

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

04 Jul 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

 

Complaint Case No. 95/21

 

 

 

In the matter of:

 

		ShriAshishGoyal S/o Shri Vishnu Kumar, R/o House No. 08, St. No.05, Bank Colony, Mandoli, Delhi-110093		Complainant
		Versus
		The Manager, IffcoTokio General Insurance Co. Ltd. Regd. Office at:- IffcoSadan, C-1,District Centre, Saket, New Delhi-110017		Opposite Party
			DATE OF INSTITUTION:         JUDGMENT RESERVED ON:                           DATE OF ORDER:		02.08.21 21.04.23 04.07.23

 

CORAM:

Surinder Kumar Sharma, President

Anil Kumar Bamba, Member

Adarsh Nain, Member

ORDER

Anil Kumar Bamba, Member

The Complainant has filed the present complaint under Section 35 of the Consumer protection Act, 2019.

Case of the Complainant

1. The case of the Complainant as revealed from the record is that the Complainant purchased motor insurance policy from Opposite Party videinsurance policy no.119W09RSNP400#MB603484w.e.f. 23.11.19 to 22.11.20 for his vehicle bearing no. DL5CJ9801 and paid premium amount of Rs. 8,883/-. On 20.08.2020 the said vehicle got stolen and Complainant lodged FIR bearing no. 019942/2020 U/s 379 IPC at Police StationGTB Enclave and Complainant’s above said vehicle was not traced and Complainant applied for insurance claim for Opposite Party. The Complainant contacted Opposite Party many times and Opposite Party company assured Complainant every time that the company shall send a letter at the address of the Complainant and after receiving the letter the Complainant have to brought the said letter in office then the claim shall reimburse and on 06.01.21 the Complainant received email from Opposite Party of refusal of insurance claim. The Complainant stated that Opposite Party refused the claim of Complainant by stating the reason that both keys of Complainant’s vehicle are unused and intentionally marks are found on blade part of the key S-2 which are manually created by any sharp object to manipulate its usage. The Complainant stated that Opposite Party never intimated to Complainant at the time of checking the keys of above said vehicle. The Complainant stated that one official of Opposite Party came to Complainant’s house and received the both keys and handover a seizure memo to the Complainant in which the official of the above said company has mentioned that one used key and one unused key. The Complainant stated that Opposite Party is not paying insurance claim to Complainant as per terms and conditions of the motor insurance policy under Motor Vehicle Act. The Complainant sent legal notice dated 08.01.21 to manager of Opposite Party for reimbursement of his claim. The Opposite Party did not give reply to legalnotice nor paid the claim of the Complainant. Hence, this shows deficiency on the part of Opposite Party. The Complainant has prayed for the entire amount of the insurance claim of the vehicle in question i.e. Rs. 2,50,000/- with 18 % interest. He further prayed for Rs. 1,00,000/- for mental harassment and Rs. 31,000/- for litigation expenses. 

Case of the Opposite Party

2. The Opposite Party contested the case and filed written statement and stated that Opposite Party company appointed surveyor to assess the loss of said vehicle and the surveyor submitted its report wherein it was reported that there was misrepresentation by Complainant. It is submitted in pre insurance inspection report dated 22.11.19 the insured vehicle was driven around 1,86,126/- kms and after the date of theft the Complainant has stated in the claim form as well as in his hand written statement that his vehicle was driven just around 65,000/- kms on the date of stolen incident which was misrepresented by the Complainant. It is further stated that if the vehicle was driven around so much kilometres that at least one key needs to be in used shape but in this case both the keys submitted are brand new and one key having forceful scratches on it. Opposite Party further submitted that after receiving report from investigator both keys were sent for further forensic examination to Sherlock institute of forensic science and in the detailed report of Sherlock institute of forensic science it was found that Accordingly, Forensic report concluded as per findings the keys marked as S-1 and S-2 are not in line with the age and total kms travelled of the insured stolen vehicle. The Opposite Party company after getting the report from investigator and forensic team the Opposite Party company repudiated the claim of Complainant on 16.12.20 vide repudiation claim note issued by Opposite Party company and the intimation regarding the no claim was already sent to Complainant by repudiation letter dated 16.12.20. The Complainant has also filed claim proposal from on 24.08.20 and gave undertaking that in case any fraud or misrepresentation was came into light at later stage then claim of the Complainant will be forfeited by the insurance company.
3. The Opposite Party further stated that Complainant has misrepresented the facts of the case and also concocted incorrect story to extract money from the Opposite Party. The Opposite Party prayed that the complaint of the Complainant be dismissed with cost as the same is not maintainable.

Rejoinder to the written statement of Opposite Party

4. The Complainant filed rejoinder to the written statement of Opposite Party wherein the Complainant has denied the pleas raised by the Opposite Partyand has reiterated the assertion made in the complaint.

Evidence of the Complainant

5. The Complainant in support of his complaint filed his affidavit wherein he has supported the averments made in the complaint.

Evidence of the Opposite Party

6. In order to prove its case Opposite Partyhas filed affidavit of ShriAlok Gupta, General Manager in Opposite Party, wherein the averments made in the written statement of Opposite Party have been supported.

Arguments & Conclusion

7.  We have heard the Ld. Counsels for the Complainant and Opposite Party. We have also perused the file and the written arguments filed by the Complainant. The case of the Complainant is that he has purchased a motor insurance policy from Opposite Party valid from 23.11.19 to 22.11.20 for his vehicle and paid premium amount of Rs. 8,883/-.It is stated by Complainant that on 20.08.20 the said vehicle got stolen and he lodged FIR at Police Station GTB Enclave and Complainant’s above said vehicle was not traced and Complainant applied for insurance claim for Opposite Party. Complainant further stated that he contacted Opposite Party many times but Opposite Party company assured every time that the company shall send a letter to his address and after receiving the letter the Complainant have to brought the said letter in office then the claim shall reimburse and on 06.01.21 the Complainant received email from Opposite Party of refusal of insurance claim. The Complainant submitted that Opposite Party refused his claim by stating the reason that both keys of Complainant’s vehicle are unused and intentionally marks are found on blade part of the key S-2 which are manually created by any sharp object to manipulate its usage. The Complainant stated that Opposite Party never intimated to Complainant at the time of checking the keys of above said vehicle. The Complainant stated that one official of Opposite Party came to his house and received the both keys and handover a seizure memoto the Complainant in which the official of the above said company has mentioned that one used key and one unused key. The Complainant stated that Opposite Party is not paying insurance claim to Complainant as per terms and conditions of the motor insurance policy under Motor Vehicle Act.
8.  The case of the Opposite Party is that in pre insurance inspection report dated 22.11.2019 the insured vehicle was driven around 1,86,126/- kms and after the date of theft the Complainant has stated in the claim form as well as in his hand written statement that his vehicle was driven just around 65,000/- kms on the date of stolen incident which was misrepresented by the Complainant. It is further stated that if the vehicle was driven around so much kilometres that at least one key needs to be in used shape but in this case both the keys submitted are brand new and one key having forceful scratches on it. Opposite Party further submitted that after receiving report from investigator both keys were sent for further forensic examination to Sherlock institute of forensic science and in the detailed report of Sherlock institute of forensic science it was found that Accordingly, Forensic report concluded as per findings the keys marked as S-1 and S-2 are not in line with the age and total kms travelled of the insured stolen vehicle. The Opposite Party company after getting the report from investigator and forensic team the Opposite Party company repudiated the claim of Complainant on 16.12.20.
9. From the above facts, it is clear that Opposite Party is not disputing the theft of the vehicle and validity of the insurance policy during the theft of the said vehicle. The Untrace report accepted by the concerned court is also filed by the Complainant which is not disputed by the Opposite Party. Opposite Party repudiated the insurance claim solely on the basis of genuineness of the keys on the ground that vehicle was driven around thousands ofkms at least one key needs to be in used shape but in this case both the keys submitted are brand new and one key having forceful scratches on it. In this regard, Complainant is filed lost article report dated 24.12.19 in which he has informed the police that he has lost his keys on 23.12.19 and he also submitted invoice regarding fitting new lock set steering dated 24.12.19.
10. In view of above discussion, we are of the considered opinion that repudiation by the Opposite Party only on the ground of genuineness of keys is not acceptable. Therefore, the complaint is allowed. Opposite Party is directed to pay the IDV of the vehicle in question i.e. Rs. 2,50,000/- to the Complainant with interest @ 6 % p.a. from the date of filing the complaint till recovery. Opposite Party is further directed to pay Rs. 15,000/- on account of mental harassment and Rs. 10,000/- towards litigation expenses to the Complainant along with interest @ 6 % p.a. from the date of this order till recovery.
11. Order announced on 04.07.23.

Copy of this order be given to the parties free of cost.

File be consigned to Record Room.

(Anil Kumar Bamba)           Member

(Adarsh Nain)     Member

(Surinder Kumar Sharma) President