Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 480.
Instituted on : 18.08.2017.
Decided on : 11.06.2019.
Shiv Kumar Sharma son of Sh.Murari Lal Sharma R/o H.No.111, Secto-14, Rohtak.
………..Complainant.
Vs.
- IFFCO Tokio General Insurance Company Ltd. Improvement Trust Market, Iffco Tower, Near Improvement Trust Office, Rohtak through its Manager.
- IFFCO Tokio General Insurance Co. Ltd. IFFCO Sadan, C1, Distt. Centre, Saket New Delhi through its Manager.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
SH. VED PAL, MEMBER.
DR. RENU CHAUDHARY, MEMBER.
Present: Sh.Deepak Bhardwaj, Advocate for the complainant.
Sh. R.K. Behl, Advocate for opposite parties.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that the complainant is owner of a Car bearing registration No. HR-12Q-6677 which was insured from opposite parties vide policy No. 98552136 valid from 16.06.2016 to 15.06.2017 for IDV of Rs.4,03000/-. That on 09.11.2016 the said vehicle met with an accident and was badly damaged which is beyond repair. That complainant duly informed the officials of the opposite parties on time and the vehicle was got surveyed by the surveyor of the opposite parties namely Shri Parkash, who prepared his assessed damaged report and surveyor also declared the insured vehicle as total loss.
But after repeated requests of the complainant to the opposite parties, the claim amount has not been disbursed to the complainant. That the act of opposite parties is illegal and there is deficiency in service on the part of opposite parties. As such, it is prayed that opposite parties may kindly be directed to disburse the insurance claim amount of Rs.403000/- alongwith interest @ 18% per annum from the date of incident till the date of actual realization and Rs.2,00,000/- as compensation alongwith Rs.3300/- as litigation expenses to the complainant as explained in relief clause.
2 After registration of complaint, notice was issued to the opposite parties. Opposite parties in their reply has submitted that the company deputed Shri Parkash Surveyor and loss Assessor to assess the loss of Car no.HR12Q-6677 and he assessed loss for Rs.377000/- on Net of salvage basis without RC and Rs.342000/- on Net of salvage basis with R.C. and after that investigations were made by the Innovative Insurance Surveyors and both confirmed that damages are not co-relating with the cause of loss. Insured not clear about the place of accident and loss not matching with the spot. As such the claim was rightly repudiated and intimation was given to the insured on 11.05.2017. Hence the complainant is not entitled for any claim. All the other contents of the complaint were stated to be wrong and denied and opposite parties prayed for dismissal of complaint with cost.
3. Ld. counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, document Ex.C1 to Ex.C8 and has closed his evidence on dated 07.12.2018. Ld. counsel for the opposite party has tendered affidavit Ex.RW1/A, Ex.RW1/B, documents Ex.R1 to Ex.R5 and closed his evidence on 24.04.2019.
5. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
6. In the present case, the claim of the complainant was denied by the respondent insurance company vide letter Ex.C1 dated 11.05.2017 on the following grounds: 1) The damages are not co related with the cause of loss. 2) The insured not clear about the place of accident and loss not matching with the spot. We have perused the documents placed on record by the parties. The respondent insurance company after receiving the information from the complainant about the loss in his vehicle, deputed a surveyor and loss assessor Sh. Shri Parkash to assess the loss as per terms and conditions of the policy, who submitted his private and confidential report on dated 10.02.2017. In his report, the surveyor has assessed the loss as per Net of salvage basis(without RC) as Rs.343000/- whereas the IDV of the vehicle was Rs.403000/-. In this report the surveyor has mentioned that he investigated the vehicle minutely and after long discussion with the repairer as well as the higher authorities of the insurance company, he came to the conclusion that the vehicle is under the limit of total loss, meaning thereby increased the liability of repair which cross the limit of 75% of the IDV value so he came to the conclusion that the settlement of the loss should be under total loss. So after considering all the facts and circumstances, he submitted his report to the company for further necessary action. In this report the surveyor Sh. Shri Parkash has not mentioned anywhere that the damages suffered by the complainant in his vehicle are not co related with the cause of loss mentioned in the claim form and this fact has also not been mentioned that the place of accident and loss not matching with the spot, whereas he submitted that the company should settle the claim as per terms and conditions of the policy or the company may take suitable decision at their end. After receiving this opinion, the insurance company deputed another investigator i.e. Innovative Insurance Surveyor and Loss Assessor Pvt. Ltd. to investigate the matter and he submitted his report with the insurance company on dated 23.03.2017. In this report the surveyor has mentioned in his conclusion, in para no.9 that : “We observed that insured is hiding some facts as the cause of loss narrated by insured is not matching with the damages of the concerned vehicle”.
7. We have perused both the reports but we could not find any concrete evidence to prove that the cause of loss narrated by the insured is not matching with the damages. After perusal of the report Ex.R3 we found that under the head spot photographs, the investigator has mentioned that “During visit at the spot in the presence of insurer, he narrated the consequences of the said incidence, during investigation we could not find any eye witness available at the spot as it was the running highway towards Panipat and there was no permanent construction or any commercial shop was available to enquire the same……”. After perusal of this report, we found that when the incident has taken place on 09.11.2016 and the Innovative Surveyor and loss assessor visited the spot in the month of March 2017 and found that there was no eye witness found on the spot regarding the incident, It is itself contradictory because the incident had taken place in the month of November 2016 and investigator visited the spot in the month of March 2017. As per our observation no one should be present on the spot for narrating the incident after a gap of approximately 5 months. As such, report submitted by the investigator is not authenticated. Hence the plea taken by the respondent that the damages are not co related with the cause of loss and the insured not clear about the place of accident and loss not matching with the spot is baseless and turned down. As such, complainant is entitled for the loss as assessed by the surveyor, as per his report Ex.R2, amounting to Rs.342000/- on the basis of net of salvage basis without RC.
7. In view of the facts and circumstances of the case, complaint is allowed and we hereby direct the opposite parties to pay the claim amount of Rs.342000/-(Rupees three lac forty two thousand only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 18.08.2017 till its realisation and also pay a sum of Rs.3000/-(Rupees three thousand only) as compensation and Rs.3000/-(Rupees three thousand only) as litigation expenses to the complainant within one month from the date of decision.
8. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
11.06.2019.
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Nagender Singh Kadian, President
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Ved Pal Hooda, Member.
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Renu Chaudhary, Member.
