DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II

Udyog Sadan, C-22 & 23, Qutub Institutional Area

(Behind Qutub Hotel), New Delhi-110016

Case No.88/2012

Sh. Arun Suneja

S/o Late Shri Hari Sharan Suneja

R/o 14-A/76, WEA,

Karol Bagh, New Delhi-110005                                   ….Complainant

Versus

Iffco Tokio General Insurance Co. Ltd.

Through Manager

Having Regd. Office at;

Iffco Sadan, C-1, Disstt. Centre,

Saket, New Delhi-110017                                         ….Opposite Party

                                                  Date of Institution      : 06.09.11        Date of Order      : 14.12.18   

Coram:

Sh. R.S. Bagri, President

Ms. Naina Bakshi, Member

Ms. Kiran Kaushal, Member

ORDER

Naina Bakshi, Member

Briefly stated, the case of the complainant is that Complainant was having a “Maruti Zen vehicle, bearing registration DL-2CV-8576 which he got insured with from OP vide insurance policy No.I-101YVRDN dated 15.12.11.  It is submitted that the car met with an accident, as his car hit against the driver at ridge road, as the complainant tried to save a man who was crossing the road in a hurry.  It is submitted that the complainant filled the claim form in the office of the OP.  The complainant took his car to Maruti Sales and Services Workshop at Naraina on 13.01.2012 wherein he was given an estimate of Rs.2.5 lakhs for getting his car repaired i.e. Rs.55,000/- for the labour and about Rs.2 lakhs as cost of the parts of the car which were damaged in the accident. The OP appointed the surveyor to examine the claim of the complainant. The surveyor without opening the car gave an estimate of approx. Rs.1.5 lackhs as expenditure to repair the damaged car. The complainant  requested the surveyor several times to open the car and to tell him the exact amount but the surveyor did not open  the car to estimate the expenditure and repair work to be done and the parts to be replaced.  The surveyor told the complainant that Rs.1.5 lakhs would be required to repair the car but Maruti Workshop had given the complainant the estimate of Rs. 2.5 lakhs for getting his car repaired and the surveyor deliberately avoided opening the car as he knew that the estimate for repairing of the car was more than Rs.1.5 lakhs. It is submitted that the surveyor wrote three formal letters to the complainant asking him give the details of the accident which he had given on the first day in the claim form but he was harassed by the surveyor who did not give him the correct estimate of the loss suffered by him due to the accident of his car. It is submitted that the surveyor told the complainant to settle the matter for a lesser amount than the insured amount of Rs.1.45 lakhs. It is submitted that the complainant was totally confused as the insurance amount of his car was Rs.1.5 lakhs and the estimate given by the Maruti Workshop was Rs.2.5 lakhs. The surveyor never gave the correct estimate. The complainant visited several times to the office of the OP company and requested them  to give the insured amount of Rs.1.45 lakhs but the complainant  never received any response from the concerned officers of the OP.   The complainant  faced lot of harassment due to the indifferent attitude of the OP. The car of the complainant has been totally damaged in the accident and he does not have so much of money to get his car repaired as the insurance amount  was only Rs.145 lakhs and the estimate given by the Maruti Car Workshop for getting  the car repaired was Rs.2.5 lakhs.  When no positive response was received from OP the complainant  sent a legal notice dated 11.02.12 to the OP but no reply was received from the OP. Hence, pleading deficiency in service and unfair trade practice on the part of the OP the complainant has filed the present complaint for directing the OP to give insurance amount of Rs.1.45 lakhs to the complainant and to give a sum of Rs.2 lakhs as compensation for harassment faced by the complainant due to the indifferent attitude of the OP and OP further be directed to pay cost of litigation to the complainant.

In the written statement OP has inter-alia stated that the complaint is liable to be dismissed on account of the complainant  being guilty of suppressing material facts from this Forum by not producing letter dated 24.01.12, 30.01.12 and 11.02.12 on record vide which the independent surveyor who had been appointed by the OP to assess the loss sustained by the insured. As per the terms and conditions of the insurance contract the insured was under due obligation to provide all the necessary documents such as original FIR, DL for verification etc. as required by the surveyor to process the claim but the insured had failed to provide any such document which were required by the surveyor to process the claim of the insured.  Vide above letters,  the surveyor time and again requested the insured to furnish several documents as referred in the above letters and give approval to the repair to start the repair works on insured vehicle. However, on the contrary the insured failed to produce the documents as required by the surveyor to process the claim and also failed to give necessary approval to the repairer. The conduct of the insured was very non cooperative and with an intent to delay the process of claim, settlement and harassed the OP. It is denied that the complainant had taken estimate of Rs.2.05 lakhs for getting the insured vehicle repaired and provided the same to the OP for indemnification. It is denied that the  insured has visited the office of the complainant  and requested for an estimate amount, on the contrary the insured has not provided the required documents to the surveyor for necessary approval to repairer to assess the loss sustained by the complainant. It is denied that the insured is entitled to claim any claim amount since he was non cooperative by the independent surveyor whose job was to assess the loss of the insured. Therefore, on account of non cooperation the claim of the complainant is liable to be dismissed.

Complainant  has filed a rejoinder to the written statement of the OP and has stated that no FIR was registered as after the accident had taken place at about 10.30 p.m. on 10.02.12, the complainant  had given in the writing to the SHO P.S. Chanakyapuri that his car hit against the driver at ridge road, in the front of Budha Garden as he tried to save a man who was crossing the road in a hurry and came infront of his car. He also stated in the letter which he gave on 10.06.12 in the police station that his nephew was sitting on the backseat and he sustained minor injuries. The complainant also stated that no one was responsible for the accident and he never wanted any police action in the matter. It is submitted that the complainant  had given the details of the accident in his claim form dated 12.01.12 which he submitted to the OP through Maruti Sales and Services Workshop at Naraina and he had also given his original driving license, original RC and the insurance policy for verification. Therefore, the complainant has submitted all the relevant documents which were forwarded by the OP company to the surveyor appointed by them and therefore the claim of the insured company that the complainant failed to produce the document as required by the surveyor to process the claim is absolutely false and denied.  It is submitted that the complainant visited the office of the OP several times and requested that he may be given the insurance amount of Rs.1.45/- lakhs for his damaged car but he never received any response from the OP. The car of the complainant has been totally damaged and it is useless for him to get his car repaired.

Complainant has filed his own affidavit in the evidence. On the other hand, affidavit of Sh. Rajiv Chaudhary, Vice-President (Claims) has been filed in evidence on behalf of the OP.

Written arguments have been filed on behalf of the parties.

We have heard the arguments on behalf of the parties and have also gone through the file very carefully.

The complainant has filed the insurance policy as Ex. CW1/A.  The complainant filed the complaint before the SHO P.S. Chanakya Puri as Ex. CW1/A-1. The police station gave a copy as Annexure CW1/B.  The complainant filed the claim form as Ex. CW1/B-1. The complainant  filed the estimate received from Maruti Sales and Services (Delhi) Naraina as Ex. CW1/C. The complainant sent a legal notice dated 11.02.12 Ex. CW1/D. The complainant sent an email dated 03.10.12 to the OP Ex. CW1/F. The OP vide letter dated 09.02.12 sent an email to the complainant as Ex. CW1/G.  The OP filed a surveyor report dated 28.06.12 which we mark as Annexure-1 for the purposes of proper identification wherein he has stated that

“ After instruction from Iffco Tokio General Insurance Co. Ltd., the subject vehicle was inspected by the undersigned at M/s Maruti Sales and Services  (Delhi), Naiana Indl. Area on 14.01.2012.  During inspection we found that the insured vehicle was badly damages to the front side. As per the insured version’s in the claim form that while going towards Dhaula Kuan vide Ridge Road, suddenly a pedestrian who was trying to cross the road came in front of insured vehicle. To save the collision with him, insured steered his vehicle towards right side but his vehicle went out of control and struck with the driver at front side.

As such the damages of insured vehicle was attributing with the cause and nature of accident narrated by the insured in the claim from so we allow the front side to the insured and settled the claim with the repairer. We also sent a letter dated 17.01.2012 to the insured requested him to kindly submit the remaining claim documents i.e. FIR (if any), Original DL for verification & Towing Receipt and also asked him some queries related to the subject accident.

After few days when we reached at the repairer’s workshop, we found that insured did not give the approval to the repairer to start the repair work on his vehicle. Therefore we send three letters dated 24.01.2012,30.01.2012 & 11.02.2012 to the insured and requested him to kindly produce the remaining claim documents and give the approval to the repairer to start the repair works on his vehicle. But insured did not produce any claim documents to the undersigned neither he gave the approval to the repairer to start the repair works on his vehicle.

When we again visited at the repairer’s workshop, it was learnt from the repairer that the insured took away his vehicle from their workshop without getting it repair. It seems that insured is no more interested to take the subject claim. Hence we have no other option except to close the claim please take  the suitable decision at your end subject to approval  of under writer.”

It is evident from the record that the complainant had not repaired his car from Maruti Sales and Services. The complainant filed all the documents with the OP as per the claim form as Ex. CW-1/B-1.   As per the insurance policy Insured Declared Value (IDV) of the vehicle was Rs.1,45,000/-. The authorized service centre of Maruti Sales and Services gave an estimate of Rs.2,02,500/- i.e. more than the IDV amount, the OP should have given atleast Rs.1,45,000/- i.e. IDV to the complainant. Not paying the full IDV amount i.e. Rs.1,45,000/-to the complainant amounts to deficiency in service and unfair trade practice on the part of the OP.  

In the light of above discussions we find OP to be guilty of deficiency in service and allow the complaint with the direction to OP to pay Rs.1,45,000/- i.e. full the IDV of the vehicle with interest @ 6% per annum from the date of filing of the complaint till realization within one month from the date of receipt of copy of this order failing which OP shall liable to pay 9% interest on the above said amount.

Let a copy of this order be sent to the parties as per regulation 21 of the Consumer Protection Regulations. Thereafter file be consigned to record room.

Announced on 14.12.18.