Haryana

Ambala

CC/141/2011

PRADEEP SHARMA - Complainant(s)

Versus

IFFCO TOKIO GENERAL INSURANCE CO - Opp.Party(s)

P.K GOEL

23 Dec 2016

ORDER

BEFORE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMBALA.

                                                        Complaint No. 141 of 2011

                                                        Date of instt:   06.05.2011

                                                        Date of decision:23.12.2016

 

                        Pardeep Sharma son of Sh. Brij Bhan, R/o H.No.160, New Rattangarh Colony, Manav Chowk, Ambala City.

 

                                                                           ...Complainant.

                          Versus

1. Iffco Tokio General Insurance Co. Ltd., 6330, 2^nd Floor, above Dena Bank, Punjabi Mohalla, Ambala Cantt through its Branch Manager.

 

2. Iffco Tokio General Insurance Co. Ltd., Iffco House, 3^rd Floor, 34 Nehru Place, New Delhi-19 through its authorized official/Manager.

                                                                         …Opposite parties.

Complaint under section 12 of

 

BEFORE:  SH. DINA NATH ARORA, PRESIDENT.  

                SH. PUSHPENDER KUMAR, MEMBER                   

 

Present:-   Sh. P.K. Goel, Adv. for complainant.

                Sh. Mohinder Bindal, Adv. for Ops.

 

ORDER:

                In nutshell, the facts of the complaint are that  complainant is owner of Bolero LX Car bearing regn. No.HR01-Z-9500  and he got insured the said car  from United India Insurance Co. Ltd. for the period from 14.12.2009 to 13.12.2010. It has been submitted that  immediately  before expiry of said period, he went to office of Op No.1 and deposited a sum of Rs.13,404/- as full insurance against a sum of Rs.4,75,000/- and the insurance cover was in continuity  and there was no break up in the period of insurance as  first insurance. It has been submitted that on 14.12.2010, the vehicle  of the complainant while driving the car by him met with an accident and the car was damaged and got repaired from M/s P.P. Automobiles Pvt. Ltd. Karnal and a sum of Rs.1,57,628/- spent on the repair etc. Matter was reported to the OP insurance company, they appointed surveyor but after sometime his claim was repudiated vide letter dated 06.04.2011  on  the ground that  policy was commenced from 5 P.M. on 14.12.2010 while the accident was verified to be occurred at 3:45 P.M. on 14.12.2010 and thus outside  from the period of  insurance cover. It has been submitted that  it was the duty of Op to issue cover note for the period w.e.f. 13.12.2010 after receiving of payment from the  complainant on the said day and OP of its own cannot put  the date of period to be commence from 14.12.2010 5.P.M. onwards as there was not break up and the insurance premium was paid in its continuity and even otherwise also, the first insurance was paid to M/s United India  Insurance Company and not to OP and thus Op  was  bound  to issue cover note  policy for  period to be commenced from 13.12.2010 and not from 14.12.2010.  As such, the OP insurance company is negligent in providing proper service and the act of Op is a deficiency in service. Hence, the present complaint seeking relief as per prayer clause.

2.             Upon notice, Ops appeared through counsel and tendered reply to the complaint raising preliminary objections qua suppression of material facts by complainant, maintainability of complaint and cause of action. On merits, it has been averred that as per record  the vehicle in question was  insured with OP insurance company at the relevant period. OP has submitted that complainant called an agent of OP insurance company to insure the vehicle in question after office hours and that too without the availability of the vehicle in question  so to avoid any manipulation, in such like cases, the insurance policy will come into force after 24 hours of its issuance and this fact was apprised and clearly stated to the complainant at that time.  After mutual discussion and understanding the said policy was issued by the agent and  thus policy was effective from 14.05.2010 at 5.00 P.M.  alongwith certain terms & conditions. It has been submitted that complainant in  order to get claim from Op mentioned the time of accident as 8.00 P.M. on 14.12.2010 whereas as per report of investigator appointed by OP, the alleged  accident had taken place well before 3.45 p.m. on 14.12.2010 i.e. before the effectiveness and coming into force of the policy. Further it has been submitted that upon intimation of alleged accident, Mr. Deepankur Soni was deputed to assess the loss who vide his report dated 18.12.2010 assessed actual loss to the vehicle of Rs.1,31,947/-. Further, since, the alleged accident  taken place on the same day of the insurance policy coming into force i.e. 14.12.2010 itself at 5.00 P.M., so investigator M/s Royal Associate was also deputed to investigate the matter  who reported that manipulations being made by the complainant as  the alleged accident had infact taken place at well before 3.45 p.m. on 14.12.2010 instead of 8.00 P.M being  mentioned by the complainant whereas the insurance policy in question came into force at 5.00 p.m. on 14.12.2010. As such, the OP insurance company vide letter dated 06.04.2011 repudiated the claim of complainant and the Op prayed for  dismissal of complaint with costs.

3                 To prove his version, complainant tendered his affidavit as Annexure CX alongwith documents as annexure C-1 to C-19 and close his evidence. On the other hand, counsel for Op tendered affidavits Annexures RX, RY & RZ alongwith document as Annexure R-1 to R-10 and closed the evidence on behalf of OP.  During the course of proceedings, complainant moved an application for cross examination  of witnesses  of OP  i.e. Kashmir Singh, Investigator and Depankur Soni, Surveyor and Loss Assessor on 17.10.2016 and the same was dismissed vide our separate order dated 16.12.2016.

4.                We have heard learned counsel for both the parties and have gone through the pleadings as well as perused the record placed on file. Case of the complainant is that vehicle bearing regn. No.HR01-Z-9500 owned by him was insured with United India Insurance Co. Ltd. for the period from 14.12.2009 to 13.12.2010 (Annexure C-2) and the vehicle before expiry of the said period was further got insured from OP insurance company while depositing a sum of Rs.13404/- as full insurance against total sum assured of Rs.4,75,000/- vide policy (Annexure C-4)  for the period from 14.12.2010 to Midnight on 13.12.2011.  Counsel for complainant has vehemently argued that since the present insurance policy was in continuation of the previous policy, so at the time of accident on 14.12.2010, the vehicle was duly covered under the insurance policy and the OP insurance company has wrongly repudiated his legal claim.

                On the other hand, counsel for Ops has argued that they have rightly repudiated the claim of complainant as the accident in question occurred on 14.12.2010 at 3.45 p.m. whereas the insurance policy had been commencing from 14.12.2010 at 5.00 p.m. as is clear from document Annexure R-2.  As such, there is no illegality on the part of OP in repudiating the claim of complainant vide letter dated 12.06.2013 (Annexure R-1). Counsel for the Ops also stressed arguments on the point that at the time of alleged accident the vehicle was being driven by one Sh.Brij Bhan Sharma who was not authorized to drive the vehicle in question nor he has produced his license for verification.   

5.             From the above arguments, the following two moot  questions have arise for consideration before us are:-

a)     Whether at the time of accident, vehicle in question was under insurance cover or not?

b)     Whether the vehicle was being driven by a person holding a valid driving license, at the time of accident?

                Perusal of document insurance policy (Annexure C-2) issued by previous insurer of the vehicle i.e. United India Insurance Company Ltd. reveals that  the vehicle in question was insured for the period from 00.00 Hrs on 14.12.2009 to midnight on 13.12.2010 and thereafter the vehicle was got insured by complainant with the Op insurance company for the period from 14.12.2010:00:00:00 to Midnight on 13.12.2011 00:00:00 (Annexure C-4) by paying premium of a sum of Rs.13,404/- on 13.12.2010 (Annexure C-3).

                After going through pleadings of the parties as well as record placed on file, we are of the view that the cover note (Annexure C-3)  and policy document  Annexure C-4) issued by OP insurance company is continuation of the previous policy (Annexure C-2) issued by United India Insurance Company Limited as the policy in question commence from midnight of 13.12.2010 (from midnight 12:01 A.M. on 14.12.2010), as such, the vehicle was under cover of insurance period prior to  the accident  allegedly occurred on 14.12.2010 at 3.45 p.m. As per document Annexure R-2, complainant has paid premium on 13.12.2010 and the previous policy has also been expired on 13.12.2010 but the OP arbitrarily endorsed its starting period from 5.00 P.M on 14.12.2010 whereas it should start just expire of the previous policy. Perusal of policy (Annexure C-4) bearing no.P400#:74846922 reveals date of issuance of policy as 15.12.2010 and period of insurance starts from 14.12.2010 00:00:00 to midnight on 13.12.2011 but  the OP wrongly mentioned  starting period from 5.00 P.M. on 14.12.2010. OP had taken the premium from the complainant for complete one year ending upto mid-night of 13.12.2011 which can only start w.e.f. mid-night of 14.12.2010.  It is not case of the OP that insurance had been done by them upto 5.00 P.M. of 14.12.2011.   It is clear that complainant has deposited the premium amount on 13.12.2010 at 5.00 P.M., the policy shall remain enforce from 12:01 A.M of the day 14.12.2010  which means that  the risk cover of the vehicle starts on 14.12.2010 12:01 A.M. to 13.12.2010 12:00 P.M. and  it does not have any effect whether the accident occurred at 3.45 P.M. or 7.00 P.M. since the police commencement has already started prior to both the alleged timings of accident. Accordingly, we held that the vehicle at the time of accident was covered under insurance policy.

                The contention of counsel for OP that as per statement of Brij Bhan father of complainant (Annexure R-5), the accident occurred at 7.00 P.M on 14.12.2010 whereas as per OPD slip of CHC Kaul (Annexure R-7), the patient Brij Bhan has been shown to be entered in hospital at 3.45 P.M. on 14.12.2010, as such, there is contradiction in the statement of Brij Bhan driver of the vehicle and the endorsement of the doctor of CHC, Kaul regarding the time of accident.

                It is not disputed that the accident had took place on 14.12.2010 but as per arguments of the OP there is contradiction in the point of time of the accident but this plea of the OP does not find any merit in the present circumstances whether accident occurred at 3.45 p.m. or 7.00 p.m. since as per policy (Annexure C-4), the risk cover of the vehicle has already started from 14.12.2010 12:01 A.M. to 13.12.2011 upto midnight.      

                Now we are coming to the other point: whether the vehicle was being driven by a person holding a valid driving license at the time of accident.  Counsel for the Op argued that at the time of alleged accident, the vehicle was being driven by one Brij Bhan Sharma other than the person registered owner of the vehicle. To rebut this contention, complainant has placed on record copy of driving license of that Brij Bhan as Annexure C-7 which reveals that he was authorized the vehicle of the following description: Tractor, Motor Cycle/Scooter WG, Car & Jeep-NT. The vehicle which met with an accident falls within the description of Car/Jeep, so as per Annexure C-7, the  vehicle was being driven by a person holding a valid driving license.  Furthermore, the complainant has also placed on record his driving license Annexure C-8, perusal of which shows that he was also authorized to drive vehicle in question. In this regard, contention of counsel for OP is that the driving license of Brij Bhan was not produced before them for its verification but  this contention of OP is not believable since perusal D.L. of Brij Bhan (Annexure C-7) reveals that copy of the driving license has been placed on record on 05.03.2012 but since then Op has never  take assistance of the Forum to verify the driving license of Brij Bhan which means that the Op  insurance company was satisfied that Brij Bhan was legally authorized to drive the vehicle in question.

                Report of surveyor appointed by OP insurance company (Annexure R-10) reveals that the surveyor has assessed loss occurred to the vehicle of complainant as Rs.1,31,947/- after deducting salvage value of Rs.5386/- but in our view the surveyor has wrongly deducted the salvage of Rs.5386/- because the parts/salvage are of no use to the complainant.

7.                In view of the above discussion, we are of the confirmed view that the Op insurance company has wrongly repudiated the claim of complainant since the vehicle was well within cover of insurance policy on the alleged day of accident.  Accordingly, we allow the present complaint and direct the OP to comply with the following direction within thirty days of the receipt of copy of the order:-

1. To pay a sum of Rs.1,37,333/- to the complainant alongwith with simple interest @ 9% per annum from the date of filing of complaint till actual realisation. Complainant is directed to handover the salvage to the OP insurance company within the stipulated period of thirty days.
2. Also to pay a sum of Rs.5000/- as litigation charges.

                   Copies 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 :23.12.2016.                             

                                                                                      Sd/-

                                                                              (D.N. ARORA)

                                                                                 PRESIDENT.

 

                                                                            Sd/-

                                                               (PUSHPENDER KUMAR)

                                                                                 MEMBER.