Haryana

Karnal

CC/386/2020

Hemant Kumar - Complainant(s)

Versus

Iffco Tokio General Insurance Company Limited - Opp.Party(s)

S.N. Bhardwaj

17 Jul 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                        Complaint No. 386 of 2020

                                                        Date of instt.25.09.2020

                                                        Date of Decision:17.07.2023

 

Hemant Kumar aged about 28 years son of Shri Sukhbir Singh, resident of house no.1534, Shivaji Colony, Hansi Road, Karnal. Aadhar no.2142 1746 1479. Mobile no.73062-25538.

 

                                               …….Complainant.

                                              Versus

 

1. Iffco Tokio General Insurance Co. Ltd. Sector-12, Urban Estate, Karnal, through its Branch Manager. (Policy no.YIT/97352130, valid from 23.01.2019 to 22.01.2020.

 

2. YAMAHA, Pankaj Autos, near Namesty Chowk, Bye Pass, Karnal at present near New Grain Market, G.T. Road, Karnal through tis Manager/Authorized signatory.

                                                                      …..Opposite Parties.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

 

Before   Sh. Jaswant Singh……President.

              Sh. Vineet Kaushik……Member 

      Dr. Rekha Chaudhary……Member

          

 Argued by: Shri Naresh Kumar, counsel for the complainant.

                    Shri Mohit Goyal, counsel for the OP no.1.

                    OP no.2 exparte.

 

                    (Jaswant Singh President)

ORDER:                     

          

                 The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant is the registered owner of Yamaha Motorcycle bearing registration no.HR-05BA-4768 and got insured the same with the OP no.1, vide policy no.YIT/97352130, valid from 23.01.2019 to 22.01.2020 (period of own damage cover) and period of liability cover is 23.01.2019 to 22.01.2024. The complainant had purchased the said motorcycle from the OP no.2. On 12.10.2019, the complainant met with an accident near village Lohari, Rampura (Punjab) at about 5.30 a.m. when he was going to Bhatinda. In the said accident, the motorcycle was badly damaged and complainant also received grievous injuries and he has taken treatment from various hospitals and remained on bed upto long time. The abovesaid motorcycle had been given to OP no.2 by the father of complainant for repair under the insurance policy. One Ankit, who is employee of the OP no.2 had come to the complainant in hospital and took his signature on various forms and also took the copy of all relevant documents. Thereafter, vide letter dated 07.11.2019, OP no.1 demanded towing receipts and medical receipts, which were deposited by the complainant but till today no compensation has been given by the OP no.1 to the complainant and OP no.2 has not repaired the motorcycle. OP no.1 has refused to give the damages/claim by saying that wrong date of accident has been mentioned in the claim form. The complainant never fills up the claim form with his own hands. All paper formalities have been done by Ankit who is the employee of the OP no.2. How and in what manner the wrong date has been mentioned in the claim form reason best known to OP no.2 or his employee. Since 15.10.2019, motorcycle of the complainant is lying with the OP no.2 and OP no.2 since then giving assurance to the complainant that claim will be granted by the OP no.1 and then the motorcycle will be handed over to the complainant. OP no.1 intentionally and willfully has not passing the claim of the complainant. OP no.2 now demanded Rs.75,000/- from the complainant. Complainant requested the OP no.1 number of times to settle the claim but OP no.1 did not pay any heed to the request of complainant. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

2.             On notice, OP no.1 appeared and filed its written version raising preliminary objections with regard to maintainability and concealment of true and material facts. On merits, it is pleaded that after receiving the information about the alleged loss, OP immediately deputed its surveyor who inspected the damaged vehicle and thereafter the OP had sent letter dated 07.11.2019 to the complainant for submission of towing receipt as the vehicle of the complainant reportedly met with an accident at Rampura (Bathind) and thereafter shifted to Karnal. The complainant reportedly got some injuries in the alleged accident, hence advised to submit the treatment papers. There was no reply from complainant side of the said letter. OP had sent first reminder letter dated 10.12.2019 and thereafter final reminder dated 26.12.2019 requested to the complainant to submit the desired documents to enable them process the claim further. When OP had not received any documents or response from complainant side, OP left with no other option but to close the claim of the complainant on the ground of non-compliance of the requirement. The closure of the claim duly communicated to the complainant, vide letter dated 19.02.2020. It is further pleaded that the vehicle of the complainant not repaired till the date and no repair bills submitted by the complainant to OP to assess the loss as per the terms and conditions of the policy. So, there is no question arises for settlement of the claim without repair of the vehicle. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied by the OP and prayed for dismissal of the complaint.

3.             OP no.2 did not appear despite service and opted to be proceeded against exparte, vide order dated 29.04.2022 of the Commission.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of registration certificate Ex.C1, copy of insurance policy Ex.C2, copy of invoice dated 03.01.2019 Ex.C3, copy of temporary certificate of registration Ex.C4, copy of letter dated 07.11.2019 by OPs to complainant regarding demand of documents Ex.C5, copy of medical treatment record of complainant Ex.C6, copy of general case sheet of Punjab Health System Corporation Ex.C7, copy of discharge summary Ex.C8, copy of IPD bill detail Ex.C9, copy of LAMA Summary dated 12.10.2019 Ex.C10, copy of IPD bill detail of Adesh Institute Bhatinda Ex.C11, copy of computed Temography report dated 12.10.2019 Ex.C12, copy of IPD bill detail of Virk Hospital, Karnal Ex.C13, copy of discharge summary of Virk Hospital Ex.C14, copy of treatment record of Virk Hospital Ex.C15, copy of MRI C-Spine report Ex.C16, copy of CECT Head report Ex.C17, copy of aadhar card Ex.C18, copy of PAN card of complainant Ex.C19, copy of Toe receipt Ex.C20, copy of delivery slip Ex.C21, copy of admission report of Bhatinda Ex.C22 and closed the evidence on 08.12.2022 by suffering separate statement.

5.             Learned counsel for the OP no.1 has tendered into evidence affidavit of Sameer Gupta, Vice President Ex.OPW1/A, copies of letters dated 19.02.2020, 26.12.2019, 10.12.2019, 07.11.2019 Ex.OP1 to Ex.OP4, copy of terms and conditions of the insurance policy Ex.OP5, copy of claim form Ex.OP6, copy of estimate/bill Ex.OP7 and closed the evidence on 04.05.2023 by suffering separate statement.

 6.            We have heard the learned counsel for the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got insured his vehicle with the OP. On 12.10.2019, the said vehicle met with an accident and complainant also received grievous injuries in the accident. The intimation regarding the accident was given to OP no.1. Complainant got repaired the vehicle in question from OP no.2. As per demand of surveyor, complainant submitted all the required documents with him and requested to settle the claim but OP no.1 failed to settle the same. He further argued that the motorcycle is still in the possession of the OP no.2 but OP no.2 is not ready to release the same without payment of the repair charges and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP no.2, while reiterating the contents of written version, has vehemently argued that the OP had sent letter dated 07.11.2019 to the complainant for submission of towing receipt and to submit the treatment records but complainant did not submit the same, so the claim of the complainant was closed on the ground of non-compliance of the requirement and lastly prayed for dismissal of the complaint.

 9.            We have duly considered the rival contentions of the parties.

10.           Admittedly, complainant got insured his vehicle from the OP no.1. It is also admitted that the said vehicle met with an accident during the subsistence of the insurance policy. The claim of the complainant has been closed, vide letter dated 19.02.2020 on the following grounds, which are reproduced as under:-

“In respect of your claim, we have appointed surveyor Mr. Jasvinder Singh. You are kindly requested to please refer to earlier correspondence dated 07.11.2019, 10.10.2019 and 26.12.2019 wherein we had requested for the following documents.

1. Authentic Towing receipt.
2. Medical receipt.

Inspite of regular reminders, we have not received the above mentioned documents/information. We request you to send us the marked documents within 7 days on receipt of this letter to enable us to expedite the claim process. In case, if we do not hear from you, it will be presumed that you are not interested in pursuing your claim and the said claim will be treated as “Close” due to non-compliance of requirement.”

 11.          Learned counsel for the complainant has submitted that complainant has already submitted the demanded documents. The onus to prove his case was relied upon the complainant. To prove his case, complainant has placed on file, the copy of towing receipt Ex.C20 and medical bills Ex.C6, Ex.C7, Ex.C8 to Ex.C1. When the complainant has placed on record the above mentioned documents then as to why he would not supply the same to the OP no.1 when his personal interest is involved for getting his claim amount and further will indulge himself in unwanted litigation. It appears that OP has sought the alleged documents just to harass the complainant and to delay the claim of the complainant. Hence, in view of the above, we found no substance in this contention of the OP no.1.

12.  

“It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy”.    

13.           Keeping in view that the ratio of the law laid down in aforesaid judgment, facts and circumstances of the present complaint, we are of the considered view that act of the OP no.1 while closing the claim of the complainant amounts to deficiency in service and unfair trade practice, which is otherwise proved genuine one. 

14.           Complainant claimed Rs.1,50,000/- but as per estimate/bill Ex.OP7, complainant has spent Rs.55100/- on the repair of the motorcycle in question.  Hence, the complainant is entitled for the same alongwith interest, compensation for mental pain and agony and litigation expenses etc.

15.           In view of the above discussion, we partly allow the present complaint and direct the OP no.1 to pay Rs.55100/- to the complainant alongwith interest @ 9% per annum from the date of closing of the claim till its realization.  We further direct the OP no.1  to pay Rs.15,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.5500/- for the litigation expense. We also direct the OP no.2 to handover the motorcycle in question to the complainant on receipt of estimate bill of Rs.55100/-This order shall be complied within 45 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:17.07.2023   

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

(Vineet Kaushik)        (Dr. Rekha Chaudhary)

                          Member                      Member