Haryana

Karnal

CC/491/2021

Sandeep Sharma - Complainant(s)

Versus

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

Rajesh Sharma

07 Nov 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                          Complaint No. 491 of 2021

                                                          Date of instt.14.09.2021

                                                          Date of Decision 07.11.2023

 

Sandeep Sharma son of Shri Prem Chand, resident of Ward No.14, Near Bus Stand, Assandh, District Karnal.

 

                                                 …….Complainant.

                                              Versus

 

Iffco Tokio General Insurance Company Limited, SCO No.19-20, Hafed Building, Sector-12, Urban Estate, Karnal, through its branch manager.

 

                                                                      …..Opposite party.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.       

      Sh. Vineet Kaushik…….Member

      Dr. Suman Singh…..Member

 

 Argued by: Shri Rajesh Sharma, counsel for complainant.

                    Shri Rohit Gupta, counsel for the OP

 

                    (Jaswant Singh President)

ORDER:   

                

                The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that the complainant is registered owner of a tractor make Sonalika DI 750 bearing registration No.HR40H-7694. The said vehicle was got insured with the OP which was valid from 02.01.2020 to 01.01.2021 and the OP got assessed the IDV as Rs.6,46,000/-. On 12.08.2020, the complainant parked the tractor trolley in the side of choutala road, Panipat because a technical fault had developed in the tractor and gone to the workshop for calling mechanic. Due to late night, there was no mechanic. On the morning of next day i.e. 13.08.2020, when the complainant reached at the spot, and found the tractor trolley missing. The matter was reported to the police vide FIR No.246 dated 13.08.2020, under Section 379 of IPC. Intimation in this regard was given to the OP on 28.08.2020 and also deposited all the requisite documents. Complainant visited the office of OP so many times and requested to settle the claim but OP did not pay any heed to the request of complainant and lingered the matter on one pretext of the other and lastly referred the claim of complainant, vide letter dated 29.10.2020 as “No Claim”. In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability; cause of action; locus standi and concealment of true and material facts. etc. On merits, it is pleaded that on receipt of intimation, OP appointed an independent investigator M/s Karnal Associates to investigate into the claim. The investigator thoroughly investigated the loss and submitted their report to the OP and opined that the insured has concealed the actual facts and misrepresent the fats to mislead the insurance company to take the insurance claim and also opined that in case the insurance company belief upon the unreliable version of the insured, the said loss falls under gross negligence as the tractor was left unattended 60 Kms far from insured residence. On perusal of the report of investigator, a detailed letter dated 29.10.2020 was released to the insured intimating rejection of his claim under the insurance policy. Furthermore, the complainant has not submitted original keys, original registration certificate, court accepted final report etc. which was demanded vide letter dated 10.09.2020. 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 and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Sandeep Sharma Ex.CW1/A, copy of Aadhar Card Ex.C1, copy of FIR Ex.C2, copy of no claim report Ex.C3, copy of insurance policy Ex.C4, copy of Rc Ex.C5 and copy of untrace report Ex.C6 and closed the evidence on 27.10.2022 by suffering separate statement.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Devendra Kumar, General Manager and Authorised Signatory Ex.OP1/A, copy of insurance policy Ex.OP1, copy of investigation report Ex.OP2, copy of letter dated 29.10.2020 Ex.OP3 and copy of leter dated 10.0.2020 Ex.OP4 and closed the evidence on 03.08.2023 by suffering separate statement.

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

7.             Learned counsel for the complainant, while reiterating the contents of complaint, has vehemently argued that complainant got insured his tractor with the OP. On 13.08.2020, his tractor was stolen by some unknown person. Intimation in this regard was given to the OP and an FIR was also got registered. OP appointed an investigator. The complainant submitted all the relevant documents to the OP. Despite that, OP did not settle the claim of complainant and lingered the matter on one pretext or the other and repudiated the claim on the false and frivolous ground and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for OP, while reiterating the contents of written version, has vehemently argued that on the basis of intimation of the complainant, an independent investigator was appointed to investigate the matter and after thoroughly investigation of the matter, he submitted his report whereby opined that the complainant in order to take the claim has concealed the true and material facts from the OP.  He further argued that neither the complainant has submitted the untrace report nor registration certificate and keys of the tracor in question to the OP to settle the claim. The claim of the complainant has been rightly closed by the OP and lastly prayed for dismissal of the complaint with heavy costs.

9.             The claim of the complainant has been closed by the OP, vide letter Ex.OP3 dated 29.10.2020 on the grounds which are reproduced as under:-

“With reference to you above mentioned claim, we have deputed M/s Karnal Associates to investigate the loss. The report of the said investigator has been received and after perusal of same, we have observed the followings:

1. You have stated that you left the vehicle at a worksite near Panipat Chautala Road at around 08:00 PM on 12.08.2020 after your vehicle allegedly developed a mechanical fault. During the investigation, all the person spoken to at worksite denied occurrence of any theft of vehicle there or even any vehicle being left overnight at the site on the fateful night. The same has been confirmed by the supervisor/in charge of the worksite in writing. This complete denial of occurrence of theft raises serious apprehension about the veracity of loss particular provided by you. Coupled with the fact that you have failed to sbmit both keys of the tractor indicate that you have seemingly misrepresent loss particulars.
2. You have stated in your statement that your friend Mr.Mahabir accompanied you on 13.08.2020 when the loss was discovered by you. This has been totally contradicted by him in his statement. Your friend Mahabir has stated that he has no knowledge of how and from where the insured vehicle was stolen. He also did not accompany you to Police Station for registering FIR. This contradiction in your statement again raise serious apprehension about the truthfulness of loss particulars provided by you.
3. You have stated that you left the vehicle at worksite unattended for overnight after it developed mechanical fault and went away to your home in Assandh. This act of yours of leaving the vehicle unattended overnight is gross negligence and breach of condition #5. The condition is reproduced below for reference;

 

The insured shall take all reasonable steps to safeguard the vehicle from loss or damage and to maintain it in efficient condition and the company shall have at all times free and full access to examine the vehicle insured or any part thereof or any driver or employee of the insured. In the event of any accident or breakdown, the vehicle insured shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle insured be driven before the necessary repairs are effected any extension of the damage or any further damage to the vehicle shall be entirely at the insured’s own risk.  

 

You have not been able to substantiate through any evidence as to how a new tractor developed mechanical fault all of sudden when it was working without any trouble prior to alleged loss.

 

Based on the above observation, it is concluded that you have failed to establish the occurrence of the alleged theft beyond reasonable doubt rather you have misrepresented facts in support of your claim. This is violation of Principle of utmost good faith and policy condition #8 and declaration given in claim form which is reproduced below:-

We bring to your kind notice, the declaration signed by you in the claim form is as follows:-

I/We the above named do hereby to the best of my/your knowledge and belief, warrant the truth of the foregoing statements in every respect and agree that if I/we have made any false or fraudulent statement or there be any suppression or concealment of facts, the claim shall be forfeited.

 

Condition No.8 of policy schedule notes “the due observance and fulfillment of the terms, conditions and endorsement of this policy in so far as they relate to anything to be done or complied with by the insured and the truth of the statements and answers in the said proposal shall be conditions precedent to any liability of company to make any payment under this policy.

You would appreciate that the claim is settled within terms and condition of the policy only after establishing the reported loss beyond reasonable doubt based on verification of loss particulars provided by you. However, as mentioned above you have not been able to establish the occurrence of loss beyond doubt, rather you have misrepresented.

 

Therefore, based on the above observations and breach of principle of utmost good faith, condition #5 and 8 as mentioned above, your reported claim is tenable and is being closed as “No Claim”.

 

10.           Vide letter Ex.OP4 dated 10.09.2020, the OP has demanded the following documents from the complainant :-

i)              Claim form duly filled stamped (in case of company owner) and signed by the insured.

ii)             Original insurance policy/cover note.

iii)            Stamped FIR, if delay, proof of timely intimation to police on 100 number or received copy of intimation to police.

iv)            Acknowledged copy of letter address to RTO intimating theft and making vehicle non use.

v)             Copy of the vehicle’s registration certificate.

vi)            Loan sanction letter from financier (if applicable).

vii)           Loan Statement and non repossession letter from bank/financier.

viii)           Original purchase invoice.

ix)            All the sets of original keys of lost vehicle provided by manufacturer.

x)             Original court accepted FR U/s 173 Cr.P.C. (duly signed and rubber stamp by judicial court magistrate).

xi)            Final police investigation report/untrace report certified by SHO/Police Station.

xii)           Explanation on reason for delay in FIR, if any.

xiii)           Explanation on reason for delay in intimation to ITGI, if any.  

 

11.  

12. Moreso, in the investigation conducted by the investigator appointed by the OP, it has came that there are so many contradictions in the statement of the complainant as well as concealment of the facts. As the complainant in his statement given to the investigator has stated that he alongwith his friend Mr.Mahabir went to the place of incident on 13.08.2020 but in his statement his friend Mahabir denied this fact and also stated that he has no knowledge of how and from where the insured vehicle was stolen. The complainant also stated that he has left the tractor in question at worksite unattended for overnight after it developed mechanical fault and went away to his home at Assandh. The statement given by the complainant raises a doubt over the theft of tractor in question as no person would left newly purchased vehicle unattended, at a place 60 Kms away from his residence. Furthermore, the complainant also not supplied the original keys of the tractor to the OP. It seems that the tractor in question has never been stolen, rather the complainant has prepared a concocted story only in order to take the benefit of the insurance policy.  

13.           Keeping in view, the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, we are of the considered view that there is no deficiency in service and unfair trade practice on the part of the OP.

14.           Thus, as a sequel to abovesaid discussion, the present complaint is devoid of any merits and same deserves to be dismissed and same is hereby dismissed. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance

 

Announced

Dated: 07.11.2023                                                                   

                                                                  President,

                                                    District Consumer Disputes

                                                    Redressal Commission, Karnal
 

 (Vineet Kaushik)           (Dr. Suman Singh)                    

    Member                                 Member