Haryana

Karnal

CC/253/2018

Vikram Pal - Complainant(s)

Versus

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

Virender Malik

25 Jun 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                                   Complaint No. 253 of 2018

                                                          Date of instt. 01.10.2018

                                                          Date of Decision 25.06.2019

 

Vikram Pal, age 35 years, son of Shri Dharam Pal, resident of V.P.O. Untla, Tehsil Madlauda, District Panipat, Adhar no.960433785946, Mobile no.9215070007.                                                                                                                                                                                                                                                        …….Complainant

                                        Versus

 

1. Iffco Tokio General Insurance Company Ltd. plot no.2, BNC 4^th floor, Sector 28-A, Madhya Marg near Tribune Chowk, Chandigarh through its Divisional Manager/authorized person.

2. Iffco Tokio General Insurance Company Ltd. 34 Nehru Place, New Delhi through its Manager/authorized person.

3. Iffco Tokio General Insurance Company Ltd. HAFED District office, SCO no.19-20, Ground floor, Karnal (Haryana) through its Manager/authorized person.

 

                                                                         …..Opposite Parties.

  

           Complaint u/s 12 of the Consumer Protection Act. 

 

Before     Sh. Jaswant Singh……President.

      Sh.Vineet Kaushik ………..Member

   

 

 Present:  Shri Virender Malik Advocate for complainant.

                   Shri Naveen Khatterpal Advocate for opposite parties.

 

                   (Jaswant Singh President)

ORDER:                    

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that complainant is owner of vehicle/SLX Mohindra Bolero bearing registration no.HR-06AE-8379, which was got insured from the OPs, vide policy no.68316988, valid from 28.11.2016 to 27.11.2017 for sum insured of Rs.6,50,000/- and the complainant has paid the insurance premium of Rs.31,658/- to the OPs. On 8.6.2017 at about 9.45 p.m. the insured vehicle was met with an accident. In this complainant has lodged the report with the Police Post Sector 6-7, HUDA, Panipat. The complainant has also lodged his claim with the OPs, vide claim no.37123982. The surveyor of OPs has surveyed the insured vehicle and the complainant furnished entire documents as per the requirement to the surveyor i.e. claim form, insurance cover note/policy, DDR, copy of ration card, copy of bills and a cancelled cheque, but till today the OPs  did not make the payment/insurance amount to the complainant. OPs have served the letter dated 9.4.2018  in which they have taken the false and bogus plea intentionally and deliberately with the intention to avoid the claim of the complainant. The complainant on his level best fulfilled the terms and conditions of the insurance company and has not violated the terms and conditions of insurance policy, but OPs have not released the claim amount of the complainant till date. In this way there was deficiency in service on the part of the OPs. Hence complainant filed the present complaint.

2.             Notice of the complainant was given to the OPs, who appeared and filed written version raising preliminary objection with regard to cause of action; jurisdiction and concealment of true and material facts. On merits, it is pleaded that on receiving intimation from insured/owner regarding loss of vehicle, OPs appointed an independent IRDA licensed surveyor Mr. Deepankur Soni and for investigation deputed Grover Associates to investigate the matter. Both of them submitted their respective reports. On perusal of investigation report it was come on record that nature and cause of accident is doubted. Loss location was also not justified. Towing receipt provided and does not stands verified and there have been break in involved details of which have been mentioned above, also there has been some facial/accessories changes in the vehicle. Thereafter, OP sent letter dated 9.4.2018 followed by Reminder letter dated 25.04.2018 and Final Reminder letter dated 3.7.2018 in which it is specifically stated that as per IRDA Licensed independent surveyor Mr. Deepankur Soni and Investigator M/s Grover Associates following points comes:

1. Cause of loss is not at all justified as per surveyor/investigator report.

2. Even such a major loss claim was not known/aware to nearly persons and also there was no eye witness.

3. Even you have not taken the third party loss vehicle details (from which your vehicle was dashed) which were parked as per your information/statement.

4. Also as per the physical inspection of said accident vehicle there must have been injuries to driver (who was driving the vehicle at the time of accident) because the steering due to has touched the driver seat, thus injury to driver abdomen and lower position of body cannot be ruled out.

5. However, the towing receipt submitted by you is also not authentic/genuine as it was verified and found that no such towing bills was signed by the crane services.

By letters and reminders, complainant was once again requested to please provide the actual facts of the accident and other details as per the above points to justify the loss as per terms and conditions but complainant has not submitted any reply against said letters. The insured has made misrepresentation and concealment of original facts in following manner:

a) In the claim particulars provided by insured in his statement, it has been mentioned that the insured himself was driving the vehicle at the time of accident and did not suffer any injury and escaped unhurt. The nature and extent of frontal damages in such that the steering wheel has moved downwards towards driver’s seat. With impact of the accident, this would result in serious injury to the person who was driving the vehicle at the time of accident which was contrary to the statement of insured. This indicates conclusively that the insured Vikram Pal was not in the driver’s seat at the time of accident as mentioned in the claim form.

b) Insured has provided Towing bill no.239 dated 29.06.2017 issued by M/s Khalsa Crane Services. During the investigation, authenticity of the bill has not been confirmed by towing agency, who have denied signing the said towing bill.

c) As per the statement of insured, accident happened due to the insured vehicle crashing into a standing Truck/Trolla while saving a Nilgai. The damages in such accident would be mostly linear in direction. However, during investigation, it has been found that the damages are not correlating with the accident. As per the statement of the insured given to investigator, insured was driving the vehicle at speed of 55-60 km/hr. At this speed the damages would not be to the extent as observed in the physical inspection done after the reported loss.

d) The frontal impact to vehicle would damage the headlight of the vehicle, whereas during investigation the headlight was found to be intact and removed from its position and kept inside the engine compartment.

e) As per the loss particulars provided by insured, the accident happened on the by road of NH-44. However, on the physical verification of the spot during forensic investigation it has been found that on western side of the spot is a 6ft wall and on the Eastern side the ground level is at a dept of 5-6 ft and the area if populated and surrounded by warehouses, houses, vacant plot, HUDA dussera ground etc. making the byroad inaccessible to stray animals from both sides.

Further, Yamuna enclave, HUDA Panipat is located on the northern side of the spot of accident and the main road is connected to sector 13-17 HUDA Panipat. There are no chance of stray animal like Nilgai coming to this byroad from North-South direction also. The observation, as mentioned above indicates that the material fats with regard to driver at the time of accident, injuries to the driver and occupants, cause of loss, place of loss have been concealed and not reported correctly to the OP. Insured misrepresentation of facts leads to violation of condition no.8 of the terms and conditions of the policy. So, the claim of the complainant, has been repudiated by the OPs, vide repudiation letter dated 30.08.2018. Hence there is no deficiency in service on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence his affidavit Ex.CW1/A and documents Ex.C1 to Ex.C10 and closed the evidence on 13.3.2019.

4.             On the other hand, OPs tendered into evidence affidavit of Rajiv Ranjan Ex.RW1/A, affidavit of Deepak Grover Ex.RW2/A, affidavit of Desh Deepak Ex.RW3/A and documents Ex.R1 to Ex.R11 and closed the evidence on 18.06.2019.

5.             We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned counsel for the parties.

6.             The case of the complainant, in brief, is that he is owner of vehicle/SLX Mohindera Bolero, which is insured from the OPs for the sum insured of Rs.6,50,000/-. On 8.6.2017 at about 9.45 p.m. said vehicle was met with an accident and complainant has lodged the report with the Police. The complainant also lodged his claim with OPs. The surveyor of the OPs has surveyed the insured vehicle. The claim of the complainant has been repudiated by the OPs on 30.08.2018, which is not justified in the eye of law.

7.             On the other hand, the case of the OPs is that on receiving intimation from complainant regarding loss of vehicle, OPs appointed an independent IRDA Licensed Surveyor Mr. Deepankur Soni and for investigation deputed Grover Associates to investigate the matter. Both of them submitted their respective reports. On perusal of investigation report it has come on record that nature and cause of accident is doubted. So, claim of complainant was rightly repudiated on 30.08.2018.

8.             Admittedly, the vehicle was met with an accident during subsistence of the policy. Intimation was given to the police and in this regard a DDR Ex.C4 was lodged by the police in the concerned police station. On receiving intimation from the insured/complainant regarding the loss of vehicle, OPs appointed surveyor and investigator. Both of them submitted their respective reports. Following points has been observed by the OPs after going through the surveyor and investigation report:

1. Cause of loss is not at all justified as per surveyor/investigator report.

2. Even such a major loss claim was not known/aware to nearly persons and also there was no eye witness.

3. Even you have not taken the third party loss vehicle details (from which your vehicle was dashed) which were parked as per your information/statement.

4. Also as per the physical inspection of said accident vehicle there must have been injuries to driver (who was driving the vehicle at the time of accident) because the steering due to has touched the driver seat, thus injury to driver abdomen and lower position of body cannot be ruled out.

5. However, the towing receipt submitted by you is also not authentic/genuine as it was verified and found that no such towing bills was signed by the crane services.

9.             We have gone through the surveyor report Ex.R2 & Ex.R4. We are not agree with the observation pointed out in the reports. It is not possible in the night time that there must be eye witness, complainant noted down the registration number of the third party loss vehicle, Driver must received injuries. Other point taken by the OPs that towing receipt was not authentic/genuine. If OPs had any doubt about the towing receipt then they had remedy to examine or tendered the affidavit of the person who had issued the towing receipt, but OPs failed to do so. The onus to prove the facts that nature and cause of accident is doubted, upon the OPs but OPs failed to prove their version. Thus, we are of the firm view that acts of the OPs amounts to deficiency in service and unfair trade practice.

10.            Thus, as a sequel to above discussion, we allow the present complaint and direct the OPs to pay insured amount of the vehicle in question to the complainant with interest @ 9% per annum from the date of repudiation of the claim till its realization. We further direct the OPs to pay Rs.15,000/- to the complainant as compensation for harassment, mental agony as suffered by him and  towards litigation expenses. The complainant is also directed to get transfer the vehicle in question in the name of OPs and also deposit the salvage of the vehicle with them. This order shall be complied within 30 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:25.06.2019

                                                                       

                                                                  President,

                                                           District Consumer Disputes

                                                           Redressal Forum, Karnal.

               

                (Vineet Kaushik)

                    Member