Haryana

Karnal

CC/440/2020

Balram - Complainant(s)

Versus

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

S.S. Moonak

13 Sep 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                          Complaint No. 440 of 2020

                                                          Date of instt.19.10.2020

                                                          Date of Decision 13.09.2023

 

Balram aged 31 years, son of Shri Ram Chander, resident of house no.178, village and P.O. Jharothi, District Sonepat: 131 001, (Haryana) through his special power of attorney Sunil Kumar son of Shri Suresh Pal, resident of village Chirao, District Karnal. Aadhar card no.6416 0453 5479.

 

                                                 …….Complainant.

                                              Versus

 

1. Iffco Tokio General Insurance Company, through its Branch Manager, Hafed Building, Sector-12, Karnal.

 

2.  M/s Bansal Motors, opposite Neel Kanth Dhaba, on G.T. Road, Madanpur, District Karnal through its authorized person.

 

                                                                      …..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 S.S. Moonak, counsel for complainant.

                    Shri A.K.Vohra, counsel for the OP no.1.

                    Shri Narinder Jattu, counsel for the OP no.2.

 

                    (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 the complainant is the registered owner of the truck bearing registration no.HR-69-C-9369, Model 2018. The said truck was insured with the OP no.1, vide policy no.75011780 for a sum of Rs.23,20,000/-. The policy was comprehensive/package and valid from 31.03.2019 to 30.03.2020 with zero depth.  On 26.09.2019, the vehicle was being driven by Sunny and was going from Sonepat to Rohtak, the truck was unloaded, when the truck reached near village Mahipur Mod within the area of P.P. Farmana (Police Station Kharkoda), District Sonepat, a stray cow came in front of the truck-trolla  and  it turned turtle and struck against the roadside trees and the said truck was totally damaged. The matter was reported to the Local Police and necessary investigations were conducted in this regard. After the accident, the truck was brought to the workshop of OP no.2 at Karnal with the help of crane and a sum of Rs.30,000/- was paid as crane charges. The truck remained stationed in the workshop of OP no.2 for three months for its repair etc. The matter was reported to OP no.1, surveyor was appointed, who inspected the vehicle at the premises of OP no.2. Estimates were prepared, all the other formalities were completed. The complainant had spent huge amount of Rs.6 lakhs on the repair of the said truck and Rs.50,000/- as incidental expenses. After completing the entire repair work, change of accessories, damaged parts, repair of parts, the surveyor of the OP no.1 again visited the premises of OP no.2 and inspected the truck again. The complainant submitted all the relevant documents to the officials of the OP no.1 and also completed all the other formalities. Despite all this, the officials of the OP no.1 intentionally and deliberately did not settle the claim and delayed the matter unnecessarily, even no response was given whether the claim has been settled or repudiated. Prior to this truck was insured with the New India Assurance Company Ltd. Complainant visited the office of OP no.1 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 email dated 18.03.2020 as ‘claim is not admissible, it has been closed as no claim’ on the false and frivolous ground. 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; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that an intimation of claim was received by OP on 28.09.2019, informing that the vehicle in question has met with an accident on 26.09.2019 i.e. after the delay of two days. On receipt of intimation, OP appointed a surveyor Shri Bharat Bhusan, an independent IRDAI accredited surveyor and loss assessor to survey and assess the loss of the vehicle. The said surveyor conducted the survey at Bansal Motors and after careful examination of the vehicle in question, noted down its damages and submitted his report to the OP. On going through the survey report, document on record and pre inspection photos of insured vehicle, the following discrepancies have been found:-

.       Vehicle surveyed at Bansal Motors is all together different from the vehicle produced at the time of pre-risk inspection.

.       Chasis number in the damaged vehicle is different from chasis number on the insured vehicle. (Chasis no.MC2J6DRC0JB007477 was inspected as per the Pre Investigation while the RC submitted for the claim bears the chasis no.MC2T6DRC0JB007477)

.       Colour of the trailer and make on trailer including trailer design of insured vehicle are different from that of damaged vehicle produced for survey.

.       The vehicle produced for survey is fixed with two fuel tanks whereas insured vehicle in pre inspection photos and reports has only one fuel tank.

.       Physical condition of cabin including internal accessories and fitments, are different in damaged and insured vehicle.

 

 3.            So, in view of the above observation, it was concluded that the vehicle for which the claim was lodged and surveyed by the surveyor was not the same vehicle which was shown at the time of pre-inspection while procuring insurance cover and insured by the OP via policy no.75011780 w.e.f. 31.03.019 to 30.03.2020. The claim of the complainant was legally repudiated, vide order dated 21.11.2019. There is no deficiency in service and unfair trade practice on the part of the OP no.1. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

4.             OP no.2 appeared and filed its separate written version and stated that complaint is not concerned with the OP and prayed for dismissal of the complaint qua OP no.2.

5.             Parties then led their respective evidence.

6.             Learned counsel for the complainant has tendered into evidence affidavit of Sunil Kumar Ex.CW1/A, copy of special power of attorney Ex.C1, copy of RC Ex.C2, copy of driving licence of driver Ex.C3, copy of insurance policy Ex.C4, copy of old insurance policy Ex.C5, copy of email dated 18.03.2020 regarding repudiation of claim Ex.C6, copy of service/repair estimate Ex.C7, copy of premium receipt Ex.C8, copy of letter dated 29.03.2019 Ex.C9, copy of aadhar card of special power of attorney Sunil Ex.C10 and closed the evidence on 21.10.2021 by suffering separate statement.

7.             In additional evidence, learned counsel for the complainant has tendered copy of authorization certificate of National Permit (Goods) Ex.C11 and closed the additional evidence on 28.03.2023 by suffering separate statement.

8.             On the other hand, learned counsel for the OP no.1 has tendered into evidence affidavit of Hardeep Singh Ex.OP1/A, affidavit of Bharat Bhushan Insurance Surveyor Ex.OP1/B, copy of repudiation letter dated 21.11.2019 Ex.O2, copy of motor final survey report dated 05.11.2019 Ex.O3 (Ex.O8 repeated), photographs of vehicle Ex.O4 and Ex.O5, copy of insurance policy alongwith terms and conditions Ex.O6 and closed the evidence on 22.07.2022 by suffering separate statement.

9.             Learned counsel for the OP no.2 has tendered into evidence affidavit of Rattan Lal Bansal Ex.OP2/A, copy of supplementary deed to partnership deed Ex.OP2/1 and closed the evidence on 22.07.2022 by suffering separate statement.

 10.          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.

 11.          Learned counsel for the complainant, while reiterating the contents of complaint, has vehemently argued that complainant got insured his vehicle with the OP no.1. On 26.09.2019, his vehicle  met with an accident and was badly damaged. Intimation in this regard was given to the OP no.1. The vehicle was brought to the workshop of OP no.2. OP no.1 appointed a surveyor, who inspected the vehicle  and prepared his report. The complainant has spent an amount of Rs.6,00,000/- on the repair of the vehicle. The complainant submitted all the relevant documents to the OP no.1. Despite that, OP no.1 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. Learned counsel for the complainant has relied upon the case laws titled as Om Parkash Versus Reliance General Insurance and anr. in Civil Appeal no.15611 of 2017 decided on 4.10.2017; LIC of India and Anr. Vs.Kuldeep Kaur IV(2007) CJP 335 of our Hon’ble State Commission and Clearvision Industries Versus United India Insurance Co. Ltd. IV(2015) CPJ 674 (NC)

12.           Per contra, learned counsel for OP, while reiterating the contents of written version, has vehemently argued that on 26.09.2019, vehicle in question was met with an accident and intimation in this regard was given to OP no.1 on 28.09.2019. On receipt of intimation, OP appointed a surveyor Shri Bharat Bhusan, who after careful examination of the vehicle in question found many discrepancies. The claim of the complainant has been rightly repudiated by the OP and lastly prayed for dismissal of the complaint with heavy costs.

13.           Learned counsel for the OP no.2 argued that there is no relief claimed by the complainant against the OP no.2 and prayed for dismissal of the complaint qua OP no.2.

14.           Admittedly, complainant got insured his vehicle with the OP no.1. It is also admitted that the said vehicle met with an accident during the subsistence of the insurance policy.

15.           The claim of the complainant has been repudiated by the OP no.1, vide letter Ex.O2 dated 21.11.2019 on the grounds which are reproduced as under:-

“With reference to the loss reported on 28.09.2019, we have deputed Bharat Bhushan Surveyor and Loss Assessor associates for verification of facts and assessment of the said loss.

During perusal of claim papers and pre-risk inspection report it is observed that

.       Vehicle surveyed at Bansal Motors is all together different from the vehicle produced at the time of pre-risk inspection.

.       Also it is observed that chasis number in the damaged vehicle is different from chasis number on insured vehicle.

.       Colour of the trailer and make on trailer including trailer design of insured vehicle are different from that of damaged vehicle surveyed by the surveyor.

.       The vehicle produced for survey is fixed with two fuel tanks whereas insured vehicle in pre inspection photos and reports has only one fuel tank.

.       Physical condition of cabin including internal accessories and fitments, are different in damaged and insured vehicle.

It is, therefore, concluded that you have not disclosed the true facts and have misrepresented the loss particulars in support of your claim which is breach of policy condition no.8 and declaration given by you in the claim form”.

16.           In the abovesaid letter, OP has alleged that the vehicle surveyed is all together different from the vehicle produced at the time of pre-risk inspection, there are difference in the chasis number, colour and make including trailer design, vehicle is having two fuel tanks and condition of the cabin including internal accessories are different in damaged and insured vehicle.

17.           OP has alleged that at the time of inspection, the chasis number of the vehicle was MC2J6DRC0JB007477 but as per the registration certificate(RC) chasis number was MC2T6DRC0JB007477 and there is difference in the chasis number.  There is only difference in the word “J” and of “T”. Complainant has placed on file National Permit (Goods) Ex.C11, in said permit chasis number has been mentioned as MC2T6DRC0JB007477. Hence, there is only typical mistake in the hands of the Registering Authority and for that complainant cannot be blamed.  The other queries raised by the OP in its repudiation letter are purely baseless and unjustified. The claim cannot be repudiated on the ground of such type of queries. Thus, the claim of the complainant has been repudiated on purely technical grounds. In this regard, we relied upon Om Parkash’s case (supra) whereby Hon’ble Supreme Court of India held the decision of the insurer to reject the claim has to be based on valid grounds- Rejection of the claims on purely technical grounds in a mechanical manner will result in loss of confidence of policy holder in the insurance industry.

18.  

“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”.

19.           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 act of the OP no.1 while repudiating the claim of the complainant amounts to deficiency, which is otherwise proved genuine one. 

20.           As per the survey report Ex.O3(Ex.O8) dated 05.11.2019, the loss has been assessed by the surveyor of the OP to the tune of Rs.5,71,078/-but complainant has claimed Rs.6,00,000/- the cost of the repair of the vehicle. Complainant has relied upon the service/repair estimate Ex.C7 but that is only an estimate not the final bill/tax invoice. Hence, the report of the surveyor will prevail. In this regard we are relying upon the case law titled as United India Insurance Co. Vs. Maya 2(2008) CPJ paged 182 (NC), wherein it has been held that a surveyor report should not be dismissed summarily as the surveyor is independent and qualified person under the relevant provision of Insurance Act, 1938. In view of this authority as well as the facts and circumstances of the case, we are of the considered view that the OPs are liable to pay the loss assessed by the surveyor alongwith interest, compensation for mental agony and harassment and litigation expenses.

21.            In view of the above discussion, we partly allow the present complaint and direct the OP no.1 to pay Rs.5,71,078/- (Rs.five lakhs seventy one thousand seventy eight only) the loss assessed by the surveyor of the OP alongwith interest @ 9% per annum from the date of repudiation of the claim i.e. 21.11.2019 till its realization to the complainant. We further direct the OP no.1 to pay Rs.25,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.11,000/- for the litigation expense. The complaint qua OP no.2 stands dismissed. 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:13.09.2023                        

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

            (Vineet Kaushik)        (Dr. Rekha Chaudhary)

                Member                        Member