Chandigarh

DF-II

CC/576/2020

Sandeep Singh - Complainant(s)

Versus

IFFCO-TOKIO General Insurance - Opp.Party(s)

Simran Grewal Randhawa

09 Oct 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-II, U.T. CHANDIGARH

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Consumer Complaint  No	:	576 of 2020
Date  of  Institution	:	26.10.2020
Date   of   Decision	:	09.10.2024

 

 

 

 

Sandeep Singh, aged 30 years, s/o Sh.Amarjit Singh, Resident of Village Chananke, Block Tarsikka, District Amritsar.

             … … … Complainant

 

Versus

1.  IFFCO-TOKIO General Insurance, Plot No.2 B & C,     Sector 28-A, Madhya Marg, Chandigarh, Pin-   160002.

2.  IFFCO-TOKIO General Insurance Co. Ltd., 1^st and 2^nd Floors, Sohan Singh Complex, Shastri Nagar, Ludhiana, Punjab, Pin-141001.

3.  Castel Toyota, ANR Motors Private Limited, Daburji, G.T. Road, Near Bye Pass, Amritsar, Punjab, Pin-143001.

4.  S.G.L. Charitable Hospital, Village Mustafabad,     P.O. Subhanpur, G.T. Road, District Kapurthala, Punjab, through its Medical Director, Pin-    144802.

   … … … Opposite Parties

 

BEFORE:  MR.AMRINDER SINGH SIDHU,       PRESIDENT

                MR.SURESH KUMAR SARDANA,       MEMBER

                               

 

Argued by:    Ms.Simran Grewal Randhawa, Counsel for Complainant.

Sh.J.P.Nahar, Counsel for OP No.1 & 2.

Sh.Kanwar Pahul Singh, Counsel for OP No.3.

OP No.4 ex-parte.

 

 

ORDER BY AMRINDER SINGH SIDHU, M.A.(Eng.),LLM,PRESIDENT

 

1]       The complainant has filed the present complaint pleading that he got his vehicle Innova Crysta 24G bearing Registration No.PB-01-C-8738 insured from OP No.2. It is stated that on 19.03.2020 at about 4-5 P.M., the said vehicle Toyota Innova met with an accident near Subanpur, Jalandhar, due to sudden coming of cattle in front of the vehicle. Due to impact, one passenger namely Harjit Kaur passed away and other passengers received injuries. The vehicle was also damaged badly. It is stated that the said Innova Car was being used for commercial purpose and at the time of accident, the said vehicle was being driven by the driver Amandeep s/o Sh.Premchand, employed by the complainant. The driver immediately informed the complainant qua the occurrence, who informed the agent of OP No.3 namely Kulwant and sent him photos & RC of the vehicle through whatsapp on the very same day of occurrence. It is stated that neither the driver of the complainant nor the complainant lodged the DDR. The DDR qua the accident was registered by the police only.

    It is stated that when agent Kulwant expressed his inability to help the complainant in order to get the insurance claim, the complainant get e-mail address of one Manik Kapoor, Manager and Area Incharge of OP No.2 and on 27.03.2020, the complainant sent the photos & documents of the vehicle. The response from OP No.2 was received on 29.03.2020 and complainant was asked to intimate the claim on the call center. The complainant called call center number and raised his complaint, however, the call center executive clarified that only the claim of the loss is being registered at the moment due to nationwide lockdown in progress. It is further stated that no person/agent from OP No.1 & 2 ever came to check or survey the vehicle and it was on 08.05.2020, when the complainant himself went to the agency of OP No.3 to get the vehicle repaired and since then the vehicle is lying in the agency. Afterwards, the complainant contacted OP No.1 & 2 several times but OP No.1 raised objections over the veracity of the occurrence on one pretext or another. It is stated that it was concluded by OP No.1 & 2 on the basis of their own investigation that driver Amandeep was not driving the vehicle at the time of accident and SGL, Hospital where passenger Harjot Kaur was taken, had mentioned the time of accident as 2.10 PM and time of brining the deceased to hospital as 2.59 PM.

    It is stated that vide letter dated 07.10.2020, OP No.1 rejected the claim of the complainant on the ground that the reported claim is payable only when the loss particulars provided are established beyond reasonable doubt and the claim is found to be admissible under the policy terms and conditions. It has been observed in the said letter that the complainant has misrepresented the facts and driver particulars in support of his claim. Alleging the aforesaid acts on the part of OP Insurance Company amount to deficiency in service and unfair trade practice, the complainant has filed the present complaint with a prayer to direct the OPs to pay an amount of Rs.9,05,186/- as the amount of repair to be paid by OP No.1 to OP No.3; pay compensation for mental agony & harassment and loss of income suffered by the complainant and litigation expenses.

 

2]       OP No.1 & 2 filed their joint written version and stated that complainant is concealing the true facts and not putting forth the actual facts. It is denied that insured vehicle met with an accident on 19.03.2020 at about 4-5 PM due to sudden coming of cattle in front of the vehicle. It is stated that Amandeep Singh s/o Sh.Prem Singh was driving the car at the time of accident and not Amandeep s/o Sh.Prem Chand as claimed by the complainant.

    It is stated that the vehicle was being driven by one Amandeep Singh S/o Sh.Prem Singh and while going from Ludhiana to Baba Bakala at 2:10 PM on 19.03.2020, the vehicle met with an accident and in the vehicle three ladies were also travelling namely his mother Harjeet Kaur, his wife Kuldeep Kaur and his sister Paramjeet Kaur. The GD No.030 dated 19.03.2020 was lodged at 4:15 PM after the SGL Hospital sent a message to the police about the road side accident in which one person died and the others were injured. The police visited the site of accident and also the hospital and then recorded the GD at the instance of Amandeep Singh (wrongly mentioned as Mandeep Singh) S/o Sh.Prem Singh. It is stated that Sh.Amandeep Singh alongwith his three relatives were going from Ludhiana to Batala and when they reached near Rasidi then suddenly the left side tyre of the vehicle burst and vehicle became unbalanced and struck against the road divider on the left side and his mother fell out on the road due to opening of the door of the car & sustained head injuries and on reaching the hospital she was declared dead. It is stated that since no one was responsible for the accident, he did not lodge any complaint and did not pursue any legal action against anybody.

    It is stated that the complainant has mentioned in his claim form the name of another driver namely Sh.Amandeep S/o Sh.Prem Chand. On investigation of the claim, it was found by the investigator Sh.Jatinder Dhiman that the driver was not Amandeep at the time of accident. It is stated that as per the complainant the driver Amandeep had picked up two passengers namely Kuldeep Kaur and Harjeet Kaur from Batala to Ludhiana at 6:00 AM whereas it was found by the investigator that as per his mobile and his mobile map location on 19.03.2020 at 6.00 AM, he was at Anandpur Sahib which was approximately 150 KM from Batala and thus it was concluded that the driver has been changed in this case. Even the details of GDR and the statements of the complainant and his reported driver Amandeep are at variance in respect of the cause of accident as well as the number of occupants in the car. It is further stated that it is quite possible that Sh.Amandeep Singh S/o Sh.Prem Singh was driving the vehicle but he was not having the valid and effective driving license as he alongwith his family members resides in England and the driving license, if at all, he was holding, it was valid for driving the vehicle in England and not in India, hence, Sh.Amandeep s/o Sh.Prem Chand was planted to be driver at the time of accident so that the claim can be obtained from Insurance Company. Thus, the insured has misrepresented the facts and driver particulars in support of his claim and breached the policy terms & conditions and his claim was rightly repudiated by the OP No.1 & 2. Denying any deficiency in service or unfair trade practice as well as all other allegations, the OP No.1 & 2 have prayed for dismissal of the complaint. 

3]        OP No.3 filed their separate written version and while admitting the factual matrix of the case with regard to vehicle was brought in the agency of OP No.3 and the same is lying pending its repairs, stated that subject matter of the complaint pertains to the payment of insurance claim which is in between the complainant and OP No.1 & 2. It is stated that OP No.3 is only dealership concern of Toyota Kirloskar Motor P. Ltd. which is the manufacturer of the cars; hence, OP No.3 is having no concern with the payment of insurance claim to the complainant. Denying any deficiency in service on their part, the OP No.3 has prayed for dismissal of the complaint.

4]       The OP No.4 did not turn up despite service of notice, hence, OP No.4 was proceeded against ex-parte vide order dated 02.12.2022.

5]       Replication has also been filed by the complainant controverting the assertions of OP No.1 & 2 as made in their written version.

6]       Parties led evidence in support of their contention.

7]       We have heard the learned counsels for the parties and have gone through entire documents on record.

8]       At the very outset, it may be observed that when it is an admitted case of the parties that the complainant had obtained the subject policy from OP No.2, valid w.e.f. 30.05.2019 to 29.05.2020, by paying the requisite premium and the subject car met with an accident in the month of March 2020 and thereafter the complainant had raised claim, which was repudiated by OP No.1 & 2 Insurance Company as No Claim in breach of terms & conditions of the policy, the case is reduced to a narrow compass as it is to be determined if OP No.1 & 2 Insurance Company is unjustified in repudiating the claim of the complainant on the ground that the complainant had misrepresented the facts and the driver particulars in support of his claim and the complainant is entitled for the reliefs prayed for in the consumer complaint, as is the case of the complainant, or if OP No.1 & 2 Insurance Company have rightly repudiated the claim of the complainant and the consumer complaint of the complainant, being false and frivolous, is liable to be dismissed, as is the defence of the OP No.1 & 2 Insurance Company.

9]       In the backdrop of the foregoing admitted and disputed facts on record, one thing is clear that the entire case of the parties is revolving around the terms and conditions of the subject policy (Annexure C-5/Exhibit OP-1&2/1) and Investigation Report (Exhibit OP-1&2/3).

10]      The OP No.1 & 2 Insurance Company, vide its repudiation letter dated 07.10.2020 (Annexure C-10/Exhibit OP-1&2/8), stated that the reported claim is payable only when the loss particulars provided are established beyond reasonable doubt and the claim is found to be admissible under the policy terms and conditions and as the complainant has misrepresented the facts & driver particulars in support of his claim, OP Insurance company expressed their inability to consider the claim of the complainant under the terms and conditions of the policy and repudiated the claim as No Claim in breach of terms & conditions of the policy. The claim of the complainant was got investigated by the Insurance Company. During investigation, it was found that deceased family member(son) Mandeep Singh s/o Prem Singh had given his statement to the police in which he confirmed that he was travelling in the car along with her mother Harjit Kaur, wife Kuldeep Kaur and sister Parampreet Kaur in which his mother Harjit Kaur died in the accident and they did not want to lodge any police report in this case and on the basis of the statement of Mandeep Singh, police lodged the DDR on the same day of the accident i.e. 19.03.2020 with DDR No.30. It is observed by the Investigator that after checking the police report and hospital record, he found that police entered the name of deceased son wrongly in policy report as Mandeep Singh s/o Prem Singh instead of Amandeep Singh s/o Prem Singh. Copy of the General Diary Details is annexed with the complaint as Annexure C-1. Thus, it is clear from General Dairy Details (Annexure C-1) that there were four persons in the vehicle and Amandeep Singh son of Sh.Prem Singh was driving the car at the time of accident as there is no mention of any driver with them.

    It is observed by the Investigator that as per the statement of Sandeep Singh, only two passengers named Harjit Kaur and Kuldeep Kaur were sitting in the car along with his paid driver Amandeep Singh s/o Prem Chand but as per the statement of driver Amandeep Singh one lady Harjit Kaur and one man was sitting in the car at the time of the accident, but as per the police report, four people were sitting in the car.

    It is observed by the Investigator that as per the statement of driver Amandeep Singh, the accident happened between 6 PM to 7 PM but as per the hospital record, the accident happened at 2.10 PM near Haimbowal.

    It is further observed by the Investigator that most of the taxi drivers use the map location application to search the clients spot and during investigation, he inspected the mobile phone of driver Amandeep Singh s/o Prem Chand and as per his mobile map location on 19.03.2020 at 6 AM, he was at Anandpur Sahib which was approx. 200 KMs from Batala, so it is not possible for him to pick the passengers from Batala.

    It is finally observed by the Investigator in his Investigation report that “Driver Change and Mis-representation of Facts are found in this case”

11]      The Investigation Report is an important piece of document which cannot be brushed aside until and unless there is any cogent and reliable evidence to disprove it. The complainant/insured has not submitted any objection before this Commission regarding the investigation report stating on what ground it is not admissible in evidence and what is the cogent and reliable evidence contrary to the investigation report. The investigation report cannot be disbelieved and cannot be rejected without any forceful evidence on the part of the complainant.

12]      In the light of the aforesaid discussions, it would be unsafe to hold that there is any deficiency or unfair trade practice on the part of the OPs for not allowing the claim of the complainant. Hence, the present consumer complaint, being devoid of any merit, is hereby dismissed leaving the parties to bear their own costs.

13]      The pending application(s) if any, stands disposed of accordingly.

         The Office is directed to send certified copy of this order to the parties, free of cost, as per rules & law under The Consumer Protection Rules & Act accordingly. After compliance file be consigned to record room.

Announced

09.10.2024                                                               

Sd/-

 (AMRINDER SINGH SIDHU)

PRESIDENT

 

 

Sd/-

 (SURESH KUMAR SARDANA)

MEMBER

as