DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II

U.T. CHANDIGARH

[Consumer Complaint Case No: 470 of 2011]

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              Date of Institution : 12.10.2011

                   Date  of Decision   : 10.10.2012

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Jagjeet Singh son of Sh. Gurbax Singh, resident of Village Desu Majra, Near Sunny Enclave, Kharar, District S.A.S. Nagar, Mohali.

                                     ---Complainant

V E R S U S

[1]  Innomaxx Financial Services Pvt. Limited, SCO No. 2433-34, 2^nd Floor, Sector 22-C, Chandigarh, through its Manager.

[2]  Bharti AXA General Insurance Co. Limited, SCO No. 350-352, Sector 34-A, Chandigarh, through its Zonal Manager.

[3]  Bharti AXA General Insurance Co. Limited, 1^st Floor, The Ferms Icon, Survey No. 28, Next to Akme Ballet, Doddanekundi, Off Outer Ring Road, Bangalore – 560037, through its Divisional Manager.

   ---Opposite Parties

BEFORE:  SH. LAKSHMAN SHARMA           PRESIDENT

         MRS.MADHU MUTNEJA             MEMBER

         SH. JASWINDER SINGH SIDHU     MEMBER

Argued By:    Sh. Amrit Pal Singh, Proxy Counsel for

Sh. Ravi Kumar Bhatti, Counsel for Complainant.

Opposite Party No.1 ex-parte.

Sh. Paras Money Goayl, Counsel for Opposite Party No.2 & 3.

PER JASWINDER SINGH SIDHU, MEMBER

1.       Complainant has filed the present complaint, against the Opposite Parties on the ground that the Complainant insured his vehicle bearing Regn.No.PB-27-C-1011 from the Opposite Party No.1, who is an authorized Agent of Opposite Party No.2. The period of insurance was effected from 16.01.2011 to 15.01.2012. While subscribing for the policy, all the facts with regard to the previous policy subscribed by the Complainant were disclosed to the Agent of Opposite Party No.1. Even the previous policy was also showed to the Agent of the Opposite Party No.1. Based on this information, the insurance amount was calculated, which was duly paid by the Complainant. The Complainant claims that the Opposite Parties did not send the insurance policy to the Complainant as promised. The cover note issued by the Opposite Party No.2 [Annexure C-1].

         Unfortunately, the vehicle met with an accident on 5.8.2011. The Opposite Parties were duly informed promptly and a claim was lodged with them. Complainant supplied all the required documents as demanded, copies of the same are attached as Annexure C-2 to C-4 respectively.

         The Complainant was surprised on receiving a letter dated 17.9.2011 through which the Opposite Parties rejected the genuine claim of the Complainant on the ground of concealing material facts and also on the ground of having signed a wrong declaration. The Complainant claims that he has not signed any such type of declaration nor any such declaration or proposal form was presented to him, thus, alleging the rejection of his claim as a gross deficiency in service on the part of the Opposite Parties, has preferred the present complaint, seeking the following relief:-

    The complaint of the complainant is duly supported by his detailed affidavit.

2.       Notice of the complaint was sent to OPs seeking their version of the case. However, despite service, nobody has appeared on behalf of Opposite Party No.1, therefore, it was proceeded against exparte on 15.11.2011.

3.       The Opposite Parties No.2 and 3 have contested the claim of the complainant by filing their joint reply, taking preliminary objections to the effect that the present complaint is misconceived, without any merits and having been presented with unclean hands and suppressed material facts and as no cause of action has arisen in favour of the Complainant reason being the claim of the Complainant was repudiated after due application of mind as per the terms and conditions of the insurance policy.  

         On merits, the Opposite Parties have repeated their preliminary objections, while replying to the averments of the present complaint, in their para-wise reply. Contents of para 1 are admitted. However, in reply to contents of para no. 2 which are denied being wrong admitting to the fact that the extension of the policy was subject to its terms and conditions and the declaration given by the Complainant at the time of opting for getting his vehicle insured as mentioned in the proposal form; copy of the policy and proposal form are annexed as Annexure R-1 and R-2 along with the rely; While claiming that the Complainant had purposely mentioned No Claim Bonus in the proposal form, claiming that he had not availed any claim from the previous insurer, thus, entitling himself for the same the affidavit of the agent of the insurance company who had witnessed the presentation of the proposal form is annexed as Annexure R-3. In reply to para 6 of the complaint, the event of happening of the accident and the Opposite Parties having appointed a surveyor as per IRDA guidelines who in turn filed his survey report assessing the loss of the vehicle to the tune of Rs.14,670/- is annexed as Annexure R-4. In reply to para 7, the contents of which are denied being wrong and claiming that the repudiation of the claim of the Complainant vide letter dated 17.9.2011 is claimed to be as per terms and conditions of the insurance policy; it is further claimed that the Complainant in order to get no claim bonus had concealed material facts and had give a wrong declaration to the effect that he had not claimed any loss against previous insurance policy; and as such, he was not entitled for no claim bonus. The relevant portions of the proposal form wherein the different declarations claimed by the Opposite Parties are printed, are reproduced in para 7 of the reply. Thus, claiming no deficiency in service or unfair trade practice on their part, the answering Opposite Parties have prayed for the dismissal of the complaint with heavy costs.  

         The reply of the Opposite Parties No.2 and 3 is duly verified and is supported by detailed affidavit of Deepa Chacko.

4.       Having gone through the entire complaint, version of the Opposite Parties, the evidence of the parties and with the able assistance of the learned counsel for the parties, we have come to the following conclusions.

5.       As the subscription of the policy for the period 16.1.2011 to 15.1.2012 for the car bearing registration no. PB-27-C-1011 by the Complainant is not denied. Even the event of the happening of the accident on 5.8.2011, against which a claim was lodged, with the Opposite Parties, too, is admitted. The fact that the claim of the Complainant was duly assessed by the surveyor appointed by the Opposite Parties, who had opined that the claim of Rs.14,670/- is payable for the loss suffered by the Complainant. However, the present complaint of the Complainant is an outcome of the repudiation of the claim of the Complainant, vide letter dated 17.09.2011 (Annexure C-5) from the side of the Opposite Parties, through which the Opposite Parties claimed that as the Complainant having stated that he had not made any claim in the previous policy and thus was eligible for no claim bonus upon expiry of the previous policy and that the Complainant had signed the NCB declaration. The Opposite Parties through their letter dated 17.9.2011 Annexure C-5 have claimed that M/s Bajaj Alliance GIS Limited the previous insurer of the Complainant had informed in writing that there was one claim lodged with the previous insurer, thus, as per the provisions of motor insurance provided by the insurance regulator, the Complainant was not eligible for no claim bonus in the policy of the year subscribed for by the Complainant with the answering Opposite Parties. A part of NCB declaration under two different clauses is also found reproduced in the letter Annexure C-5.   

6.       After having gone through the letter as well as the copies of the proposal forms brought on record by the Complainant, as well as by the Opposite Parties it is found that the page no.1 of the proposal form Annexure C-1 submitted by the Complainant and Annexure R-2 from the side of the Opposite Parties are not the same; as in the column marked with a colored bar wherein “write complete address for online and accurate delivery of policy document” the column where “period of insurance from”, is found to be “blank” in Annexure C-1; whereas, a quote of “NCB – 20%” is found printed on Annexure R-2.  Faced with this situation, on 26.09.2012, when the arguments of the Complainant were heard, the counsel for the Opposite Parties had claimed that the Complainant might have tempered with the document Annexure C-1 and had preferred to seek adjournment to argue on the next date of hearing. On 27.09.2012, when the arguments of both the parties were heard, the Complainant had brought on record the original of Annexure C-1, which was taken upon on file and marked as Annexure C-1/A. This document clears the entire picture of the present complaint, and we are of the view that the Complainant while subscribing for the insurance policy from the answering Opposite Parties did not lay any claim for no claim bonus as claimed by the Opposite Parties.  It is also established that the Opposite Parties have tempered with the document in their custody by making additions so as to deny the genuine claim of the Complainant which is highly objectionable.           

7.       In these circumstances, we are of the view that as it is established beyond all reasonable doubts that the Opposite Parties are not only deficient in rendering proper service to the Complainant, but have also acted in a totally irresponsible manner while processing the claim of the Complainant. The contents of the repudiation letter claim that the answering Opposite Parties have applied their mind, while repudiating the claim, but we find that the Opposite Parties have applied their mind purposely only to repudiate the claim of the Complainant after having tempered with the documents in their custody. Such kind of acts of commissions of the officials of the Opposite Parties should not go unaddressed. The Opposite Parties must make it a point to investigate the matter and fix the responsibility of the official, who had conducted himself in a totally irresponsible manner while doctoring this document in his records and also was brazen enough to tender the same under oath as evidence during the proceedings of this complaint.          

8.       As the Opposite Party No.1 has failed to put up appearance on being served as such it had not contested the claim of the Complainant and same goes unrebutted against it. We feel no reason to absolve Opposite Party No.1 of its liabilities. Hence, the present complaint succeeds against all the Opposite Parties i.e. OPs No.1, 2 and 3, jointly and severally, and the same is allowed qua them. The Opposite Parties are directed, to:-

[a]  To pay the assessed amount of Rs.14,670/- as per surveyor report (Annexure R-4);

[b]  To pay Rs.30,000/- on account of deficiency in service and causing mental harassment to the Complainant, as well as for tempering with the documents in their custody;

[c]  To pay Rs.10,000/- as cost of litigation;

9.       The Opposite Parties while releasing the award of this order, are also directed to also investigate, at their end, about the lapses and the acts of omission & commission committed by its official(s), while tempering with the cover note (Annexure R-2), within a period of three months, and after fixing the responsibility, the Opposite Parties shall recover the amount of compensation suffered by them, in the present case, from the concerned official(s).   

10.      The above said order shall be complied within 45 days of its receipt by Opposite Parties; thereafter, they shall be liable for an interest @18% per annum on the amount mentioned in sub-para [a] & [b] of para 8 above, apart from cost of litigation of Rs.10,000/-, from the date of institution of the present complaint i.e. 12.10.2011, till it is paid.  

11.      Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room.

Announced  

10^th October, 2012

Sd/-

(LAKSHMAN SHARMA)

PRESIDENT

Sd/-

(MADHU MUTNEJA)

MEMBER

Sd/-

 (JASWINDER SINGH SIDHU)

MEMBER

‘Dutt’