Rajinder singh filed a consumer case on 08 Aug 2024 against Kotak General Ins.Co.Ltd in the Ludhiana Consumer Court. The case no is CC/21/404 and the judgment uploaded on 13 Aug 2024.
DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.
Consumer Complaint No: 404 dated 01.09.20221. Date of decision: 08.08.2024.
Rajinder Singh aged 68 years son of Shri Lal Singh, Proprietor of M/s. R.S. Sweets, resident of B-5, BRS Nagar, Ludhiana.
..…Complainant
Versus
Kotak General Insurance Company Limited, having its Office at H-78, 7th Floor, Himalaya House, Kasturba Gandhi Marg, New Delhi-110001 through its authorized person.
2nd address of OP (Policy Issuing Office): SCO 151-152, Second Floor, Sector 9-C, Chandigarh. …..Opposite party
Complaint Under Section 35 of the Consumer Protection Act as amended up to date for illegally rejection of the genuine claim in respect of vehicle having temporary registration No.PB-10(TC)-3199 Engine No.R18ZK1004681, Chassis No.MAKFC667BLN002817 and for compensation along with other reliefs.
QUORUM:
SH. SANJEEV BATRA, PRESIDENT
MS. MONIKA BHAGAT, MEMBER
COUNSEL FOR THE PARTIES:
For complainant : Sh. Nitin Kapila, Advocate.
For OP : Sh. Vyom Bansal, Advocate.
ORDER
PER SANJEEV BATRA, PRESIDENT
1. Shorn of unnecessary details, the facts of the case are that the complainant, being Proprietor has been carrying the firm M/s. R.S. Sweets for earning his livelihood. The complainant purchased Honda Civic car Bearing Engine No.R18ZK1004681, Chassis No.MAKFC667BLN002817 from M/s. Lally Motors Ltd., Ludhiana vide invoice No.SL00320-25 dated 24.05.2020 for Rs.21,52,209/-. A temporary registration no.PB10(TC)-3199 was issued. The said vehicle was got insured from the OP vide policy No.1215727400 for sum assured of Rs.20,25,000/- on premium of Rs.69,770/- having validity from 24.05.2020 to 23.05.2021 for own damage as well as for third party liability and compulsory P.A. for owner and driver.
The complainant stated that on 05.10.2020 at about 05.00 AM, the when car was driven by driver Balvir Singh son of Sh. Baldev Singh, it met with an accident near Jain Temple on 200 Feet Road, Ludhiana as one stray animal came in front of the car. In an attempt to save the stray animal, the driver lost the balance of car as a result, the car struck against a pole and turned towards other side of the road i.e. towards Devgun School. Due to said accident, short circuit occurred and car caught fire which was extinguished by the Fire Brigade but the car fully burnt. The driver Balvir Singh sustained burn injuries and got treatment being outdoor patient. A DDR No.14 dated 05.10.2020 was lodged at P.P. Basant Avenue, P.S. Sadar, Ludhiana. A Fire Call Report No.398/FB/D dated 06.10.2020 as issued by Office of Assistant Divisional Fire Officer Ludhiana. The complainant further stated that the car was totally damaged in burn incident and was beyond any repairs. Thereafter, he lodged a claim with the OP but the OP rejected the claim vide repudiation letter dated 16.01.2021 on flimsy ground that the vehicle was not having permanent registration certificate. According to the complainant, the OP is liable to pay an amount of Rs.20,25,000/- being sum insured under the said policy and also the complainant is entitled to compensation of Rs.5,00,000/- due to non-settlement of his genuine claim. The complainant has already deposited amount for issuance of permanent registration certificate with M/s. Lally Motors Ltd. Due to COVID-19 situation and due to imposition of nationwide lockdown, the Government of India, Ministry of Road Transports & Highways, New Delhi issued advisories dated 30.03.2020, 09.06.2020 and 24.08.2020 vide which direction was issued to all State and Union Territories regarding extension of validity of documents relating to Motor Vehicles Act, 1988 and Central Motor Vehicles Rules, 1989. It was further advised that the validity of fitness, permanent (all types), driving licence, registration or any other concerned document(s) whose extension of validity could not or not likely be granted due to lockdown and which had expired since 01.02.2020 or would expire by 31.12.2020, the same might be treated as valid till 31.12.2020. In terms of the said advisories, the temporary registration certificate of the vehicle in question was valid till 31.12.2020 whereas the temporary registration number was issued to the complainant on 24.05.2020 i.e. well within the extended time limit as per circular/notification of the Ministry of Road Transport & Highway. The complainant further requested that he requested the OP to accept his genuine claim but they paid no heed due to which the complainant suffered mental pain agony, harassment. In the end, the complainant has prayed for issuing direction to the OP to pay the claim of Rs.20,25,000/- for complete damage of Honda Civic car along with compensation of Rs.5,00,000/-.
2. Upon notice, the OP appeared and filed written statement. In the factual submission, the OP stated that the Vehicle being Honda Civic ZX CVT bearing registration No. NEW Chassis No. MAKFC667BLN002817 Engine No. R18ZK1004681 was insured by them for Own Damage period of 24.05.2020 to 23.05.2021 vide policy no. 1215727400 under Kotak Car Secure Bundled Policy. All the conditions under the policy were fully understood by the Complainant/Insured before taking the policy and he had thoroughly read the policy wordings. Further the benefits under the policy are governed by the terms and conditions of the Policy and the liability of the OP is limited to the insured perils occurring within the policy period subject to conditions and exceptions as mentioned in the terms and condition of the Policy. The OP further stated that a claim was reported by the insured for damage to the insured vehicle on 05.10.2020 which was registered vide Claim No. 10110065595. Thereafter, the Insurance Company appointed IRDA licensed and independent Surveyor/Loss Assessor namely Bansal & Company to conduct the survey of the loss to the vehicle who visited the Insured and collected Claim Form and other documents and issued letter dated 20.10.2020 and 16.01.2021 to the insured thereby calling him to provide the Valid RC of the vehicle amongst others. The said surveyor ultimately submitted his report dated 25.01.2021 whereby the cause of accident was narrated as "My driver got out of control while saving stray animal, the car hit on the divider & pole & after crossing the divider & turned a turtle & caught fire of its own & got burnt fully." The surveyor assessed the liability of the Insurance company at Rs. 19,98,000/- as per Policy and observed that the claim is not payable as there was no valid RC of the Vehicle. The OP also appointed M/s. Probe Services Investigator to verify the accident and vide its report dated 09.11.2020 it was reported that the claim has been misrepresented and the vehicle was not registered at the time of the accident. After receiving all the said documents, the Authorized officials of the OP applied their mind and assessed the claim in terms of the policy conditions and found the claim to be not payable and the same was closed as No-Claim vide letter dated 01.02.2021 as the Insured had not provided the valid RC and other documents as demanded by the surveyor in his letters. The OP further stated that the claim of the complainant, has been decided after through application of mind by its officials in terms of the coverage under the policy and the claim of the Complainant has been registered and attended in terms of the Policy conditions and the Policy terms are binding for both parties. According to the OP, it has rendered full services without any deficiency to the complainant.
The OP assailed by complaint by taking preliminary objections on the grounds of maintainability; lack of jurisdiction and cause of action; non-joinder of financer i.e. HDFC Bank as party; the complainant is not a consumer; concealment of material facts etc.
On merits, the OP reiterated the crux of averments made in the preliminary objections and factual submission of the case. The OP has denied that there is any deficiency of service and has also prayed for dismissal of the complaint.
3. In evidence, the complainant tendered his affidavit as Ex. CA and reiterated the averments of the complaint. The complainant also placed on record documents Ex. C1 is the copy of vehicle tax invoice of Lally Motors Private Limited, Ex. C2 is the copy of delivery note cum gate pass dated 24.05.2020, Ex. C3 is the copy of Trade Certificate issued by Government of Punjab, Motor vehicle Department, Ex. C4 is the copy of ledger of R.S. Sweets, Ex. C5 is the copy of Certificate cum Policy Schedule, Ex. C6 is the copy of driving licence of the complainant, Ex. C7 is the copy of driving licence of Balvir Singh, Ex. C8 is the copy of Aadhar Card of the complainant, Ex. C9 is the copy of DDR No.14 of 05.10.2020, Ex. C10 is the copy of bill of Satnam Recovery, Ex. C11 is the copy of Fire Call report dated 06.10.2020, Ex. C12 is the copy of medical prescription slip of Dr. Rajiv Kalra dated 05.10.2020, Ex. C13 to Ex. C16 are the copies of photographs of the vehicle, Ex. C17 is the copy of Final Letter dated 16.01.2021 issued by Bansal & Company, Ex. C18 is the copy of account statement of the complainant, Ex. C19 is the copy of advisory dated 09.06.2020 issued by Government of India, Ministry of Road Transport and Highways, Ex. C20 is the copy of advisor dated 27.12.2020 issued by Government of India, Ministry of Road Transport and Highways and closed the evidence.
4. On the other hand, the counsel for the OP tendered affidavit Ex. RA of Sh. Omkar Kulkarni, Assistant Manager-Litigation of the OP as well as affidavit Ex. RB of Sh. Gurjeet Singh, Proprietor Probe Services, Yamunanagar, affidavit Ex. RC of Sh. Vijay Bansal, Insurance Surveyors & Loss Assessors, Ludhiana along with documents Ex. R1 is the copy of policy documents, Ex. R2 is the copy of Claim Form, Ex. R3 is the copy of Reminder dated 20.10.2020 issued by Bansal & Company, Ex. R4 is the copy of Final Letter dated 16.01.2021 issued by Bansal & Company, Ex. R5 is the copy of survey report of Bansal & Company, Ex. R6 is the copy of investigation report of Probe Services, Ex. R7 is the copy of repudiation letter dated 01.02.2021, Ex. R8 is the copy of order dated 02.12.2014 issued by Government of Punjab, Transport Department and closed the evidence.
5. We have heard the arguments of the counsel for the parties and also gone through the complaint, affidavit and annexed documents and written statement along with affidavits and documents produced on record by both the parties.
6. The complainant, being Proprietor of M/s. R.S. Sweets, purchased Honda Civic 1.8 ZX CVT (I-VTEC) car from M/s. Lally Motors Private Limited for Rs.21,52,209/- vide invoice dated 24.05.2020 Ex. C1. A temporary registration No.PB10-TC-3199 Ex. C3 was issued by Government of Punjab, Motor Vehicle Department. The complainant got insured the car from the OP vide Kotak Car Secure-Bundled Comprehensive Policy Ex. C5 = Ex. R1 valid from 24.05.2020 to 23.05.2021 having IDV value Rs.20,25,000/-. The said vehicle met with an accident on 05.10.2020 at about 05.00 AM in the area Jain Temple, 200 Feet Road, Ludhiana when its driver Balveer Singh, in order to save the stray animal, lost the balance over car and it struck against a pole. The car turned turtle and it caught fire which was extinguished by Fire Brigade. A DDR No.14 dated 05.10.2020 Ex. C9 was lodged with P.P. Basant Avenue, P.S. Sadar, Ludhiana and a Fire Call Report dated 06.10.2020 Ex. C11 was issued. A claim was lodged by the complainant with the OP vide Claim Form Ex. R2. The OP appointed Bansal & Company Surveyor and Loss Assessor to assess the loss who after thorough survey, assessed the loss to be Rs.19,98,000/- vide his report Ex. R5. The surveyor vide his report Ex. R5 made the assessment and observations which is reproduced as under:-
“10. ASSESSMENT:-
After going through the details of the loss and on receiving the necessary information and raking the relevant factors into consideration and after getting the estimate of repairer, we assess the loss as under:-
ASSESSMENT ON NOS BASIS
On is as is where basis without RC -250000.00
NET AMOUNT PAYABLE ON NOS BASIS 1998000.00
11. OBSERVATION:
Though as per the documents the claim is not payable, however, if the claim would have been paid it would have been settled on Net of Salvage Basis without RC.”
The OP also appointed M/s. Probe Services, Investigator to verify the RC of the vehicle who vide his report dated 09.11.2020 Ex. R6 made the following observation:-
“Case Summary and Observation
Reported that driver had to take the relative of the owner on the way and leave the railway station on 05.10.2020. But before reaching him the car had an accident and caught fire. Accident happened in order to save a stray animal who suddenly came in front of car.
Misrepresentation of facts found in the claim. Also vehicle not registered at the time of loss.”
After scrutiny of the reports of the surveyors, the OP repudiated the claim of the complainant vide repudiation letter dated 01.02.2021 Ex. R7, the operative part of which reads as under:-
“We invite reference to the above claim registered with us and communication vide dated 09.10.2020. Upon due scrutiny of all documents and information furnished with us. It is to bring to your notice that post intimation of loss, a surveyor has been appointed to assess the loss. In view to proceed with the claim and assessment of veracity of loss, your good self was requested to submit requisite documents and information. Same as communicated to you vide letter dated 20.10.2020 & 16/01/2021. However, till date we have not received any response on the requirement.
In light of the above mentioned facts, it is inferred that you are not interested to pursue with your claim and above mentioned claim cannot keep open for indefinite period. Hence on this pretext we are closing the above mentioned claim as “NO CLAIM”.
7. Now the point for consideration arises whether the OP was justified in closing the claim of the complainant as ‘NO CLAIM’?
8. Perusal of repudiation letter Ex. R7 reveals that the claim was closed as ‘NO CLAIM’ mainly on the ground of non-submission of requisite documents and information which the complainant was asked to furnish vide letters dated 20.10.2020 and 16.01.2021. Both these documents have not been brought on record by the OP so to decipher that what type of documents and information was sought from the complainant. However, one letter dated 16.01.2021 Ex. C17 produced by the complainant which was written by Sh.Vijay Bansal on behalf of Bansal & Company. It is mentioned in the said letter that at the time of accident the car was not having valid registration certificate which is violation of the policy terms and conditions as well as Section 39 of the Motor Vehicle Act. It is settled law that an insurance company canot go beyond the scope of repudiation letter and cannot plead new facts in the written statement. Still considering the peculiar facts and circumstances of the case, in order to adjudicate the controversy conclusively, this Commission proceeds to determine whether there was violation of terms and conditions of the policy or Section 39 of the Motor Vehicle Act.
8. Admittedly, the said vehicle was purchased by the complainant on 24.05.2020 from M/s. Lally Motors Private Limited but instead of issuing a provisional registration certificate, a temporary registration certificate bearing No.PB10-TC-3199 was issued. The complainant could not get the vehicle registered with the registering authorities within stipulated time and in the meanwhile, the vehicle met with an accident resulting in damage. The counsel for the complainant has referred to letter dated 09.06.2020 Ex. C19 issued by Government of India, Ministry of Road Transport & Highways (MVL Section) wherein due to spread of COVID-19, the validity of the documents relating to Motor Vehicle Act was extended. Relevant para 4a of Ex. C19 is reproduced as under:-
“4. Taking into consideration the grim situation still continuing due to conditions for prevention of spread of COVID-19 across the country, it is advised that-
9. The validity and extension was firstly extended up to 30.09.2020. Subsequently, vide letter dated 27.12.2020 Ex. C20, the same was further extended up to 31.12.2020. As such, this Commission is of the view that the extension of period also applies to the new registration of vehicles as well as extending period for renewal of other documents as well. So it cannot be said that the vehicle was not registered at the time of accident. As such, there is no violation of any terms and conditions of the policy and Section 39 of the Motor Vehicle Act. Therefore, in view of the facts and circumstances, this commission is of the opinion that the OP was not justified in repudiating the claim of the complainant for want of provisional registration certificate of the vehicle in question.
10. It is not disputed that in this case after the receipt of the claim, a surveyor Bansal & Company was appointed by the OP who vide his Private & Confidential Survey Report dated 25.01.2021 Ex. R5 assessed the loss at Rs.19,98,000/-. The report Ex. R5 has not been challenged by the complainant on any ground nor any evidence has been led by the complainant to prove that the report is faulty for some reason or the other. So it would be just and appropriate if the claim of the complainant is allowed to the extent of Rs.19,98,000/- as assessed by the surveyor in survey report Ex. R5. The OP is also burdened with composite costs of Rs.10,000/-.
11. As a result of above discussion, the complaint is partly allowed with direction to the OP to reimburse the amount of Rs.19,98,000/- as assessed by the surveyor in survey report Ex. R5 to the complainant within 30 days from the date of receipt of copy of order, failing which the complainant shall be held entitled to interest @8% per annum from the date of order till date of its actual payment. The OP shall also pay a composite costs of Rs.10,000/- (Rupees Ten Thousand only) to the complainant. Compliance of the order be made within 30 days from the date of receipt of copy of order. Copies of the order be supplied to the parties free of costs as per rules. File be indexed and consigned to record room.
12. Due to huge pendency of cases, the complaint could not be decided within statutory period.
(Monika Bhagat) (Sanjeev Batra) Member President
Announced in Open Commission.
Dated:08.08.2024.
Gobind Ram.
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