Complaint No: 342 of 2019.

                                                          Date of Institution: 25.11.2019.

                                                                  Date of order: 26.12.2023.

Parun Sharma Son of Surinder Pal, resident of Bharat Colony, Faizpura, Aliwal Road, Batala, Gurdaspur.

                                                                                                                                    …...........Complainant.                                                                                                                                                                                                                                                                                                                                                                                                        

                                                       VERSUS

1.       Liberty General Insurance Limited., Registered Office, 10th Floor, Tower-A, Penisuala Business Park, Ganpat Rao, Kadam Marg, Lower Parel, Mumbai – 400013, through its General Manager.

2.       Liberty General Insurance Limited., Registered Area Office, SCO No.9, Burj Punjab, Ranjeet Avenue, Amritsar, Punjab – 143001, through its Area Manager.

                                                                                                                             ….Opposite parties.

                                    Complaint u/s 12 of Consumer Protection Act.

Present: For the Complainant: Sh.Satyan Khajuria, Advocate.

               For the Opposite Parties: Sh.Sandeep Ohri, Advocate.  

Quorum: Sh.Lalit Mohan Dogra, President, Sh.Bhagwan Singh Matharu, Member.

ORDER

Lalit Mohan Dogra, President.

          Parun Sharma, Complainant (here-in-after referred to as complainant) has filed this complaint under section 12 of the Consumer Protection Act (here-in-after referred to as 'Act') against Liberty Gen. Ins. Ltd. Etc. (here-in-after referred to as 'opposite parties).

2.       Briefly stated, the case of the complainant is that the complainant owns a car Hyundai Creta bearing registration No.PB-06-AB-0020. It is pleaded that the complainant purchased the above said vehicle from M/s Novelty Hyundai BG International P.O Hardochande, Batala in the year 2017 and got the insurance cover of his car from the OP No. 1 who has a tie-up / contract with M/s Novelty Hyundai, Batala. The OP No. 2 is a sub-office of the OP No. 1 who deals with its customers in the area of Batala. It is further pleaded that on 07.12.2018 the complainant again got his car insured from the OP No. 1 and paid gross premium in the tune of Rs.15,631/- and the OP’s issued the cover note to the complainant. It is further pleaded that on 12.09.2019 the complainant's car met with an accident and the complainant sent his car for the repair where the OP’s surveyor made the estimate and sent the estimate report for insurance claim. It is further pleaded that  after the repair when the complainant went to get the delivery of the car, he was shocked to know that his insurance claim has been refused by the OP’s on the pretext that the OP’s inadvertently gave no claim bonus to the complainant while insurance policy in the sum of Rs.2,396/-. It is further pleaded that the complainant when contacted the OP’s they failed to give any satisfactory reply and rather than admitting their mistake, started blaming the complainant. It is further pleaded that complainant was further shocked to know that inspite of issuance of insurance policy by the OP’s, his car did not have the insurance cover. It is further pleaded that due to this illegal act and conduct of the opposite parties the complainant has suffered great loss and also suffered mental agony, Physical harassment and inconvenience. It is further pleaded that there is a clear cut deficiency in service on the part of the opposite parties.

       On this backdrop of facts, the complainant has alleged deficiency and negligence in service and unfair trade practice on the part of the opposite parties and prayed that necessary directions may kindly be issued to the opposite parties to pay the repair amount i.e. Rs.15,175/- as well as the policy premium amount paid by the complainant i.e. Rs.15,631/- alongwith Rs.1,00,000/- for mental harassment and Rs.20,000/- for litigation expenses to the complainant,  in the interest of justice.

3.       Upon notice, the opposite parties appeared through counsel and contested the complaint and filing their written reply by taking the preliminary objections that the complainant has no cause of action to file the present complaint and the complainant has no locus standi to file the present complaint. It is pleaded that the insurance is a Contract between two parties and both the parties are bound with the terms and conditions of the policy. It is further pleaded that the insurance is a contract based on utmost good faith and it is the duty of the insured to disclose all the relevant facts at the time of getting the policy. It is further pleaded that in the present case, there is concealment on the part of the complainant and as such the present complaint is liable to be dismissed, as there is breach of the utmost good faith and there is no deficiency in service on the part of the opposite parties. It is further pleaded that the claim has been intimated regarding in respect of the loss alleged to have taken 17.09.2019. It is further pleaded that on intimation of the claim, the OP got the vehicle inspected by the in-house surveyor and the surveyor assessed loss for an amount of Rs.10,903/- subject to the terms of the Policy. It is further pleaded that on scrutiny of the claim as a matter of procedure the OP got the NCB confirmed from the rest while insurer. It is further pleaded that on confirmation of the same it was observed that the complainant had reported a claim under the expiring policy and as such the complainant wasn't entitled for NCB. It is further pleaded that complainant also provided the copy of the Certificate of Previous Insurance Policy, issued by Bharti AXA General Insurance Company bearing No. HAK/S6442738 which was valid for a period from 22.11.2017 to 21.11.2018 vide said policy, complainant represented that the said policy is effective and further the complainant has not made any claim during the currency of expiring policy. It is further pleaded that relying on the representation the premium was collected after giving no claim bonus benefit of 20%. It is further pleaded that now upon enquiry made from previous insurer, it reveals that the vehicle previously met with an accident and the complainant also got claim during previous expired policy. It is further pleaded that but, inspite of that complainant has not disclosed the said fact and made incorrect statement. It is further pleaded that the NCB Declaration clause forming part and parcel of the proposal form clearly provides as under:- "I/We declare that the rate of NCB claimed by me/us is correct and no claim as arisen in the expiring policy period. I/we further undertake that if the declaration is found to be incorrect, all the benefits under the policy will stand forfeited. It is further pleaded that the condition No. 8 of the policy terms and conditions clearly provides that it is the duty of the insured to make true of the statements and answers in the said proposal, shall be condition precedent to any liability of the company to make any payment under the policy. Hence, the claim of the complainant was repudiated vide letter dated 10.10.2019 as per the terms and conditions of the Policy, which has been duly sent through registered post dated 11.10.2019. It is further pleaded that even otherwise, if this Ld. Commission comes to the conclusion that there is any liability of the Insurance Company, then in that case, the liability is only as per the terms and conditions of the policy and as per coverage and as per the loss assessed by the surveyor.

          On merits, the opposite parties have reiterated their stand as taken in legal objections and denied all the averments of the complaint and there is no deficiency in service on the part of the opposite parties. In the end, the opposite parties prayed for dismissal of complaint with costs.

4.       Learned counsel for the complainant has filed an affidavit of Parun Sharma, (Complainant) alongwith other documents as Ex.C-1 to Ex.C-3.

5.       Learned counsel for the opposite parties has tendered into evidence affidavit of Sh. Sandeep S K, (Authorized Signatory, Liberty Gen. Ins. Co. Ltd., Chandigarh) as Ex.OPW-1 alongwith other documents as Ex.OP-1 to Ex.OP-6.

6.       Rejoinder not filed by the complainant.

7.       Written arguments not filed by both the parties.

8.       Counsel for the complainant has argued that complainant had got his car Hyundai Creta insured with the opposite parties after making payment of  premium of Rs.15,631/-. It is further argued that said car met with an accident on 12.09.2019. However, the opposite parties refused to pay the claim on the ground that the opposite parties had inadvertently given no claim bonus to the complainant in the policy Ex.C1 for Rs.2,396/-. The opposite parties refused to pay the claim of Rs.15,175/- to the complainant which amounts to deficiency in service on the part of the opposite parties.

9.       On the other hand counsel for the opposite parties has argued that on receiving intimation the surveyor assessed the loss as Rs.10,903/-. However, on scrutiny of the claim as a matter of procedure the opposite parties got NCB confirmed from the previous insurer and it was observed that complainant had reported the claim under the expiring policy and as such complainant was not entitled to claim. It is further argued that complainant wrongfully obtained no claim bonus benefit of 20%. Accordingly, claim was rightly repudiated by the opposite parties vide repudiation letter dated 10.10.2019 Ex.OP-1.

10.     We have heard the Ld. counsels for the parties and gone through the record.

11.     Admittedly the car of the complainant was insured with the opposite parties insurance company. It is further admitted fact that the car of the complainant met with an accident on 12.09.2019. It is further admitted fact that complainant availed no claim bonus benefit for the same of Rs.2,396/-. It is further admitted fact that the surveyor deputed by the opposite parties had assessed the payable loss of Rs.10,903/- to the complainant. It is further admitted fact that the claim lodged by the complainant has been repudiated by the opposite parties. The only issue for adjudication before this Commission is whether the repudiation of the claim by the opposite parties if justified or not.

12.     Perusal of record shows that complainant had availed benefit of Rs.2,396/- as per the policy of insurance as no claim bonus but the opposite parties have not been able to bring on record any fact and evidence that the complainant deliberately concealed the claim under the previous claim policy. Moreover, we are of the view that it was the duty of the opposite parties to have confirmed the status of the previous policy while issuing the policy of insurance and since opposite parties failed to get the status of previous policy verified at the time of accepting the premium for renewal. As such thereafter opposite parties are not justifying in repudiating the claim on any such ground. However, perusal of file shows that surveyor deputed by the opposite parties has assessed payable loss of Rs.10,903/-. As such opposite parties are directed to pay the amount as assessed by the surveyor after deducting Rs.2,396/- from the same received by the complainant as No Claim Bonus.

13.     Accordingly, present complaint is partly allowed and opposite parties are directed to pay the amount of Rs.8,507/- to the complainant alongwith interest @ 9% P.A. from the date of loss i.e. 12.09.2019 till realization. Opposite parties are further directed to pay Rs.1,000/- to the complainant for mental tension, harassment and Rs.1000/- as costs of litigation. Entire exercise shall be completed within 30 days from the date of receipt of copy of this order.

14.      The complaint could not be decided within the stipulated period due to heavy pendency of Court Cases, vacancies in the office and due to pandemic of Covid-19.

15.     Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record.  

                               (Lalit Mohan Dogra)

                                                                         President 

Announced:                                          (B.S.Matharu)

Dec. 26, 2023                                                Member

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