Haryana

Karnal

CC/143/2023

Aman Dev Sharma - Complainant(s)

Versus

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

Ms. Seema Bhardwaj

04 Dec 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No.143 of 2023

                                                        Date of instt 02.03.2023

                                                        Date of Decision: 04.12.2024

 

Aman Dev Sharma son of Shri Gautam Dev Sharma, resident of # House no.43, Gali no.4, R.K. Puram, Karnal.

 

                                                                        …….Complainant.

                                              Versus

 

1.  Manager, Iffco Tokio General Insurance Company Ltd. # SCO no.19-20, Par-1, Sector-12, Karnal-132001 (Haryana).
2. MD & CEO, Iffco Tokio, General Insurance Company Limited registered office Iffco Sadan, C-1, District Centre Saket, New Delhi-110017.

…..Opposite Parties.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

Before   Shri Jaswant Singh……President.     

      Ms. Sarvjeet Kaur…..Member

 

Argued by: Ms. Seema Bhardwaj, counsel for the complainant.                         Shri Mohit Goyal, counsel for the OPs.

                   

                     (Jaswant Singh, President)

ORDER:   

                

                The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant is working in the Border Road Organization as JE (Civil) Doomdooma, District Teensukhia Assam presently. Complainant is having a car bearing registration no.HR-75B-7077 and the same was got insured bumper to bumper with the OPs, vide policy no.1-2 D7R50BEP400 # M0726702, valid from 12.04.2022 to 11.04.2023. On 29.10.2022 at 11.00 a.m., the said car met with an accident near Ladwa, District Kurukshetra. At that time, his father was driving the car and he was having valid licence for L.M.V. The car was got repaired by Surendra Motors, the authorized dealer of Maruti Company. The windscreen of the car has also been cracked in addition to the other damages. OPs appointed a surveyor namely Sawan Kumar, who declined the claim of windscreen on the ground that said damage is not due to this accident whereas the windscreen was cracked in the said accident. Father of complainant sent various emails but all the complaints are still lying pending. Due to serving so far from Karnal in Boarder Road Organization, it is not possible for complainant to pursue the case, so complainant authorized his father to pursue the present complaint. Due to the act and conduct of OPs, complainant has suffered mental pain, agony and harassment. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

2.             On notice, OPs 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 the intimation was received by the Insurance Company that one car bearing registration No.HR-75B-7077 has met with an accident on 29.10.2022. On receipt of said intimation, the OPs immediately deputed its surveyor to assess the loss to the damaged vehicle, if any. The said surveyor visited the Surendera Motors, Karnal where the damaged vehicle was shifted after the accident. The damaged vehicle was fully inspected by the surveyor. The surveyor assessed the loss of the damaged vehicle to the tune of Rs.13,243/-and the same was approved by the OPs and paid to repairer Surender Motors, Karnal as cashless settlement. The dispute is regarding front wind screen of the vehicle, which was claimed by the insured but not allowed by the surveyor. As per version of the insured in the claim form, the vehicle was collided with another vehicle from rear right side and due to impact of the accident, the front wind screen of the vehicle also damaged. The vehicle of the complainant was collided from rear right side and rear right side door and rear right quarter panel was damaged in the collision. The complainant was also demanding the front windscreen glass of the vehicle. The impact of the accident was not major, hence it is not possible to damage the front wind screen which was located for away from the point of impact. Hence, it has been concluded that the damages to the wind screen was not related to the accident dated 29.10.2022 and same was not allowed. The OPs already settled and paid the admissible claim amount as per insurance policy terms and conditions. The damages to the windscreen glass were no correlated with the cause and nature of accident, hence not allowed by the surveyor and the same was well within the knowledge of the insured. Hence, there is no negligence or deficiency in service on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.          

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of insurance policy Ex.C1, copy of service estimate/bill Ex.C2, copy of invoice Ex.C3, copy of accident claim of the car in question Ex.C4, copy of email dated 30.12.2022 Ex.C5 and closed the evidence on 03.08.2023 by suffering separate statement.

5.             On the other hand, learned counsel for the OPs has tendered into evidence affidavit of Gurinder Kaur, General Manager Ex.OPW1/A, copy of claim form Ex.OP1, copy of photograph of car Ex.OP2, copy of insurance policy Ex.OP3 and closed the evidence on 05.09.2024 by suffering separate statement.

6.             We have heard the learned for the parties and perused the case file carefully and also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got insured his vehicle with the OPs. On 29.10.2022, the said vehicle met with an accident. The windscreen of the vehicle has also been cracked in addition to the other damages. The OPs paid the claim of other parts and declined the claim of windscreen of the car on the false and frivolous ground and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for OPs, while reiterating the contents of written version, has vehemently argued that on receipt of claim intimation, OPs appointed a surveyor, in order to assess the loss qua the vehicle in question. The loss of the damaged vehicle to the tune of Rs.13,243/- was approved and paid to repairer Surender Motors, Karnal as cashless settlement but claim with regard to damages of windscreen of the insured vehicle  has not been paid  because said damage does not correlate with the cause of accident and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, complainant got insured his vehicle with the OPs. It is also admitted that during the subsistence of the insurance policy, the vehicle in question met with an accident. It is also admitted that the insured declared value (IDV) of the vehicle in question was Rs.3,00,000/-. It is also admitted that the amount of Rs.13,243/- has already been paid by the OPs.

11.           The claim of the complainant with regard to windscreen has been rejected by the OPs on the ground that the damage to the windscreen does not correlate with the cause of accident.

12.           The abovesaid claim has been repudiated by the OPs on the abovesaid ground. The onus to prove its case was relied upon the OPs but OPs have miserably failed to prove the same by leading any cogent and convincing evidence.  To prove its case, OPs have placed on file only affidavit of Gurinder Kaur, General Manager Ex.OPW1/A, copy of claim form Ex.OP1, copy of photograph of car Ex.OP2 and copy of insurance policy Ex.OP3. OPs have not placed on file any surveyor report, vide which surveyor has rejected the claim of windscreen. Further OPs have neither examined the said surveyor nor tendered his affidavit in its evidence. Hence, it appears that OPs have rejected the claim of the complainant on the basis of presumption and assumption, which is not admissible in the eyes of law. Furthermore, on perusal of photographs Ex.OP2, it appears that the cracks on the windshield are not old one. Hence the plea taken by the OPs that the damages of the windscreen of insured vehicle do not correlate with the cause of accident has no force.

13.           Furthermore, nowadays it has become a trend of insurance companies, they issue the policies by giving false assurances and when insured amount is claimed, they make such type of excuses. Thus, the denial of the claim of complainant is arbitrary and unjustified. In this regard, we place reliance on the judgment of Hon’ble Punjab and Haryana High Court titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, wherein the Hon’ble Punjab and Haryana High Court has held as under:-

“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”.

14.           Keeping in view that the ratio of the law laid down in aforesaid judgment, facts and circumstances of the present complaint, the act of the OPs while rejected the claim of complainant amounts to deficiency in services and unfair trade practice, which is otherwise proved genuine one.

15.           As per service estimate Ex.C2, the cost of the windshield is Rs.3595/-. Hence, complainant is entitled for the said amount alongwith interest, compensation for mental pain, agony and harassment and litigation expenses etc.

16            Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OPs to pay Rs.3595/- (Rs. three thousand five hundred ninety five only) alongwith interest @ 9% per annum from the date of filing the complaint i.e. 02.03.2023 till its realization to the complainant. We further direct the OPs to pay Rs.4,000/- to the complainant on account of mental agony, harassment suffered by him and for the litigation expenses. 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:04.12.2024

         President,

      District Consumer Disputes                            

      Redressal Commission, Karnal.

 

                (Sarvjeet Kaur) 

                      Member