Chandigarh

DF-II

CC/83/2019

Babbu - Complainant(s)

Versus

Ms/ Future Generali India Insurance Company Limited - Opp.Party(s)

Manoj Kumar Adv.

26 Dec 2019

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II

U.T. CHANDIGARH

 

Consumer Complaint No.	:	83/2019
Date of Institution	:	13.02.2019
Date of Decision	:	26.12.2019

 

                                       

                       

 

Babbu s/o Sh.Chunan, H.No.2494, Mauli Jagran, Chandigarh

                                ...  Complainant.

Versus

1.     M/s Future Generali India Insurance Co. Ltd., through its Manager/Authorized Officer, SCO 4-5, 2^nd Floor, Sector 8-C, Chandigarh -160017.

 

2.     M/s Future Generali India Insurance Co. Ltd., through its Manager/Authorized Officer, 6^th Floor,  Tower 3, Indiabulls Finance Centre, Senapati Bapat Marg, Elphinstone Road, Mumbai-400013, Maharashtra.

…. Opposite Parties.

 

BEFORE:
	SHRI RAJAN DEWAN,	PRESIDENT
	SMT.PRITI MALHOTRA,	MEMBER

 

 

Argued by:-
	Sh.Manoj  Kumar, Adv. for the complainant
	Sh.Sachin Ohri, Adv. for the OP(s)

 

      

 

PER RAJAN DEWAN, PRESIDENT

1.         Briefly stated, the complainant got renewed Insurance Policy of his vehicle make Mahindra Pick Up bearing registration No.CH-01TA-9314 with the OPs vide Insurance Policy (Annexure C-1) for the period from 30.10.2017 to 29.12.2018.  It has further been averred that after getting loaded certain fruits on the vehicle, he started heading from Sector 26, Chandigarh towards Solan, Himachal Pradesh to deliver the goods on 07.12.2018. However after reaching at around Majri Chowk, Near Sector 2, Panchkula at around 8:15 P.M., unfortunately the vehicle loaded with goods collided with divider and got damaged,  he himself has a narrow escape.  He immediately called up the Customer Care Representative of the OPs and the Police to register the FIR.  However, the representative of the OPs suggested the complainant to get FIR registered first and in the meantime, the OPs were supposed to inform the Loss Assessor to assess the loss/damage to the vehicle.  The complainant alleged that the Police reached the spot but did not register the FIR. However, the Police might have registered the DDR in daily routine.  As per the instructions of the OPs, he towed the vehicle to M/s Radhe Shyam Denting & Panting, Manimajra who prepared the estimate of Rs.74,950/- but he incurred a sum of Rs.60,750/- on the repairs of the vehicle.  On enquiry, he was informed that the loss was approved for Rs.21,200/- instead of Rs.60,750/-.  It has further been averred that OP No.1 asked the complainant to submit the cancelled cheque in which sanctioned amount wish to be credited and offered advance satisfaction form for signatures to him. Since he was not satisfied, therefore, made remarks of protest as being unsatisfied on the said form and immediately the OP denied the claim.  Finally, he got served a legal notice dated 16.01.2019 upon the OPs but to no effect.  Thereafter, he received a letter (Annexure C-9) stating therein that why the vehicle was moved from the accident spot whereas the same was removed whereas the same was moved to the Service Centre on the instructions of the OPs.  Alleging that the aforesaid acts amount to deficiency in service and unfair trade practice on the part of the OP, the complainant has filed the instant complaint.
2.         In their written statement, the OPs while admitting the factual matrix of the case have pleaded that  the claim was lodged with OPs and the surveyor was appointed to access the liability as per terms and conditions of the Insurance Policy. On investigation, it was found that the complainant had mis-represented the true facts in the claim form and given wrong details with regard to the reason for the occurrence of the accident and also did not disclose the name of the driver and as such the claim was repudiated vide letter dated 04.01.2018 (Annexure R-2).  It has been denied that the OPs are liable to pay Rs.60,750/- as claimed.  It has been admitted that the surveyor had assessed the claim to Rs.21,200/-.  It has further been pleaded that the complainant has violated the terms and conditions of the Insurance Policy.  Pleading that there is no deficiency in service on its part, a prayer for dismissal of the complaint has been made.
3.         The complainant filed rejoinder to the written reply of the OPs controverting their stand and reiterating his own.
4.         We have heard the learned Counsel for the parties and have gone through the documents on record.
5.         The grouse of the complainant is that he had actually spent a sum of Rs.60,750/- on the repairs of the vehicle whereas the surveyor had assessed the claim to Rs.21,200/- but despite this OPs have wrongly and illegally repudiated the claim vide letter dated 04.01.2018 (Annexure C-9).
6.         Per contra, the stand of the OPs is that the complainant had mis-represented the true facts in the claim form and given wrong details with regard to the reason for the occurrence of the accident and also did not disclose the name of the driver and removed the vehicle from the spot  of accident before spot surveyor completion and as such the claim was repudiated vide letter dated 04.01.2018 (Annexure R-2)
7.         In the present case, the factum of accident of the vehicle has not been denied by the OPs.  It is also established from the repudiated letter dated 04.01.2018 placed on record by the parties that the insurer had timely informed the OPs regarding the accident.  The contentions of the OPs that the complainant did not provide an opportunity to assess the loss at the accident spot and provided different version about the driver in the claim form are not tenable in view of the fact that the OPs have not placed on record the claim form and the surveyor report or any other convincing documentary evidence in support of their version.  The OPs have not been place on record any letter or e-mail sent to the complainant seeking any query regarding the wrong information furnished in the claim or the driver particulars etc.  Once the complainant had informed the OPs immediately after the accident and as such it cannot be said that the OPs have been prejudiced in any manner in investigation of the case as the surveyor appointed by the OPs had inspected the vehicle and assessed the loss to the tune of Rs.21,200/- as per the terms and conditions of the Insurance Policy.  Moreover, it is not understood as to why the OPs did not take place on record the surveyor report.  On the contrary, the OPs have repudiated the claim vide its letter dated 04.01.2018 instead of releasing the claim as assessed by its surveyor. In this view of the matter, the repudiation of the claim by the OPs is held to be illegal and unjustified.
8.         It has been argued on behalf of the complainant that he is entitled to Rs.60,750/-  actually incurred by him on the repairs of the complainant. However, we are of the considered view that if the complainant is interested in contesting the report of the Surveyor with regard to the assessment of loss/damages, then he should have brought on record the details of estimated loss as perceived by the complainant duly backed by a professional/qualified person and his affidavit. This is the least expected from any party who wishes to challenge the report of a licensed/qualified person which a Surveyor is. Nothing to this effect has been shown in view of which we are not in a position to hold that the complainant is entitled to the amount as claimed in the complaint, without any reliable and convincing evidence.
9.         In New India Assurance Co.Ltd. & Anr. Vs. New Good Luck Retrading Works, III (2009) CPJ 262, it was held that the Surveyor’s report cannot be brushed aside easily, without valid justification.
10.         In Dabiruddin Cold Storage Vs. New India Assurance Co.Ltd.,& Ors., I (2010) CPJ 141 (NC), it was held that Surveyor’s report being important document, cannot be easily brushed aside.  The insurer was held liable to pay loss assessed by the Surveyor, with interest.                                                                          
11.         In New India Assurance Co.Ltd., Vs. Febama Agencies, I (2013) CPJ 133 (NC), it was held that report of Surveyor  is  an  important  document and  it  is to be relied upon unless, it is contradicted by more credible evidence.
12.         The Insurance Company is, thus, legally liable to pay the amount as assessed/recommended by the surveyor and non-payment of the same after receipt of the surveyor report to the complainant itself amounts to deficiency in service as also indulgence into unfair trade practice on the part of the OPs. 
13.         In view of the above discussion, the present complaint deserves to be allowed and the same is accordingly allowed.    The OPs are directed as under;-

1. To pay the amount of Rs.21,200/- as recommended by the surveyor to the complainant alongwith interest @ 9% p.a. from the repudiation letter  (Annexure R-2), till its actual realization.
2. To pay a sum of Rs.10,000/- towards mental agony and physical harassment.
3. To pay a sum of Rs.7,000/- as litigation expenses.

This order be complied with by the OPs, within 45 days from the date of receipt of its certified copy, failing which the amount at Sr.No.(ii) shall also carry interest @ 9% per annum from the date of this order till actual payment besides compliance of other directions.

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

Announced 26/12/2019	Sd/-
	(RAJAN DEWAN) PRESIDENT
	Sd/-
	(PRITI MALHOTRA) MEMBER