Chandigarh

DF-I

CC/14/2015

Sh. J.C. Kapoor - Complainant(s)

Versus

M/s Oriental Insurance Company Ltd. - Opp.Party(s)

J.C. Kapoor

13 Oct 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I, U.T. CHANDIGARH

============

Consumer Complaint  No	:	CC/14 /2015
Date  of  Institution	:	8/01 /2015
Date   of   Decision	:	13/10/2015

 

 

 

 

Sh. J.C. Kapoor S/o Sh. K.D. Kapoor, R/o H. No. 3598, Sector 37D, Chandigarh.

 

….Complainant

Vs.

 

M/s Oriental Insurance Company Ltd., SCO No.99-100, Sector  17-B, Chandigarh-160017 through its Regional Manager.

 

…… Opposite Party. 

 

BEFORE:  SH. P.L. AHUJA                                  PRESIDENT

                   MRS.SURJEET KAUR                       MEMBER

                   SH. SURESH KUMAR SARDANA     MEMBER

 

 

For Complainant	:	Complainant in person.
For OP	:	Sh. Ram Avtar, Advocate.

 

 

PER SURESH KUMAR SARDANA, MEMBER

 

 

 

                The facts, in brief, are that the complainant insured his vehicle i.e. TATA  Indigo with the  OP  for the period from 4.9.2013 to 3.9.2014  for a value of Rs.2,05,000/-. Unfortunately the said vehicle caught fire and DDR to this effect vide Annexure C-V was lodged with the Police.    It has been alleged that  the complainant vide letters Annexure C-VII, VIII and IX requested the OP for settlement of his claim but the OP failed to do so and rather repudiated his claim vide Annexure C-X on the ground that the complainant did not disclose previous Claim to the OP.   It has further been stated that the complainant wrote a letter Annexure XI to  United India Insurance Company regarding previous claim. The United India  Insurance Company vide Annexure XII informed the complainant that the payment of Rs.7034/- was released on 30.5.2014.  Thus it was clear from this that the previous claim was issued to the complainant on 30.5.2014 i.e. after the  cover note in dispute was issued on 4.9.2013 and as such it was not possible for the complainant to intimate regarding the previous claim.  It was further stated that the aforesaid acts of the Opposite Party, amounted to deficiency, in rendering service, as also indulgence into unfair trade practice. When the grievance of the complainant, was not redressed, left with no alternative, a complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter to be called as the Act only), was filed.

2.           Notice of the complaint was sent to Opposite  Party, seeking its version of the case.

3.          Opposite Party in its reply admitted the fact that it insured the  vehicle of the complainant from 4.9.2013 to 3.9.2014.  It was also admitted that the complainant lodged claim  with the OP vide application dated 14.7.2014.  It was further submitted that in the proposal form it was revealed that the vehicle was earlier insured with United India Insurance Co. Ltd..  The said insurance company released a sum of Rs.7034/- on 30.5.2014 to the complainant but the complainant while lodging his claim with the OP on 14.7.2014 purposely did not reveal this fact.  It was further stated that the complainant intentionally suppressed this fact from the OP  while obtaining the policy in question and availed NCB for which he was not entitled and as such the OP rightly repudiated his claim.  It was further stated, that neither there was any deficiency, in rendering service, on the part of the Opposite Party nor it indulged into unfair trade practice. The remaining allegations, were denied, being wrong

4.          The complainant has filed a rejoinder, wherein he has reiterated all the averments, contained in the complaint, and repudiated those, contained in the written version of Opposite Party.

 

5.          Parties were permitted to place their respective evidence on record, in support of their contentions.

 

6.          We have heard the complainant in person, ld. counsel for the OP and have perused the record, along with the written arguments filed on behalf of both the sides.

 

7.          The main grouse of the Complainant is that his claim was wrongly rejected by the Opposite Party on the ground that he had taken the claim in the previous insurance policy, but he had never disclosed the said fact to it at the time of renewal of the said Policy and thereby claimed the NCB. In this way, the Complainant misrepresented and concealed the material facts while taking the Policy in question and violated the terms and conditions of the Policy as well as G.R..  The Counsel for the complainant further submitted that the payment of Rs.7034/- was released on 30.5.2014, much later than the initiation of the current insurance period i.e. 4.9.2013, as such there is no question of misrepresentation.

 

8.          We feel that the objection raised by the OP that the Complainant was guilty of concealment of facts qua NCB does not have any merit for the reasons recorded hereinafter. The plea of the complainant is that he has not availed NCB by misrepresentation from OP as OP never obtained declaration from him regarding the claim previously claimed by him from United India Insurance Company i.e. earlier insurance company.. On the other hand, OP has failed to rebut this contention of the complainant by way of producing on record any cogent evidence wherein the complainant had given any wrong declaration on the date of signing of declaration(date of issue of cover note) regarding claim previously claimed by him from earlier Insurance Company(United India Insurance Co.). Hence, in absence of any cogent evidence the contention of OP that the complainant obtained NCB from it by misrepresentation does not have any merit and the same is rejected. Even otherwise, it was the duty fastened upon the Opposite Party to verify about the entitlement of the NCB to the Complainant at the time of issuance of the insurance policy especially when the policy was being renewed from it.

9.          More so, the Policy continued running from 4.09.2013 to 3.09.2014 (Annexure C-2) and the fresh claim was lodged on 14.7.2014. During this period, OP Insurance Company, even after 10 months of the present Policy i.e. till 14.7.2014 (the date of lodging new claim), neither enquired from the previous insurance company about the entitlement of the Complainant to get NCB, if any, nor demanded the difference of NCB from the Complainant, nor cancelled the insurance policy on any such ground. It is only after lodging of fresh claim that the OP Insurance Company had taken such stand which is not justified.

 

10.          Furthermore, Opposite Party has failed to prove on record that it has followed the procedure enshrined in Clause (f) of GR 27 of India Motor Tariff, which is reproduced as below:-

 

“(f) In the event of the insured, transferring his insurance from one insurer to another insurer, the transferee insurer may allow the same rate of NCB which the insured would have received from the previous insurer. Evidence of the insured's NCB entitlement either in the form of a renewal notice or a letter confirming the NCB entitlement from the previous insurer will be required for this purpose.

 

Where the insured is unable to produce such evidence of NCB entitlement from the previous insurer, the claimed NCB may be permitted after obtaining from the insured a declaration as per the following wording:

 

“I/We declare that the rate of NCB claimed by me/us is correct and that no claim as arisen in the expiring policy period (copy of the policy enclosed). I/We further undertake that if this declaration is found to be incorrect, all benefits under the policy in respect of Section I of the Policy will stand forfeited.”

 

Notwithstanding the above declaration, the insurer allowing the NCB will be obliged to write to the Policy issuing office of the previous insurer, by recorded delivery calling for confirmation of the entitlement and rate of NCB for the particular insured and the previous insurer shall be obliged to provide the information sought within 30 days of receipt of the letter of enquiry, failing which the matter will be treated as a breach of Tariff on the part of the previous insurer. Failure of the insurer granting the NCB to write to the previous insurer within 21 days, after granting the cover will also constitute a breach of the Tariff.”

 

 

11.          It is evident from the afore-extracted Clause (f) of G.R.27 of India Motor Tariff that the insurer was also duty bound to write to the previous insurer, within 21 days, after granting the cover for confirmation of the entitlement and rate of NCB.  Since the policy had been issued by the Opposite Party, in respect of the vehicle,  in question, in favour of the complainant, it was its duty to obtain the information, as to whether, any claim had been obtained by the complainant, in respect of the Policy, of the previous year, within 21 days, but it failed to do so. Under these circumstances, the fault also lay, on the shoulders of the Opposite Party, in not confirming about this factum, within the specified time, stipulated in the aforesaid Clause (f) of GR 27 of India Motor Tariff.

12.          Hence, the present complaint of the Complainant deserves to succeed against the Opposite Party, and the same is partly allowed. The Opposite  Party  is directed, , to:-

 

[a]     Pay Rs.2,05,000 after deducting NCB therefrom with interest @9% p.a. from the date of filing of the claim, till realization.

[b]     pay Rs. 800/- as demurrage  charges.

 

[c]      Pay Rs.30,000/- on account of deficiency in service and causing mental and physical harassment to the Complainant; 

 

[d]     Pay Rs.10,000/- towards costs of litigation;

 

         

13.          The above said order shall be complied within 30 days of its receipt by Opposite Party; failing which it, shall be liable for an interest @12% per annum on the amount mentioned in sub-para [a]  of Para above from the date of filing of the claim, till it is paid. The amount as per sub-para [b] &[c] above, shall carry interest @12% per annum from the date of institution of this complaint, till it is paid, apart from costs of litigation.

 

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

 

Announced

13^th  October, 2015                                                                  

 (P.L. AHUJA)

PRESIDENT

 

(SURJEET KAUR)

MEMBER

 

(SURESH KUMAR SARDANA)

MEMBER