Delhi

StateCommission

CC/1652/2018

SURAJ GUPTA - Complainant(s)

Versus

M/S ROYAL SUNDARAM GENERAL INSURANCE CO. LTD. - Opp.Party(s)

ASHU JAIN

26 Feb 2020

ORDER

IN THE STATE COMMISSION: DELHI

(Constituted under section 9 of the Consumer Protection Act, 1986)

 

 

Date of Hearing:­­­20.02.2020

                                                                                                              

                                                                   Date of decision:26.02.2020

 

Complaint No.1652/2018

 

IN THE MATTER OF

 

SH. SURAJ GUPTA @ SUNNY,

S/o Sh. Rishi Kumar Gupta,

R/o B-48, Gali No. 8, Bihari Colony,

Shahadara, Delhi-110032                                          ….Complainant

 

VERSUS

 

          ROYAL SUNDARAM GENERAL INS. CO. LTD.

          108-109 & 111, First Floor, Ambadeep,

          14, K.G. Marg, New Delhi-110001                                 ....Opposite Party

 

 

HON’BLE  SH. ANIL SRIVASTAVA, MEMBER                            

 1.   Whether reporters of local newspaper be allowed to see the judgment?            Yes     

 2.   To be referred to the reporter or not?                                                                   Yes

 

Present:       Sh. Ashu Jain, Counsel for the Complainant

                   Ms. Deepa Chako, Counsel for the OPs

 

ANIL SRIVASTAVA, MEMBER

JUDGEMENT

1.           This complaint has been filed before this Commission under Section 17 of the Consumer Protection Act 1986, the Act, by Sh. Suraj Gupta resident of Delhi, the complainant, against the Royal Sundaram General Insurance Co. Ltd., hereinafter referred to as Ops, alleging deficiency of service on the part of the OPs in rendering service to the complainant, they having not approved the claim preferred for indemnification consequent upon the accident of the insured vehicle on 24.04.2018 resulting in the damage to the vehicle and praying for the relief as under:-

 

1. Direct the OP to pay an amount of Rs. 32,41,350/- i.e. the insurance Declare Value of the damaged car of the complainant along with interest @ 18% per annum from the date of claim filing of claim earlier i.e. 20.09.2018 before this Hon’ble Forum till the same is awarded amount is paid to the complainant by the OP.
2. Direct the OP to pay compensation for harassment, financial loss and mental agony in the sum of Rs. 5,00,000/-
3. Direct the OP to pay the compensation of Rs. 55,000/- as the cost of the present litigation.
4. Direct the OP to take custody of the damaged car and the disposed off the same in scrap or allow the complainant for the same and pay the parking charges of the same till such orders are being made.
5. Hon’ble Forum may kindly pass any other order or orders in favour of the complainant and against the OP as deem fit and proper in the facts and circumstances of the case.

 

Any other order or orders in favour of the complainant and against the OP as deem fit and proper in the facts and circumstances of the case.

 

2.           Facts of the case necessary for the adjudication of the complaint are these.
3.           The complainant the owner of Mercedes Benz Car bearing registration number DL06C7484 had his vehicle insured with the Ops vide certificate of Insurance/Policy number VPC0940465000100 for the period from 24.01.2018 to 23.01.2019 having IDV of Rs. 32,41,350/- for the premium of Rs. 1,11,704/-. On the intervening night of 24.04.2018 and 25.04.2018 at about 12:10 a.m. the insured vehicle met with an accident at Moti Nagar Road, Jakhira Goal Chakkar, Delhi and in the process the entire engine of the said car was damaged. The said car was stated to have been towed to the authorised service station at Sahibabad on 25.04.2018 on which date the Ops were also informed of the accident. It appears that thereafter investigation was done and the survey was conducted but since no decision was forthcoming, the complainant had filed a complaint before this Commission earlier bearing number CC-1237/2018 which complaint was withdrawn on 04.10.2018, the Ops having passed orders repudiating the claim on 14.09.2018 and accordingly this complaint has been filed assailing the said repudiation letter, praying for the payment of an amount of the Insurance Declared Value of the damaged car.
4.           The Ops were noticed and in response thereto they have filed their reply resisting the complaint both on technical ground as also on merit, submitting in the first blush the report of the Investigator Mr. Vikas Kumar stating and observing as under:-

 

“The investigator contacted the insured on mobile no. 7011976548 and enquired about details related to the car in question along with details of the current accident. The insured refused to answer any of the queries of the investigator on the pretext of having submitted the documents to the surveyor appointed by the company.

We requested him to spare some of his valuable time for investigation/verification purposes and arrange our meeting with his father Rishi Kumar Gupta for spot identification/verification purposes to which he refused on the pretext that he had no time for such formalities and we can identify the spot at our own by verifying the details as mentioned by him in the claim form.

After having left with no other option, our representative went to Zakhira Roundabout, Delhi on individual basis and held inquiries related to the accident from the local shopkeeper available at the pan shop, motor mechanics, puncher repair shop. None of the person whom we met were aware of any such accident and they refused to confirm anything in writing.

After having carried out necessary investigations at spot and the residence of the insured, our representative checked the records of Insurance Bureau of India and on going through the same it was observed that the vehicle had availed an OD Claim on 14.08.2016 from ICICI Lombard in tune of Rs. 16,72,200/-.

The investigator observed as under:-

“....the insured is not cooperating in providing written statement or identifying spot. He is not ready to disclose the source of purchase of the subject vehicle. ...”

 

5.           Secondly they have placed before us the report of the Surveyor Mr. Ritesh Kumar Gupta dated 05.09.2018, stating and observing as under:-

 

“We have observed that maximum mechanical internal parts were in already repaired condition, some parts with mechanical defects, some parts missing and now all parts are being claimed new. The seat belts observed tightened up completely which indicates that at the time of accident seat belts were not engaged which also suggest the possibility of nobody sitting on the driver seat at the time of impact. The subject case needs to be investigated in details. There is no purchase proof provided by insured for the subject vehicle and insured did not substantiate the reason of declaring such high IDV value and hence the sum insured basis.

Moreover, the cost of missing parts cannot be considered and also the parts which are similar to old reconditioned repaired parts cannot be considered new which is against the principle of indemnify. The parts with mechanical defects and not relevant to cause of loss also cannot be considered. Hence, the repairing of the vehicle will make the insured ultimately bearing very high amount of the repairing cost. ...”

          The surveyor further observed as under:-

“Insured did not provide the complete facts relevant to subject claim. No detailed statement provided regarding injury and police report. No clarifications provided about so many parts missing and in already repaired condition. We have shared our detailed observations with repairer vide our mail dated 16^th June 2018 regarding repairs. But we have been informed later that insured had moved out his vehicle without any repairs. As per our observations we are now submitting our independent report for further discretion of insurer based on any additional information retrieved in the case and as per terms and conditions of the policy.”

6.           Based on the reports of the investigator and the surveyor the Ops have submitted that the complainant is not entitled to the claims as preferred and passed orders on 14.09.2018 repudiating the claim as under:-

 

Dear Sir,

 

Ref. Policy No.VPC0940465000100

Chassis No. DL06CM7484

Claim No. PV00424583

Date of Accident 24.04.2018

 

With reference to the above mentioned claim, we observe from the claim papers that damage to the vehicle are not relevant to the cause and nature of accident narrated in the claim form. Also, there has been misrepresentation of facts with regard to date and cause of accident.

 

Hence, we regret our inability to entertain the claim.

         

7.           The Ops emphasising the point that the complainant has not furnished the documents as demanded nor he has shown any cooperation have justified their action repudiating the claim and accordingly have prayed for dismissal of the claim since the complainant has not been able to establish his case for the acceptance of the claim.   
8.           The complainant had thereafter filed the rejoinder rebutting the contentions raised in the reply and reiterating his averments contained in the complainant. Both the complainant and the Ops have filed their evidence by way of affidavit in support of the submission made in their pleadings. Written arguments filed by both parties are also on record.
9.           This matter was listed before this Commission for final hearing on 19.02.2020 when the counsel for both sides appeared and advanced their arguments, in support of the pleadings, the complainants, the insured vehicle having been damaged as a fall out of the accident, for the approval of the claim with interest and the Ops for the dismissal of the complaint, the complainant having not been able to establish his case with the support of evidence and other related papers. I have perused the records of the case and given a careful consideration to the subject matter.
10.  Short question for adjudication in this complaint is whether there exists any infirmity in the repudiation done by the Ops on 14.09.2018. This leads to another question whether the complainant has been able to establish his case relying on the evidence furnish.
11. I have read and re read the report of the surveyor. The surveyor has observed, inter alia, that maximum mechanical internal parts were in already repaired condition, some parts with mechanical defects, some parts missing and now all parts are being claimed new. Secondly, the surveyor has further observed that the insured did not provide the complete facts relevant to the subject claim. No towing bill provided- The surveyor report has not been countered.
12. Before deliberating the matter it would be equitable to see the law on the subject matter. The State Commission, Punjab in the matter of Gurtej Singh Brar versus National Insurance Co. Ltd., as reported in IV (2016) CPJ 9 (Pub) has held that the surveyor’s report cannot be brushed aside in the absence of specific reason. The Hon’ble NCDRC in the matter of United India Insurance Co. Ltd. versus Raj Kumar as reported in I [2016] CPJ 555 (NC) is pleased to hold that the report of the licensed report appointed by Insurance Company under the provisions of the insurance Act has to be given due importance. The Hon’ble NCDRC in yet another matter, in the matter of Ankur Sharma versus United India Insurance Co. Ltd. and ors as reported in I [2013] CPJ 440 (NC) is pleased to hold as under:-

 

“Report of the surveyor appointed by Insurance Company is an important document and the same should not rejected by the consumer forum unless cogent reasons are recorded to do so.”

 

The Hon’ble Supreme Court of India in the matter of United India Insurance Co. Ltd. versus Roshan Lal oil Mills Ltd. as reported in (2000) 10 SCC 19 is pleased to hold that the survey report cannot be given go by.

Similarly the Hon’ble NCDRC in the matter of Murli Cold Storage Ltd. versus Oriental Insurance Co. Ltd., reported in II [2014] CPJ 593 (NC) has held

 

“In the absence of any plausible ground and valid reasons, the Insurance Company is not expected to reject report prepared by surveyor on cogent material and with due application of mind.”

 

13. Infact as laid down by the Hon’ble NCDRC in the matter of Keshav Trading Company versus United India Insurance Co. Ltd. reported in IV [2013] CPJ 159 (NC) the surveyor’s report has significant evidentiary value unless it is proved otherwise which complainant failed to do so. The same view was taken by the Hon’ble NCDRC in the matter of Iffco Tokio General Insurance Co. Ltd. versus Beena Raghav reported in III [2015] CPJ 75 (NC).
14. It is a settled position of law that the surveyor’s report should get due weightage and it should be rejected only on solid reasons as held by the Hon’ble NCDRC in the matter of New India Assurance Co. Ltd versus Balaji Emporium as reported in I (2015) CPJ 588 (NC).
15. Coming back to the facts of the case, the version of the complainant to the effect that the insured vehicle soon after the accident when it was badly damaged was removed to the authorised service station of the manufacturer is not duly corroborated. No receipt or document exists on record to show whether the vehicle was lifted through crane or by anyother mode. There exists no evidence of any person from the area where the accident happened substantiating the point of the complainant. In these circumstances the only inescapable and irresistible conclusion is that the complainant has not been able to establish his claim for want of evidence which means and, to put it differently, there exists no ground to differ from the surveyor report, not approving the claim.
16. Having regard to the discussion done and legal principles set out above, I am of the considered view that there is no infirmity in the report of Surveyor and if that be the case, repudiation done by the Ops is fully justified. The complaint being devoid of merit is consequently rejected.
17. Ordered accordingly.
18. A copy of this order be forwarded to the parties to the case free of cost as is statutorily required.
19. File be consigned to records.

 

 

(ANIL SRIVASTAVA)

MEMBER