DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION (CENTRAL)ISBT KASHMERE GATE DELHI

COMPLAINT CASE NO. 87/2016

No. DC/ Central/

vs.

Coram:       Ms. Rekha Rani, President

                    Shri Vyas Muni Rai, Member

                   Ms. Shahina, Member (Female)

ORDER

Ms. Shahina, Member (Female)

1. The Complaint has filed the present complaint against the OP. The facts as alleged in the complaint are that the complaint is the registered owner of his vehicle Maruti ECCO registration no. DL9CL7238 has purchased a insurance policy bearing no.3109043114010000002830 for the period of 25-11-2014 to 24-11-2015 form the OP for total insured value of Rs.1,70,000/-. It is alleged that the said vehicle met with a road accident near Bala Ji Mandir, Shikohabad, UP with a container no. RJ06G4907 dated.07-01-2015 along with complaint, his wife & brother who were going from Delhi to Etava, by using his EECO car, at about 04:00 PM and due to heavy fog met with an accident. Complainant and his brother got several serious injurious & ECCO van was badly damaged. It is further alleged that in this regard complainant was admitted in Yashwant Nursing Home, Agra for his treatment from 07-01-2015 to 12-01-2015 and he spent more than Rs.2,00,000/- on his treatment. It is further alleged that the said vehicle got repaired form an authorized Maruti Suzuki Service Station KTL Pvt. Ltd., Mugal Road, Kamla Nagar, Agra UP and he spent Rs.2,00,000/- on  repair. The complainant submitted his claim for the amount of repair with the OP and fulfilled all the formalities. But the OP  failed to pay any amount and repudiated the claim of complainant vide letter dated.22-12-2015 with the reason, “Not pursued by insured”. It is alleged that all bills of repair in original were already submitted to respondent. On these facts complainant has pleaded that the OP has failed to provide its service as per terms of insurance policy. Therefore, OP is liable for deficiency in service and unfair trade practice on its part. The complainant has filed present complaint for the following reliefs:-

1. Direct the OP to pay Rs. 1, 70,000/- alongwith interest at the rate of 24% per annum till its realization to the complainant.
2. Direct the OP to pay sum of the Rs.1, 00,000/- as compensation to the complainant towards mental agony and harassment and business losses. The OP may be ordered to pay punitive compensation as well.
3. Direct the OP to pay the litigation expenses of Rs.20,000/- to the complainant.

2. OP appeared and filed its reply/written statement. In its written statement OP has stated that the claim submitted by the complainant was examined and the assessed amount was offered to the complainant subject to providing the original bills and other documents. It is alleged that the complainant failed to do so hence, the file was closed as no claim. It is submitted that the company on receipt of intimation had deputed Sh. S.K. Malik for the assessment of the loss, the said surveyor after examining the vehicle submitted his report dt.15-04-2015 assessing the loss of Rs.1, 01,285.93. Thereafter, OP Company sent letters dated.10-12-2015, 17-12-2015, and 22-12-2015 seeking various documents and original bills and vouchers.  It is alleged that the complainant failed to provide the documents accordingly the claim was closed as ‘no claim’. It is further alleged  and prayed that the complaint be rejected with cost as the respondent company has not caused any deficiency in service.
3. Complainant has filed rejoinder to the written statement of OP. It is stated that the OP did not offer any amount towards the claim of the complainant. It is further denied that the OP ever demanded the original bills of repair of vehicle or other documents. The surveyor assessed the value of lost vehicle improperly and he was biased. There is no negligence on the part of the complainant as pleaded.
4. Complainant has filed his affidavit in evidence. On the other hand, affidavit of Sh. Ramesh Mehar Divisional Manager has been filed in evidence on behalf of the OP. Written Argument have been filed on behalf of the parties. We have heard the arguments on behalf of both the parties. We have also gone through the records of the case.

5. The real controversy involved in the present case is as to whether the complainant filed the documents of repair with OP or Not. The dispute lies in narrow campas. Admittedly, the vehicle involved in the present complaint was repaired. Copy of bills and receipts are EX-CW/C to CW-1/F. The complainant has filed the copy of FIR dated 03-02-2015 and the copy of the registration certificate of the vehicle. We mark the same as Annexure-1 for the purpose of identification. The complainant has filed copy of insurance policy valid from 25-11-2014 to 24-11-2015. Which we mark as Annexure-2 for the purpose of identification. The complainant has filed the copy of bills dated.12-01-2015, 17-03-2015 amounting to Rs. 1, 77,128/-. Which we mark as Annexure-3 for the purpose for identification.  The OP has filed the copy of the surveyor report dated.15-04-2015 as Annexure-R/1 wherein the assessed amount has been shown as Rs.1,01,285.93/-. The OP vide letter dated.10-12-2015, 17-12-2015 requested to the complainant to file the documents as Annexure-R/3 (colly). The OP vide letter dated 22-12-2015 informed the complainant that “we are closing your claim filed” on account of the following reason.

1. No claim-not pursued by insured              

6. We have read the documents available on record and have considered the claim of the complainant and the response of the OP. OP has not stated clearly that which were the material documents required by it to process the claim nor complainant has proved beyond doubt about the submission of the documents on his part. However, we don’t find substance in repudiating the claim by the OP on the ground that ‘no claim, not pursue by the insured’. The very language in the repudiation letter of OP is vague.

After due consideration, we allow the claim of the complainant for Rs. 1,01,285/- as assessed by the surveyor to meet the ends of justice from the date of filing of the complainant till realization.

We further direct OP to pay to complainant an amount of Rs. 5,000/- as compensation and litigation charges.

7. Copy of this order be sent to the parties as per rules. File be consigned to record room.

Announced on this 29^th of July 2022.