DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION (EAST)

GOVT. OF NCT OF DELHI

CONVENIENT SHOPPING CENTRE, FIRST FLOOR,

SAINI ENCLAVE, DELHI – 110 092

C.C. No. 429/2022

QUORUM:   

Judgment By: Shri S.S. Malhotra (President)

JUDGMENT

By this judgment the Commission would dispose off the present complaint filed by the Complainant against OP alleging deficiency in service in not reimbursing the claim w.r.t. accident of the vehicle.

1. Brief facts as stated by the complainant in the complainant are that she is the owner of the vehicle number HR 38 AA 7544 which was duly insured with OP vide Policy No.360500312110000279 from 16.06.2021 to 15.06.2022, however, the said vehicle met with an accident on 29.10.2021 when it was travelling towards Jaisalmer i.e. near Ramdevra District Jaisalmer Rajasthan for which an FIR was lodged to the concerned Police Station being GD No.039 dated 30.10.2021 and information of the same was also given to the OP whereafter one Sh. Surendra Singh Bhatti surveyor of the OP reached the spot same day and damaged vehicle was shifted by crane at Chandrasons 28A, Pratap Nagar, Jodhpur where from the quotation of the repairing of the vehicle was given which is attached as Anneuxre-3 (as per annexure-3 the amount of repair was Rs.4,42,936/- and it is not mentioned in the complaint). Complainant after minor repair brought the vehicle to Delhi i.e. at Tempo Automobiles Pvt. Ltd. Shivaji Nagar Industrial Area, New Delhi and also received a quotation from them which is annexed as Annexure-4 (The amount of such repair was Rs.4,06,434/- and is not mentioned in complaint).  The amount of repair was too much and complainant was having shortage of funds, and then one Sh. Kanwaljit Singh, the authorized representative of OP at Divisional Office Delhi, suggested that vehicle can be repaired partly at Mahadev Motors Sonipat with less expenditure and as such vehicle was repaired by Mahadev Motors near Saraswati School, CNG Pump, Murthal Road, Sonipat, and complainant purchased the required parts from different places at competitive rates and then submitted all the documents related with the repair of the vehicle to Sh. Kanwaljit Singh and Sh. Tarun Kumar as per the requirement however no claim was granted to the complainant. She sent a representation to the Delhi Regional Office on 05.04.2022 but did not receive any reply and then she came to know unofficially that insurance company/OP has an objection relating to the previous insurance company for claiming ‘no claim bonus benefits’ of the last year and then she sent a representation again with detailed explanations w.r.t. ‘no claim bonus benefits’ in the previous year and it is submitted that she has not received any claim from the previous insurance company for the previous year as NCB, although she had lodged a claim in the previous year w.r.t. committing theft /accessories from the vehicle but the said claim was ultimately rejected by the OIC and no claim was ever received by the complainant, but despite that complainant had not received any proper reply from the OP and as such she has filed the present complaint against the OP seeking directions that OP be directed to pay Rs.2,02,169/- to the complainant along with interest @ 24% p.a., Compensation of Rs.2,00,000/- in favour of the complainant and Rs.50,000/- towards litigation charges.
2. The OP has filed its reply taking preliminary objection that complaint is liable to be dismissed  as there is no cause of action against the OP, complaint has been filed with ulterior motives and malafide intentions and there has been no cause of action in favour of the complainant or against the OP, there is no disclosure of any cause of action against the OP, there is no deficiency on the part of OP and claim of the complainant has been rightfully rejected as the complainant has lodged a claim in the previous years and has taken the policy by concealing the facts and when the clarifications was sought from the complainant w.r.t. to the ‘no claim bonus benefit’ received against the policy issued last year, no response was given by the complainant and therefore the claim was rightfully rejected and therefore complaint of the complainant is liable to be dismissed.  
3. As far as merits are concerned the complainant is owner of the vehicle, she had a valid policy, the vehicle met with an accident at Jaisalmer, it was taken to Jodhpur where quotation for repair was received, and when it was brought to Delhi for repair another quotation was received are the facts which have not been denied and it is reiterated that claim was decided by Sonipat Branch Office of the answering respondent, and accordingly Divisional office of OP at Delhi has no role to play and claim was denied by Sonipat branch for the reason that the complainant have not fulfilled the terms and conditions of the policy and have not disclosed any fact w.r.t. ‘no claim bonus’ for the last year and since there is violation of the terms and conditions of the policy the claim was rightfully rejected. It is further submitted that during investigation, from the previous insurance company, it was found that complainant has lodged a claim w.r.t. the previous policy, and since no reply was given, the OP has denied the claim.   
4. The complainant has filed Rejoinder thereby denying the contents of the written statement and reaffirming the contents of the complaint and has specifically submitted that although she has lodged the claim against certain thefts w.r.t. accessories but ultimately no claim was granted by the previous Insurance Company i.e. OIC and therefore complainant has not concealed any material facts from the OP.
5. Complainant has filed her own evidence by way of affidavit whereas OP has filed evidence of Sh. Sarabjit Oberoy its AR.
6. Both the parties have filed their written arguments.   
7. The Commission has heard the arguments and perused the record.
8. The issue in nutshell is that OP claims that complainant has not disclosed facts w.r.t. receiving the ‘no claim bonus’ for the last year and despite having taken the benefits of ‘no claim bonus’ this fact was concealed by complainant and therefore the claim was rejected. It is quite surprising that once the complainant is mentioning a fact in the complaint itself that she definitely had ‘lodged’ the claim w.r.t. theft of certain accessories from the vehicle of the complainant and further mentioning that although claim was lodged but no amount was received, and such claim was rejected, the OP still is harping on the point that complainant has concealed some facts. In the entire written statement, the OP has nowhere mentioned that complainant infact has received any claim in the previous year against NCB benefit and  despite having received the NCB she has not mentioned this fact in the complaint. The defense of OP itself is restricted only to the extent of lodging of the claim. Even the OP is not mentioning that complainant has received the NCB benefits. The Commission is of the opinion that if a claim has been lodged and has not been given by the insurance company or has been denied by the insurance company, then complainant is well within its right to say that she has not received any NCB benefit against the previous year’s policy and therefore this contention of the OP is not well found and is rejected.
9. As far as other aspects are concerned nothing is disputed rather everything is admitted i.e. the vehicle was damaged in an accident and certain quotation were received. The issue however is that how much amount the complainant had spend on the repair of the vehicle and in the entire complaint, complainant has no where mentioned except in the prayer clause where she submitted that OP be directed to pay Rs.2,02,169/-. Certain bills were attached which are not legible but now the legible copy of the bills have been filed on record. The counsel for the complainant today although has stated that the exact calculated amount is Rs.246315/- instead of Rs.202169/- but even this does not appear to be correct calculation.  From the record the first bill is of Rs.40,000/-, the second bill is Rs.64,578.80/-, the third bill is of Rs.5015/-, the fourth bill is Rs.5600/- and the fifth bill is for Rs.73,000/- for labour which is towards the labour and yet another bill of Rs.13500/- towards crane charges and if the total amount of this is calculated Rs.201694/-.  Although bill No.1 to 4 are duly tax paid bill but Bill No.5 is on the letter head of Mahadev Motors but this is without any GST. Counsel for complainant submits that the vehicle was got repaired privately and since that mechanic did not have GST number the bill therefore is like this. In any case if labour of Rs.73000/- has been paid for repairing the damaged vehicle, the same has to be correlated with the policy of the insurance as the insurance company generally pays the labour charges to their authorized service centre on a pre fixed rates. The counsel for complainant /complainant has no satisfactory reply to this as to how this labor has been correlated  and submits that whatever the Commission feels reasonable in view of the extent of damage be awarded. The Commission has perused the record and therefore it is presumed that if not Rs.73000/- certain amount definitely would have been spent on the labour charges keeping in view of the extent of damage/fault the Commission is assessing the same as Rs.40,000/- and the total amount which the OP should have paid comes to Rs.171694/-.  The Commission accordingly hereby orders that rejection of the claim of the complainant in Toto on the basis of NCB claim by OP when it has not been able to prove that complainant has received any NCB claim for the previous year amounts to deficiency in service. The Complainant although has not been able to prove that non payment of entire claim by the OP amounts to deficiency in service by the OP but has been able to prove that there were certain deficiencies in not reimbursing the claim but not to the extent as explained in the complaint.   
10. Keeping in view of the totality of the facts and circumstances and the calculations made Commission hereby orders that OP is directed to  pay Rs.171694/- to the complainant along with interest @ 9% p.a. from the date of filing the complaint to the date of actual payment along with compensation of Rs.20,000/- and litigation expenses of Rs.7500/-. 

This order be complied with within 30 days from the date of receipt of the order and if not complies with by OP then OP would pay interest @ 12% on all the above amounts from the date of filing the complaint till its realization.       

Copy of the order be supplied / sent to the parties free of cost as per rules.

File be consigned to Record Room.    

Announced on 09.07.2024.