Punjab

Ludhiana

CC/14/572

M/s Inega International - Complainant(s)

Versus

National Ins.Co.Ltd - Opp.Party(s)

M.S.Sethi

19 Feb 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, LUDHIANA.

       C.C. No: 572 of 20.08.2014

                                                                      Date of Decision:26.02.2015

1.M/s Inega International, Street No.2, Gopal Nagar, Haibowal Kalan, Ludhiana through its Prop. Rattan Deep Singh.

2.Rattan Deep Singh Prop. M/s Inega International, Street No.2, Gopal Nagar, Haibowal Kalan, Ludhiana.

……Complainants

                                                    Versus          

1.National Insurance Company Limited, branch Mandi Mullanpur, Raikot Road, Ludhiana through Senior Branch Manager.

2.National Insurance Company Limited,D.O.-IV, Kasar Ganj, Ludhiana through Divisional Manager.

                                                                             ……...Opposite Parties

        Complaint under section 12 of the Consumer Protection Act,1986.

         

Quorum:     Sh.R.L.Ahuja, President.                 

                   Sh.Sat Paul Garg, Member.             

                   Ms.Babita, Member.

                 

Present:       Sh.M.S.Sethi, Adv. for complainants.

Sh.D.R.Rampal, Adv. for Ops.

 

ORDER

R.L.AHUJA, PRESIDENT

 

1.                Present complaint under Section 12 of the Consumer Protection Act, 1986 (herein-after in short to be described as ‘Act’) has been filed by M/s Inega International, Street No.2, Gopal Nagar, Haibowal Kalan, Ludhiana through its Prop. Rattan Deep Singh and others(hereinafter in short to be referred as ‘complainants’) against National Insurance Company Limited and others (herein-after in short to be described as ‘Ops’)- directing them to quash the repudiation letter dated 31.10.2013 and to pay the claim against the repair bills limited upto policy IDV of Rs.11 lakh alongwith interest @12% from the date of lodging of claim till payment besides Rs.1 lakh as compensation and Rs.22,000/- as litigation costs to the complainants.

2.                In brief, the case of the complainants is that the complainant No.1 purchased the vehicle Cruze-2.LTZ Model in the year 2011 from Padam Motors, Ludhiana in the name of complainant no.2 and same was being used by the complainant no.1 for its own needs as well as for attending the office and to residence. The complainant no.2 got insured the said vehicle bearing registration No.PB-10-DZ-5909 with the Ops for the period 8.2.2012 to 7.2.2013 through dealer Padam Motors and paid the premium of Rs.24,027/- against the IDV of Rs.11 lakh. During the said tenure, the complainants lodged the insurance claim against the accident dated 23.1.2013 and submitted the claim form, copy of driving license, copy of RC and repair bill of Rs.13,20,750/- etc. However, instead to pay the settle claim on cash loss basis as assured by the Ops, the Ops repudiated the claim vide its letter dated 21.10.2013 on the ground that as per his dealer, the complainant was entitled for 20% ‘No Claim Bonus’ for not claiming in the previous year and the complainant hereby confirmed that the claim was taken last year that has been confirmed by TATA AIG Gen.Ins.Co.Ltd vide on confirmation of NCB. However, repudiation of the claim without issuing any notice asking for any clarification/justification on the NCB is not genuine and justified which act of Ops is claimed to be deficiency in service on the part of their part as Ops levelled the false allegations that as per terms and conditions, OD claim stands repudiated based on wrong declaration. NCB as given by the Ops in its policy dated 12.3.2012 and cover note dated 18.2.2012 is nowhere relates to the previous claim paid by the TATA AIG General Ins.Co.Ltd for the period 2.2.2011 to 1.2.2012 because the policy was issued by the Ops not on the basis of the previous policy of TATA AIG, rather the same was issued on the basis of new contract entered into with the complainant. There was a gap of 7 days in getting the insurance cover from the Ops and the Ops itself treated the present policy as fresh which is evident from the policy No.404002/31/11/6100002807 dated 18.3.2012 in which, the Ops had given the particular under the head address of issuing office: previous policy no, Raikot Road, Mullanpur, Punjab, whereas, in the cover note 40110444423 dated 18.2.2013 instead to give the details of Tata AIG General Ins.Ltd. However in the cover note dated 8.2.2012, the particulars of previous insurance company was duly given by the Ops but the Ops never considered the same which evident that Ops entered into fresh contract due to gap of 7 days. Further, previously the vehicle was insured for Rs.10,94,079/- for the period 2.2.2011 to 1.2.2012 by the Tata AIG Insurance Company but the Ops never considered continuation of the policy from the last date of 1.2.2012 of policy of Tata AIG, rather, the OPs issued the policy w.e.f.8.2.2012 to 7.2.2013. Further, in the previous policy issued by Tata AIG, the IDV of the said vehicle was determined to Rs.10,94,079. So in case of continuation of the said policy, IDV was required to be minimized to RS.929967/- by reducing IDV by way of deprecation at least @15% of the IDV, whereas, present insurance coverage was made for Rs.11 lakh, so issuing the fresh policy by the Ops against the new IDV and period of insurance against the proposal and there is no wrong declaration so far made by the complainants. The Ops are responsible for rendering deficient services for repudiating the entire claim on illegal grounds. Hence, this complaint.

3.                Upon notice of the complaint, OPs were duly served and appeared through their counsel Sh.D.R.Rampal, Advocate and filed their written reply, in which, they took up certain preliminary objections that complaint is not maintainable in the present form as the same is false and frivolous one; the complaint is bad for non-joinder and mis-joinder of necessary parties; the complainants have not come to this Forum with clean hands and they have suppressed the material facts qua the facts that the claim of the complainants is not payable one as they have obtained the ‘No Claim Bonus’ of 20% from the payable premium and by that way, they have got the No Claim Bonus i.e Rs.5940/- and claim of the complainants was repudiated by competent authority of the answering Ops and repudiation letter dated 21.10.2013 was duly sent to the complainants informing that they are not entitled to any compensation and there is no deficiency in service on the part of the answering Ops. The complainants have estopped by their act and conduct from filing this complaint as they have falsely dragged the answering Ops in false litigation and the intricate question of law and facts are involved in this case and this case cannot be summarily decided by this Hon’ble Forum and the facts of the case require elaborate evidence and only Civil Court is competent to decide the present case after providing due opportunities to the parties to lead their evidence. On merits, it is submitted that the parties are governed by the terms and conditions of the insurance policy. Further, it is submitted that the vehicle in question was earlier insured by Tata AIG General Insurance Company valid for the period of 2.2.2011 to 1.2.2012. The complainant did not disclose this fact that he claimed the compensation from another insurance company namely Tata AIG Gen.Insurance Co. The complainant had signed wrong declaration dated 8.2.2012 for insurance of the vehicle as there was gap/break in insurance and complainant mentioned the name of earlier insurance company but it did not disclose with regard to lodging the claim in earlier insurance policy. The alleged accident took place on 23.1.2013. The complainant did not give immediate intimation with regard to the alleged accident and no spot survey was got conducted by the complainant. The complainant gave intimation with regard to alleged accident dated 23.1.2013 on 4.2.2013 and also disclosed that vehicle in question is lying at Padam Motors, Ludhiana. The answering Ops deputed Er.Ramesh Goyal as surveyor for assessing the loss and survey of the vehicle. The said surveyor did the survey on 11.2.2013 and on subsequent dates and assessed the loss at Rs.2,74,000/- on Net of salvage basis. The complainant also gave affidavit dated 20.3.2013 to accept the loss which was settled by the surveyor. The surveyor gave motor survey report dated 29.3.2013 and recommended the loss without prejudice to the rights o the insurance company and subject to policy terms and conditions. The RC of the vehicle in question and DL of RattanDeep Singh was got verified by answering Ops through Sh.R.S.Ahluwalia, Investigator, who gave verification report dated 16.9.2013 and 18.3.2013 respectively. The answering Ops had sent email dated 5.2.2013 to Tata AIG Gen. Insurance Co. with regard to confirmation of claim bonus. Tata AIG Gen.Ins. had confirmed with regard to lodging of the claim in earlier insurance policy and payment of the claim to the insured and also confirmed that complainant is not entitled to any ‘No Claim Bonus’. On receipt of aforesaid survey reports, verification reports and confirmation of the claim lodged and paid in earlier insurance policy by Tata AIG Gen.Ins., the competent authority of answering OPs scrutinized the claim and found that the complainant has illegally claimed 20% No Claim  Bonus and has violated the terms and conditions of the insurance policy and also suppressed the material facts and the said insurance cover was not available to the complainant and claim of the complainant was repudiated by the competent authority of the company and repudiation letter dated 21.10.2013 was duly posted to the complainant. Due services have been rendered by the answering Ops and there is no deficiency in service on the part of the answering Ops. At the end, denying all other allegations of the complaint, answering OPs prayed for the dismissal of the complaint.

4.                In order to prove the case of the complainants, learned counsel for the complainants tendered into evidence affidavit of complainant no.2 as Ex.CAI, in which, he has reiterated all the allegations made by the complainants in the complaint.  Further, learned counsel for the complainants has proved on record the documents Ex.C1 to Ex.C7.

5.                On the other hand, in order to rebut the case of the complainants, learned counsel for the OPs adduced evidence by placing on record affidavit Ex.RA of Sh.P.S.Makkar, its Deputy Manager, in which, he has reiterated all the contents of written reply filed by OPs and refuted the case of the complainant. Further, learned counsel for the Ops tendered into evidence affidavit Ex.RB of Er.Ramesh Goyal, who was deputed as surveyor by the Ops in order to conduct the survey and assess the loss suffered by the vehicle bearing registration No.PB-03U(temp)-5699, in which, he has proved his motor survey report dated 29.3.13 Ex.R19 alongwith documents Ex.R20 to Ex.R56. Further, learned counsel for the OPs has proved on record documents Ex.R1 to Ex.R58.

6.                We have heard the learned counsel for both the parties.

7.                Learned counsel for the complainants has contended that there is no continuity of the policy. Rather, the policy in question was a separate policy issued by the Ops to the complainant. So, Ops have wrongly and illegally repudiated the claim of the complainants on the basis of ‘No Claim Bonus’ was taken by the complainant in the earlier policy purchased from Tata AIG General Insurance Company and furthermore, Ops have no right to reject the claim of the complainants in toto. Further, learned counsel for the complainants has relied upon judgment titled as National Insurance Co.ltd. and another vs. Avtar Singh-IV(2006)CPJ-92(Punjab State Commission).

8.                On the other hand, learned counsel for the Ops has contended that the complainants have concealed the fact qua obtaining of NCB and discount of 20% in the premium from the previous insurance company while obtaining the insurance policy in question from the Ops by giving the wrong declaration. So, Ops have rightly repudiated the claim of the complainants as the complainants have suppressed the material facts.

9.                We have considered the rival contention of learned counsel for the parties and have also perused the record on the file very carefully.

10.              Perusal of the record reveals that it is an admitted fact between the parties that the complainant no.1 had purchased the vehicle in question i.e. Cruze-2.LTZ from Padam Motors, Ludhiana which was insured with the OPs for the period from 8.2.2012 to 7.2.2013 on payment of premium by getting the discount of 20% on account of NCB. It is further a proved fact that vehicle in question met with an accident on 23.1.2013 and due intimation was given to the OPs by the complainants and the claim alongwith relevant documents was lodged, which was registered and processed by the Ops. Further, it is a proved fact that surveyor Er.Ramesh Goyal was deputed by the OPs in order to survey and assess the loss caused to the vehicle in question, who after his thorough inspection and spot survey, submitted his detailed motor survey report dated 29.3.2013 Ex.R19, vide which, he had recommended the loss to the tune of Rs.2,74,000/- on Net of Salvage basis. However, the claim of the complainants was repudiated by the Ops vide letter dated 21.10.2013 Ex.C3(Ex.R58) on the ground that the complainant had made wrong declaration regarding ‘No Claim Bonus’ which was confirmed by Tata AIG Gen.Insurance Co.Ltd., with whom, the vehicle was insured prior to the issuance of the present insurance policy and further, the complainant had taken 20% discount on the premium of the policy on account of NCB which clearly amounts to violations of the terms and conditions of the policy.

11.              Perusal of the report dated 29.3.2013 Ex.R19 of Er.Ramesh Goyal, Engineers, Surveyors and valuers reveals that he had specifically mentioned the constructive total loss/net of salvage basis of the vehicle in question by describing the IDV of the vehicle to the tune of Rs.11 lakh, accepted IDV by insured to the tune of Rs.9,25,000/-, less wreck value (as offered by insured) with RC to the tune of Rs.6,50,000/- which after applying the less excess clause, comes to Rs.2,74,000/-.

12.              During the course of arguments, learned counsel for the complainants has not denied the fact qua the insurance coverage of the vehicle taken by the complainant from the earlier insurance company i.e.Tata AIG General Insurance Company, from whom, he had taken the claim against that policy. Further, learned counsel for the complainants has not denied about the taking of 20% NCB while making the payment of premium to the OPs. Though, OPs have the repudiated the claim of the complainant in toto. However, it is a well settled principle of law that claim of the complainant cannot be rejected in toto. However, the same can be settled on non-standard basis in view of the judgments passed by the Hon’ble Supreme Court of India titled as Amalendu Sahoo vs. Oriental Insurance Co.Ltd.-2010-ACJ-1250 and National Insurance Co;.Ltd vs. Nitin Khandewal-2008-ACJ-2035, vide which, the claim of the insurer was ordered to be settled on non-standard basis, in case of violation of terms and conditions of the insurance policy.

13.               In view of the above discussion and law laid down by the Hon’ble Supreme Court of India, we hereby allow this complaint and as a result, direct the OPs to settle and pay the claim of the complainant on non-standard basis as per the surveyor report dated 29.3.2013 Ex.R19 and as per the terms and conditions of the insurance policy to the complainants, failing which, Ops are liable to pay interest @9% p.a. from the date of lodging of claim till its realization. Further, Ops are directed to pay compensation and litigation costs compositely assessed at Rs.7000/-(Seven thousand only) to the complainants on account of mental pain, agony and harassment suffered by the complainants. However, OP shall be at liberty to deduct the amount of difference of premium which the complainants are liable to pay on account of NCB availed by them. Compliance of order be made within 30 days from the date of receipt of copy of this order which be made available to the parties free of costs. File be completed and consigned to record room.

 

  (Babita)              (Sat Paul Garg)              (R.L.Ahuja)

   Member               Member                       President.   

Announced in Open Forum

Dated:26.02.2015

Gurpreet Sharma.