Before the District Consumer Disputes Redressal Forum, Room No. 208 2^nd Floor, District Administrative Complex, Tarn Taran

Consumer Complaint No  :  65 of 2017

Date of Institution                      : 04.09.2017

Date of Decision               : 17.09.2019

Karamjit Singh Pannu son of Joginder Singh resident of VPO Naushehra Pannuan Tehsil and District Tarn Taran

                                                ...Complainant

Versus

1. National Insurance Company Ltd. having its Divisional Office at 803-A, 8^th Floor, Tower-C, Konnectus Building Opp. New Delhi Railway Station, Bhavbhuti Marg, New Delhi, 110002 through its Divisional Manager, 
2. National Insurance company Ltd. having its District Office at Madan Mohan Maliya road, Amritsar through its Manager.

…Opposite Parties.

Complaint Under Section 12 and 13 of the Consumer Protection Act, 1986.

Quorum:               Sh. Charanjit Singh, President

Smt. Jaswinder Kaur, Member

For Complainant                     Sh. H.S. Sandhu Advocate

For Opposite Parties               Ms. Neenaa Kapur Advocate

ORDERS:

Charanjit Singh, President;

1        The complainant Karamjit Singh Pannu has filed the present complaint under Section   12 and 13 of the Consumer Protection Act (herein after called as 'the Act') against National Insurance Company Ltd. having its Divisional Office at 803-A, 8^th Floor, Tower-C, Konnectus Building Opp. New Delhi Railway Station, Bhavbhuti Marg, New Delhi, 110002 through its Divisional Manager and another (Opposite Parties) on the allegations of deficiency in service and negligence in service on the part of opposite parties with prayer to direct the opposite parties to release the Insurance Claim of Rs. 4,39,295/- to the complainant i.e. claim amount and the complainant has also prayed Rs. 2,00,000/- as compensation and Rs. 50,000/- as litigation expenses.

2        The case of the complainant in brief is that the complainant is a Government Employee and for his personal transfer needs, he has kept a Maruti Swift VDI Car having registration No.PB46-9666 and has got insured this car with the Opposite parties vide Insurance Policy NO.35101031156137418003 valid from 27.10.2015 to 29.10.2015 (However, correct date is 30.10.2015 to 29.10.2016) by paying a premium of Rs.11,790/- to the opposite parties through its representative at Tarn Taran. Unfortunately, the above mentioned car met with a road side accident and was totally damaged in this accident and regarding, this a Rapat Rojnamcha No. 6 dated 22.10.2016 was got registered by the complainant at Police Post Naushehra Pannuan District Tarn Taran Tehsil & District Tarn Taran. After lodging the Rapat Rojnamcha, the complainant approached the opposite parties and got lodged the claim with the Opposite parties for the damaged vehicle which was fully insured by them for a value of Rs.4,39,295/- and also supplied copy of Insurance Policy along-with copy of Rapat Rojnamcha and other required documents to the Opposite parties at Tarn Taran and the Opposite parties assured the complainant that the insurance claim for the damaged vehicle will be released to the complainant within fortnight. The complainant waited for the claim but inspite of repeated requests and correspondence, no claim was issued by the Opposite parties. The complainant inspite of fulfilling all the formalities, the complainant through his counsel sent a legal notice of 15 days to the Opposite parties on 20.7.2017 for obtaining the claim amount from the Opposite parties. Feeling dissatisfied by the act and conduct of the opposite parties, the complainant perforce has filed this complaint against the opposite parties.

3        After formal admission of the complaint, notice was issued to Opposite Parties and opposite parties appeared through counsel and filed written version contesting the complaint by taking preliminary objections that the complainant has not come to the Forum with clean hands and has tried to conceal the material facts from this Forum, therefore, the complaint is not maintainable and the complainant is not entitled for any relief. The complainant is estopped by his own act and conduct from filing the present complaint. It has been perused that the insured has concealed the material facts, meaning thereby has violated the terms and conditions of the policy covered under the insurance policy. The case of the insured has not been decided as yet as the insured has not fulfilled the formalities required to substantiate the claim after reporting the matter to opposite parties from the date of accident, keeping in view the terms and conditions of policy, it is clear that there is no cause of action and there is no question of deficiency and lapse on the part of opposite party, hence, the complainant is neither to get any relief nor entitled to get any compensation and interest as claimed. On merits, it was pleaded that the facts relating to the ownership of car bearing registration No. PB46-9666 and insurance are concerned, the same is matter of record. Rapat Roznamcha is required to be verified and investigations have to be followed after the information given to the opposite parties and which is done after approval of the same.  The complainant approached the opposite parties but the matter was under investigation and opposite parties could not allow the claim without fulfilling the complete formalities prescribed and as per terms and conditions of the policy. The present case / matter is under investigation and has not been decided so far , the case was verified and after considering the facts and terms of insurance policy taken by the complainant claim will be settled as it has been revealed that the investigations and requirements were not fulfilled to enable the claim to be settled and all the other allegations in the complaint have been denied by the opposite parties and prayer was made for dismissal of the complaint with costs. 

4        To prove the case of complainant, Ld. counsel for the complainant has tendered in evidence affidavit of complainant Karamjit Singh Ex. C-1 alongwith documents Ex. C-2 to Ex. C-5 and closed the evidence. On the other hands, Ld. counsel for the opposite parties tendered in evidence documents Ex. OPs/1 to Ex. OPs/4, affidavit of Gurpreet Singh investigator Ex. OPs/5, affidavit of Kewal Raj Incharge NIC Ex. OPs/6 and closed the evidence.

5        We have heard the Ld. Counsels for the complainant and opposite parties and have gone through the evidence and documents placed on the file by the parties.

6        In the present case, there is no dispute that the car bearing registration No. PB46-9666 was got insured by the complainant from opposite parties vide insurance cover copy of which is Ex.C-2 and the insurance is valid w.e.f. 30^th October, 2015 to 29^th October, 2016 and the premium was paid to the tune of Rs. 11,790. Ex. C-2 also shows that IDV value of the vehicle to the tune of Rs. 4,39,295/-.  The complainant has also produced on record Rapat Ex. C-3 on the record. Rapat is also on the record as Ex. OPs/2 and Newspaper cutting Ex. OPs/3 which show that the accident of the vehicle has taken place during the insurance period of the policy. In the written version, the opposite parties have stated that the complainant approached the opposite parties but the matter was under investigation and opposite parties could not allow the claim without fulfilling the complete formalities prescribed and as per terms and conditions of the policy.  In the letter dated 2.11.2017, Ex. OPs/4, the opposite parties have mentioned that the intimation was given on 5.12.2016 to the opposite party. In the present case, the complainant gave intimation regarding the accident to opposite parties in the month of December 2016. The opposite parties intentionally delayed the payment of claim to complainant and got monitory benefit by retaining the amount of claim. As per guidelines of IRDA, the Insurance Companies have to decide the every claim within a period of three months from the date of its intimation and they cannot take more than six months even in special circumstances and in present case, the opposite parties have not settled the claim of complainant even after passing a long time and complainant is also entitled for interest and compensation alongwith insurance value of the vehicle from the date of intimation till the date of final realization. Ld Counsel for complainant has placed on record copy of citation in CC No.86 of 2015, titled as Phoenix Comtrade Pvt Ltd Vs United India Insurance Co. Ltd wherein Hon’ble National Consumer Disputes Redressal Commission, New Delhi held that Consumer Protection Act, 1986, Section 14-Insurance Claim-Interest-Delay in payment of insurance claim-Held-Since the insurer has utilized the aforesaid amount, the complainant is also entitled to an appropriate interest on that amount-As per the guidelines issued by IRDA, the maximum period of six months from the date of the lodgment of complaint is available to the insurer for payment of the claim. He has further placed reliance on citation in First Appeal No.215 of 2015 with First Appeal No. 230 of 2015 dated 30.09.2015 in case titled as United India Insurance Company Limited Vs Jaswant Rai Verma with Jaswant Rai Verma Vs United India Insurance Company Limited, wherein Hon’ble State Consumer Disputes Redressal Commission, U T, Chandigarh observed that Consumer Protection Act, 1986 Section 2 (1) (g) Insurance Regulatory and Development Authority Regulations, 2002-Insurance Claim-theft of vehicle-Investigator appointed by Insurance Company – Untraced report not filed by Police – State Commission held that as per Insurance Regulatory and Development Authority Regulations, 2002, in special circumstances of the case, the Surveyor could take six months for submission of his report, from the date of his appointment. In the instant case, the opposite party has not decided the claim within prescribed period. As such, it amounts to deficiency in service on the part of the opposite party.

7        The complainants have placed on record Policy Ex. C-2 in which Insured Declared Value is Rs. 4,39,295/- which is valid from 30.10.2015 to 29.10.2016 and the vehicle in question has damaged during the period of insurance policy on 21.10.2016 which is quite evident from Rapat Ros Namcha Ex. OP-5.

8        In view of the above discussion, the present complaint is partly allowed and the opposite parties are directed to make the payment of Rs. 4,39,295/- /-  (Rs. Four Lacs Thirty Nine Thousand, two hundred ninety five only) to the complainant within one month from the date of receipt of copy of this order, subject to furnishing the letter of subrogation, power of attorney for transfer of Registration certificate of the vehicle in question. The complainant has also been harassed by the opposite parties, as such the complainant is also entitled to Rs. 7,500/- ( Rs. Seven Thousand and Five hundred only) as compensation on account of harassment and mental agony and Rs 5,000/- (Rupees Five Thousand only) as litigation expenses. Opposite Parties are directed to comply with the order within one month from the date of receipt of copy of the order, failing which the complainant is entitled to interest @ 9% per annum, on the awarded amount, from the date of accident till its realisation.  Copy of order be supplied to the parties free of costs as per rules. File be consigned to record room.