M/s. Vaishno Fruit Bio Ripening Cold Rooms through its Partner Mr.Naresh Mahajan complainant through the present complaint has sought the necessary directions to the opposite party namely National Insurance Co., Pathankot through its Senior Divisional Manager to make payment of Rs.4,90,000/- i.e. insured sum towards claim for theft of Mahindra Bolero vehicle bearing registration No.HP 38B 6614 to him alongwith interest @ 12% per annum. Opposite party be also directed to pay Rs.1,00,000/- for mental agony, harassment and inconvenience suffered by him.,

2.         The case of the complainant in brief is that he purchased a Mahindra Bolero Vehicle in the name of  M/s. Vaishno Fruit  and Bio Ripening Cold Rooms with registration No.HP 38B 6614, Model 2010, Engine No.GAA4F20100, Chassis No.MAIXA2GFKA5G78640 from the Universal Motors G.T.Road, Amritsar vide Invoice No.33049 dated 31.07.2010 for Rs.6,10,300/-. After the payment of annual premium of Rs.12,993/-, the vehicle got insured by the National Insurance Company vide policy No.401500/31/12/6100004170 with IDV (Insured Declared Value ) of Rs.4,90,000/-  valid from 31 August 2013 till 30 August 2014. He has further pleaded that the aforesaid vehicle was parked outside his house i.e. 15, Mirpur Colony, Pathankot on 30 May 2014 at about 10 P.M. after getting it properly locked. He woke up next morning at about 5 AM but did not find the vehicle where it was parked last night. He immediately informed the police as well as the insurer regarding theft of said Mahindra Bolero and lodged FIR No.70/2014 dated 31.05.2015 under section 379 IPC at the P.S. Division no.2 Pathankot. The opposite party was duly intimated regarding theft of the vehicle immediately and lodged the claim in respect of theft of the vehicle with the request to process the claim as his vehicle was comprehensively insured including theft case. He provided all necessary documents to the opposite party as required by them. The untraced report/cancellation report as and when issued by the concerned police has also been supplied to the opposite party. Even NCRB report has been provided to the opposite party. He has next pleaded that he was astonished to receive the letters dated 6.11.2015, 26.11.2015 and 8.12.2015 from the opposite party wherein it was stated to settle his claim for Rs.2,92,224/- on Non Standard Basis and demanded letter of Subrogation & Indemnity Bond, Consent letter, Discharge Voucher and fresh NCRB Report and was asked to submit the same on or before 15.12.2015 otherwise his file will be closed as “NO CLAIM”. It was surprise for him as there is no occasion for the opposite party to approve his claim on non-standard basis without any fault on his part as the stolen vehicle has been insured for IDV Rs.4,90,000/- by the opposite party. Traumatized by the approved amount he met with Sr.Divisional Manager on 15.12.2015 and some other higher officials of Divisional Office, Pathankot and discussed the whole matter for approving the claim at Rs.2,92,224/- instead of insured value of Rs.4,90,000/- which the opposite party is under liability to pay. He gave in writing to the opposite party on 17.12.2015 requesting them to process and pay his claim at the earliest. On that day, the officials of opposite party gave him assurance that his claim would be processed and paid at the earliest. He has next pleaded that numerous complaints at the online portal of Integrated Grievance Management System of both IRDA and National Insurance Company have been filed from 27.12.2015 to 17.1.2016 but the opposite party has failed to make payment of his claim. Thus, there is deficiency in service on the part of the opposite party. Hence this complaint.

3.        Upon notice, the opposite party appeared and filed its written version through its counsel, taking the preliminary objection that the complainant has no cause of action to file the present complaint; the complainant does not fall within the definition of consumer and is running the vehicle was commercial purpose and as such the complaint is liable to be dismissed and there is no deficiency in service on the part of the insurance company. The complainant wants to take the undue advantage of the wrong IDV value mentioned in the policy. Actually, it is the vehicle who is at fault and refused to accept the amount as per terms and conditions of the policy and as per GR 8 of IMT which provides regarding the Schedule of depreciation. The claim has been filed by the complainant regarding the theft of his vehicle. The matter has been duly investigated and during inquiry, it came to the notice of the insurance company that the vehicle was old one and the IDV value of the vehicle has been wrongly mentioned as Rs.4,90,000/-. The IDV value of the vehicle decreased every year. As GR-8 of IMT, the Schedule of depreciation is given and as per that Schedule there is depreciation of 40% of the age of vehicle is between 3 years but no exceeding 4 years. So, the above schedule makes it clear that IDV value has been wrongly mentioned as Rs.4,90,000/- if we go through the actual price of the new vehicle in dispute. Even in the previous policy of the vehicle in dispute having no.36160031120100002416 issued by the New India Assurance Ltd. Valid for a period from 22.7.2012 to 21.7.2013 showing the IDV value of the vehicle as Rs.4,90,000/-. So, it is obvious that the value for the next year will decreases as provided under GR-8 of IMT (Indian Motor Tariff Schedule). The correct IDV as per schedule comes to Rs.3,92,292/- and as the complainant failed to produce the second ignition key, due to which the claim has been decided on non-standard basis and the amount of Rs.98073/- has been deducted and further the amount of Rs.2000/- for less policy excess clause has been deducted. On merits also, the same pleadings have been repeated and dismissal of the complaint again prayed.

4.                Counsel for the complainant tendered into evidence affidavit of Sh.Naresh Mahajan Partner of M/s.Vaishno Fruit  Ex.C-W1/A, along with the other documents exhibited as Ex.C1 to Ex C21  and Ex.C-5A and closed the evidence.

5.        On the other hand, the opposite party tendered into evidence affidavit of Parveen Kumar, Branch Manager Ex.OP1 alongwith the other documents exhibited as Ex.OP2 to OP12 and closed the evidence.

6.    We have carefully examined all the documents/evidence produced on record and have also judiciously considered and perused the arguments duly put forth by the learned counsels along with the incidental scope of adverse inference for of some documents that have been somehow ignored to be produced by the contesting litigants. We observe that the present dispute prompted at the complainant’s theft-claim’s partial-settlement by the OP insurers on non-standard basis alleging inadvertent acceptance of an exaggerated IDV figure in the policy and subsequent non-delivery of the duplicate key of the stolen vehicle to them.

7.       We find that the OP insurers’ have duly accepted (Ex.C2) an IDV of Rs. 4.90 Lac (as determined per the vehicle’s RC) and also accepted the IDV based ‘insurance premium’ of Rs.12,993/- and thus they are presently estopped to question & contest the terms of own-issued policy at the time of settlement of an insurance claim. Regarding, the non-delivery of duplicate keys of the stolen vehicle due to its non-availability stands reliably well explained as deposed in the affidavit Ex.C13 and the OP insurers have failed to produce any cogent ‘evidence’ so as to justify their ‘non-acceptance/non-reliance’ of the same and settling the claim on non-standard basis. The clarification has been accepted Ex.C14 by the investigator.

8.     Further, we find that the OP insurers have unduly harassed the complainant by indulging him in purposeless correspondence (Ex.C15 to Ex.C21) instead of having settled the claim as per the extant IRDA guidelines on the subject; and that rakes them up for an adverse statutory award under the applicable statute. Moreover, we find that the OP insurers have not issued any prior-notice or post-intimation of claim payment on non-standard basis and

as such it amounts to ‘deficiency in service’ on the part of the insurers. Thus, the above claim settlement on non-standard basis by the insurers being arbitrary in nature stand disproved along with documentary and other evidence as produced during the present proceedings.

9.       In the light of the all above, we partly allow the present complaint and thus ORDER the OP insurers to settle and pay the impugned insurance accident claim in full to the complainant as per the insurance policy issued by them besides Rs.5,000/- as compensation (for the harassment inflicted) and Rs .3,000/- as cost (of litigation) within 30 days of the receipt of the copy of these orders otherwise the aggregate awarded amount shall attract interest @ 9% PA form the date of filing of complaint till actual payment. 

10.     Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to records. 

                                                                    (Naveen Puri)

                                                                              President.      

ANNOUNCED:                                                      (Jagdeep Kaur)

August, 17 2016.                                                 Member

*MK*