Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 414.
Instituted on : 13.11.2014.
Decided on : 04.08.2016.
Sandeep son of Surender Singh resident of village Mokhra Khas Tehsil Meham Distt. Rohtak.
………..Complainant.
Vs.
National Insurance Company Ltd. through its Divisional Manager, Outer Quilla Road, Rohtak.
……….Opposite party.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.JOGINDER KUMAR JAKHAR, PRESIDENT.
MS. KOMAL KHANNA, MEMBER.
SH. VED PAL, MEMBER.
Present: Sh.Surender Hooda, Advocate for the complainant.
Sh.R.K.Behl Advocate for the opposite party.
ORDER
SH. JOGINDER KUMAR JAKHAR, PRESIDENT :
1. The present complaint has been filed by the complainant with the averments that he is registered owner of vehicle bearing no. HR15A-8666 and the same was got insured with the opposite party for the period 15.02.2012 to 14.02.2013 and the IDV of the vehicle is Rs.430000/-. It is averred that during the period of insurance policy of said vehicle the alleged vehicle met with an accident and suffered damages badly. DDR dated 15.05.2012 was got registered in PS Pundri District Kaithal regarding the accident. It is averred that the complainant informed the opposite party about the said accident and lodged his claim regarding damages of said vehicle. It is averred that complainant suffered damages of Rs.250000/- on the repair and touchan expenses of said vehicle and got repaired the said vehicle at Raj Motors, Rothak and completed all the necessary formalities as required by the opposite party and requested to pay the amount of claim but the opposite party have not paid the claim amount to the complainant till date and raised arbitrary and illegal objection. It is averred that the act of opposite party of refusing the genuine claim of the complainant is illegal and amounts to deficiency in service. As such it is averred that the opposite party may kindly be directed to pay the claim amount of Rs.250000/- along with interest compensation and litigation expenses to the complainant.
2. On notice, opposite party appeared and filed its written reply submitting therein that the company has deputed the surveyor to assess the damages and assessed the loss for Rs.150000/- subject to terms and conditions of insurance policy and rules. Claim was not payable as the complainant concealed the material facts. It is averred that at the time of renewal of policy the insured has taken no claim bonus @ 20% but the previous insurer i.e. UIIC has confirmed that he has preferred one claim under policy no.0209003100110038098(expiring policy) which was concealed by the insured at the time of renewal for the period from 15.02.2012 to 14.02.2013. As such insured was not entitled for no claim bonus @ 20% for which he was not entitled as such all benefits under the policy are forfeited as per the norms. Hence after the legal process answering opposite party no claim the file and was duly informed to the insured on 29.07.2013. It is averred that the company has rightly no claim the claim. All the other contents of the complaint were stated to be wrong and denied. Opposite party prayed for dismissal of the complaint with cost.
3. Both the parties led evidence in support of their case.
4. Ld. Counsel for the complainant in his evidence tendered his affidavit Ex.CW1/A and documents Ex.C1 to Ex.C4 and has closed his evidence. On the other hand ld. counsel for the opposite party tendered affidavit Ex.R1, documents Ex.R2 to Ex.R7 and closed his evidence.
5. We have heard ld. counsel for the parties and have gone through material aspects of the case very carefully.
6. In the present case insurance and accident of the vehicle is not disputed. It is also not disputed that after the accident opposite party appointed the surveyor who as per his report Ex.R2 has assessed the loss amounting to Rs.1500060.52/- but the opposite party vide its letter Ex.R4 has repudiated the claim on the ground that since the complainant has claimed No Claim Bonus @ 20% for which he was not entitled and as such all benefits under the policy were forfeited as per norms. To prove its contention opposite party has placed on record copy of cover note Ex.C6 and copy of email Ex.R3.
7. After going through the file and hearing the parties it is observed that the claim of the complainant has only been repudiated on the ground that the complainant had concealed the fact of availing claim on his previous policy and has availed the benefit of NCB 20% in the present policy for which he was not entitled. To prove its contention, opposite party has placed on record certificate of insurance Ex.R6 issued by the previous insurer i.e United India Insurance Co. but the document Ex.R3 is only a computer generated document and is not supported with the affidavit of the previous insurer. Moreover opposite party has failed to place on record any declaration taken from insured at the time of issuing the policy to the effect that no claim has arisen in the expiring policy period. Hence opposite party has failed to prove the fact that the complainant has violated the terms and conditions of the policy. In this regard we have placed reliance upon the order dated 23.11.2015 issued by the Hon’ble State Commission, Haryana, Panchkula in First Appeal No.137 of 2015 titled as United India Insurance Company Vs. Balbir Singh whereby it is held that: “Neither the appellant/insurance company obtained declaration from the complainant at the time of issuing insurance policy nor had written letter to the previous insurer, to collect information in this regard within the prescribed period of 21 days, which constitute a breach of the Tariff in view of GR 27 of the India Motor Tariff. So complainant cannot be made to suffer for the default on the part of appellant”, Hon’ble H.P.State Commission, Shimla in 2009(2)CPC 583 titled as National Insurance Co. Ltd. Vs. Prem Singh has held that: “Reason for repudiating a valid claim for accidental vehicle was that respondent/complainant had obtained “No Claim Bonus” of 20% from insurer of vehicle-But Development Officer of insurer had failed to have a declaration from insured to that effect-An insurer have failed in their duties-Repudiation on this ground not justified, as per 2006(3)CLT 367 titled Pravin Kumar Jain Vs. UIIC Hon’ble State Commission Raipur has held that : “No breach of policy have been established by the respondent/insurer-Non settlement of the claim of the complainant amounts to deficiency in service”. In view of the aforesaid law which are fully applicable on the facts and circumstances it is observed that the repudiation of claim by the opposite party is illegal and as such complainant is entitled for the claim amount as assessed by the surveyor”. On the other hand law cited by ld. counsel for the opposite party cited in 2015(2)CLT 107 titled Inder Pal Rana Vs. National Insurance Company is not fully applicable on the facts and circumstances of the case as in the present case no misrepresentation has been proved by the opposite party.
8. In view of the aforesaid findings and discussions, it is directed that opposite party shall pay the amount of Rs.150060.52/- say Rs.150060/-(Rupees one lac fifty thousand and sixty only) along with interest @ 9% p.a. from the date of filing the present complaint i.e. 13.11.2014 till its actual realization and shall also pay a sum of Rs.3500/-(Rupees three thousand five hundred only) as litigation expenses to the complainant maximum within one month from the date of decision failing which the opposite party shall be liable to pay interest @ 12% p.a. on the awarded amount from the date of decision. Complaint is allowed accordingly.
9. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
04.08.2016.
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Joginder Kumar Jakhar, President
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Komal Khanna, Member.
……………………………….
Ved Pal, Member
