DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II, U.T. CHANDIGARH

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M/s Matrix Engineering, Plot No. 435, Phase-IX, Mohali, through its Proprietor/ Authorized Signatory.

              ---Complainant

Vs

National Insurance Company Limited, SCO No. 323-324, Sector 34-A, Chandigarh, through its Chief Regional Manager.

---- Opposite Party

BEFORE:    SH.LAKSHMAN SHARMA              PRESIDENT

MRS.MADHU MUTNEJA               MEMBER

           SH.JASWINDER SINGH SIDHU        MEMBER

Argued By:    Sh. Devinder Kumar, Counsel for Complainant.

Sh. Rajneesh Malhotra, Counsel for Opposite Party.

PER MADHU MUTNEJA, MEMBER

1.        This complaint relates to non-payment of insurance claim by the Insurance Company for the accidented Maruti Zen car belonging to the Complainant.

          Factually speaking, the Complainant had got its Maruti Zen car No. CH01W-7991 insured with the Opposite Party, from 24.04.2009 to 23.10.2010. Unfortunately, on 30.04.2010, the vehicle met with accident during the period of insurance. However, despite lodging of claim, submitting relevant documents and completing all formalities required by the Opposite Party, the claim was not paid.

          As per the Complainant when the claim was lodged, a Surveyor was appointed by the Opposite Party to assess the loss, who made an assessment of Rs.49,641.50 against an estimated loss of Rs.75,138.75 (Survey report Annexure C-2). The vehicle was got repaired from M/s Lall Autos, 399, Industrial Area, Phase-I, Panchkula, M/s Standard Motors, authorized retail counters of TATA Motors and stockists of Maruti genuine parts. 

          The Complainant has submitted that an amount of Rs.75,138.75 was spent towards the repair of the vehicle, but the Opposite Party has not yet paid the claim and is delaying the matter on one pretext or the other despite submission of all original bills. As per the Complainant, the Opposite Party has even got the vehicle re-inspected and the salvage has been disposed off. As such, alleging deficiency in service, the Complainant has filed the present complaint, praying for payment of the amount spent on repair, along with compensation for harassment and costs of litigation.

2.        After admission of the complaint, notice was sent to the Opposite Party.

3.        The Opposite Party in reply has taken preliminary objections to the effect that there is no deficiency in service on their part. The claim has been assessed by the Surveyor as per the terms and conditions of the Policy. However, the claim can only be released after the re-inspection of the vehicle and preparation of final report regarding replacement of parts. As per the Opposite Party despite repeated reminders by the Company and the Surveyor, the Complainant has not produced the vehicle for re-inspection and hence, the claim has been closed as ‘No Claim’.

          On merits, Opposite Party has admitted the issuance of the insurance policy to the Complainant for the relevant period (Annexure R-1). Opposite Party has further submitted that on receipt of intimation regarding the accident, Sh. Gopal Krishan and Associates was appointed as Surveyor to assess the loss suffered by the vehicle. After detailed Survey, the Surveyor submitted his survey report dated 16.7.2009 and assessed the loss to the extent of Rs.30,301.69/- before deduction of salvage value of Rs.1500/- (Surveyor Report Annexure R-1A). An amount of Rs.11,900/- has been approved for payment against the claim. The Surveyor has specifically mentioned in the report that the insured has been apprised that the replacement shall be allowed keeping in view the extent of damages relating to the cause and nature of accident and any part found not replaced during the re-inspection would be deducted from the assessment. The claim is not payable as per the estimate/ bill given by the repairer.

          The Opposite Party has further submitted that after the vehicle was repaired, a re-inspection was to be carried for which M/s Pee Kay and Co. were appointed. The Complainant did not bring the vehicle for re-inspection. Despite reminders, the salvage parts were not shown for verification. In the light of this situation, the file was closed as ‘No Claim’. Hence, reiterating again and again that the claim has not been paid as the Complainant has not brought the vehicle for re-inspection due to which the file has been closed, the Opposite Party has prayed for dismissal of the complaint.

          The Opposite Party has also repeatedly referred to their preliminary objections, while replying to each averment of the present complaint in their para-wise submission in the same affidavit. Thus, claiming no deficiency in service or unfair trade practice on their part, the Opposite Party has prayed for the dismissal of the complaint.    

          Also on record is an affidavit of Sh. Sudhir Kr. Goyal, Dy. Manager, National Insurance Co. Ltd., Manimajra, Chandigarh, wherein the same situation has been reiterated with the main allegation that the Complainant has not brought the vehicle for re-inspection after repair, due to which the claim has not been paid.

4.        Parties led evidence in support of their contentions.

5.        We have heard the learned counsel for the parties and have perused the record.

6.        In support of its case, the Complainant has placed on record, the re-inspection report dated 21.07.2009 carried out by Wg Cdr. R.L. Sharma (Retd.), Surveyor and Loss Assessor, along with the supporting affidavit. The remarks of this report, are relevant to the controversy, and are reproduced below: -

“Remarks: All the replacement of parts and other repair jobs have been completed as recommended during survey. Ten photos of the car and its salvage arranged during Reinspection are also attached.”

          Also on record is an affidavit of one Sh. Parvinder Kumar of M/s Pee Kay & Co., who is the Surveyor and Loss Assessor deputed by the Opposite Party to re-inspect the vehicle after it was repaired. As per this affidavit, the Complainant has not brought the vehicle for re-inspection, when called for. Apart from this, affidavit of Gopal Krishan of M/s Gopal Krishan and Associates, Surveyor and Loss Assessor is also on record. It is submitted in the said affidavit that the surveyor report dated 16.7.2009 is correct on the basis of survey/ investigation carried out and the assessed amount for payment is Rs.11,900/-.

          A perusal of the surveyor report of Gopal Krishan & Associates shows that on the basis of summary of assessment a sum of Rs.30,301.69/- was found payable. However, after deduction of depreciation and rubber and glass parts, a total amount of Rs.11,900/- was finally assessed as payment due to the Complainant. The Complainant has stated in its affidavit that re-inspection was done by Wg. Cdr. R.L. Sharma (Retd.), Surveyor and Loss Assessor and the salvage of the damaged parts were disposed off. The Opposite Party in reply has stated that re-inspection was to be carried out by M/s Pee Kay & Co. 

7.        The accident took place on 30.4.2009. The car has been repaired and the Surveyor has assessed the loss. The Complainant has spent a sum of Rs.75138.75/- but the Surveyor has allowed payment of Rs.11,900/- only. The claim is not being paid due to the fact that re-inspection has not been carried out.

          The controversy regarding re-inspection can continue for ever and it is now almost 3 years since the date when the car as per the Complainant has been re-inspected. The Opposite Party has not denied the re-inspection report of Wg. Cdr. R.L. Sharma. At the same time, they have averred that the case was closed because the Complainant did not bring the car for re-inspection before M/s Pee Kay & Co. However, there is no correspondence on record to show when the Opposite Party or the Surveyor has asked the Complainant to bring its car for re-inspection and refusal to the same, if any, by the Complainant. The amount allowed by the Surveyor is not so large that the Opposite Party should adopt such a stick in the mud attitude and not pay what is rightfully due to the Complainant. Otherwise also, the surveyor report is final and binding on the parties unless challenged.

8.        The Hon’ble Supreme Court of India in Sikka Papers Limited Vs. National Insurance Company Limited, (2009) 7 Supreme Court Cases 777 has held:-

 “Insurance Act, 1938 – S.64-UM – Surveyor/ Loss assessor’s report – Weightage to be given – Held, though not the last word, yet there must be legitimate reason for departing from report – No infirmity found in Surveyor’s report and therefore held, Insurance Company rightly admitted claim as per the report.”

          The Hon’ble National Consumer Disputes Redressal Commission in case New India Assurance Company Ltd. Vs. Rabindra Narayan, I (2010) CPJ 80 (NC) has held: -

“….Surveyor’s report being important piece of evidence, to be given weight and relied upon, unless proved unreliable.”

          In an another case Dabirudin Cold Storage Vs. New India Assurance Company Ltd. & Ors., I (2010) CPJ 141 (NC), the Hon’ble National Consumer Disputes Redressal Commission has held that:-

“…….Surveyor’s report being important document, cannot be easily brushed aside.”

          It is thus clear that the Surveyor’s report is final, unless challenged by either the Complainant or the Opposite Party with specific contentions and averments. Neither the Complainant, nor the Opposite Party, in the present case, have filed any written objections to the surveyor’s report hence, for all purposes the report is final and binding on both the parties.  

9.        As per the remarks on the re-inspection report of Wg. Cdr. R.L. Sharma, placed on record by the Complainant, the job has been completed as recommended during the survey. Hence, in the given situation, the amount assessed by the Surveyor should be paid by the Opposite Party to the Complainant without any further ado.

10.       The complaint is allowed accordingly. The Opposite Party is directed to pay Rs.11,900/- to the Complainant as assessed by the Surveyor. In addition, the Opposite Party will pay Rs.10,000/- to the Complainant for delaying the claim unnecessarily for almost three years. The Opposite Party shall also pay Rs.7,000/- to the Complainant towards cost of litigation.

11.       This amount be paid by the Opposite Party within 45 days of the receipt of this order, failing which Opposite Party shall also be additionally liable for an interest @18% per annum on the awarded amount, from the date of this order, till the date of payment, besides the cost of litigation.  

12.       Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room.

Announced

12^th September, 2012.                                              

Sd/-

 (LAKSHMAN SHARMA)

PRESIDENT

Sd/-

(MADHU MUTNEJA)

MEMBER

Sd/-

(JASWINDER SINGH SIDHU)

MEMBER