Haryana

Karnal

CC/318/2021

Kushal Deep - Complainant(s)

Versus

National Insurance Company Limited - Opp.Party(s)

J.B. Rohilla

03 Apr 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                        Complaint No. 318 of 2021

                                                        Date of instt.08.07.2021

                                                        Date of Decision:03.04.2024

 

Kushal Deep aged about 23 years son of Shri Subhash Chand, resident of village and post office Kutail, Tehsil and District Karnal. Aadhar no.7709-9226-9875.

                                               …….Complainant.

                                              Versus

 

National Insurance Company Ltd. Branch office, branch office at Dhanwant Building, opposite Bus Stand, old G.T. Road, Karnal, through its Divisional Manager.

       

                                                                 …..Opposite Party.

 

Complaint under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.      

      Sh. Vineet Kaushik…….Member

      Dr.  Suman Singh…..Member

 

 Argued by: Shri J.B.Rohilla, counsel for the complainant.

                    Shri Lal Singh Lote, counsel for the OP.

 

                     (Jaswant Singh, President)

ORDER:   

                

                The complainant has filed the present complaint under Section 35 of the Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments nthat complainant is the owner of a vehicle Mahindra and Mahindra Bolero Pickup CBC PS 1.7, bearing registration no.HR-45-C-8945 and the same was got insured by the complainant with the OP, vide policy no.39010231196300002619, valid from 23.04.2019 to 22.04.2021.On 03.07.2019 at about 12.30 a.m. (mid night), the driver of the vehicle namely Aman Kumar was returning to his house at village Kutail from Karnal and when he reached at Kutail Turn then in the meantime a vehicle was moving ahead to the vehicle of complainant and suddenly the driver of said vehicle without giving any indicator take turn and due to which the vehicle in question struck with that vehicle. In the meantime, a vehicle was coming from behind and driver of said vehicle hit his vehicle into the vehicle of complainant. Due to said accident, vehicle of complainant got badly damaged. The intimation regarding the said accident was sent to OP immediately and on receipt of intimation, OP appointed a surveyor and surveyor inspected the spot. Complainant submitted the relevant documents relating to the vehicle i.e. insurance policy, R.C. D.L. etc. to the surveyor. On receipt of said documents, surveyor of OP advised to complainant to get estimated the cost of repair of damaged vehicle. On the assurance of surveyor, complainant took the damaged vehicle to the authorized service centre of Mahindra and Mahindra vehicle i.e. P.P. Automotive Pvt. Ltd. and got estimated the cost of repair. As per quotation the estimated cost for repairing the vehicle was Rs.10,63,056/-. Complainant submitted the estimated report to the OP to get repair the damaged vehicle but OP started postponing the matter on one pretext or the other and finally on 26.05.2020, OP dismissed the claim of complainant on the ground that permitted submitted by complainant is valid from 20.02.2020 whereas the date of accident is 03.07.2019 which clear show that the insured vehicle is not having permit on the date of loss. After receiving the said letter, complainant approached the OP and told that the vehicle was brand new and he had applied for completing the documentation of new purchased vehicle but prior to get the documentation complete, the vehicle met with an accident and damaged and further told that the vehicle in question was fully insured at the time of accident but the OP did not pay any heed to the request of complainant. It is further alleged that complainant got repaired his vehicle from National Motors, Namastey Chowk, Karnal and paid Rs.4,11,900/-. Thereafter, complainant lodged the claim with the OP and requested to pass the claim of complainant but OP refused to pay the same by saying that the file of complainant has already been closed. Due to this act and conduct of OP, complainant has suffered huge loss, physical and mental harassment. In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability and concealment of true and material facts. On merits, it is pleaded that the complainant has not supplied the Route permit at the time of spot inspection to the investigator appointed the OP but the same got available on 04.03.2020 after lapse of 8 months and the validity of same from 20.02.2020 to 19.02.2025 whereas the accident took place on 03.07.2019 as such there is no valid route permit on the date of accident and OP is not liable for any loss. It is further pleaded that the Insured Declared Value (IDV) of the alleged vehicle is Rs.6,49,877/- whereas the assessed amount on repair basis exceed the prescribed limit of CTl i.e. 75% of the IDV. Therefore, the repair is not viable. It is further pleaded that the complainant has not completed the required formalities till 26.05.2020 and the permit submitted by the complainant is valid from 20.02.2020 whereas the accident took on 03.07.2019 which clearly shows that the insured vehicle is not having permit for commercial use as date of loss as such the claim file of the complainant has been closed as ‘No Claim’ by the OP, vide letter dated 26.05.2020. There is no deficiency in service on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of claim repudiation letter dated 26.05.2020 Ex.C1,  copy of claim intimation letter dated 03.07.2019 Ex.C2, copy of insurance policy Ex.C3, copy of driving licence Ex.C4, copy of RC Ex.C5, copy of bills of repair Ex.C6 to Ex.C8 and closed the evidence on 11.01.2023 by suffering separate statement.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Monika Ranote, Assistant Manager Ex.OP1/A, copy of claim intimation letter Ex.OP1, copy of letter dated 12.06.2020 Ex.OP2, copy of final survey report dated 12.03.2020 Ex.OP3, copy of letter of complainant dated 04.03.2020 Ex.OP4, copy of Form SR 28 Ex.OP5, copy of report of verification of driving licence Ex.OP6, copy of affidavit dated 14.11.2019 Ex.OP7, copy of confirmation of 64VB compliance Ex.OP8, copy of insurance policy Ex.OP9, copy of interim report dated 02.08.2019 Ex.OP10, copy of Cardekho auctions condition Ex.OP11, copy of clarification of permit dated 04.05.2020 and 11.05.2020 Ex.OP12 and Ex.OP13, copy of verification of RC status Ex.OP14, copy of RC Ex.OP15, copy of PAN card Ex.OP16, copy of survey report dated 08.08.2019 Ex.OP17, copy of letter dated 15.01.2020 Ex.OP18, copy of repudiation letter dated 26.05.2020 Ex.OP19, copy of bill crane charges Ex.OP20 and closed the evidence on 06.11.2023 by suffering separate statement.

6.             We have heard the learned counsel for the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for the complainant, while reiterating the contents of complaint, has vehemently argued that complainant got insured his vehicle with the OP. On 03.07.2019 the said vehicle met with an accident and was badly damaged. The intimation in this regard was sent to OP and on receipt of intimation OP appointed a surveyor for verification of the facts. Complainant submitted all the relevant documents with the surveyor. Complainant brought the vehicle to P.P. Automotive Pvt. Ltd. and got estimated the cost of repair for Rs.10,63,056/-. Complainant submitted the estimated report to the OP to get repair the damaged vehicle but OP did not pay the same and finally on 26.05.2020, OP denied the claim of complainant on the on the false and frivolous ground. He further argued that complainant got repaired his vehicle from National Motors, Namastey Chowk, Karnal and paid Rs.4,11,900/-. Complainant lodged the claim with the OP and requested to settle the same but OP refused to settle the same on the ground that the claim file of complainant has already been closed and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that complainant has not supplied the Route permit  to the investigator but the same got procured on 04.03.2020 after lapse of 8 months and the validity of same from 20.02.2020 to 19.02.2025 whereas the accident took place on 03.07.2019 as such there is no valid route permit on the date of accident and OP is not liable to pay any claim and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, the vehicle of complainant met with an accident during the subsistence of the insurance policy. It is also admitted that the insured declared value (IDV) of the vehicle is Rs.6,49,877/-.

11.           The claim of the complainant has been repudiated by the OP, vide repudiation letter Ex.C1/Ex.OP19 dated 26.05.2020, on the ground which is reproduced as under:-

“The permit submitted by complainant is valid from 20.02.2020 whereas date of accident is 03.07.2019 which clear shows that the insured vehicle is not having permit for commercial use as date of loss.

Hence, on the basis of above facts, the abovesaid claim file is closed as No Claim without any further correspondence.”

 

12.           The claim of complainant has been repudiated by the OP on the aforesaid ground. The complainant has not tendered the Route Permit of the relevant time. It appears that complainant was not having the route permit at the time of accident. Thus, there is violation of terms of conditions of the insurance policy. Complainant has not got recorded the DDR/FIR of the alleged accident. No injuries have been reported by the complainant in the said accident but the accident has not been denied by the OP. No doubt, complainant has violated the terms and conditions of the insurance policy but in that eventuality, the claim of the complainant cannot be repudiated in toto.  In this regard we can rely upon the authority cited in Revision Petition no.1870 of 2015(NC) decided on 14.08.2018 titled as New India Assurance Co. Ltd. Versus Thirath Singh Brar,  and authority of our own Hon’ble State Commission in First Appeal no.717 of 2016 decided on 6.4.2017 titled as United India Insurance Company Limited and others Versus Anshul Bansal.  In both judgments it was held that in case of any breach of warranty/condition of the policy the insurer is liable to pay 75% of admissible claim on non-standard basis.

13.           Further,  Hon’ble Punjab and Haryana High Court in case titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, has held as under:-

“It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy.    

14.           Keeping in view that the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, we are of the considered view that acts of the OP, while repudiating the claim of the complainant in toto amounts to deficiency in service and unfair trade practice, which is otherwise proved genuine one. Hence, complainant is entitled to get 75% only of the admissible claim on non-standard basis.

15.           Complainant got repaired his vehicle from National Motors, Namastey Chowk, Karnal and spent Rs.4,11,900/-. As per surveyor report Ex.OP3, the loss assessed by the surveyor of the OP is Rs.4,46,877/-. The insured declared value (IDV) of the vehicle is Rs.6,49,877/- but the complainant has spent Rs.4,11,900/- as repair charges only. The said amount is not more than 75% of the IDV of the vehicle. Hence the complainant is entitled for 3,08,925/- i.e. 75% of the  repaired amount alongwith interest, compensation and litigation expenses etc.

16.           Thus, as a sequel to abovesaid discussion, we partly allow the present complaint and direct the OP to pay Rs.3,08,925/- (Rs. three lakhs eight thousand nine hundred twenty five only) to the complainant. We further direct the OP to pay Rs.20,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.11,000/- for the litigation expenses. This order shall be complied within 45 days from the receipt of copy of this order. It is made clear if the awarded amount is not paid by the OP within stipulated period then awarded amount will carry interest @ 9%   per annum from the date of announcement of the order till its realization. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:03.04.2024     

                                                                  President,

                                                       District Consumer Disputes

                                                       Redressal Commission, Karnal.

 

(Vineet Kaushik)        (Dr. Suman Singh)

                     Member                       Member