Delhi

New Delhi

CC/466/2017

Narender Kumar Singh - Complainant(s)

Versus

National Insurance Company Ltd - Opp.Party(s)

08 Jun 2023

ORDER

 

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-VI

(NEW DELHI), ‘M’ BLOCK, 1^STFLOOR, VIKAS BHAWAN,

I.P.ESTATE, NEW DELHI-110002.

Case No.CC-466/2017 

IN THE MATTER OF:

Shri Narender Kumar Singh

Shop No. 58-59,

Maruti Truck Parking Road,

Gurgaon – 122001.

…. Complainant

 

Versus

 

National Insurance Co. Ltd.

Motor Claim Hub RO-1,

Jeewan Bharti, Tower -2, 4^th Floor,

124, Connaught Circus,

New Delhi – 110001.

…. Opposite Party

 

Quorum:

Ms. Poonam Chaudhry, President

Sh. Bariq Ahmad, Member

Date of Institution:11.10.2017

Date of Order   :08.06.2023   

 

ORDER`

BARIQ AHMAD, MEMBER

1. The present complaint has been filed under Section 12 of the Consumer Protection Act, 1986 (in short CP Act) against Respondent/Opposite Party (in short OP) alleging deficiency of services.

2. Briefly stated the facts of the case are that the complainant is the registered owner of Ashok Leyland commercial vehicle bearing Regd. No. HR-55-R-8387 and obtained insurance in respect of the said vehicle from the OP, Policy No. 354301/31/15/610001583 for the period of one year from 23.02.2017 to 22.02.2018 for a sum insured of Rs.5,80,000/- and paid the consideration amount of Rs.24,908/- to the OP in lieu of the same. The above policy was renewal of previous policy. The OP issued only a computerized 2 pages schedule policy which does not contain any terms and conditions.
3. That unfortunately on 21.10.2016, the aforesaid vehicle met with a  serious accident and the intimation about the accident/loss to the vehicle was also lodged by the Complainant with the OPs local office DO Purnea who deputed Mr. Swaraj Kumar as Spot surveyors.
4. It is alleged that the deputed surveyor inspected the site of accident on the same day, took photographs of spot along with other documents of vehicle including driving 1icense of Mr. Dhan Mohan Mishra who was on wheel at the time of accident. The deputed surveyor submitted its report dated 21.10.2016 to OP confirming the details of vehicle, accident as well as of driving license.
5. It is alleged that since the vehicle was to be brought to Gurgaon for its repair, the same was sent to workshop and an estimate of Rs.8,01,800/- were submitted to the OP and OPs are requested to register the claim and depute some surveyor for final assessment of loss sustained by the complainant insured vehicles.
6. It is alleged that the OPs deputed one surveyor namely Mr. Vinod Kumar Wadhwa, who inspected the accidental vehicle, got it photographed, took all necessary documents including the driving license of Dhan Mohan Mishra and alleged to have submitted his report assessing the loss on repair basis without discussing the same with the complainant. The complainant was not intimated of the assessment nor a report of the said deputed surveyor was ever given to the complainant as per provisions of law.
7. It is further alleged that the complainant's claim was not settled by OP till 24.03.2017 inspite of various reminders verbal as well as written to the OPs Branch office as well as to their Divisional Office asking for the assessment and or its details but no intimation about the assessment of loss or information about the surveyors report was ever provided to the complainant.
8. It is stated that the complainant had no option but to take the delivery of the fully repaired vehicles from the authorized dealers who were pressing the complainant to take delivery of the same.  The complainant after great persuasion with the repairers made a payment of Rs.8,01,800/- to the various persons who were involved in the repair of vehicle and took the delivery of the vehicle.
9. It is further stated that finding no response to the aforesaid letters, telephone calls and personal visits to the office of the OPs for the settlement of the genuine claim, the complainant visited the Regional office of the OPs on 10.03.2017. The complainant was informed that the OPs surveyors namely Mr. Vinod Kumar Wadhwa had made assessment of loss for an amount of Rs.3,73,345/- only but no detailed information about the assessment was ever conveyed to the complainant either by the surveyor  or by the OPs.
10. It is alleged that the OPs did nothing to settle the claim of the complainant even thereafter and in spite of the fact that all the required papers were submitted to them on the very first date to the spot surveyor and again to the 2^nd surveyor and that the complainant have been reminding them over phone, by way of letters and by personal visits.
11. It is alleged that the OPs are playing the tactics of delaying the genuine claim of the complainant on one pretext or the other and by doing so the OPs were also harassing the complainant by withholding the payment of his genuine claim so that out of frustration the complainant might grease their palm.
12. It is stated that to the otter shock of the complainant, a letter dated 24.03.2017 was received from the OP Regional office wherein the OP raised irrelevant queries about the name of driver and informed that because of concealment of facts which is violation of condition no. 8 of policy, the claim of the complainant is not maintainable and called for the explanation of complainant to be submitted within 10 days of issue of the above letter.
13. It is alleged that the complainant immediately sent a detailed reply on 08.04.2017 to the OPs. The OPs deputed an investigator at their own against all insurance Law and IRDA Rules and obtained some illegal report without any intimation to the complainant based on which the claim of the complainant was finally repudiated by the OPs on 17.07.2017.
14. It is also alleged that non-settlement of the claim of the complainant for 10 months is a clear case of deficiency in service on the part of the OPs as per the CP Act. The vehicle met with an accident on 21.10.2016, the intimation of the claim was given immediately when spot surveyor was deputed by OPs who visited the spot within hours of accident and had clearly confirmed the name of driver of vehicle in his report. Thereafter another surveyor was deputed who also submitted his report along with completion of all claim formalities were also submitted to the OPs. Hence, this complaint.
15. It is prayed that OP be directed to pay a sum of Rs.8,01,800/- along with interest thereon @ 24%, Rs.2,00,000/- on account of mental agony, pain and suffering, and a sum of Rs.1,50,000/- being the cost of the present litigation.
16. Notice of the complaint was issued to OP, upon which OP entered appearance and filed written statement contesting the complaint on various grounds inter alia that the complainant in the claim form mentioned that Mr. Dhan Mohan Mishra was driving the insured vehicle at the time of the accident whereas at the time of taking Superdari in the Criminal Court Mr. Anil Kumar Yadav was depicted as the Driver at the time of accident. As per the intimation, Sh. Chattu Baitha was Driver of insured vehicle at the time of the accident. The driving license of Mr. Chattu Baitha was found fake from the issuing transport authority. Thus, it is a apparent that the complainant/insured have concealed the material fact which is violation of condition no. 8 of the insurance policy.
17. It is averred that the insured did not supply the requisite documents to the OP. As per FIR No. 181/16 both the driver and cleaner were badly injured in the accident. The treatment papers of the driver and cleaner were not supplied to the OP. There is a clear violation of the terms and condition was rightly repudiated vide repudiation letter dated 17.07.2017. It is stated that the Insurance company is not liable to pay any claim to the complainant, as he has violated the terms and conditions of insurance policy.
18. Rest all the averments as averred by the complainant in his complaint were denied and prayed to dismiss the complaint.
19. The parties produced the evidence in support of their respective averments.
20. We have heard the Ld. counsel for Parties and perused the record.
21. It is, however, not in dispute that the complainant continued to be the registered owner of the said insured vehicle, on the date of the accident. Complainant has filed the particulars of driver license. It is argued by the counsel for the complainant that before employing the driver, he had taken driving test and  that he was driving the vehicle satisfactorily.
22. The complainant himself submitted a motor claim No.3545013116639000000181 dated 24.11.2016, with the claim form, along with the requisite documents, to the Insurer by Registered Post.  Aggrieved by the action of the Insurer company in not releasing the claim of the complainants, towards reimbursement of losses on account of the accident, the complainant approached the District Forum/Commission.
23. It is patently clear that the complaint had been resisted by the Insurer on the purported ground that the as per the intimation Chhathu Bhaitha was driver of the subject vehicle but as per claim form Dhan Mohan Mishra was driving the subject vehicle and driving licence of Chhathu Bhaitha was found fake on verification from the issuing authority. The complainant strenuously contended that the Insurer had not produced a scrap of document before the District Forum to show that the driving license is fake.
24. The learned counsel for the complainant relied upon United India Insurance Co. Ltd. V. Lehu & Ors. As also three judge Bench Judgment reported as National Insurance Co. Ltd. V. Swaran Singh and Others that the owner has no mean to verify the genuineness of driving license produced before him, provided that the owner finds the driver is competent to drive the vehicle. Similar question again came up for consideration before Hon`ble Supreme Court in a judgment reported as Rishi Pal Singh v. New India Assurence Co. Ltd. 2022 Live Law (SC) 646 that the owner of the vehicle is expected to verify the driving skills and not run to the licensing authority to verify the genuineness of the driving license before appointing a driver. Therefore, once the owner is satisfied that the driver is competent to drive the vehicle, it is not expected from the owner thereafter to verify the genuineness  of the driving license issued to the drive.
25. In any case, as held by this Court in Om Prakash vs. Reliance General Insurance and Another (2017) 1 SCC 724 delay in intimation of accident, or submission of documents due to unavoidable circumstances, should not bar settlement of genuine claims.
26. It had also been argued on behalf of the complainant, that the Surveyor appointed by the Insurer had not taken a consent letter from the complainant after the Survey, and further not taken any consent to appoint second surveyor as per IRDA.
27. It is not the case that the claim application filed by the complainant was time barred. Moreover, the Insurer had, in any case, duly sent its Surveyors/ Assessors to assess the loss. The claim of the complainant could not have, in this case, been resisted, either on the ground of delay in lodging the FIR, or on the ground of delay in lodging an Accident Information Report, or on the ground of delay in making a claim.
28. We therefore hold OP guilty of deficiency in service, OP is directed to pay the claim of Rs.8,01,800/- (Rupees Eight Lakh One Thousand Eight Hundred Only) with interest @12% per annum from the date of filing of claim within 4 weeks of the receipt of the order, failing which OP will be liable to pay interest @ 14% p.a. till realization. The OP will also pay Rs.1,00,000/- (Rupees One Lakh Only) towards compensation mental agony and Rs.25,000/- (Rupees Twenty five Thousand Only) as cost of litigation within the 30 days of receipts of the order.
29. The order be uploaded on the website of the Commission.

Copy of order will provided/sent to all parties free of cost.

File be consigned to record room with a copy of the order.

Announced in open Forum on 08/06/2023.

 

(POONAM CHAUDHRY)

 President

 

 

 

                                                 (BARIQ AHMAD)                                   

                                                          Member