Before the District Consumer Disputes Redressal Forum, Room No. 208 2^nd Floor, District Administrative Complex, Tarn Taran

Consumer Complaint No    :   59 of 2017

Date of Institution                      :   23.08.2017

Date of Decision               :   25.06.2019

1. Manjit Singh son of Bahal Singh resident of House No. 44, G. No. 2, Ward No. 6 Patti, Tehsil Patti, District Tarn Taran,
2. Baljit Singh son of Kartar Singh through his L.Rs.

1. Manjeet Kaur w/o Baljit Singh;
2. Gurpeet Singh son of Baljit Singh;
3. Jagpreet Singh son of Baljit Singh;
4. Kuldeep Singh son of Baljit Singh all residents of Ward No. 15, near Gurudwara Baba Vishavkarma, Gali No.2 Patti, District Tarn Taran.

                                                                             …..Complainants

Versus

1. National Insurance Company Limited through its authorized officer, Branch Chheharta at Opp. Thumbs Up Factory, G.T. Road, Chheharta, Amritsar-143001
2. National Insurance Company Limited through its authorized officer registered office 3, Middleton Street, Post Box No. 9229 Kolkata-700071.

                                                                             …Opposite Parties.

Complaint Under Section  11, 12 and 13 of the Consumer Protection Act .

Quorum:               Sh. Charanjit Singh, President

Smt. Jaswinder Kaur, Member

For Complainant                     Sh. M.P. Arora Advocate.

For Opposite Parties               Ms. Neenaa Kapur Advocate

ORDERS:

Charanjit Singh, President;

1        The complainants Manjit Singh etc. have filed the present complaint under Section 11, 12 and 13 of the Consumer Protection Act (herein after called   as 'the Act') against National Insurance Company Limited through its authorized officer, Branch Chheharta at Opp. Thumbs Up Factory, G.T. Road, Chheharta, Amritsar and another  (Opposite Parties) on the allegations of deficiency in service and negligence in service on the part of the opposite parties with further prayer to direct the opposite parties to pay an amount of Rs. 1,70,000/- incurred by the complainant for repair of damaged vehicle with interest to the complainant and opposite parties be directed to pay compensation of Rs.20,000/- and Rs. 10,000/- as litigation expenses.

2        The case of the complainant in brief is that the complainant Manjit Singh is resident of H. No.44, G. No.2, Ward No.6, Patti, Tehsil Patti, District Tarn-Taran. The Baljit Singh (deceased) son of Kartar Singh was resident of Patti, who died on 07-01-2016, as such, the present complaint has been filed by the complainant Manjit Singh as well as legal heirs of the Baljit Singh(deceased). The complainants have purchased Vehicle Insurance policy from the opposite parties No.1 & 2 i.e. National Insurance Company bearing No:401901/31/16/6300001292 in favour of the complainant for his Tata Truck LPT 2515 bearing registration No: PB-46F-9992 and the insured declared value of vehicle is Rs.6,00,000/- and the same is a valid for the period of 26.8.2016 to 25.8.2017. The vehicle of the complainant/insured is covered under the above said policy, which covers all the risks to the vehicle and the opposite parties are under obligation to pay the claim of the insured/complainant, if any loss occurs to the vehicle during the insurance period. On 14.6.2017, the above truck of the complainant was being driven by driver Jagpreet Singh, met with an accident near Zira due to which the truck was badly damaged. The complainant has given the intimation to the officials of the company on time and afterwards the investigator sent by the company has visited the spot and has taken photographs of the damaged truck. In this regard, a report was lodged at Police Station Zira, District Ferozepur vide rapat No.16 dated 17.6.2017.  The complainant has also given written representation to the company with regard to release of claim of the damaged vehicle due to the accident. The estimated cost memo prepared by the workshop by the workshop to repair the truck was also sent by the complainant to the respective office of the company but the company has not given reply to the same. The season of the business of the complainant was on peak in those days as such, non-repairing of the truck was causing very much loss to the complainant, as such, the complainant has repaired his truck after waiting for some days after serving a legal notice upon the company with regard to repair of the truck. Due to the above said accident, the complainant/insured has suffered loss due to cost incurred upon the repair of the vehicle as the vehicle was badly damaged and such kind of damage is covered under the insurance policy. After some days, the opposite parties have asked the complainant to submit certain documents and the complainant had deposited all the required documents to the company. Afterwards, the complainant has requested the opposite parties many times to admit his genuine claim but the company is lingering on the matter on one & other pretext and finally, the opposite party has orally declined to admit the genuine claim of the complainant and the complainant has requested to submit a written repudiation in this respect but the opposite parties have flatly refused to admit the genuine request of the complainant. The company has not given the genuine claim of the complainant till today as the complainant/insured has not breached any known conditions of the policy but the opposite parties had done nothing to justify the genuine claim of the complainant/insured. The above conduct of the company is un-businesslike conduct as well as it is deficiency in services. Hence the opposite parties are liable to pay the amount of loss occurred to the insured car alongwith the interest up till date. The complainant has suffered a loss of 1,70,000/- as cost incurred upon the repair of the damaged vehicle including the expenses on transportation for taking the vehicle to Patti. The complainant has further physically and mentally harassed by the opposite parties. Feeling dissatisfied by the act and conduct of the opposite parties, the complainant perforce has filed this complaint against the opposite party.

3        Notice of this complaint was sent to the opposite parties and opposite parties appeared through counsel and filed written version taking preliminary objections that the complainant has not come to the Forum with clean hands and has tried to conceal the material facts from this Forum, therefore, the complaint is not maintainable and complainant is not entitled for any relief. The complainant is estopped by his own act and conduct from filing the present complaint. The case of the insured has not been decided yet as the insured has not fulfilled the formalities required to substantiate the claim after reporting the matter to opposite parties from the date of accident. Keeping in view the terms and conditions of policy, it is clear that without requisite documents which is mandatory for the investigation process, the claim cannot be disposed of and letters dated 28.6.2017 and 6.7.2017 etc. have been duly sent to the complainant to comply with but same have not been complied with so far. In the set of circumstances mentioned above, it is clear that there is no cause of action and there is no question of deficiency and lapse on the part of opposite parties, hence, the complainant is neither to get any relief nor entitled to get any compensation and interest as claimed. The present complaint is not maintainable and pre mature. On merits, it was pleaded that the alleged accident at Zira has to be verified and other investigation regarding the occurrence has not been seen and investigator is deputed to investigate the things that a due process has to be followed after submitting the claim and thereafter, company appoints the surveyor to assess the actual loss occurred to the party. This all needs time and the complainant is not ready to listen to the process to be followed and has filed the premature complaint. Everything has to be followed in procedure caused of action is pre mature and all this process of investigation needs time to clear the claim. Third Party administrator demanded the insured to submit the documents, but certain formalities have not been completed so far and the matter is in process to consider the reimbursement on merits. However, the same has never been supplied. The opposite parties have denied the other contents of the complaint and prayed for dismissal of the complaint.

4        In order to prove their case, the complainant tendered in evidence, affidavit of Manjit Singh Ex. C-1, affidavit of Gurpreet Singh Ex. C-2 alongwith documents Ex. C-3 to Ex. C-29, lead their evidence and closed the evidence. The opposite parties tendered in evidence affidavit of Gurkewal Singh Kairon Assistant Manager Ex. OPs/1 alongwith documents Ex. OPs/2 to Ex. OP/4 and closed the evidence.

5        We have heard the Ld. counsel for the parties and have also carefully gone through the evidence and documents on the file.

6        Ld. counsel for the complainant contended that. The complainants have purchased Vehicle Insurance policy from the opposite parties No.1 & 2 i.e. National Insurance Company bearing No:401901/31/16/6300001292 in favour of the complainant for his Tata Truck LPT 2515 bearing registration No: PB-46F-9992 and the insured declared value of vehicle is Rs.6,00,000/- and the insurance is a valid insurance policy for the period of 26.8.2016 to 25.8.2017 vide policy Ex. C-3. He further contended that the vehicle of the complainant/ insured is covered under the above said policy He further contended that on 14.6.2017, the above truck of the complainant was being driven by driver Jagpreet Singh, met with an accident near Zira due to which the truck was badly damaged. He further contended that the complainant has given the intimation to the officials of the company on time and afterwards the investigator sent by the company has visited the spot and has taken photographs of the damaged truck. In this regard, a report was lodged at Police Station Zira, District Ferozepur vide rapat No.16 dated 17.6.2017 which is Ex. C-7.  The complainant has also given written representation to the company with regard to release of claim of the damaged vehicle due to the accident. He further contended that the estimated cost memo prepared by the workshop to repair the truck was also sent by the complainant to the respective office of the company but the company has not given reply to the same. He further contended that the season of the business of the complainant was on peak in those days as such, non-repairing of the truck was causing very much loss to the complainant, as such, the complainant has repaired his truck after waiting for some days after serving a legal notice upon the company with regard to repair of the truck. Due to the above said accident, the complainant/insured has suffered loss due to cost incurred upon the repair of the vehicle as the vehicle was badly damaged and such kind of damage is covered under the insurance policy. He further contended that after some days, the opposite parties have asked the complainant to submit certain documents and the complainant had deposited all the required documents to the company. Later on, the opposite party has orally declined to admit the genuine claim of the complainant and the complainant has requested to submit a written repudiation in this respect but the opposite parties have flatly refused to admit the genuine request of the complainant and prayed for to allow the complaint.

7        Ld. counsel for the opposite parties contended that the complainant has not come to the Forum with clean hands and has tried to conceal the material facts from this Forum, therefore, the complaint is not maintainable and complainant is not entitled for any relief. She further contended that the complainant is estopped by his own act and conduct from filing the present complaint. The case of the insured has not been decided yet as the insured has not fulfilled the formalities required to substantiate the claim after reporting the matter to opposite parties from the date of accident. She further contended that keeping in view the terms and conditions of policy, it is clear that without requisite documents which is mandatory for the investigation process, the claim cannot be disposed of and letters dated 28.6.2017 and 6.7.2017 etc. have been duly sent to the complainant to comply with but same have not been complied with so far. She further contended that there is no question of deficiency and lapse on the part of opposite parties, hence, the complainant is neither to get any relief nor entitled to get any compensation and interest as claimed. She further contended that the present complaint is not maintainable and pre mature. She further contended that accident at Zira has to be verified and other investigation regarding the occurrence has not been seen and investigator is deputed to investigate the things that a due process has to be followed after submitting the claim and thereafter, company appoints the surveyor to assess the actual loss occurred to the party. This all needs time and the complainant is not ready to listen to the process to be followed and has filed the premature complaint. She further contended that third Party administrator demanded the insured to submit the documents, but certain formalities have not been completed so far and the matter is in process to consider the reimbursement on merits. However, the same has never been supplied. Ld. counsel for the complainant has contended that the complainants have submitted all the documents relating to the policy, but the opposite parties have not decided the claim within time and it is also deficiency in service. The complainant has relied upon 1994(1), CPJ 179:1993 CPC 646 in case titled Surinder Kaur Vs Oriental Insurance Co. Ltd. (H.S.C.D.R.C).  Ld. counsel for the complainant has prayed for dismissal of the complaint.

8        In the present case, insurance of the vehicle in question is not disputed and insurance is valid w.e.f. 26.8.2016 to 25.8.2017 and insurance declared value of the vehicle in question is Rs. 6,00,000/- vide insurance policy Ex. C-3. The vehicle in question met with an accident on 14.6.2017 and the complainants have lodged Rapat No. 16 dated 17.6.2017 in police Station Zira Ex. C-7.  The main stand of the opposite party in the present case is that the complainant has not submitted the requisite documents to the opposite party. The complainant has placed on record one representation Ex. C-8 in which the complainant has pleaded that the truck of the complainant met with an accident and he immediately informed the opposite parties and one surveyor went to the spot and clicked the photographs and the said application is addressed to the Manager, National Insurance Company and is Ex. C-8 and receipt dated 17.6.2017 of the same is Ex. C-9. The complainant has also placed ion record legal notice dated 1.7.2017 sent to the opposite parties through their counsel and receipt of the same is Ex. C-11 on the record in the said legal notice it is pleaded that investigator sent by the company has visited the spot and has taken photographs of damaged truck. The said legal notice is Ex. C-10 and its receipt is Ex. C-11. It shows that the complainant is requesting the opposite parties again and again for settlement of the claim. The opposite party has placed on record letter dated 28^th June, 2017 Ex. OPs/3 and the said letter is in response of representation dated Nil Ex. C-8. From Ex. C-8 it is not denied by the opposite parties that surveyor has not come to the spot and has not taken the photographs. However to the contrary, the opposite parties have pleaded in the written version that surveyor is to be appointed in this case. Furthermore, the stand of the opposite party is that the insurance company has sent the letter dated 28.6.2017 and 6.7.2017. But the opposite party has not placed on record letter dated 6.7.2017 and its receipt. However, the opposite parties have placed on record one letter dated 28.6.2017 Ex. OPs/3 in which the opposite parties are demanding some documents. The complainant has also placed on record one receipt of Courier Ex. OPs/4 and it is written on the Courier to Manjit Singh Patti. The said receipt of courier does not show that the said letter has been received by the complainant Manjit Singh or not and it does not bear the signatures of complainant/ Manjit Singh. Moreover, the said receipt does not bear the complete address of complainant. It does not proved that the letter Ex. OPs/3 has been delivered to the complainant. Patti is a very big town and any item cannot send to a person by mentioning only his name and town name. There might be many persons by the name of Manjit Singh in Patti town. The opposite parties have also not placed on record affidavit of any employee of concerned Courier Agency to prove the fact that the letter Ex. OPs/3 has been delivered to the complainant. It has been proved on record that accident has been taken place and rapat has been lodged at Police Station Zira. In 1994(1), CPJ 179:1993 CPC 646 (Supra) it has been held that period of deciding the claim is 3 months. It is usual with the insurance companies to show green pastures to the consumers when they are to sell their policies. But however when it comes to the payment for claim, they invent all sort of excuses to deny the claim. Reliance in this connection can be had on the decision of Hon’ble Apex Court in case of Dharmendra Goel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation.  This ‘take it or leave it’, attitude is clearly unwarranted not only as being bad in law, but ethically indefensible.  It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. In similar set of facts the Hon’ble Punjab & Haryana High Court in case titled as New India Assurance Company Limited Vs. Smt.Usha Yadav & Others 2008(3) RCR (Civil) Page 111went on to hold as under:-

“It seams that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy. The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5000/- for luxury litigation, being rich.”

9        The complainants have placed on record receipts Ex. C-5, C-6, C-12 to Ex. C-19 amounting to Rs. 1,45,470/- which has been spent by the complainants on the vehicle in question for repair etc. The insured declared value of the truck in the policy is Rs. 6,00,000/-. As such, the complainants are entitled to Rs. 1,45,470/- from the opposite parties.

10      In view of the above discussion, the present complaint is partly allowed and the opposite parties are directed to release a sum of Rs. 1,45,470/-  (Rs. One Lac forty five thousand four hundred and Seventy Only) to the complainant. Complainants is also entitled to Rs. 7,500/- ( Rs. Seven thousand and five hundred only) as compensation on account of harassment and mental agony and Rs 5,000/- (Rupees Five Thousand  only) as litigation expenses. The complainant No. 1 is entitled to 1/2 share and complainant No. 2(i) to 2(iv) are entitled to the remaining 1/2 share in equal shares of the awarded amount. Opposite Parties are directed to comply with the order within one month from the date of receipt of copy of the order, failing which the complainant is entitled to interest @ 9% per annum, on the awarded amount, from the date of accident till its realisation.  Copy of order be supplied to the parties free of costs as per rules. File be consigned to record room.