BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, FATEHABAD.
Complaint no.234/2018.
Date of instt.27.8.2018.
Date of Decision:11.10.2019.
Nitin Kumar aged 32 years son of Radha Krishan, resident of Ashok Nagar, Fatehabad.
..Complainant.
Versus
- National Insurance Company Limited, Branch Office, G.T. Road, Second Floor, above Union Bank of India, Branch Fatehabad.
- National Insurance Company Limited, 3, Middleton Street, Post Box No.9229, Kolkata.
..Respondents/OPs.
Complaint under Section 12 of Consumer Protection Act, 1986.
Before: Sh.Raghbir Singh, President.
Sh. Jasvinder Singh, Member.
Argued by: Sh. Suraj Kiran, Advocate for complainant.
Sh. N.D. Mittal, Advocate for the OPs.
ORDER
The present complaint under Section 12 of Consumer Protection Act, 1986 has been filed by the complainant against the Opposite Parties (hereinafter to be referred as OPs) with the averments that he is registered owner of vehicle i.e. Scooty bearing registration no. HR-22N/8838 and the above said vehicle was got insured by the complainant from the OPs vide insurance policy number 6200002880 having validity for the period from 23.01.2017 to 22.01.2018 for a sum assured of Rs.40,137/-.
2. It is further submitted that on 05.01.2018 at around 6:00 pm the complainant had gone to visit the shop of his friend in Anaj Mandi, Sirsa and after parking the aforesaid vehicle in front of the shop the complainant went inside the shop to meet his friend and after some time, when the complainant came back outside of the shop he found that the aforesaid vehicle was lying in a totally damaged condition. After enquiry the complainant came to know that one tractor trolley hit against his Scooty while the Tractor was being reversed. Upon this an intimation was given to the Insurance Company without any further delay and claim form was submitted with the OPs. On the intimation of the complainant, he was directed by the OPs to take the said vehicle in the workshop of M/s Arora Motors, Dabwali Road, Sirsa where surveyor of the OPs visited and took the photographs of the said vehicle and estimate of repair amounting of Rs.40,638/- was prepared. He was assured by the Surveyor that insurance value of the said vehicle will be paid to the complainant within a short period. Thereafter, as per the instructions of the OPs all the relevant documents were submitted by the complainant with the OPs for settlement of insurance claim. However till date neither the said vehicle has been repaired by the OPs nor the insurance claim has been paid to the complainant. Therefore, a legal notice on 26.04.2018 was got issued by the complainant to the OPs. Thereafter, on 03.05.2018 the OP had sent reply of the notice and demanded the details regarding validity of the temporary R.C. and the date when he applied for registration with the authorities, spot survey and other relevant information. The above said information was given by the complainant to the OPs vide letter dated 17.05.2018. Thereafter, vide letter dated 20.07.2018 sent by the OP to the complainant the claim was closed as “No Claim”.
3. It is further submitted that the above said act on the part of Ops amounts to deficiency in rendering service to him by not making payment of the genuine insurance claim to the complainant.
4. The complainant has prayed that the OPs may be directed for making a payment of the aforesaid amount of Rs.40,638/- alongwith interest and compensation to the tune of Rs.30,000/-. Hence, the present complaint.
5. On being served, the OPs appeared through their counsel and resisted the complaint by filing a written statement wherein various preliminary objections with regard to locus standi, maintainability, cause of action and concealment of true and correct facts etc., have been raised.
6. In reply on merits, it is submitted that the complainant approached M/s Bala Ji Motors for repair on 16.10.2017 and got the estimate of the repair prepared. However, till then the Scooty in question was not validly registered and its temporary registration had already expired. Therefore, the complainant suddenly took away his Scooty from the premises of the said Bala Ji Motors and got the same registered on 08.12.2017. It is further submitted that after getting the permanent registration, the complainant concocted a false story of alleged accidental damage suffered on 05.01.2018 and gave intimation of the said accident to the insurer OPs on 10.01.2018 after a delay of 5 days and without lodging any FIR and without getting spot survey done. It is further submitted that in actual the accident had taken place on 16.10.2017 when the estimate for repair was got prepared from M/s Bala ji Motors and no accident had taken place on 05.01.2018 as alleged by the complainant. No FIR was lodged by the complainant regarding the occurrence and not survey was got done because the same would have exposed the falsity of the story put forward by the complainant. However, after receiving an intimation of the alleged loss the OPs immediately deputed Sh.O.P.Madan a licenced Surveyor and Loss Assessor to assess the loss. The Surveyor submitted his report dated 24.04.2018 whereby the loss was assessed as Rs.15,420/-. The Surveyor vide his report has also observed that the stated version of date, place and cause of accident are doubtful as the loss seems to be old one. The Surveyor also recommended for getting the above said matter investigated. It is also further submitted that the OPs also got investigated the matter from Sh. Madan Goyal Advocate, empanelled investigator of the company. The investigator requested the complainant to provide the documents pertaining to temporary registration, DDR or FIR, spot verification and statement of eye witnesses. However, the above said information was not sent by the complainant despite registered letters dated 12.05.2018,07.06.2018 and 16.06.2018. The above said investigator also opined that the loss in the present case seems to be old one and no accident had taken place at the time as alleged by the complainant. Therefore, the insurance claim of the complainant was denied as no claim.
7. It is further submitted that there is no deficiency on the part of the OPs in rendering service to the complainant and the present complaint deserves dismissal being devoid of merits.
8. The learned counsel for the complainant tendered in evidence affidavit of complainant as Ex. CW-1/A and documents as Annexure C-1 to C-11 and closed the evidence of the complainant. On the other hand, the learned counsel for the OPs tendered in evidence affidavit of Vinod Senior Deputy Manager as Ex. RW-1/A and the affidavit of Sh. Madan Goyal, Advocate as Annexure RW-2/A and the documents as Annexure R-1 to Annexure R18 and closed the evidence of the OPs.
9. We have duly heard the arguments advanced by learned counsel for the parties and have also perused the documents placed on record. It is the case of the complainant that he had obtained an insurance policy for his Scooty bearing registration number HR-22N-8838 from the OPs for the period 23.01.2017 to 22.01.2018. It is further the case of the complainant that on 05.01.2018 at around 6:00PM the complainant had gone to the shop of his friend in Anaj Mandi, Sirsa on the above said Scooty and after parking the Scooty in front of the shop, the complainant went inside the shop to meet his friend. When the complainant came back outside of the shop, he found that the said Scooty was lying on the road in a totally damaged condition. Upon enquiry, it came into the notice of the complainant that the tractor Trolley had hit the Scooty and on account of the same, the above said Scooty was damaged. It is further the case of the complainant that regarding the above said loss the complainant immediately gave information to the insurance company and on the direction of the OPs, the complainant took the damaged Scooty in the workshop of M/s Arora Motors, Dabwali Road, Sirsa where the Surveyor of the OPs estimated the damage in the Scooty to the tune of Rs.40,638/-. It is further the case of the complainant that neither the insured Scooty was repaired by the OPs nor the insurance claim was disbursed to the complainant. Therefore, a legal notice was given by the complainant to the OPs and in response to the legal notice certain documents were sought by the OPs from the complainant and the same were sent by the complainant to the OPs vide letter dated 17.05.2018. Despite this fact the OPs has denied the insurance claim to the complainant by giving reasons as “No Claim”. It is further the case of the complainant that the genuine insurance claim of the complainant has been declined by the OPs on false and flimsy ground.
10. On the other hand, it is the case of the OPs that in fact the insured Scooty had met with an accident on 16.10.2017 and not on 05.01.2018 as alleged by the complainant. It is further case of the OPs that on 16.10.2017, the complainant had not obtained the registration certificate from the registration authority and the temporary registration issued to the complainant had already expired. Therefore, the complainant first of all got the permanent registration on 08.12.2017 and thereafter intentionally concealed the actual date of accident and has concocted the false story of accident on 05.01.218.
11. In view of the position as discussed aforesaid the insurance claim in the present case has been rebutted by the OPs on the ground that no accident had taken place on 05.01.2018 and the insured vehicle met with an accident on 16.10.2017 and on that day the insured Scooty was not having a permanent registration number. Therefore, the onus was upon the OPs to prove that the insured vehicle met with an accident on 16.10.2017 and not on 05.01.2018. However, the OPs have not produced any authentic, credible or cogent evidence to prove that the insured vehicle had met with an accident on 16.10.2017 i.e. prior to 08.12.2017. Therefore, we are of the considered opinion that the above said ground taken by the OPs for declining the insurance claim of the complainant is not tenable.
12. Regarding the loss caused to the insured vehicle on account of accident, it is pertinent to mention here that the OPs had appointed the independent surveyor to assess the loss. The assessor namely Sh. O.P.Madan after examining the vehicle has assessed the loss to the tune of Rs.15,420/-. In the present case, the damage to the insured vehicle had occurred on 05.01.2018 whereas intimation regarding the same was given to the insurance company on 10.01.2018after a delay of 5 days and no FIR regarding the occurrence was got recorded by the complainant. Keeping in view the above said facts, we deem it appropriate to allow the present complaint on non-standard basis. Therefore, the OPs are directed for making the payment of 75% of the loss of Rs.15,420/- as observed by surveyor. Keeping in view all the facts and circumstances of the case, we do not deem it appropriate to grant compensation to the complainant. The present order be complied with within the period of 45 days, otherwise the above said amount shall carry an interest at the rate of 8% per annum for the default period. Copy of this order be Copy of this order be communicated to the parties free of costs. File be consigned to the record after due compliance.
Announced in open Forum.
Dated: 11.10.2019.
(Jasvinder Singh) (Raghbir Singh)
Member President
