BEFORE THE DISTRICT CONSUMER  DISPUTES REDRESSAL FORUM; FATEHABAD.

 Complaint Case No.76 of 2017.

 Date of Instt.:27.03.2017.

Date of Decision:14 .12 .2017.

Paramjeet Singh son of Karam Chand, resident of Jakhan Dadi, Ratia, Tehsil Ratia and District Fatehabad.

                                                                                                                              ..Complainant

                                                              Versus

National Insurance Company Limited, above Union Bank of India, Fatehabad, Tehsil & District Fatehabad through its Branch Manager.

                 ..Respondent/OP

Before:                                Sh.Raghbir Singh, President.

                                              Sh.R.S.Panghal, Member.

Mrs.Ansuya Bishnoi, Member.

Present:                               Sh.Jiternder Thakkar, Adv. for the complainant.

                                              Sh.N.D.Mittal, Adv. for OP.

ORDER

                                              The present complaint under Section 12 of Consumer Protection Act, 1986 has been filed by the complainant against the OP with the averments that he is registered owner of vehicle i.e. Canter Tata 407 bearing Registration No.HR-37B/ 2160 and he had got the same insured with the OP vide insurance policy No.420701/31/15/6300003792 valid from 31.03.2016 to 30.03.2017. The complainant made a payment of insurance amount of Rs.17,996/- to the OP at the time of issuance of the policy and as such he falls within the definition of Consumer  as provided under the Consumer Protection Act, 1986.

2.                           It is further submitted that the vehicle of the complainant met with an accident on 22.06.2016 within the jurisdiction of Police Station Bhikhi, District Mansa, Punjab where DDR No.17 dated 22.06.2016 was recorded regarding the accident and the damages caused to the insured vehicle on account of accident.

3.                           It is further submitted that the complainant got the repairing and denting & painting etc. of the insured vehicle by down following instructions of the OP and thereafter submitted a bill of Rs.40,000/- to the OP. The complainant made a request to the OP for settlement of the claim and he was assured by the OP that his claim will be settled very soon. Thereafter the complainant kept on visiting the OP for settlement of the claim and payment of the bills submitted by him, but all in vain.  However the OP repudiated the claim of the complainant on false and filmsy ground that the vehicle in question was being driven by Parveen Kumar who was not having a driving licence. However in fact the vehicle in question was being driven by the complainant himself and the said fact is mentioned in DDR No.17 dated 22.06.2017. The above said act on the part of OP amounts to deficiency in service and the complainant is entitled for insurance claim along-with compensation. Hence, the present complaint.

4.                           On being served, the OP appeared and resisted the complaint by filing a written version wherein various preliminary objections have been raised i.e. that the complainant has got no locus-standi to file the present complaint; that the complainant has given false and fabricated facts and has not approached this Forum with clean hands; that complainant has no cause of action to file the present complaint etc.

5.                           On merits, it is submitted that the accident occurred on 21.06.2016 but the intimation to the insurance company was given on 27.06.2016 i.e. after a delay of six days. As per condition No.1 of the terms and conditions of insurance policy the insured was bound to give intimation of accidental loss to the company immediately. The above said delay in intimation is a serious violation of the terms and conditions of the policy and deprived the insurance company to get the spot survey done to know the exact cause of manner and mode of accident. It is also further submitted that the vehicle in question was a goods vehicle but the same was carrying passengers when the accident occurred. It is a settled proposition of law that insurance company is not liable to make good any accidental loss in case of goods vehicle is used for carrying passengers.

6.                           It is also further submitted that the vehicle in question was being driven by Parveen Kumar as disclosed by the complainant in the claim-form. However the complainant did not produce the driving licence of said Parveen Kumar which clearly shows that Parveen Kumar was not having a valid driving licence at the time of occurrence of accident.

7.                           It is also further submitted that after getting intimation of the accident the OP deputed surveyor and loss assessor to assess the loss suffered by the vehicle. Sh.Mohit Chug, Surveyor conducted final survey and assessed the net payable amount as Rs.24,395/-. However in view of the breach of terms and conditions of policy and provisions of Motor Vehicle Act the complainant was not entitled to get any compensation. Therefore the claim of the complainant was repudiated by the OP. The repudiation of the claim of the complainant by the OP is perfectly in accordance with the terms and conditions of the policy and sustainable in the eyes of law. Therefore, the present complaint is liable to be dismissed.

8.                           In evidence the complainant produced his affidavit as Annexure C1 along-with documents Annexure C2 to Annexure C8 and closed the evidence. On the other hand Sh.Suresh Chaudhary, Authorized Signatory of OP produced his affidavit as Annexure RW1/A on behalf of OP. The OP also tendered in evidence documents Annexure R1 to Annexure R13 and closed the evidence.

9.                           The learned counsel for the complainant in his arguments reiterated the submissions made in the complaint and further contended that a genuine claim of the complainant has been repudiated by the OP on false and filmsy grounds. It was further contended by the learned counsel that due to bonefide mistake it was submitted by the complainant in the claim-form that at the time of occurrence of accident Sh.Parveen Kumar was driving the vehicle in question. In fact the complainant himself was driving the vehicle in question at the time of accident. The same is also evident from the DDR No.17 dated 22.06.2016 (Annexure R2) got recorded by Paramjeet Singh. However the OP by taking the benefit of this error has repudiated the genuine claim of the complainant on the ground that Parveen Kumar who was driving the vehicle at the time of accident was not having a driving licence.

10.                        On the other hand the learned counsel for the OP argued that the decision of the OP in repudiating the insurance claim of the complainant is perfectly in accordance with the terms and conditions of the insurance policy and sustainable in the eyes of law. It is also further contended that the driver of the vehicle in question was not having a driving licence at the time of accident. It is also contended by the learned counsel that the vehicle in question was a goods carrier whereas at the time of accident it was carrying passengers which is in violation of terms and conditions of the insurance policy as well as provisions of Motor Vehicle Act. The counsel also contended that information regarding the accident was given by the complainant to the OP after a lapse of 6 days as such the complainant has violated the terms and conditions of insurance policy. The learned counsel in support of his contention has relied upon the decision rendered by Hon’ble National Commission in Revision Petition No.1407 of 2014 titled as Reliance General Insurance Co. Ltd. Vs. Jivabhai Maldebhai Godhaniya decided on 09.05.2017 and the decision in case titled as Naresh Kumar Vs. as Reliance General Insurance Co.Ltd. & Anr,  cited as IV(2012) CPJ 493(NC) and case titled as Sher Singh Thakur vs. New India Assurance Co. Ltd. decided by Hon’ble National Commission on 23.02.2017.

11.                        We have duly considered the arguments advanced by learned counsel for the parties and have also perused the documents placed on the record of the case file. It is not disputed that insurance of the vehicle in question was issued by OP. It is also not disputed that the vehicle in question met with an accident and suffered damages during the subsistence of the insurance policy. It is also not in dispute that surveyor has assessed a net loss of Rs.24,395/-. From perusal of the repudiation letter dated 29.12.2016, it is revealed that insurance claim of the complainant has been repudiated  by the OP inter-alia  on the ground that at the time of occurrence of accident Sh.Parveen Kumar was driving the vehicle as disclosed by the complainant himself in claim-form submitted before the OP, but no driving licence of the said Parveen Kumar was ever produced before the OP by the complainant for settlement of the claim. Therefore the complainant has violated the terms and conditions of the insurance policy and as such not entitled for insurance claim.  We are of the considered view that above said contention of the OP is not tenable. From perusal of DDR No.17 dated 22.06.2016 (Annexure C-6) recorded by the police on the statement of Paramjeet Singh complainant it is evident that at the time of occurrence of accident Paramjeet Singh was driving the vehicle in question. This fact is further reaffirmed by the complainant in his complaint dated 27.03.2017 supported by an affidavit. Therefore we are of the view that Paramjeet Singh was driving the vehicle at the time of occurrence of accident and on account of an error on the part of complainant stating in the claim-form that Parveen Kumar was driving the vehicle at the time of accident the claim cannot be repudiated if it is otherwise genuine.

12.                        The other ground taken in the repudiation letter for denying the claim of the complainant is that the vehicle in question was a goods carrying vehicle but at the time of accident it was carrying passengers which is in violation of terms and conditions of the policy. We are of the considered opinion that above said violation is not a fundamental breach of the terms and conditions of the insurance policy and as such the insurance claim of the complainant cannot be repudiated in toto. From perusal of the record it is revealed that 4 or 5 members of the family of the complainant were sitting in the vehicle in question and the accident has occurred on account of the fact that stray animals suddenly came in front of the vehicle in question. Therefore the accident in the present case has not occurred on account of sitting of 4 or 5 passengers in the vehicle in question.

13.                        Keeping in view all the facts and circumstances of the case we are of the considered opinion that it is a fit case to allow the present complaint for grant of insurance claim on non-standard basis.

14.                        Accordingly the present complaint is allowed partly and the OP is directed to release 75% of Rs.24,395/- i.e. the loss as assessed by the Surveyor to the complainant within a period of one month. A copy of this order be furnished/given to both the parties free of cost as provided in the rules.  File be consigned to record room after due compliance.

ANNOUNCED IN OPEN FORUM.                                                                                   Dt.14.12.2017

                 (Ansuya Bishnoi) (R.S.Panghal)     

                    Member               Member              

President                                                                                                                  

         DCDRF, Fatehabad