BEFORE THE DISTRICT CONSUMER DISPUTES

REDRESSAL FORUM, JALANDHAR.

Complaint No.181 of 2017

Date of Instt. 12.06.2017

Date of Decision: 10.07.2018

Anoop Singh aged about 35 Years S/o Makhan Singh R/o Village Nandanpur, Post Office Nagra, Tehsil and District Jalandhar.

..........Complainant

Versus

1. National Insurance Company Ltd. having its Head Office 3, Middleton Street, Post Box No.9229, Kolkata 700071 through its Managing Director.

2. The Branch Manager, National Insurance Company Ltd., Panesar Complex, 20, G. T. Road, Jalandhar 144001.

….….. Opposite Parties

Complaint Under the Consumer Protection Act.

Before: Sh. Karnail Singh (President)

Smt. Harvimal Dogra (Member)

Present: Sh. Gurvinder Arora, Adv Counsel for the Complainant.

Sh. AK Arora, Adv Counsel for the OP No.1 and 2.

Order

Karnail Singh (President)

1. The instant complaint is filed by the complainant, wherein alleged that the complainant is registered owner of TATA Vista Car bearing No.PB08-CE-1218. The complainant obtained an insurance policy of the said car from the OPs bearing policy No.404304311561000002876 dated 07.12.2015 valid till 06.12.2016. The complainant also paid the premium for the said insurance policy to the OPs.

2. That the above said vehicle was used by the complainant for his domestic use and unfortunately, the same met with an accident near Workshop Chowk, Jalandhar on 28.07.2016 at about 05:00 a.m, when the complainant was going from his house to Ludhiana for his personal work and when he reached near Workshop Chowk, Jalandhar, suddenly a bull came in front of the car of the complainant and when the complainant tried to save himself from the bull and he turned the car towards left side and it struck with a truck and then against a footpath and even one mexi cap vehicle was coming from behind and it also struck the car of the complainant from back side, due to which the car of the complainant wad badly damaged.

3. The complainant reported the matter to the police of P.S. Division No.2, Jalandhar and a DDR No.11 dated 28.07.2016 was also registered. The complainant immediately informed the OPs regarding the accident and accordingly, the OP appointed a surveyor on 28.07.2016, who visited the spot and had also inspected the car of the complainant in accident and he also took the photographs and signatures of the complainant at that time and later on, surveyor submitted the report to the OPs regarding the accident. The OPs also again appointed new surveyor Arun Kumar & Company, who also inspected the vehicle of the complainant at M/s Kosmo Tata (Pvt. Ltd.), Jalandhar on 02.08.2016. The OPs sent a letter dated 05.12.2016 bearing memo No.1165 and sought two documents i.e. NOC from financier and consent by insured on affidavit, which was sent by the OPs to the complainant for the settlement of the claim. The complainant paid the whole loan amount to his finance company and obtained No Due Certificate from the said company and the complainant also signed the affidavit of consent sent by the OPs. The complainant handed over NOC and affidavit of consent to the OPs immediately, but even despite that no claim of the complainant was settled. It is worth mentioning here that the insurance policy of the complainant was for a sum of Rs.3,50,000/- and the loss of the vehicle was about Rs.5,00,000/-. That again the OPs sent a letter dated 23.09.2016 bearing claim No.404304/31/16/61/90000133-2 and again sought documents NOC, Toying Receipt and Consent on affidavit. It is worth mentioning here that the complainant had already submitted an affidavit of consent and NOC and again gave the said documents along with toying receipt to the OPs and requested that the complainant should be paid the amount of Rs.3,50,000/-, which is the insured amount, though the loss was of Rs.5,00,000/-, but the OPs put off the matter on one pretext or the other. The complainant also requested number of times to the OPs to pay the insured amount to the complainant i.e. Rs.3,50,000/-, but the OPs are putting off the matter on one pretext or the other and now they are refusing to pay any amount to the complainant. The complainant has been subjected to undue harassment, inconvenience, financial loss, mental agony on account of the deficiency in services on the part of the OPs and on account of unfair trade practice. A cause of action accrued to the complainant to file the present complaint with the prayer that the OPs may kindly be directed to pay the sum of Rs.3,50,000/-, the loss of the vehicle in the accident along with Rs.5,00,000/- on account of mental tension, sufferings, harassment, financial loss etc. due to the deficiency in services on the part of the OPs regarding non payment of the sum insured for the vehicle, in the interest of justice.

4. Notice of the complaint was given to the OPs and accordingly, both the OPs appeared through their counsel and filed their joint written reply and contested the complaint by taking the preliminary objections that there is no deficiency of service or unfair trade practice on the part of the OPs and that being so the present complaint is not maintainable. It is further averred that immediately on the receipt of information qua the loss caused to the vehicle of the complainant in the alleged accident, M/s Arun Kumar and Company was appointed as Surveyor to assess the loss. M/s Arun Kumar and Company, the surveyor appointed in the said case submitted their Interim Survey Report dated 01.09.2016, vide which it was recommended to settle the claim for a sum of Rs.1,20,000/- on cash loss settlement. Further in their interim report dated 01.09.2016, the loss to the tune of Rs.1,93,917/- was assessed. On the receipt of Interim Survey Report dated 01.09.2016, letter dated 23.09.2016 was written to the complainant to submit NOC from the financier of the vehicle, towing receipt and consent on affidavit for settlement of the claim on cash loss basis. Thereafter, reminders dated 11.11.2016 and 05.12.2016 were sent to the complainant by the OPs. On the receipt of NOC from the financier and affidavit of consent by the complainant for settlement of claim on cashless basis, matter was referred to the competent authority and the competent authority has not approved the mode of settlement of the claim on cashless basis. Accordingly, email dated 27.02.2017 was sent by the OPs to the surveyor M/s Arun Kumar and Company advising him that the competent authority has not approved the case of the complainant for cashless mode of settlement and as such, he was asked to advise the company for another mode of settlement. Letter dated 28.02.2017 to this effect was also sent to the complainant and he was asked to get repaired his vehicle at the earliest and deposit bills and receipts for the same with the OPs. Sh. Arun Kumar of M/s Arun Kumar and Company, the surveyor appointed in the said case also sent an email dated 01.03.2017 to the repairer asking them to start repair of the vehicle in question as cashless mode proposed to the insurer has been denied. Letter dated 17.04.2017 to this effect was sent by the surveyor to the complainant asking him to start repair work of the vehicle and call the surveyor for verification of the vehicle in repair phase. It was further advised that in case no response was received from the complainant, independent survey report shall be submitted to the insurer i.e. the OPs. Letter dated 18.04.2017 was sent by the OPs to the complainant advising him that cashless mode of repair is denied by the competent authority and advised him to start the repair of his vehicle and further letter dated 18.05.2017 was also sent to the complainant again asking him to get the repair of vehicle and submitted all the related documents with the surveyor to enable the OPs to settle the claim. In the said letter. Thereafter, reminder dated 25.05.2017 was sent to the complainant, but to no effect. The complainant had not started the repair of the vehicle and has not submitted the repair bills and other related documents with the surveyor and as such, the file of the complainant stands closed and letter dated 31.05.2017 to this effect was sent to the complainant. In view of the facts explained above, the complainant has not complied with the formalities for the settlement of the claim i.e. did not get the vehicle repaired and failed to submit the repair bills of the vehicle with the company and as such, the claim file of the complainant was rightly closed by the OPs. It is further alleged that the complainant has not come to the Forum with clean hands and as such, he is not entitled for the relief and even the complainant has not completed the formalities for the settlement of claim. On merits, it is admitted that the complainant got insured his vehicle with the OP and it is also admitted that the vehicle of the complainant was met with an accident and claim was submitted, but thereafter, the complainant himself did not complete the formalities for settlement of the claim. The other allegations as made in the complaint are categorically denied and lastly submitted that the complaint of the complainant is without merit and the same may be dismissed.

5. In order to prove the case of the complainant, the complainant himself tendered into evidence affidavit Ex.CA along with documents Ex.C-1 Insurance Policy, Ex.C-2 Estimate Loss of the Vehicle, Ex.C-3 Copy of the DDR, Ex.C-4 Copy of RC of the vehicle and Ex.C-5 Copy of Driving License of the complainant and then closed the evidence.

6. Similarly, counsel for the OP No.1 and 2 tendered into evidence affidavit of Sunita Saini, Branch Manager as Ex.OA and affidavit of Arun Kumar, Surveyor as Ex.OB along with some letters and documents Ex.O-1 to Ex.O-13 and then closed the evidence.

7. We have heard the learned counsel for the respective parties and also gone through the case file very minutely.

8. There is no dispute between the parties that the vehicle owned by the complainant, got insured with the OP after paying the premium and the said policy period was 07.12.2015 to 06.12.2016 and further it is also not in dispute that the vehicle in question was met with an accident on 28.07.2016 and got a loss to the vehicle and it was inspected by the Surveyor appointed by the OP and claim of the complainant was closed as No Claim on the ground that the complainant did not submit the documents as well as failed to comply the other formalities.

9. We have analyzed the respective submissions of both the counsel for the parties and find that the complainant alleged that the vehicle has been totally damaged and its repair cost have been estimated by M/s Kosmo Tata Pvt. Ltd. Workshop to the tune of Rs.5,00,000/- and to this effect, the complainant has proved on the file Estimate Report Ex.C-2 of the said company. We have gone through the Estimate Report Ex.C-2 and find that the same does not having the name of the Kosmo Company nor having the insurance policy number of the complainant even the vehicle number is not mentioned on the said estimated report, so in the absence of these significant features, how we can assume that the said estimate report Ex.C-2 is having concerned with the vehicle of the complainant, rather from any angle, the said estimated report having no connection with the vehicle of the complainant and as such, we find that the complainant is not cooperating with the insurance company rather claiming the amount of the IDV i.e. Rs.3,50,000/-, whereas as per insurance terms and conditions of the insurance policy, the complainant is entitled for the amount of damages caused to the insured vehicle. In case, the vehicle is declared totally damaged, then the complainant will become entitle to recover the IDV, but in this case, there is no such type of evidence brought on the file by the complainant to prove that the vehicle in question has been fully damaged. Moreover, the report Ex.C-2 proved on the file by the complainant, is not related to the vehicle in any way, so under these circumstances, we find that the letter sent by the complainant i.e. Ex.O-4 that cashless claim of the complainant have been declined by the competent authority and as such, the complainant was asked to get repaired his vehicle from the workshop and submitted bill, so that the insurance claim of the complainant will be settled. Regarding that the OP sent so many letters i.e. Ex.O-5 to Ex.O-9, but the complainant did not bother to get repair the vehicle despite repeated reminders of the OP as well as Surveyor and as such, we find that there is no deficiency in service on the part of the OPs rather the complainant himself not cooperating with the OP and as such, we reach to the conclusion that the complainant may either get the amount assessed by the Surveyor in his report Ex.O-13 i.e. Rs.1,93,917.15 or to get repaired the vehicle from any authorized workshop and submit the bill to the Insurance Company, who will pay the said amount and accordingly, this complaint of the complainant is disposed of with no order of cost, compensation as well as litigation expenses. The complaint could not be decided within stipulated time frame due to rush of work.

10. Copies of the order be supplied to the parties free of cost, as per Rules. File be indexed and consigned to the record room.

Dated Harvimal Dogra Karnail Singh

10.07.2018 Member President