DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BARNALA, PUNJAB.

Complaint Case No : CC/36/2022

Date of Institution   : 27.01.2022

Date of Decision    : 12.06.2024

Amar Singh son of Shimbu Dayal resident of Pandhi Scan Centre, Barnala, Tehsil and District Barnala.            

                          …Complainant Versus

1. New India Assurance Company Ltd. Sangrur through its Development Officer/Branch Manager. 

2. New India Assurance Company Ltd. Sangrur Regd. & Head Office New India Assurance Bldg. 87 MG Road, Fort, Mumbai-400001. 

                            …Opposite Parties

Complaint Under Section 35 of Consumer Protection Act, 2019.

Present: Sh. Vijay Singh Poonia counsel for complainant.

Sh. Anuj Mohan counsel for opposite parties.

Quorum:-

1. Sh. Jot Naranjan Singh Gill : President

2.Smt. Urmila Kumari : Member

3.Sh. Navdeep Kumar Garg : Member

ORDER

JOT NARANJAN SINGH GILL, PRESIDENT

1. The complainant namely Amar Singh has filed the present complaint under Section 35 of the Consumer Protection Act 2019, (amended upto date) against New India Assurance Company Ltd. & others (hereinafter referred as opposite parties).  

2. The facts leading to the present complaint are that the complainant has got insured his vehicle Maruti Swift VXI bearing registration No. PB-19U-0605 from the opposite parties for the period from 23.4.2021 to 22.4.2022 and had duly paid the insurance premium against said insurance against which a policy bearing No. 9800003121091012777 was issued by opposite parties. It is further alleged that on 5.7.2021 the said vehicle of the complainant met with an accident near Shahjehanpur Flyover at Rajasthan and to this effect the complainant had duly intimated the opposite parties and lodged the insurance claim with the opposite parties and in this regard the opposite parties issued claim No. 98000031210390003745. The complainant got repaired the said vehicle from Saradhna Motors, N-8, Opposite Power House Delhi Road Kotputli, Jaipur (Rajasthan) on which an amount of Rs. 1,44,732/- was spent on the repair of the vehicle. The complainant had paid the said amount of Rs. 1,44,732/- to said Saradhna Motors. It is alleged that the complainant had already submitted all the requisite documents with the opposite parties for the disbursal of the amount of said insurance. The opposite parties with malafide and dishonest intentions has wrongly closed the said claim of the complainant vide letter dated 9.12.2021 and wrongly mentioned that the complainant had withdrawn his claim by giving his consent through undated letter. The complainant requested the opposite parties to issue disbursal of the claim amount but the opposite parties flatly refused to accede the request of the complainant. The complainant also got served a legal notice dated 20.12.2021 upon the opposite parties but the opposite parties did not redress the grievance of the complainant. The said act of the opposite parties amounts to deficiency in service and unfair trade practice. Hence, the present complaint is filed for seeking the following reliefs.- 

i)To release/disburse the claim amount of Rs. 1,44,732/- alongwith interest to the complainant.   

ii)To pay Rs. 1,00,000/- as compensation for causing physical pain, mental agony, inconvenience and financial loss and Rs. 20,000/- as litigation expenses.   

3. Upon notice of this complaint, the opposite parties appeared and filed written version by taking preliminary objections interalia on the grounds that the present complaint is not maintainable. The complainant has concealed the true and material facts from this Commission. This Commission has got no jurisdiction to try and decide the present complaint. The complainant unnecessarily dragged the opposite parties into uncalled litigation. The complainant has got no locus-standi and cause of action etc. 

4. On merits, it is submitted that the opposite parties repudiated the claim of the complainant because at the time of accident the complainant was brought to Kailash Super Specialty Hospital, Behror in a drunkard condition by his two colleagues, who were also under the influence of liquor. This fact was also declared by Dr. Abhay Dhanwal who treated the complainant at said hospital and in this regard doctor issued letter dated 25.10.2021 & 2.11.2021. The said act and conduct of the complainant against the terms and conditions of the insurance policy. Moreover, the office of the opposite parties situated at Behror sent a letter dated 17.11.2021 to the complainant to provide his medical details, but the complainant failed to provide the said information to the said office. The opposite parties also sent a registered AD to the complainant regarding the repudiation of his claim. It is further submitted that the reply to the legal notice was sent to the complainant through registered post. All other allegations of the complainant are denied and prayed for the dismissal of complaint with costs.  

5. Ld. Counsel for the complainant has filed rejoinder to the written version filed by opposite parties and denied the averments as mentioned in the reply.  

6. To prove the case the complainant tendered into evidence his own affidavit Ex.C-1, copy of policy schedule Ex.C-2, copy of RC Ex.C-3, copy of Invoice Ex.C-4 (containing 4 pages), copy of letter dated 11.10.2021 Ex.C-5, copy of letter dated 9.12.2021 Ex.C-6 (containing 2 pages), legal notice Ex.C-7, postal receipts Ex.C-8 & Ex.C-9 and closed the evidence. 

7. To rebut the case the opposite parties tendered into evidence affidavit of Narinder Singal Ex.O.Ps-1, copy of policy Ex.O.Ps-2 (containing 2 pages), copy of investigation report Ex.O.Ps-3 (containing 4 pages), copies of prescription slips Ex.O.Ps-4 to Ex.O.Ps-6 and closed the evidence. 

8. We have heard the learned counsel for the parties and have gone through the record on file. Written arguments filed by complainant.

9. Ld. Counsel for the complainant argued that the complainant has got insured his vehicle Maruti Swift VXI bearing registration No. PB-19U-0605 (Ex.C-3) from the opposite parties for the period from 23.4.2021 to 22.4.2022 and had duly paid the insurance premium against said insurance against which a policy bearing No. 98000031210910127775 was issued by opposite parties (Ex.C-2). It is further argued that on 5.7.2021 the said vehicle of the complainant met with an accident near Shahjehanpur Flyover at Rajasthan and to this effect the complainant had duly intimated the opposite parties and lodged the insurance claim with the opposite parties and in this regard the opposite parties issued claim No. 98000031210390003745 dated 11.10.2021 (Ex.C-5) and the complainant got repaired the said vehicle from Saradhna Motors, N-8, Opposite Power House Delhi Road Kotputli, Jaipur (Rajasthan) on which an amount of Rs. 1,44,732/- was spent on the repair of the vehicle (Ex.C-4). It is argued that the complainant had already submitted all the requisite documents with the opposite parties for the disbursal of the amount of said insurance but the opposite parties with malafide and dishonest intentions has wrongly closed the said claim of the complainant vide letter dated 9.12.2021 (Ex.C-6) and wrongly mentioned that the complainant had withdrawn his claim by giving his consent through undated letter. It is also argued that the complainant also got served a legal notice dated 20.12.2021 Ex.C-7 upon the opposite parties but the opposite parties did not redress the grievance of the complainant.

10. Ld. Counsel for the opposite parties argued that the opposite parties repudiated the claim of the complainant because at the time of accident the complainant was brought to Kailash Super Specialty Hospital, Behror in a drunkard condition by his two colleagues, who were also under the influence of liquor and this fact was also declared by Dr. Abhay Dhanwal who treated the complainant at said hospital and in this regard doctor issued letter dated 25.10.2021 & 2.11.2021 (Ex.O.Ps-4 & Ex.O.Ps-5) and the said act and conduct of the complainant is against the terms and conditions of the insurance policy. It is further argued that the office of the opposite parties situated at Behror sent a letter dated 17.11.2021 to the complainant to provide his medical details, but the complainant failed to provide the said information to the said office. 

11. It is admitted fact that the complainant has got insured his vehicle Maruti Swift VXI bearing registration No. PB-19U-0605 from the opposite parties for the period from 23.4.2021 to 22.4.2022 (Ex.C-2 & Ex.O.Ps-2). Ex.C-2 further shows under the head of Schedule of Premium in the column of Nil depreciation an amount of Rs. 3,022/- has been paid. Further, in Ex.O.Ps-2 against the column Nil depreciation Yes is mentioned. It means that the Nil depreciation policy was issued by the opposite parties to the complainant. The allegation of the complainant is that the opposite parties with malafide and dishonest intentions has wrongly closed the said claim of the complainant vide letter dated 9.12.2021 Ex.C-6 and wrongly mentioned that the complainant had withdrawn his claim by giving his consent through undated letter. We have gone through the letter date 9.12.2021 Ex.C-6 vide which at Para No. 2 of the letter it is mentioned “As you have withdrawn your claim by giving your consent through your letter dated_____we are closing your claim file as NO CLAIM”. Further, in Para No. 3 of the letter it is mentioned that we are closing your claim file on account of the following reason: Closed-No Claim not pursued by insured. But the opposite parties have failed to place on record the above said undated letter vide which the complainant has given his consent for closing the claim. 

12. Moreover, the allegation of the opposite parties is that the opposite parties repudiated the claim of the complainant because at the time of accident the complainant was brought to Kailash Super Specialty Hospital, Behror in a drunkard condition by his two colleagues, who were also under the influence of liquor. To support this allegation the opposite parties have placed on record Investigation Report dated 3.11.2021 Ex.O.Ps-3 of Er. Kapil Khatana vide which at Page No. 2 in the column of Points to noted:- at point No. 2 it is mentioned that Road side accident case came to hospital at about 11:30 PM Patient Alchol infulance positive + ( In primary observation). Unconscious state, multiple sign of injuries. Further, at the bottom of Page No. 2 in the column of Points to be noted at point No. 3 it is mentioned that Patient Amar Singh alcohol influence test not done by any means. (Blood test etc.) and at Point No. 4 it is mentioned that Patient alcohol influence not confirmed by the Doctor Abhay Dhanwal. Further, at Page No. 3 of the above said investigation report in the column of Points to Note:- at Point No. 3 it is mentioned that Patient was unconscious so, it was his primary thought that patient was also in the alcohol influenced. So, he wrote the same in his primary prescription. No test of investigation was done at the same time so, it was not confirmed from his side now. Further, in the column of Remarks:- it mentioned at Point No. 3 that No test facility was available in the same hospital which can prove the alcohol presence in the patient. Further, at Point No. 4 it is mentioned that No test was done by any of staff or Doctor for the alcohol presence for the patient Amar Singh. At Point No. 6 it is mentioned that At last it can't confirm from the Doctor side that the patient was in influence of the alcohol at the time of accident. So, from the perusal of the above said investigation report Ex.O.Ps-3 it cannot be ascertain that at the time of accident the patient was in the influence of alcohol because as per above said investigation report no blood/medical test in this regard was done by any of staff or doctor as is mentioned in the above said investigation report. Therefore, the above said allegation of the opposite parties is not tenable. Moreover, the opposite parties have also failed to place on record any evidence regarding the non submission of required documents from the side of complainant. So, we are of the view that the opposite parties have repudiated the claim of the complainant on such flimsy grounds and there is deficiency in service on the part of the opposite parties. On the other hand, the complainant to prove his claim has placed on record copy of Tax Invoice of Saradhna Motors Ex.C-4 which shows that the complainant has paid an amount of Rs. 1,44,732/- to the Saradhan Motors, N-8, Opposite Power House Delhi Road Kotputli, Jaipur (Rajasthan) for the repair of the above said vehicle and the complainant has paid the extra premium for Nil depreciation. 

13. In view of the above discussion, the present complaint is partly allowed and the opposite parties are directed to pay Rs. 1,44,732/- to the complainant alongwith interest @ 7% per annum from the date of filing the present complaint till its realization. The opposite parties are further directed to pay Rs. 10,000/- on the account of consolidated amount of compensation alongwith litigation expenses to the complainant. 

14. Compliance of the order be made within the period of 45 days from the date of the receipt of the copy of this order.

15. Copy of this order be supplied to the parties free of costs as per rules. File be consigned to the records after its due compliance. 

ANNOUNCED IN THE OPEN COMMISSION:

       12th Day of June, 2024

 

            (Jot Naranjan Singh Gill)

            President

 

(Urmila Kumari)

Member

 

(Navdeep Kumar Garg)

Member