Delhi

North

RBT/CC/261/2022

SACHIN GUPTA - Complainant(s)

Versus

NEW INDIA ASSURANCE COMPANY LTD - Opp.Party(s)

01 Jul 2024

ORDER

District Consumer Disputes Redressal Commission-I (North District)

[Govt. of NCT of Delhi]

Ground Floor, Court Annexe -2 Building, Tis Hazari Court Complex, Delhi- 110054

RBT/CC No/261/2022

                                                                                     [DCDRC-V CC No.365/2018]

In the matter of

Sh. Sachin Gupta  

R/o SE-19, 2^nd floor

Singal Pur Extension

Shalimar Bagh, Delhi-88                                                                   ...Complainant

Versus

The New India Assurance Company Limited

A-2/3, Lusa Tower, Azadpur, Delhi

Also at:

Regional Office-2

Core-1, 10^th floor, Scope Minar

Laxmi Nagar, District Centre, Delhi                                                 ...Opposite party

           

ORDER
01/07/2024

Ms.Harpreet Kaur Charya, Member

The present complaint has been received by way of transfer vide order No.F.1/SCDRC/Admn./Transfer/2022/330 dated 16/04/2022 of Hon’ble Delhi State Consumer Dispute Redressal Commission, where the matter was transferred from DCDRC-V (North West) to this Commission. 

1. This complaint has been filed by Sh. Sachin Gupta, the Complainant, alleging deficiency in services against, The New India Assurance Co. Ltd., Opposite Party (OP).  
2. Facts necessary for the disposal of the present complaint are, the Complainant being the registered owner of Chevrolet Optra bearing Registration No.DL-4CAD-1405, got it insured from OP vide Policy No.32161131150100000366 for the  period 30/03/2016 to 30/03/2017 (sic).
3. On 28/12/2016, the insured vehicle, while being driven by the relative of the complainant, met with an accident at Bawana, Delhi.  OP was duly informed and surveyor, Sh. Udayveer Singh was appointed.  On 03/01/2017, the surveyor inspected the vehicle at Laxmi Automobiles.  It has been alleged by the complainant that as the surveyor did not settle the claim in writing, thus, the repairs could not be started. 
4. An email dated 09/01/2017, was sent to the surveyor for settlement/approval of the repairs which was replied by the surveyor via emails dated 10/01/2017 and 11/01/2017 raising certain queries. The said queries were replied through emails dated 12/01/2017, however, the claim was not settled. Again, emails dated 20/03/2017 and 22/03/2017 were sent to the OP and surveyor.
5. As the claim was not settled by OP, on 25/03/2017, the workshop demanded parking charges @Rs.100/- per day.  Thereafter, the complainant appointed an independent surveyor at his own cost and paid Rs.4,090/-.  The complainant paid Rs.1,41,538/- in cash to M/s Laxmi Automobiles and Global Spares. Rs.8,700/- were also paid as parking charges from 28/12/2016 to 24/03/2017.
6. Despite several personal visits and telephonic reminders, OP did not settle the claim. Hence, the present complaint with the prayer for directions to OP to pay Rs.1,41,538/ paid to the repairer in cash to M/s Laxmi Automobiles  and Global spares and Rs,8,700/- paid on account of parking charges Rs.100/- per day for period 28/12/2016 to 24/03/2017 ; Rs.4,090/- paid as surveyor fees; interest @24% p.a. on the cost of repair from the date of accident till realization; Rs.1,80,000/- on account of mental agony and Rs.50,000/- as cost of litigation.
7. The complainant has annexed the policy schedule cum certificate as Annexure-C-1; registration certificate as Annexure-C-2; driving license of his relative as Annexure-C-3; claim intimation letter to OP dated 30/12/2016 as Annexure-C-4; Motor Vehicle Claim Form, estimate issued by M/s Laxmi Automobiles  emails dated 09/01/2017, 10/01/2017, 11/01/2017, 12/01/2017, 20/03/2017, 22/03/2017, Copy of RTI and surveyor report dated 18/01/2017 as  Annexure-C-5.  Cash memos dated 15/04/2017 and 28/04/2017 for repairs and parking charges issued by M/s Laxmi Automobiles, cash memo issued by Global Spare dated 28/03/2017, report of the surveyor appointed by the complainant, re-inspection report and survey fee bill as Annexure-C-6.
8.  Notice of the present complaint was issued to OP. 
9. Written statement has been filed on behalf of OP, where they have raised preliminary objections such as the surveyor was appointed and the complainant to fail to provide the requisite documents as requested vide letter dated 24/04/2017. It has been denied that the complainant is the owner of the vehicle as no ownership document was submitted at the time of taking insurance cover. Damage to the vehicle on 28/12/2016 in accident has been denied. It has also been denied that the insured vehicle is not in roadworthy condition and is a case of complete loss.
10. It has been submitted that complainant had availed the coverage of 11 years old vehicle from Muradnagar Office of OP despite the fact that the complainant is residing in Delhi.  Intimation of the claim has been admitted.
11. The surveyor after examining the vehicle had submitted his report dated 18/01/2017. As per the surveyor, the information provided by the complainant that one Sh. Pramod Kumar was driving the insured vehicle and suddenly stray cattle, who were fighting hit the car from left side and in order the save the car he steered the vehicle to the right side, which resulted in collusion with another car.  Admittedly the incident was not reported to the police nor was any spot survey obtained.
12. The surveyor assessed the loss of Rs.14,893.75P . Despite repeated requests the complainant did not take the surveyor to the spot of the alleged incident.  It has been further submitted that the address of the repairer and insured is same and it was the second claim made by the complainant with similar damages and similar loss.  Since the loss seemed to be manipulated, the surveyor after examining the previous claim file had made various observations as follows:-

1. There is no contact number mentioned neither in the previous claim form nor in this claim form.
2. The address of the insured mentioned on the claim form, policy and RC is SE-19 IInd floor, Shalimar Bagh, Delhi while address of the repairer is      SE-19, Shalimar Bagh, Delhi.
3. The writing/style of signature of insured on the claim form and name written on the estimate in the column of registered owner name is same.
4. Insured is not ready to get our visit to the place of accident.
5. We have sent email and a registered letter on 10/01/2017 and 11/01/2017 requesting him to give us the contact no, copy of pan card and fix a meeting to the spot.
6. The cause of accident in previous claim file was left side hit by buffalos and now in this claim vehicle’s left side hit by stray cattle.
7. Previous accident took place at Sampla and vehicle went for repair at Laxmi Automobiles branch located at Bahadurgarh NIA Branch.

13. Since the complainant had already taken a claim of Rs.83,000/- under the same policy, thus clarification was sought.  The complainant had also lodged a claim with Oriental Insurance Co. on the same car which was repudiated.  OP has further submitted that in a separate claim the complainant’s brother (Jatin Gupta) had shown complainant driving his 12 years old car and the cause of accident was same as in the two claims as of the complainant.
14. The claim was to be settled after the repairs have been carried out by the complainant.
15. The complainant has tried to gain unlawfully by fabricating and forging the loss; the complainant has not approached the commission with clean hands and has concealed material fact.  Rest of the contents of the complaint have been denied with the prayer for dismissing the complaint with cost. 
16. Rejoinder to the written statement was filed by the complainant.  It has been stated that the agent of the OP had collected the premium and got the policy issued from the office of the OP at Muradnagar for which complaint was made to OP, however no action was taken against the agent.
17. It has been further submitted by the complainant that police report was not mandatory as per IRDA guidelines as no third party loss from the insured vehicle was there at the time of accident. The damages and place of accident were not similar as alleged by the OP.
18. Evidence by way of affidavit has been filed by the parties. Complainant has got himself examined and repeated the contents of his complaint. 
19. The complainant has also got examined Sh.Rajkumar Singh, Surveyor and loss Assessor appointed by him in support of his allegation. It has been deposed that he had visited the workshop on 25/03/2017 for survey and inspected the vehicle and also the photographs.  He has further deposed that he had assessed the loss for a sum of Rs.1,01,000/- and submitted the re-inspection report dated 22/04/2017.
20. OP has got examined Ms. Monika Goyal, AO, Legal on their behalf.  She has also reiterated the submission made in the written statement and has got exhibited the surveyor report dated 18/01/2017 by M/s Udayveer & Associates as Ex.R-2.  As the claim filed by the complainant does not appear to be genuine at the recommendations of the surveyor and the complainant failed to provide requisite documents for the settlement of the claim, the same was repudiated. 
21. OP has also relied upon the re-inspection report dated 22/02/2017 by Sh. Rajiv Gaur and the same is exhibited as Ex.R-3, letter dated 17/01/2017 as Ex.R-4 and another letter as Ex.R-5.
22. We have heard the arguments of Ld. Counsels for the respective parties and have perused the material placed on record. The complainant has alleged that OP did not settle his claim for repairs.  The date of accident is 28/12/2016; survey was conducted on 03/01/2017.  On 09/01/2017, the complainant through an email requested for an approval for repairs which has been duly replied by Sh.Udaiveer Singh, Surveyor vide email dated 10/01/2017 denying the settlement of the claim.  The complainant has been also requested to send the copy of the PAN Card and to fix meeting to visit at the place of accident.  It further states “we will settle your claim as early as possible after visit of the spot, till then hold the vehicle for repair”. 
23. However, in para 8 of the complaint, it has been alleged by the complainant that OP has not settled the claim despite submitting all the papers, but at the same time, OP in para 2 of the Preliminary objections of Written statement has stated: “Since no amount was payable under the policy and claim as made out already stood repudiated accordingly the present complaint is devoid of any merits and liable to be dismissed.”
24. Further, in para 7 of the OP evidence it has been reiterated that since the complainant failed to provide the requisite documents and complainant earlier also managed to obtain a frivolous claim accordingly the claim as made out by the complainant did not appeared to be genuine accordingly the same was repudiated.
25. OP has neither mentioned any date of rejection of claim nor the grounds of repudiation. Even, repudiation letter has not been filed by either of the parties. In absence of any document on record indicating repudiation of claim by OP, we cannot accept the contention of the OP that the claim has been repudiated. Hence, we here by direct OP to re-examine the claim filed by the complainant and convey its decision to the complainant with in a period of 30 days from the date of receipt of this order.
26. The present complaint is disposed of with above direction, without orders to cost.
27. Office is directed to supply the copy of this order to the parties as per rules. Order be also uploaded on the website.  Thereafter, file be consigned to the record room.

 

 

(Harpreet Kaur Charya)              Member	(Ashwani Kumar Mehta)             Member   (Divya Jyoti Jaipuriar)           President