Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 459.
Instituted on : 09.08.2017.
Decided on : 01.07.2019.
Dharambir s/o Sh. Sat Narain r/o Vill. Pauli Tehsil Julana District Jind.
………..Complainant.
Vs.
- The New India Assurance Company Ltd., Rohtak through its Branch Manager.
- The Divisional Manager, The New India Assurance Company Ltd., Divisional Office, 313, Model Town, Delhi Road, Rohtak.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
SH. VED PAL, MEMBER.
DR. RENU CHAUDHARY, MEMBER.
Present: Sh. Deepak Dixit, Advocate for complainant.
Sh.Deepak Bhardwaj, Advocate for opposite parties.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that complainant is registered owner of vehicle bearing no.HR-56B-3168 which was insured with the opposite party vide policy no.35380031160100001099 valid from 02.05.2016 to 01.05.2017. That on 08.02.2017, the said vehicle met with an accident Near Kanakwali(Maharashtra) and due to this accident, body/cabin of the above said vehicle got badly damaged. The OPs were intimated immediately after the accident through loss/damage intimation letter and motor claim form was also submitted with requisite documents. An FIR No.62 dated 08.02.2017 has been registered. That the spot survey was conducted by the surveyor of the opposite parties. Thereafter, the said vehicle was brought to Shubham Motor Store, G.T.Road, Moga(Pb.) and the complainant had incurred Rs.428187/- and further Rs.125000/- in preparing the new body of the said vehicle at Rohtak. That complainant submitted all the documents to the opposite party for getting the claim of vehicle. That complainant also served a legal notice dated 07.06.2017 to the opposite parties but the opposite parties have not made the payment of the amount of claim nor have replied the notice till date. That the act of opposite parties is illegal and amounts to deficiency in service. Hence this complaint and the complainant has prayed for directing the opposite parties to pay the claim of Rs.553187/- alongwith interest, compensation and litigation expenses to the complainant as explained in relief clause.
2 After registration of complaint, notice was issued to the opposite parties. Opposite parties appeared and filed their written reply submitting therein that on receiving the information about the accident, the opposite parties appoint Sh. D.R.Gupta, Surveyor, Loss Assessor, who submitted his report on dated 20.10.2017. The claim of the complainant is still under process because during processing the claim, it came into light that the complainant did not disclose the actual facts in the claim form and concealed the facts at the time of lodging claim from the insurance company which is breach of terms and conditions of the policy. It is not disclosed in the claim form that FIR No.62 dated 08.02.2017 u/s 279/337/184/IPC P.S.Kanakwali was got registered against the driver of the insured vehicle, in which the insured vehicle got damaged. Moreover, there is a delay of 37 days in intimating the insurance company i.e. answering opposite party. That complainant has not submitted the required documents, due to which the claim file of the insured i.e. complainant is still pending. All the other contents of the complaint were stated to be wrong and denied. Opposite parties prayed for dismissal of complaint with costs..
3. Ld. counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, documents Ex.C1 to Ex.C15 and has closed his evidence on dated 17.10.2018. Ld. counsel for the opposite party has tendered affidavit Ex.RW1/A, documents Ex.R1 to Ex.R5 and has closed his evidence on dated 22.05.2019.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. In the present case, the claim of the complainant has been repudiated by the opposite parties on the ground that the complainant has not come before the Forum with clean hands and suppressed the material facts, and the claim is still under process. Moreover, there is delay of 37 days in giving intimation to the opposite party. Perusal of the documents shows that the accident had taken place on 08.02.2017 and the surveyor Sh. Daya Ram Gupta submitted his report on 20.10.2017. As per the respondent officials, the complainant has intimated regarding the accident of vehicle belatedly i.e. after 37 days after the accident but as per the complainant, he submitted in para no.3 of the complaint that after receiving the information regarding the accident, respondent officials surveyed the complainant’s vehicle on the spot and a spot survey was conducted and regarding the accident, an FIR was also got registered. Generally when FIR was registered regarding the accident, the insurance company deputed the surveyor regarding the spot survey. Meaning thereby the complainant’s vehicle was also surveyed by the surveyor at the spot. Regarding the delayed intimation to the opposite party, we have placed reliance upon the order of Hon’ble State Commission, Haryana, Panchkula decided on 20.09.2018 by titled as Cholamandalam MS General Insurance Co. Ltd. vs. Baljeet Singh and order dated 20.08.2018 titled as Iffco Tokio General Insurance Co. Vs. Balwant Rai, whereby it is held that: “It is very clear from the circular of IRDA that the insurance company cannot repudiate the bonafide claims on technical grounds like delay in intimation and submission of some required documents. The decision of insurers to reject a claim of the claimant should be based on sound logic and valid grounds. The limitation clause does not work in isolation and is not absolute”. Reliance has also been placed upon the letter No.IDA/HLTH/ MISC/CIR.216/09/2011 dated 20.09.2011 and the same is fully applicable on the facts and circumstances of the case.
6. In the present complaint, the vehicle met with an accident in Maharashtra and thereafter the damaged vehicle was brought by the complainant for repair at Rohtak where the vehicle was re-inspected and survey was conducted by surveyor Sh. Daya ram Gupta which shows that the survey was conducted at the spot and the re-inspection of the vehicle was also conducted. As per the complainant, he had spent an amount of Rs.553187/- on the repair of the vehicle. Complainant’s vehicle was repaired at G.T.Road, Moga and thereafter at Mohan Tractor Pvt. Ltd. at Rohtak and the surveyor has assessed the loss of Rs.172326./- only.
7. The respondent also issued a letter dated 06.11.2017 Ex.R5 and through this letter, the respondent officials demanded the driving license of Dharambir, copy of log book/load challan, clarification regarding the fact that the complainant has not conducted the spot survey and also demanded the details of the bank account of the complainant alongwith IFSC and MICR code. Through this letter dated 06.11.2017 the respondent officials demanded the driving licence of driver Dharambir, whereas as per survey report Ex.R4, the whole detail regarding the driver and the driving licence had already been mentioned in the report which was submitted by the surveyor before the insurance company on 20.10.2017. Meaning thereby, the respondent officials intentionally and without any cogent reason had delayed the claim of the complainant. which amounts to deficiency in service on the part of opposite parties. Hence the complainant is entitled for the amount of loss as assessed by the surveyor.
8. In view of the facts and circumstances of the case we hereby allow the complaint and direct the opposite parties to pay Rs.172326/- (Rupees one lac seventy two thousand three hundred twenty six only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 09.08.2017 till its realization and shall also pay Rs.5000/-(Rupees five thousand only) as compensation and litigation expenses to the complainant within one month from the date of decision.
9. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
01.07.2019.
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Nagender Singh Kadian, President
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Ved Pal, Member.
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Renu Chaudhary, Member.
