Complainant Bhavneet Marwaha  through the present complaint has sought the necessary directions to the opposite parties to pay  his claim alongwith interest @ 18% per annum from the  date of accident till its realization alongwith Rs.50,000/- as suffering him in the hands of the opposite parties for his mental and physical harassment and Rs.20,000/- as litigation expenses.

2.      The case of the complainant in brief is that he is owner of Maruti Ertiga VDI BS-IV Model 2012 having Engine No.1961253, Chasis No.138690 bearing Registration no.PB 06 T 5901. On 29.03.2017, his vehicle met with an accident near Bye Pass Scheme No.7 when his driver Ladi Masih son of Sadiq Masih resident of Shehzada Nangal Gurdaspur was coming from Kahnuwan to Gurdaspur and when he crossed Aujla Over Bridge and reached near office of Electricity Board Scheme No.7 Improvement Trust Gurdaspur, two trucks were coming from the back of said Ertiga Vehicle and they were driven by their driver very rashly and negligently and they were trying to overtake and at that time his vehicle has run down from the metaled road to the Kachha Path and struck against the trees resulting him total loss of the said Ertiga. Necessary DDR No.21 dated 30.03.2017 was recorded by the Police.  The vehicle owned by him was duly insured with the opposite party no.1 and 2 and he has logged the claim with the opposite party as the vehicle has been damaged totally and the opposite party has assessed the claim of the said vehicle as Rs.4,08,348/-. All the formalities claimed by the opposite parties has been completed by him but the opposite party illegally and arbitrarily repudiated his claim on the basis that the driving license of the driver is fake which fact is wrong. The driver Ladi Masih son of Sadiq Masih was holding legal and valid license duly issued by the License Authority/D.T.O. Gurdaspur and which is valid upto 24.10.2022. The opposite party has deliberately repudiated his genuine legal and valid claim. Thus, there is deficiency in service on the part of the opposite parties. Hence this complaint.

3.          Upon notice, the opposite parties appeared and filed its written version through its counsel, taking the preliminary objection that the complaint is not maintainable and there is no such contract of indemnity between the insured and opposite party and no such policy has been issued by the opposite party covering any such risk nor the alleged risk is covered as per terms and conditions of the insurance policy, moreover there are also breach and violations of the terms and conditions of the insurance policy as such the claim is not maintainable and opposite party has got no liability in this claim. On merits, it was submitted that the claim of complainant had been repudiated by the opposite party after due application of mind by the competent Authority as the driver of vehicle was not holding and possessing a valid, genuine, effective and proper driving license issued by the competent Authority and thus the opposite party was within their rights and in view of the specific report on D/L of the driver the claim was repudiated by the opposite party. However, after receiving information from the insured regarding the occurrence on 29.3.2017 and as such loss/damage to the vehicle. Immediately Er. Inderbir Singh surveyor and loss assessor, Gurdaspur was appointed for spot verification who after his personal visit to spot regarding  occurrence and damage etc. and had also collected documents from Insured i.e. D/L, R/C and Policy and submitted his report on 3.4.2017. Later on subsequently as per report of Er.Arun Udhey Singh surveyor and loss assessor who had assessed the loss and  as per his detailed report submitted on loss to opposite party on 10.5.2017 for Rs.3,53,348.00 and based on his report  the committee agreed to approve the loss to the tune of Rs.3,53,300/- on net off salvage basis and on completion of committee and agreed with it. However it is made clear that the competent Authority of the company is not bound by the committee report or to pay the same at the liability of the company it is subject to the terms and conditions and stipulation of the insurance policy and the approval of the competent authority is mandatory. It has further submitted that later on the Driving license of driver was got verified from the concerned issuing authority by the investigator of insurance company who after the investigation on the  Driving license of the Driver of vehicle Sh.Laddi son of Sadiq Masih  was found to be fake as the same was got verified from the issuing license authority Gurdaspur on the driving license of the Laddi submitted to the insurance company on reporting of loss, thus said Driving license of Driver was fake and hence there being breach of term and condition of policy the claim was found not payable and hence the claim by the  competent authority of the company after due application of mind in view of the abovesaid report had repudiated claim on 27.6.2017. Thus, the claim was found not payable and the insured was duly informed with regard to the same as per repudiation letter issued to the insured/owner dated 27.6.2017 who thereafter had filed the present complaint. The same is not maintainable against the opposite party.  All other averments made in the complaint has been vehemently denied and lastly prayed that the complaint may be dismissed with costs.

4.       Complainant tendered into evidence his own affidavit Ex.CW1/A   along with other documents exhibited as Ex.C1 to Ex C5 and closed the evidence.

5.      Counsel for the opposite parties tendered into evidence affidavit of Er.Rajesh Kumar Soni, Surveyor Ex.OP-1 and of Sh.Kuldip Raj Sr. Divisional Manager Ex.OP-5 alongwith other documents Ex.OP-2 to Ex. OP-4 and Ex.OP-6 to Ex.OP-15 and closed the evidence.

6.       We have carefully examined all the documents/evidence produced on record and have also judiciously considered and perused the arguments duly put forth by the learned counsels along with the incidental scope of adverse inference for of some documents that have been somehow ignored to be produced by the contesting litigants. We observe that the prime dispute prompted at the impugned ‘repudiation’ dated 27.06.2017 of the total-loss accident claim pertaining to the insured ‘Maruti Ertiga BS-IV’ vehicle alleging that the Car Driver held and submitted ‘fake’ D L (Driving - License) along with the impugned claim. Further, the OP insurers appointed its Surveyor to assess the ‘damage’ caused to the car who assessed the loss @ 353,300/- on net off salvage basis and the same was mutually acceptable till the investigators submitted the report of ‘fake’ DL as held by the Driver.

7.       The complainant besides his own affidavit Ex.Cw1/A has produced (Ex.C2 to Ex.C5) its supporting documents to prove his complaint contented charges/allegations/claims. On the other hand, the o. n. p. (onus of proof) to the alleged falsity of ‘fake’ license laid heavily upon the OP insurers who produced OP’s Div. Manager’s and Surveyor’s affidavits (Ex.OP5 & Ex.OP1) deposing the falsity of ‘Driver License’ and the contents of ‘written statement’, respectively; and also the other supporting documents exhibited here as: Ex.OP2 to Ex.OP4 and Ex.OP6 to Ex.OP15. We find that the OP insurers through its surveyor letters (Ex.OP2 and Ex.OP4) have proved the particulars of some other DL as ‘fake’ and not that of the one (Ex.OP3) as produced on the records and as held by the Driver at the time of accident. The Surveyor has mentioned different particulars in reports (date as: 28.07.2004 instead of 13.08.2004 & validity as: 27.07.2024 instead of 24.10.2022) than that provided on the DL and thus the OP insurers have failed to prove its allegation of ‘Fake’ DL (driving license) through a valid and acceptable investigation results and as such the impugned ‘repudiation’ shall not be maintainable in the eyes of law is hereby set-aside.

8.       The analytic evaluation of the available evidence indicates of an arbitrary and hasty ‘repudiation’ since the allegation of ‘fake DL’ could not be cogently proved through some apparently reliable and acceptable evidence. Thus, we find that the instant repudiation rakes up the OP insurers to an adverse statutory award under the applicable statute. Further, in the absence of some cogent or other evidence the ‘additional-pleas’ of absence of fitness-certificate, route-permit and proper registration certificate along with other violations of the M V Act do not hold water and are liable to be dismissed as ‘bald’ statements, only.

9.       The learned counsel for the OP insurers in his endeavor to justify and support the impugned ‘repudiation’ has referred the apex court ‘judgment-orders’ in SLP 31406/2017 titled M S Middle High School vs. HDFC Ergo Gen Ins. Co Ltd., AND that of the NCDRC’s Orders in RP 2874 of 2014 titled: MRH Associates vs. National Ins. Co. Ltd. And Others; little realizing that in both the above cases the DL (Driving License) stood proved ‘fake’ on the records whereas here in the present complaint the OP insurers have not been able to prove the falsity of the related DL and somehow have been adventuring with particulars different from the DL accompanying the claim, as logged in by the complainant.        

10.     In the light of the all above, we partly allow the present complaint and thus ORDER the titled OP insurers to pay the claim in terms of the surveyor assessed amount I.e Rs.3,53,300/-  and also in conformity to the terms of the applicable insurance Policy to the present complainant besides to pay him Rs.5,000/- as compensation (for making him suffer ‘delay’ and ‘harassment’) and Rs 3,000/- as cost of the present litigation within a period of 30 days of receipt of the copy of these orders otherwise the awarded amount shall attract interest @ 9% PA from the date of orders till actual payment.

11.     Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to records.   

                                                                         (Naveen Puri)

                                                                              President      

ANNOUNCED:                                                        (Jagdeep Kaur)

July,16 2018.                                                           Member

*MK*