BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint No.162 of 2019.
Date of instt.: 03.04.2019.
Date of Decision: 11.12.2019.
Surender Kumar son of Shri Ram Lal, resident of village & post office Khinaniya, Tehsil Tibbi, Distt. Hanumangarh.
……….Complainant.
Versus
- The New India Assurance Company Limited, through its Manager, Office at Old Suvidha Building Near Railway Crossing, Dabwali, Distt. Sirsa.
- The New India Assurance Company Limited, New India Assurance building, 87 MG Road, Mumbai, through its Managing Director.
..……..Opposite Parties.
COMPLAINT UNDER SECTION 12 OF CONSUMER PROTECTION ACT, 1986.
Before: SH.R.L.AHUJA…………………………PRESIDENT
MRS.SUKHDEEP KAUR………MEMBER.
Present: Shri B.L. Narula, Advocate for complainant.
Shri A.S. Kalra, Advocate for opposite parties.
ORDER
In brief, the case of the complainant is that he is registered owner of vehicle M&M Max Imo No. RJ-31GA/7740 and had purchased an insurance policy bearing no.53370231160100002607 from opposite party no.1 through authorized agent namely Pardeep Kumar for his said vehicle for a period of one year valid from 17.8.2016 to 16.8.2017. The insurance policy was a package policy covering all type of risk including the IDV value of Rs.3,30,000/- and complainant paid an amount of Rs.19,678/- as premium amount. That on 1.4.2017, the above said vehicle of complainant met with a road side accident and damaged badly. The complainant got lodged police report in police station Ellenabad vide FIR No.77 dated 22.6.2017 (actually it is 2.4.2017 as per copy of FIR), under Sections 279/337/338 IPC against the driver of the offending vehicle No. RJ -31CA/ 5703. After this, brother of complainant intimated the op about the accident immediately. It is further averred that in this accident, the complainant received serious, grievous and multiple injuries and facture on his person and he was shifted to Hospital for treatment and on 6.4.2017, when he was discharged from the hospital, he informed the op company about the said accident and damages to his vehicle. That after information, Mr. Kuldeep Kulria was appointed as Surveyor and Loss Assessor by op company to assess the loss suffered by the vehicle. Said Kuldeep Kulria conducted the spot survey and complainant handed over the copies of registration certificate, driving licence, insurance policy, fitness certificate etc. as demanded by him. That thereafter the complainant paid visit at the office of op company on many occasions but all in vain and ultimately Senior officer of the op company told the complainant that Kuldeep Kulria surveyor of the company has been changed and now Shri Harish Sethi surveyor and loss assessor is appointed and asked the complainant to approach him. After that complainant met with Mr. Harish Sethi and provided him all the relevant documents as demanded by him. He also clicked the photographs of damaged vehicle and also obtained quotation which was prepared by Garg Motors, Sirsa in which value of damage parts was shown Rs.2,52,660.16 and labour charges were shown as Rs.51,750/- and on the basis of said quotation, Mr. Harish Sethi estimated the loss of damaged vehicle as Rs.3,04,410.02 but assessed the loss as Rs.1,41,357/- only and he also obtained signature of complainant on blank papers which are still in possession of ops. It is further averred that thereafter instead of payment of genuine claim of complainant, the ops sent a letter dated 15.2.2018 which is based on frivolous facts and said letter was duly replied by complainant. That thereafter complainant took so many rounds to the ops and requested them for disbursement of claim amount but to no effect. That ultimately complainant got issued a legal notice upon ops but ops gave a false and frivolous reply and as such they have caused deficiency in service, unfair trade practice and harassment to the complainant. Hence, this complaint.
2. On notice, opposite parties appeared and filed written statement taking certain preliminary objections. It is submitted that spot survey has been avoided by complainant and documents were also not submitted to Surveyor Mr. Kuldeep Kulria and due to non-cooperation by complainant with Mr. Kuldeep Kulria, after receipt of claim intimation from through Garg Motors and after coming to know about shifting of vehicle here at Sirsa, another Surveyor Mr. Harish Sethi was appointed by answering ops. However, according to the assessment made by expert/ technical person, the liability on the part of answering ops for the damage was for Rs.1,41,357/- only but such type liability is satisfied by way of payment of claim to the insured subject to compliance of terms and conditions of policy. It is further submitted that complainant has not submitted/ supplied the documents showing and proving hospitalization and discharge on 6.4.2017. It is further submitted that it is wrong and incorrect that Kuldeep Kulria ever conducted the spot survey and complainant handed over the documents as alleged. That after receipt of claim intimation form through Garg motors, answering ops deputed the local surveyor Mr. Harish Sethi who inspected the vehicle on 23.6.2017 itself. Surveyor was asked to submit the report/ interim report within 24 hours by sending a mail on 22.6.2017, but as complainant did not get his vehicle repaired, so matter was kept pending by the surveyor for submitting the final assessment report to the company up till 30.1.2018 and surveyor in last submitted the report to answering ops mentioning therein loss assessed by him according to his expertise. It is further submitted that estimate is not assessment, as assessment by expert is the amount assessed by him to be incurred on the vehicle. If estimated amount is to be awarded/ granted, then there is no requirement of expert or specialist. It is further submitted that claim of complainant is time barred as policy period expired on 16.8.2017 and according to policy conditions, complaint is not maintainable. It is further submitted that complainant has violated the terms and conditions of the policy and also complainant neither approached the Arbitrator nor had obtained any award or had ever filed any suit or proceeding with regard to subject matter of complainant as per terms and conditions of the policy. It is also submitted that Mr. Harish Sethi, Surveyor is not employee of the company and he has not been impleaded and joined as party, so in his absence, no finding against him can be given. All other contents of complaint are also denied and prayer for dismissal of complaint made.
3. The parties then led their respective evidence.
4. We have heard learned counsel for the parties and have perused the case file carefully.
5. The complainant in order to prove his complaint has furnished his affidavit Ex.C1 in which he has deposed and reiterated all the averments made in the complaint. He has also furnished copy of legal notice, postal receipts, copies of letters, copies of applications, copy of certificate of fitness, copy of policy etc. as Ex.C20. On the other hand, ops produced affidavit of Sh. Karan Chauhdary, Senior Divisional Manager as Ex.R1 in which he has deposed and reiterated the averments made in the written statement. They have also tendered affidavit of Sh. Harish Sethi, Surveyor and Loss Assessor as Ex.R2 and policy documents as Ex.R3
6. It is an admitted fact between the parties that complainant is owner of vehicle bearing No. RJ- 31GA/ 7740 which was insured with the opposite parties for the period 17.8.2016 to 16.8.2017. It is proved on record that said vehicle met with an accident and FIR was lodged in the police station Ellenabad. Due intimation was given to the ops and spot survey was got conducted from the surveyor and thereafter final survey was got conducted by ops from Sh. Harish Sethi, Surveyor and Loss Assessor who submitted his detailed report by which he has assessed loss payable by ops to the tune of Rs.1,41,357/-.
7. During the course of arguments, learned counsel for complainant has strongly contended that loss was to the tune of Rs.3,04,410.02, but however, the Surveyor at the instance of insurance company has arbitrarily and illegally assessed the loss to the tune of Rs. 1,41,357/- and same has also not been paid despite getting payment voucher executed from the complainant which clearly amounts to deficiency in service and unfair trade practice on the part of ops.
8. On the other hand, learned counsel for ops has also strongly contended that complainant did not lodge intimation well in time and did not produce requisite documents and nor he produced repairing bill of the vehicle till date, as a result of which the ops were not in position to make payment of the amount of loss assessed by the Survyeor.
9. The perusal of record reveals that due intimation was given by complainant after the accident well in time and even spot survey was got conducted by ops through Surveyor Mr. Kuldeep Kulria and thereafter Sh. Harish Sethi, Surveyor was appointed who after considering all the facts and circumstances assessed loss to the tune of Rs.1,41,357/-. It is settled principle of law that insurance companies are bound to pay loss to the claimants/ complainant on the basis of the surveyor report but in the present case even said amount has not been paid by insurance company despite the fact that blank payment voucher was got signed from complainant which is on file.
10. Though, opposite parties have taken the plea that complainant has not submitted requisite documents and the repairing bills but the perusal of the record reveals that accident took place on 1.4.2017 and spot survey was got conducted on 2.4.2017 and requisite documents were supplied to the ops well in time as per their requirements which find mention in the report of the Surveyor/ Investigator who found the documents to be OK. Though, as per version of ops, repairing bill has not been supplied to the ops by complainant but it appears from the facts and circumstances of the present case that since amount of loss has not been paid to the complainant who has allegedly suffered loss of more than three lacs on account of damage to his vehicle, but however, surveyor has assessed loss to the tune of Rs.1,41,357/-. So, there are pecuniary circumstances under which ops should make the payment to the complainant who is facing hard time to run his family without his source of income which has been lost due to accident of his vehicle and in these circumstances, non payment of claim amount by ops clearly amounts to deficiency in service on the part of ops.
11. In view of above discussion, we allow this complaint and direct the opposite parties to settle and pay the claim of the complainant on the basis of surveyor’s report within 30 days from the date of receipt of copy of this order, failing which ops shall be liable to pay interest on the payable amount @7% per annum from the date of order till actual realization. We further direct the opposite parties to pay Rs.10,000/- as compensation for harassment and Rs.2,000/- as litigation expenses to the complainant. A copy of this order be supplied to both the parties free of costs. File be consigned to the record room.
Announced in open Forum. Member President,
Dated:11.12.2019. District Consumer Disputes
Redressal Forum, Sirsa.
