Haryana

Ambala

CC/148/2017

Jujhar Singh - Complainant(s)

Versus

NIC - Opp.Party(s)

Rohit Gupta

26 Jun 2018

ORDER

 

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM AMBALA

 

                                                          Complaint case no.        : 148 of 2017

                                                          Date of Institution         : 19.05.2017

                                                          Date of decision   : 26.06.2018

 

 

Jujhar Singh son of Shri Basant Singh, resident of VPO Shahpur, Tehsil and District Ambala Cantt.

       ……. Complainant.

Vs.

 

 

The National Insurance Co. Ltd. B.O.LIC Building, 2^nd Floor, near Vijay Cinema, Ambala City, through its Branch Manager.

 

 

   ….….Opposite Party.

 

Before:        Sh. D.N. Arora, President.

                   Sh. Pushpender  Kumar, Member.            

                  

 

Present:       Sh. Rohit Gupta, counsel for complainant.

Sh. R.K.Vig, counsel for Ops.

 

 

ORDER:

                   In nutshell, brief facts of the present complaint is that the complainant has purchased a vehicle Maruti Eritaga bearing Regd. No. HR-37-D-1167, Chasis no.MA3FLEB1S00183194, Engine No.D-13A2145364, Model 2013, from Modern Automobiles, Ambala City under the Finance Scheme of Kotak Mohindra Bank Ltd. Ambala and the above said vehicle of the complainant was insured with the OP vide insurance proposal form for Motor Insurance dated 27.06.2016 covering period from 28.06.2016 to 27.06.2017 and complainant has paid the due premium of the insurance policy to the OP. The vehicle of the complainant met with an accident on 10.10.2016 in  Rajpura (PB) and was damaged badly. The complainant soon after the accident informed the OP and took his vehicle to the Workshop of Modern Automobiles where the vehicle of the complainant was illegally detained and they charged a sum of Rs. 12,000/- from the complainant. The OP also deputed their surveyor namely H.K.Garg, who inspected the vehicle and told the complainant that he can claim the total cost for which the vehicle has been insured i.e. Rs.5,50,000/-. The complainant submitted all required  documents/papers to the OP to get his insurance claim settled, but the OP neither settled the insurance claim of the complainant nor gave any  response rather started putting  the complainant off on one pretext or the other. The complainant has been visiting the OP time and again and have  also requested its higher authorities in writing for settlement of his insurance claim, but the OP have not cooperated the complainant . Thus there are great deficiency in service and unfair trade practice on the part of OP and due to non-co-operation of the OP, the complainant has suffered harassments mentally, physically and financially loss. A legal notice has been served upon to the OP on dated 22.04.2017 through registered AD. Hence, the present complaint.

2.                Upon notice, OPS appeared through counsel and tendered written statement and stated that   the complainant informed  to the OP regarding the loss of vehicle which took place on 10.10.2016, DDR No.14 dated 12.10.2016 was lodged. It is a matter of record that the insurance company consequent  upon the information appointed surveyor  E.r.H.K.Garg who lost no time prepared final survey report  on the basis of physical verification and the surveyor report prepared by him on the basis of actual and physical  verification of the vehicle & accordingly the loss assesses of the vehicle is Rs.391933/-. The surveyor  assessed the loss of the  vehicle in question as per attached assessment sheet. The OP wrote registered letter dated 07.6.2017 to provide the documents which has been mentioned in it, but he failed to do so. Thereafter the company again wrote letters dated 08.06.2017 & 27.06.2017 to submit  the documents  to proceed  his claim to finality but till today no  reply has been received from him and the OP/Insurance Company when found that the was not prepared to supply with the documents finally closed the claim of the complainant as “No Claim” vide letter dated 19.09.2017. Since the complainant violated the terms and conditions the company was left with no other alternative except to close the claim on legal, valid and just ground.  Hence, the Op is  not liable to pay any amount and there is no deficiency on the part of the OP and prayed for dismissal of the present complaint. 

3.               To prove his version complainant tendered his affidavit as Annexure C-A with documents as annexure C-1 to C-18 and close his evidence. On the other hand, Counsel for the OP tendered two affidavits as Annexure R-A &R-B along with Annexure R-1 to R-16 and close his evidence.

4.                We have heard counsel for the parties and carefully gone through the case file. The complainant has purchased Maruti Eritaga  which was insured with the OP for the period from 28.06.2016 to 27.06.2017 after paying the premium as per policy Annexure R-15. It is not disputed that vehicle in question met an accident on 10.10.2016 during the policy period and he informed to the OP and they have deputed the surveyor and after inspected the vehicle in question. The surveyor has assessed the loss of the vehicle Rs. 391933/- after deducting the salvage amount  Rs. 7,500/-.  The OP has not paid the above said amount to the complainant on the ground that they have sent the registered letter to provide the some documents i.e. medical record of driver, cash memos of parts replaced  and labour charges, produce the vehicle for re-inspection, loss is of dated 10.10.2016, but DDR is lodged on 12.10.2016, reasons for delayed in DDR, Original Punjab entry permit fee receipt as the same is not verified by surveyor and copy of aadhar card but complainant has failed to provide the above said documents and they have closed the claim of the complainant as per letter Annexure R-13. The above said documents are not required for releasing the claim amount assessed by the surveyor. The claim of the complainant has been closed on the technical ground is not genuine one because the above said demanding documents mentioned in Annexure R-13 appear to be just a paper  transactions as the surveyor in his report Annexure R-3 has authenticated the loss  after re-inspecting the vehicle, therefore, the ground on which the insurance company has closed the claim of the complainant is not tenable. Another strange factor which this Forum has noticed that the complainant has submitted the claim just after the incident as per Annexure R-2 and the surveyor had inspected the vehicle on 08.11.2016 & thereafter submitted his report on 21.03.2017 but the insurance company has sent the letter  demanding the abovesaid documents firstly on 07.06.2017 as per Annexure R-9 & further demanded the above said documents on 27.06.2017 & 19.09.2017. There is no explanation on the case file as to why such delay has occurred in deciding the claim of the complainant by demanding irrelevant documents as the surveyor in his report has not mentioned about the requirement of the documents. Although  he mentioned in his report about  DDR  and also re-inspected in question. 

5.                In our view, OP has wrongly withheld the claim of the complainant. It is worthwhile to mention here that insurer’s decision to reject the claim must be on sound logical and valid grounds and the insurance company are not supposed to earn the profit in shape of premium from the customers because it is their legal responsibility to indemnify the loss if occurred during the currency year but in the present case the company is trying to avoid the genuine claim of the complainant by leveling lame excuses. Therefore, the complainant is entitled for the amount assessed by the surveyor as Rs. 3,91,933/-. Hence, the present complaint is deserve to be accepted and same is hereby allowed with cost which assessed Rs. 5000/- and OP is directed to comply with the following directions within thirty days from receipt of copy of the order:-

(i)      To pay Rs. 3,91,933/- as assessed by the surveyor as per Annexure R-3 alongwith the interest @ 9% on the date of complaint till realization.

 

(ii)     To pay sum of Rs. 5000/- to the complainant as cost of litigation.

         

Copy of the order be sent to the parties concerned, free of costs, as per rules. File after due compliance be consigned to record room.

Announced on: 26.06.2018

                    

 

 (PUSHPENDER KUMAR)                (D.N. ARORA)

                   Member                                         President