| Final Order / Judgement | BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, JALANDHAR. Complaint No.336 of 2018 Date of Instt.20.08.2018 Date of Decision: 20.04.2021 Gurteshwar Singh S/o S. Satinder Singh resident of V.P.O. Nurpur, Jalandhar. ….. Complainant Versus 1. Oriental Insurance Co. Ltd., Oriental House, A-25/27, Asaf Ali Road, New Delhi-110002 2. Oriental Insurance Co. Ltd., Branch No.3, 1st Floor, Rattan Tower, Near NaamDev Chowk, Jalandhar Punjab. ..…Opposite parties Complaint under the Provisions of Consumer Protection Act. QUORUM: SH.KULJIT SINGH, PRESIDENT MRS.JYOTSNA, MEMBER ARGUED BY: For Complainant : In Person. For OPs No.1 & 2 : Sh. BrijeshBakshi, Advocate. ORDER:- KULJIT SINGH, PRESIDENT - The present complaint has been filed by complainant against the OPs, on the averments that the complainant is owner of vehicle registration No.PB08-BT-8885, Make Truck and copy of R. C. and driving license is attached with the file. That the complainant got insured his vehicle for policy NO.233102/31/2016/4962 for the period from 31.03.2016 to Midnight of 30.03.2017. That the above said vehicle/truck of the complainant met with an accident on 23.09.2016 at 05:00 am when it was parked at parking place at the side of Highway Road between Lajwanti Petrol Pump to Gangwal Dhaba, Police Station Bhogpur, District Jalandhar while a truck bearing No.JK02-BM-7175 coming with high speed from Jammu lost control to save a straying animal struck with the parked vehicle. That an FIR No.034 dated 24.09.2016 was registered in the Police Station Bhogpur, District Jalandhar. That in the said accident the front and backside of the vehicle/truck was totally damaged. The police and Surveyor visited the occurrence place. That Surveyor advised the complainant to get repaired the vehicle from workshop and promised to give the claim from the OPs later on. The complainant had spent Rs.4,07,880/- from his own pocket for the repair and replacement of the damaged parts of above said vehicle from certain workshops namely Star Auto Sales, Khalsa Denting Welding Works, Nischal Truck Body Builder, Dara Singh Auto Workshop, Avtar Automobiles, Aryan International etc. and in this regard all bills and other required documents were already given to the surveyor who assured the complainant that the claim would be given from OPs to complainant after one month. That on 15.03.2018 the complainant gave an application to their local office of OPs at Jalandhar requesting to give the claim of loss Rs.4,07,880/-. That the complainant again approached many times to the OP No.2 for approval of claim, but all in vain and also the complainant served a legal notice dated 20.03.2018, but all in vain and as such, necessity arose to file the present complaint with the prayer that the complaint of the complainant may be accepted and OPs be directed to pay the claim of Rs.4,07,880/- alongwith interest @ 18% per annum and further OPs be directed to pay Rs.50,000/- as compensation for causing mental tension and harassment to the complainant and Rs.50,000/- as litigation expenses.
- Notice of the complaint was given to the OPs, who filed reply and contested the complaint of the complainant by raising preliminary objections that the above noted complaint is not maintainable under law against the OPs. That there is complicated question of law and facts involved in the matter and the same cannot be adjudicated in summary proceedings, therefore, this Forum has got no jurisdiction to try and decide the present complaint. That the complainant has got no cause of action to file the present complaint against the answering OPs. The complaint is entirely misconceived and misdirected against the OPs. That the complainant is guilty of concealment of material facts and has not approached the Forum with clean hands and as such, is not entitled to any relief from the Forum. That contract of insurance is a contract of utmost good faith and mutual obligations are cast upon the parties. The OP deputed Er. Pritpal Singh for spot survey and he clicked the photographs of the vehicle at site and gave his report to the effect that there was damage Right Hand Rear Body Damage and Dala Damage. The complainant failed to submit any claim form or original estimate of damage repairs to the OPs and of his own accord removed the vehicle from the spot and took it to Transport Nagar for repairs without lodging any claim or submitting any other documents with the OPs. The complainant submitted letter to the OP that the vehicle No.PB08BT 8885 met with an accident on 23.09.2016 at about 5:00 Am and requested for spot survey. The OPs deputed Er. Pritpal Singh for spot survey and he clicked the photographs of vehicle at site and gave his report to the effect that there was damage right hand rear body damage and dala damage. As per same there was only body damage on the RH read side and Dala. Thereafter, the complainant failed to submit any claim form or original estimate of damage repairs to the OPs and of his own accord removed the vehicle from the spot and took it to transport nagar for repair without lodging any claim or submitting any other documents with the OPs. In the meantime on 09.12.2016 the surveyor Rajeshwar Nath of Leo Alex was deputed for survey and loss assessment and he checked the vehicle at Transport Nagar there he clicked the photographs wherein damages due to aforesaid accident were reaffirmed only on the read body dage right and side and dala of the vehicle. The insured did not meet surveyor at the site and later on telephonically time and again surveyor tried to contact him and meet him but did not meet the surveyor from 09.12.2016 upto submission of final report. Rather, surveyor asked the insured on telephone to submit claim form, RC of the vehicle, Driving Licence of driver, route permit, GR of goods being carried at the time of accident, copy of policy, estimates of repairs etc but he failed to do so. Rather, of his own accord the complainant got started the vehicle repair without any intimation to the OPs. The surveyor again visited during repairs on 23.12.2016 and he clicked photographs thereof. The complainant was again asked to submit estimates and bills and other documents as above but he failed to do so. Thereafter, in order to make final inspection of the vehicle and to settle the claim letter dated 23.01.2017 was issued to complainant by the surveyor to provide claim form duly filled, RC of the vehicle, Driving Licence, Route Permit of repairs, bills of repairs. Another letter was issued by OP to complainant to provide necessary documents and bills to settle the claim. But to no effect as the complainant failed respond to the letters and provide the requisite documents. As such, surveyor was constrained to submit final report only on the basis of spot inspection report, his inspections before and during repairs and photographs of estimates provided by complainant and surveyor submitted his report on 29.03.2017 and enumerated all the items therein and assessed the net loss at Rs.20,000/- as per spot survey report, physical inspection dated 09.12.2016 and 23.12.2016 taking into account only the damage/loss caused due to the accident and assessed the amounts payable on account of alleged accident as stated above. However, the surveyor specifically mentioned that letter to the insured/ complainant remained unanswered and he did not recommend the loss for consideration.Thereafter, as the complainant had failed to submit duly filled claim form or all other requisite documents etc as such the OP was constrained to close the file as No claim on account of default of complainant. The no claim intimation was sent to complainant. Thereafter, in a clandestine manner the complainant has got manipulated wrong and false bills at a later stage. The said bills were never provided during the processing of the claim to the surveyor or the company when the complainant was being requested and even letter were issued to him and before he claim was closed as no claim. Even a bare perusal of alleged bills clearly shows that the same are not even related to the alleged accident/loss arising out of alleged accident. There is no proof of actual payment. A perusal shows that alleged cabin repairs, sunmicas, front show repair, front axle, rear axle, axle shaft, propeller shaft, bumper denting, labour charges electrical works, turning shafts, differential assembly & cowl repair are unrelated to the vehicle hit from RHS rear side or Dala damage. Similarly, bill of cabin repair, shows etc are not payable. All more so the other alleged bills ae also for suspensions repair, shaft, Kamanis, Pattaetc which are not related to RHS body damage or Dala and the same are regular maintenance or routine wear and tear repairs. The complainant did not furnished the said bill at the relevant time and the same are not genuine and procured wrongly to get the claim which is otherwise not maintainable. The claim stood finally closed on 31.03.2017 and present complaint filed belated. On merits, insurance of vehicle is admitted. No surveyor advised the complainant to get repaired vehicle from workshop and/or further promised to get the claim from OPs. It is denied that complainant spent Rs.4,07,880/- from his own pocket for alleged repair and replacement of damaged parts. All the alleged repairs and bills do not pertain to accident, since the bills mentioned the parts and damages which were not damaged on account of accident as alleged. The OPs are not liable to pay claims. Other averments of complaint are denied and prayed for dismissal of complaint.
- Rejoinder not filed.
- In order to prove their respective versions, both the parties produced on the file their respective evidence.
- We have heard the learned counsel for the respective parties and have also gone through the written arguments submitted by counsel for the complainant as well as case file very carefully.
- Learned counsel for complainant argued that said vehicle/truck of the complainant met with an accident on 23.09.2016 at 05:00 am when it was parked at parking place at the side of Highway Road between Lajwanti Petrol Pump to Gangwal Dhaba, Police Station Bhogpur, District Jalandhar while a truck bearing No.JK02-BM-7175 coming with high speed from Jammu lost control to save a straying animal struck with the parked vehicle. That an FIR No.034 dated 24.09.2016 was registered in the Police Station Bhogpur, District Jalandhar. That in the said accident the front and backside of the vehicle/truck was totally damaged. The police and Surveyor visited the occurrence place. That Surveyor advised the complainant to get repaired the vehicle from workshop and promised to give the claim from the OPs later on. The complainant had spent Rs.4,07,880/- from his own pocket for the repair and replacement of the damaged parts of above said vehicle from certain workshops namely Star Auto Sales, Khalsa Denting Welding Works, Nischal Truck Body Builder, Dara Singh Auto Workshop, Avtar Automobiles, Aryan International etc. and in this regard all bills and other required documents were already given to the surveyor who assured the complainant that the claim would be given from OPs to complainant after one month. That on 15.03.2018 the complainant gave an application to their local office of OPs at Jalandhar requesting to give the claim of loss Rs.4,07,880/-.
- On the other hand, learned counsel for OPs has argued that said vehicle/truck of the complainant met with an accident on 23.09.2016 at 05:00 am when it was parked at parking place at the side of Highway Road between Lajwanti Petrol Pump to Gangwal Dhaba, Police Station Bhogpur, District Jalandhar while a truck bearing No.JK02-BM-7175 coming with high speed from Jammu lost control to save a straying animal struck with the parked vehicle. That an FIR No.034 dated 24.09.2016 was registered in the Police Station Bhogpur, District Jalandhar. That in the said accident the front and backside of the vehicle/truck was totally damaged. The police and Surveyor visited the occurrence place. That Surveyor advised the complainant to get repaired the vehicle from workshop and promised to give the claim from the OPs later on. The complainant had spent Rs.4,07,880/- from his own pocket for the repair and replacement of the damaged parts of above said vehicle from certain workshops namely Star Auto Sales, Khalsa Denting Welding Works, Nischal Truck Body Builder, Dara Singh Auto Workshop, Avtar Automobiles, Aryan International etc. and in this regard all bills and other required documents were already given to the surveyor who assured the complainant that the claim would be given from OPs to complainant after one month. That on 15.03.2018 the complainant gave an application to their local office of OPs at Jalandhar requesting to give the claim of loss Rs.4,07,880/-.
- We scrutinized entire file of case in hand and unable to trace the receipt of said letter to complainant, which the Ops have argued to be sent to complainant. In this situation, it creates suspicion that the Surveyor why not given prior written approval before repaired the vehicle in question. Further, it creates doubt that the Surveyor why not attached original repair bill of the vehicle in question, handed over by complainant. While the photocopies of the bill of vehicle are produced by complainant in evidence as Ex.C-5 to Ex.C-11. The complainant paid premium with the Ops and the validity of the insurance is from 31.03.2016 to 30.03.20217and accident took place on 23.09.2016. The accident occurred within the validity period of insurance.
- The whole of the case of the opposite parties revolves around the survey report. But to prove the report of surveyor, the opposite parties have not placed on record the consideration of bills. In the absence of which no evidentiary value can be made on the report submitted by the surveyor. Reliance in this connection has been placed upon Manikant Vs. New India Assurance Co.Ltd. 1(2012) CPJ 88 (NC) of the Hon’ble National Commission wherein it has been held that the surveyor did not appear in court and subject himself to cross examination……….
Moreover, it is usual with the insurance company to show all types of green pastures to the customer at the time of selling insurance policies, and when it comes to payment of the insurance claim, they invent all sort of excuses to deny the claim. In the facts of this case, ratio of the decision of Hon’ble Apex Court in case of Dharmendra Goel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation. This, take it or leave it, attitude is clearly unwarranted not only as being bad in law, but ethically indefensible. It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. In similar set of facts the Hon’ble Punjab & Haryana High Court in case titled as New India Assurance Company Limited Vs. Smt.Usha Yadav & Others 2008(3) RCR (Civil) Page 111 went on to hold as under:- “It seems that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy. The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5,000/- for luxury litigation, being rich. - Resultantly, in the light of our above observations and findings the present complaint is partly allowed with direction to OPs to pay remaining insurance claim amount as per bills Ex.C-5 to Ex.C-11 i.e. for Rs.4,07,880/- as prayed by complainant. Further, OPs also to pay Rs.7000/- as compensation for causing mental agony and physical harassment to the complainant including litigation. The OPs have no right to keep and misappropriate the public money. It must go back to the public. We, therefore, ordered that the OPs will deposit a sum of Rs.3000/-, with the Consumer Welfare fund of this Commission.
- The compliance of the order be made within 45 days from receipt of copy of this order. Copies of the order be sent to the parties, as permissible, under the rules. This complaint could not be decided within stipulated time frame due to rush of work and spread of Covid-19.
- File be indexed and consigned to the record room after due compliance.
Announced in open Commission 20th of April 2021 Kuljit Singh (President) Jyotsna (Member) | |
