Punjab

Fatehgarh Sahib

CC/2/2019

Arvinder Singh - Complainant(s)

Versus

Oriental Insurance Co. - Opp.Party(s)

Sh. B.M. Singh

24 Feb 2020

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FATEHGARH SAHIB.

                                                      Consumer Complaint No.02 of 2019

                                                        Date of institution:  01.02.2019           

                                                     Date of decision   :  24.02.2020

Arvinder Singh son of Sh. Kartar Singh, resident of Mohalla Dharampura, Defence Bandh, Ward No.10, Sirhind, Tehsil and District Fatehgarh Sahib.

……..Complainant

Versus

1. Oriental Insurance Company Limited, Branch Office at Sapra Building, 1^st Floor, Bassi Road, Sirhind, Tehsil & District Fatehgarh Sahib through its Manager/Branch Manager.
2. Oriental Insurance Company Limited, having its registered and head office at A-25/27, Asaf Ali Road, New Delhi-110002, through its Manager/authorized person.

…..Opposite parties

Complaint under Section 11 to 14 of the Consumer Protection Act

Quorum

Sh. Amrinder Singh Sidhu, President

Capt. Yuvinder Singh Matta, Member   

                            

Present :   Sh. B.M.Singh, counsel for the complainant.

                  Sh. Anil Gupta, counsel for Opposite Parties.

ORDER

By Amrinder Singh Sidhu, President

                  The complainant filed the present complaint pleading that he has got insured his Maruti Swift Dzire car bearing registration No. PB-11BX-8535 from opposite parties vide policy No.233606/31/2019/4381 dated 27.08.2018 for the period from 28.08.2018 to 27.08.2019.  Earlier he got insured his vehicle from United India Insurance Company Limited and during the period of previous policy, the vehicle met with a minor accident and the complainant took claim from the previous insurance company.  The complainant purchased the above said policy through agent Gurpreet Singh Agent Code No.BA0000100239, who is known to the complainant. At the time of purchasing the above said policy the complainant disclosed to said Gurpreet Singh that a claim has been taken by the complainant from the previous insurance company, but he did not mention this fact in the present policy purchased by the complainant from the Oriental Insurance Company.  It is the duty of the agent to disclose the fact of earlier claim taken by the complainant from the previous insurance company, to his insurance company.  Unfortunately, the vehicle in question met with an accident on 13.10.2018 at Jyoti Sarup Chowk, Sirhind-Fatehgarh Sahib. The information of the said accident was immediately given by the complainant to the opposite parties. The opposite parties sent its surveyor to the spot, who clicked some photographs of the vehicle and inquired the matter from the complainant. The complainant got his vehicle repaired from Pal Motors, G.T.Road, Khanna and spent an amount of Rs.68,757/- on its repair. Intimation in this regard was also given to opposite party No.1.  The complainant completed all the formalities for getting his lawful claim. But the opposite parties have not paid the claim amount and vide letter dated 12.12.2018, without verifying the facts and documents, wrongly and illegally repudiated the claim of the complainant. The opposite parties raised excuse to the effect that as per no claim bonus confirmation received from previous insurer of the vehicle, there was claim reported under the policy, hence complainant is entitled to 0% no claim bonus but has availed 20% NCB on the policy.  It is further stated that the complainant is not at fault, as he has informed the agent of the opposite parties regarding receiving earlier claim of the minor accident. Since October 2018, the complainant has been regularly visiting the office of the opposite parties for getting his lawful claim but all in vain. The act and conduct of the opposite parties amounts to deficiency in service on their part. Hence, this complaint for giving directions to the opposite parties to pay Rs.68,757/- on account of lawful claim of the complainant and further to pay Rs.1,00,000/- as compensation for mental tension, pain, agony and harassment suffered by the complainant. He further prayed for any other relief, which this Forum may deem fit and proper in the just facts and circumstances of the case.

2.               After the service of notice upon the opposite parties, they appeared through counsel and filed written version to the complaint raising certain preliminary objections, inter alia, that the present complaint is not maintainable and is misuse and abuse of the process of law; the complaint is false, frivolous and vexatious; the complainant has not come to the court with clean hands and suppressed the true and material facts from this Forum and  the complainant has no cause of action to file the present complaint. As regards the facts of the complaint, the opposite parties stated that the opposite parties had verified from the United India Insurance Company about the claim during the previous policy period then it transpired that the complainant had obtained No Claim Bonus to which he was not entitled.  The complainant had also signed the declaration that he had not taken any claim during the policy period of the United India Insurance. The complainant had not disclosed about the previous claim as such, the claim of the complainant was rightly repudiated. There is no deficiency in service on the part of opposite parties. After denying the other averments made in the complaint, the opposite parties prayed for dismissal of the present complaint with costs.

3.               In order to prove his case, the complainant tendered in evidence his affidavit Ex. CW1/A along with copies of documents Ex. C-1 to C-5 and closed the evidence. In rebuttal the opposite parties tendered in evidence affidavit of Sh. S.K. Sharma as Ex. OP1/A and copies of documents Ex. OP-1 to OP-7 and closed the evidence.

4.               We have heard the Ld. counsel for the parties and have gone through the records.

5.               The Ld. counsel for the complainant argued on the lines of pleadings of complaint and requested to allow the complaint in favour of complainant, whereas Ld. counsel for Opposite Parties denied any kind of deficiency in service or unfair trade practice on the part of opposite parties and requested to dismiss the complaint with costs.

6.               The complainant has paid premium of Rs.13,727/- to the Opposite Parties, vide Receipt dated 27.08.2018 which is Ex. C-2, for issuance of insurance policy bearing No.233606/31/2019/4381 dated 27.08.2018 (Ex. C-1). As the complainant availed services of Opposite Parties for consideration so the complainant is the Consumer of the Opposite Parties. Further, as the complainant purchased the insurance policy of the opposite parties from their branch office at Sapra building, Ist Floor, Bassi Road, Sirhind so the complaint falls within the territorial jurisdiction of this Forum. Motor Insurance cum Policy Schedule which is Ex.C-1 clearly proves that the said policy was purchased from the branch office situated within the territorial jurisdiction of this Forum, hence, it can be safely concluded that this Forum has territorial jurisdiction to try, adjudicate and decide the present complaint. The vehicle of the complainant met with an accident on 13.10.2018 and he filed the present complaint on 01.02.2019 in this Forum, hence, the complaint is filed within prescribed period of limitation i.e. 2 years from the date of cause of action arouse to the complainant as provided in Section 24-A of Consumer Protection Act, 1986(as amended up to date). To prove his complaint, complainant has filed on record his duly attested affidavit as Ex. CW1/A wherein facts of complaint were stated on oath by him. Tax Invoice which is Ex. C-3 proves that the complainant paid Rs.68,757/- to Pal Motors, G.T.Road, Khanna for repair of his vehicle on  24.10.2018. On the other hand, to prove their version, the opposite parties, filed on record duly attested affidavit of Sh. S.K. Sharma, Sr. Divisional Manager, Ex. OP1/A. Ex. OP-1 is the proposal form, which shows that the complainant claimed 20% No Claim Bonus. Ex. OP-5 is the repudiation letter dated 12.12.2018 addressed to the complainant, vide which the opposite parties repudiated the claim of the complainant, reproduced as under:-

"As per No Claim Bonus Confirmation received from United India Insurance Co. Limited, which is previous insurer in your case there was claims reported under the policy. Hence, insured entitled to 0% No Claim Bonus' whereas you have availed 20% NCB on our policy for which you were not entitled.

Hence, as per policy terms and condition your claim file has been repudiated as "No Claim". However, you may submit us your reply within 10 days after that claim file will be closed as No Claim without any further intimation in this case".

To prove their version, the opposite parties produced on record Ex.OP-4 i.e. No Claim Bonus certificate, which proves that there was claim reported under the previous policy issued by the United India Insurance Co. Ltd. The Survey Report which is Ex. OP-7, vide which the surveyor assessed the loss to the vehicle, under the present policy, to the tune of Rs.59,500/-.

7.     Interestingly, the Ld. counsels for both the parties has relied upon the complaint titled as M/s Pawan Trading Co. Vs. United India Insurance Co. Ltd. and others 2018(3)CLT decided on 18.05.2018, vide which the Hon'ble Haryana State Commission has held as under:-

        "Para 11. In a recent Judgment cited as United India Insurance Company Limited Versus M/s Jindal Poly Buttons Limited, 2017(2) C.P.R.553, the Hon'ble National Consumer Disputes Redressal Commission, New Delhi after referring to another judgment passed by a three members bench of the Hon'ble National Commission, held that the complainant is entitled to receive payment of the amount assessed by the surveyor after making a deduction of 20% from the said amount. Facts and circumstances of the case in hand are almost similar to the facts and circumstances of the above cited case law. The revision petition was partly allowed by directing the insurer to make deduction of 20% from the loss suffered by the complainant. As per ratio of the aforesaid judgment, it is held that the insurer is entitled to make deduction of 20% from the total amount assessed Rs.2,99,500/-, for convenience the amount is taken as Rs.3,00,000/- as assessed by the surveyor and to pay the balance amount to the complainant, that is, Rs.2,40,000/- along with interest at the rate of 9% per annum from the date of filing the complaint till its realization as well as Rs.5,000/- as costs of litigation.

12.        As a result, as per discussions above in detail, the appeal is allowed, the impugned order dated January 13^th, 2017 passed by the learned District Forum is set aside. Consequently, the complaint filed by the appellant-complainant stands allowed. The opposite parties are directed to pay an amount of Rs.2,40,000/- along with interest at the rate of 9% per annum from the date of filing the complaint till its realization as well as Rs.5,000/- as costs of litigation".

8.               The facts and circumstances of the present complaint are almost similar to the facts and circumstances to the above mentioned Order and therefore applicable on the present complaint. As per ratio of the aforesaid order in the case of M/s Pawan Trading Co.(Supra), it is held that the insurer is entitled to make deduction of 20% from the total amount assessed Rs.59,500/-, for convenience the amount is taken as Rs.60,000/- instead of Rs.59,500/-, as assessed by the surveyor and to pay the balance amount to the complainant, i.e. Rs.48,000/-   along with  interest  at the rate

of 9% per annum from the date of repudiation of the claim i.e.12.12.2018 till its date of actual realization.

9.               In view of above said observations, the Opposite Parties are directed to pay an amount of Rs.48,000/- along with interest at the rate of 9% per annum from the date of repudiation i.e.12.12.2018 till its date of actual realization as well as Rs.5,000/- as costs of litigation. The complaint is partly allowed accordingly. Copies of the order be issued to the parties free of cost and thereafter file be consigned to the record room. 

10.             The complaint could not be decided within the prescribed period of time as provided under 3^rd Proviso of Section 13 (3A) of the Consumer Protection Act, 1986, because the post of President of this Forum remained vacant since 16.09.2018 and the Post of Lady Member remained vacant since 02.03.2017 and the undersigned President is now doing the additional duty for performing quasi judicial duties only for two days per week.

Pronounced                                                                                             

 Dated: 24.02.2020

(Amrinder Singh Sidhu)      

President

 

                                                                               (Yuvinder Singh Matta)       

                                                                                      Member