DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, JALANDHAR
Complaint No.454 of 2017 Date of Instt. 29.11.2017 Date of Decision: 27.04.2021
Shri Rakesh Behl, resident of EE-290, Bagh Karam Bakash, near Shri Ram Mandir, Panj Peer, Jalandhar City.
….. Complainant
Versus
1. Oriental Insurance Company Limited, Divisional Office II, 16/20, WEA, 1st Floor, Near Shastri Park, Param Singh Road, Karol Bagh, New Delhi 110005 through its Authorized Signatory.
2. Shri Rajesh Kumar, Administrative Officer, Oriental Insurance Company Limited, SVC R.O.I/ Motor Department, 10th Floor, Hansalaya Building, Barakhamba Road, New Delhi.
3. Oriental Insurance Company Limited, Division Office, Jalandhar.
..…Opposite Parties
Complaint under the Provisions of Consumer Protection Act
QUORUM:
SH. KULJIT SINGH, PRESIDENT
SMT. JYOTSNA, MEMBER
ARGUED BY:
For Complainant : Sh. Sohit Talwar, Advocate
For OPs No.1 & 3 : Sh. Brijesh Bakshi, Advocate
OP No.2 : Exparte.
ORDER:-
KULJIT SINGH, PRESIDENT
The present complaint has been filed by complainant against the OPs on the averments that he is owner of Maruti Car Model Swift Dezire VID Hatch Back bearing Regn.No. PB-08-CY-2027 bearing Chassis no. DI3A2520685 Engine No. NA3FJEBIS00678171. The complainant purchased an online policy through policy bazaar.com bearing policy no.211200/31/2017/2819 having previous policy no. 233105-31-2016-2171 purchased from OP no.1. The policy was valid up to mid night of 26th January 2017 and fresh policy was purchased on 27.01.2017 after making online payment. Unfortunately, the vehicle of the complainant met with an accident in April 2017 and he approached OP no.3 and lodged the claim. OP no.3 appointed Rahul Duggal Surveyor and Loss Assessor who conducted verification and the complainant paid charges for inspection of the vehicle by the surveyor to the tune of Rs.1,620.00 vide receipt no. 7134 dt. 1.5.2017. The complainant deposited all the necessary documents for finalization of insurance claim qua his vehicle as and when demanded by OPs. Thereafter, complainant has approached OPs for settlement of his claim, but to no effect. Ultimately, OP no.2 repudiated his claim through email with observation that the complainant while purchasing the policy had misrepresented the fact that his previous policy was expired on 27.01.2017 but his previous policy expired on 26.01.2017. As such, there is break in the insurance and it is mandatory for the policyholder to get his vehicle pre-inspected before purchase of the policy. While purchasing the new policy, complainant did not conceal any fact and all the particulars of the previous policy were duly mentioned in the new policy. Had there been any irregularity on the part of the complainant, then OP no.1 could very well cancel the policy by giving a notice that complainant had misrepresented at the time of getting new policy as the complainant had flouted the mandatory provisions. The act and conduct of OPs in illegally repudiating the claim of the complainant is negligent and deficiency in service. The complainant is entitled to receive the insurance claim as per policy. The complainant also served a legal notice dated 06.10.2017 but did not evoke any response. Therefore, the complainant has filed the present complaint and prayed that OPs be directed to settle the insurance claim of the complainant, to pay Rs.50,000/- as damages on account of unfair trade practice and cost of litigation.
Upon notice, OPs appeared and filed written reply and contested the claim of the complainant by raising preliminary objections that complaint is not maintainable. The complaint is barred by his own act and conduct. The complainant is guilty of concealment of material facts. The complainant has got no cause of action to file the complaint. On merits, it was averred that claim has been rightly repudiated as per terms and conditions of the policy. The claim has been denied on account of misrepresentation and concealment of material facts for obtaining the insurance private car package policy. The policy was valid up to midnight of 26th January 2017 and fresh policy was purchased on 27.01.2017 after making online payment. Thus it is explicitly clear that policy expired on midnight of 26.01.2017 and car of the complainant was not insured on 27.01.2017 rather new policy was bought on 27.01.2017. As such there was no insurance of the car of the complainant for 27.01.2017 and there is break of insurance even for one day then a pre-inspection is required before taking the insurance as per byelaws, provisions and terms and conditions of the policy. The vehicle of the complainant met with an accident in April 2017 whereas the motor claim form was submitted by the complainant on 08.03.2017 for alleged accident on 06.03.2017. OPs complied with all requisites to process the claim and also requested the complainant to provide copy of the previous policy as current policy. The rest of the averments of the complainant were denied by OPs even on merits and they prayed for dismissal of the complaint.
The complainant has tendered in evidence his affidavit Ex.CW-1/A on the record along with copies of documents Ex.C-1 to Ex.C-8. On the other hand, OPs tendered in evidence affidavit of Sandeep Thapa as Senior Divisional Manager as Ex.O-A along with copies of documents Ex.OP-1 to Ex.OP-5.
We have perused the written arguments filed by both the parties as well as record on the file, very minutely.
The glance of evidence is required for settlement of the case in hand. The complainant has tendered in evidence his affidavit Ex.CW-1/A on the record. The complainant alleged deficiency in service and unfair trade practice on the part of OPs. Ex.C-1 is copy of motor insurance certificate-cum-policy schedule private car package policy Zone B on the record. This policy is valid from 28.01.2017 to 27.01.2018. Ex.C-2 is copy of survey fee bill. Ex.C-3 is copy of receipt dated 18.03.2017. Ex.C-4 is copy of job card retail invoice. Ex.C-5 is copy of legal notice dated 06.10.2017. Ex.C-6 to E.C-8 are postal receipts thereof.
To refute this evidence of the complainant, the OPs relied upon affidavit of Sandeep Thapa as Senior Divisional Manager of OPs as Ex.OA on the record. Ex.O-1 is policy which is valid from 28.01.2017 to midnight of 27.01.2018. Ex.O-2 is policy which is valid from 27.01.2016 to 26.01.2017. Ex.O-4 is copy of email in which it has been specifically mentioned by OPs that previous policy of the complainant expired on 26.01.2017. If there is break in insurance pre-inspection is required before taking the insurance.
7. The main controversy involved in this case whether there is any deficiency or unfair trade practice on the part of OPs or not? The vehicle of the complainant met with an accident in April 2017. The earlier policy of the complainant which is valid from 27.01.2016 to 26.01.2017 and complainant purchased the fresh policy which is valid from 28.01.2017 to midnight of 27.01.2018. Assertion of the OPs is that policy was valid up to midnight of 26.01.2017 and fresh policy was purchased on 27.01.2017 after making the payment, thus, it is explicitly clear that the policy expired on midnight of 26.01.2017 and car of the complainant was not insured on 27.01.2017 rather new policy was bought on 27.01.2017 online through policy bazaar insurance Web Aggregator Pvt. Ltd for the period of 28.01.2017 to midnight 27.01.2017 as such there was no insurance of the car of the complainant for 27.01.2017 and there is break of insurance even for one day then a pre-inspection is required before taking the insurance as per bylaws. We do not agree with the above assertion of OPs. From perusal of policy Ex.O-1 it is clear that this policy was valid from 28.01.2017 to midnight of 27.01.2018 but in this policy collection number and date is mentioned as 27.01.2017, from perusal of this, it is clear that the complainant collect the policy on 27.01.2017. The previous policy is valid from 27.01.2016 to 26.01.2017. So the assertion of OPs is not valid. From perusal of Ex.O-4 i.e. repudiation letter, OPs mainly pointed out that previous policy expired on 26.01.2017 ad pre-inspection is required before taking the insurance. But from perusal of insurance policies Ex.OP-1 and Ex.OP-2 this fact is clear that the collection date of the policy is mentioned as 27.01.2017 and gross premium 11,312 has been received by OPs. When premium received from the complainant by OPs then it is duty of OPs to settle the claim of the complainant as per provisions of IRDA. The insurance companies collect the premiums from the insured and find ways to decline the claims without any valid reasons. This fact is settled by Hon’ble Punjab and Haryana High Court at Chandigarh in case titled as New India Assurance Company Limited versus Smt. Usha Yadav and others reported in 2008(3) RCR (Civil) Page 111 held as under:-
“It seems that the insurance companies are only interested in earning the premiums and find ways and means to decline the claims. All conditions which generally 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 cost of Rs.5000/- for luxury litigation being rich.”
8. From perusal of entire record of the case and after hearing submissions of counsel for the parties, we are considered opinion that the complaint of the complainant is partly accepted and the complainant is entitled Rs.14,997.00 as per job card retail invoice Ex.C-4 placed on the record. This amount spent by complainant himself, as such, OPs are liable to pay the same. The complainant is also entitled Rs.5000/- as compensation for mental harassment including costs of litigation.
9. The compliance of the order be made within one month from receipt of copy of this order.
10. The complaint could not be decided within the stipulated time frame, due to heavy rush of work and spread of Covid-19.
11. Let copies of the order be sent to the parties, as permissible, under the rules.
12. File be indexed and consigned to the record room after due compliance.
Announced in open Commission
27th of April 2021
Kuljit Singh
(President)
Jyotsna
(Member)
