Delhi

West Delhi

CC/14/366

J.P. Singh - Complainant(s)

Versus

Oriental Insurance Company - Opp.Party(s)

23 Apr 2019

ORDER

          DISTRICT CONSUMER DISPUTES REDRESSAL FORUM (WEST)

 

CASE NO. 366/2014

SH. J.P. SINGH

SENIOR EXECUTIVE

AIRTECH AIRCONDITIONERS

204, 1^ST FLOOR, ASHIANA BUILDING,

NEAR DARYACHA BUILDING,

HAUZ KHAS VILLAGE, NEW DELHI-110016                               …..Complainant

VERSUS

MR. RAJINDER KUMAR

DIVISIONAL OFFICER

THE ORIENTAL INSURANCE COMPANY

DO 18,6^TH FLOOR, SHAH PURI TOWER

C-58, COMMUNITY CENTRE,

JANAKPURI, NEW DELHI-110058.…..Opposite Party-1

O R D E R

K.S. MOHI, PRESIDENT

          The complainant has filed the present complaint against the OP under section 12 of the Consumer Protection Act, 1986.Complainant is the owner of Maruti Eco 5 Star with AC model 2012 having registration No. DL09CAB 7135 and got the vehicle insured with OP on 19/02/2013. The complainant got the aforesaid vehicle repaired in the authorized workshop of OP on 18/11/2013. It is further stated that on 19/11/2013 OP intimated complainant that he would get claim of last accident only, damage of left side of the vehicle and the complainant had to pay repair charges of the remaining damages caused by other accidents. The complainant filed claim with OP on 20/11/2013 when OP told complainant that he would not get the claim of even a single damage, accidents as he has not sent vehicle for repairs within 24 hours of each accident. On 30/11/2013 repairer Carnation Auto issued two invoices to the complainant for a sum of Rs. 15,763/- & Rs. 6,966/- totaling Rs. 22,729/-. The complainant filed claim for the aforesaid amount which was rejected by OP vide e-mail dated 07/02/2014 stating that the damage/assessment is under the imposed access clause of the insurance policy hence, the claim was not payable. It is prayed that since the repudiation of claim was unjustified and not as per the conditions of the policy so the present complaint for refund the amount of two invoices Rs. 22,729/- and compensation, be dismissed.

          OP filed written statement taking preliminary objections inter-alia that complaint does not disclose any cause of action. It is however, admitted that vehicle was insured under policy No. 215500/31/2013/8283 for the period from 19/12/2013 to 18/12/2014. It is further alleged that on receipt of claim OP appointed Mr. Anil Chawla, Surveyor to verify the claim. After assessment it was observed by Surveyor that the assessment of loss was Rs. 6,095/- which came under the access clause in the policy i.e. Rs. 7,000/- as imposed Excess plus Rs. 1,000/- as compulsory excess. Therefore, the claim of the complainant was not payable and was accordingly repudiated.

          When the parties were asked to file evidence complainant filed affidavit of evidence testifying the contents of the complaint on oath and also relied upon Annexure I to Annexure VI. On the other hand OP filed affidavit of evidencd of Ms. Meena Kalra, Sr. Divisional Manager reiterating the contents of the reply and relied upon Ex. OP1/A—OP1/C.

          We have heard counsel for parties and have gone through the material on record carefully and thoroughly.

          The controversy lies in a narrow compass. The issuance of the policy is not in dispute. The access clause of Rs. 7000/- and Rs. 1,000/-towards compulsory deduction have been mentioned in the policy itself and therefore, it is very difficult for the complainant to wriggle out of this clause which form part of the policy itself. Now, question arises as to whether this clause of imposed excess has been properly applied by OP while assessing the claim of the complainant. The answer is now negative. It may be clarified that since imposed clause has already been mentioned in the policy so there was not occasion for the surveyor to further assess claim of the complainant and deduct the imposed excess of Rs. 7,000/- which has already been prescribed in the policy itself. Therefore, the approach of OP in assessing the claim of complainant was against the policy itself. Since, the claimant has sought Rs. 22,729/- out of which the OP is entitled to deduct Rs. 8,000/- towards imposed excess and compulsory deduction and the remaining amount i.e. Rs. 14,729/- will be paid to the complainant.

          Keeping in view above circumstances and observations, we direct OP to refund a sum of Rs. 14,729/- and we further award a sum of Rs. 7,500/- towards mental and physical harassment and litigation expenses within 45 days from the receipt of the order. In case of default of payment in time OPs shall be liable to pay interest @ 6% p.a. from the date of filing of the complaint till actual realization.

File be consigned to Record Room.

          Copy of Order be given as per rules.

          Announced this ____23TH_______April, 2019.

 

(K.S. MOHI)                                                                             (PUNEET LAMBA)

PRESIDENT                                                                                         MEMBER