Chandigarh

DF-I

CC/62/2015

Mahinder Singh Gautam - Complainant(s)

Versus

Oriental Insurance Company - Opp.Party(s)

Vijay Singh Kaundal

06 Jul 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I,

U.T. CHANDIGARH

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Consumer Complaint No.	:	CC/62/2015
Date of Institution	:	02/02/2015
Date of Decision	:	06/07/2015

 

 

Mahinder Singh Gautam son of Sh. Vinod Gautam, resident of House No.514, Milk Colony, Dhanas, UT, Chandigarh.

…..Complainant

V E R S U S

Oriental Insurance Company, SCO No.109-111, Sector 17-D, Chandigarh through its Chief Regional Manager.

……Opposite Party

 

 

 

QUORUM:	P.L.AHUJA	PRESIDENT
	MRS.SURJEET KAUR	MEMBER
	SURESH KUMAR SARDANA	MEMBER

                                               

                                               

                       

For complainant	:	Sh. Vijay Singh Kaundal, Advocate
For OP		Sh. Ram Avtar, Advocate

                       

                 

PER P.L.AHUJA, PRESIDENT

1.         Sh. Mahinder Singh Gautam, complainant has filed this consumer complaint under Section 12 of the Consumer Protection Act, 1986, against Oriental Insurance Company, Opposite Party (hereinafter called the OP), alleging that he is owner of vehicle bearing registration No.CH-04-9268 (make Swaraj Mazda), which was insured with the OP for the period from 9.5.2013 to 8.5.2014.

                On 9.7.2013, the said vehicle met with an accident and was completely damaged. The complainant intimated the OP regarding the said accident and submitted his claim.  Thereafter the OP sent a letter dated 1.11.2013 (Annexure C-2) to the complainant alleging that his claim was likely to be repudiated as he had claimed wrong neb (NCB?).  The said letter was replied by the complainant on 21.11.2013 (Annexure C-3).  Thereafter, no response was given by the OP despite the visits and requests made by the complainant to pay the claim.  Alleging that the aforesaid acts amount to deficiency in service and unfair trade practice on the part of the OP, the complainant has filed the instant complaint. 

2.         In its written statement, OP has admitted that the truck in question was insured with it for the relevant period.  It has been averred that the policy was issued subject to conditions, clauses, warranties, exclusions, IMTs and endorsements.  It has been contended that the truck in question was insured with Chola Mandalam General Insurance Co. Ltd. upto 8.5.2013.  Chola Mandalam General Insurance Co. Ltd. had confirmed vide its report dated 29.10.2013 that a claim of Rs.44,237/- had been paid vide transaction dated 1.9.2012 to the insured/complainant against loss dated 5.6.2012.  It has been pleaded that the complainant had suppressed with regard to having received insurance claim from the previous insurance company. It has been contended that the insurance business is based on utmost good faith and a duty is cast upon the insured to honestly disclose all facts in his knowledge before issuance of fresh or renewal of policy.  It has been submitted that the claim of the complainant was rightly repudiated.  Pleading that there is no deficiency in service or unfair trade practice on its part, OP has prayed for dismissal of the complaint. 
3.         In his replication, the complainant has controverted the stand of the OP and reiterated his own. It has been admitted that the complainant received a sum of Rs.44,237/- from Chola Mandalam General Insurance Company. It has been pleaded that the complainant disclosed each and every fact to the OP at the time of obtaining new policy and the OP got signed blank proforma from him. It has been contended that the OP created concocted story to escape its liability.
4.         The parties led evidence in support of their contentions.
5.         We have appraised the entire evidence, written arguments submitted by both sides and heard the arguments addressed by the learned Counsel for the OP. 
6.         It has been urged by the complainant that his vehicle bearing registration No.CH-04-9268 make Swaraj Mazda was insured with the OP for the period from 9.5.2013 to 8.5.2014 on payment of a premium of Rs.21,842/- vide insurance policy, copy of which is Annexure C-1.  On 7.9.2013, the said vehicle met with an accident and was completely damaged. It has been contended that the complainant submitted his claim, but, the OP sent a letter dated 1.11.2013 (Annexure C-3) that his claim was likely to be repudiated on which he sent a reply dated 21.11.2013 (Annexure C-4). It has been urged by the complainant that the OP has intentionally and deliberately repudiated his claim and there is deficiency in service and unfair trade practice on its part. It has also been urged that the complainant did not fill up the proposal form and the same was filled up by the OP and in fact the signatures of the complainant were obtained on blank proforma by the OP and the OP has created a concocted story for escaping its liability.
7.         We have carefully considered the above contentions. A perusal of the copy of the insurance policy (Annexure C-1) reveals that while granting insurance in respect of the vehicle of the complainant for the period from 9.5.2013 to 8.5.2014, no claim bonus to the extent of Rs.5,271/- was allowed by the OP to the complainant. After the vehicle of the complainant met with an accident and he submitted claim with the OP, the OP sent a letter dated 1.11.2013 (Annexure C-3) whereby he was informed that he had availed 20% no claim bonus on the basis of previous insurance with Chola Mandalam General Insurance Co. Ltd. and it was confirmed by the previous insurer that he had preferred a claim under the previous insurance and as such he was not entitled for any rebate of no claim discount.  The complainant sent a letter (Annexure C-4) through his advocate wherein he informed that his client did not get claim from Chola Mandalam General Insurance Co. Ltd. At that stage, the complainant did not make any such allegation that he had not made any request for no claim bonus. The averment of the complainant in the letter (Annexure C-4) is belied by his own plea in the replication that he received a sum of Rs.44,237/- from Chola Mandalam General Insurance Co. Ltd. The copy of proposal form (Annexure R-4) submitted by the complainant with the OP company shows that he signed the following declaration :-

        “I hereby declare that the statements made by me in this proposal form are true to the best of my knowledge and belief and I hereby agree that this declaration shall form the basis of the contract between me and Oriental Insurance Co. Ltd. I hereby confirm and declare that above mentioned identification details of my vehicle No.CH04-9268 are correct. Nothing has been hidden/undisclosed. I declare that the rate of NCB stated above by me is correct and that no claim has arisen in the expiring policy (copy of the policy enclosed).  I further undertake that, if this declaration is found to be incorrect, all benefits under the policy will stand forfeited. I further understand and agree that Oriental Insurance Company will seek confirmation of above stated details from my previous insurer. Pending receipt of necessary confirmation, I agree that, though coverage under the policy will be available to me, Oriental Insurance Company will be liable to release the payment towards any claims of the policy only after a confirmation in this regard is received.

        XXX                  XXX                  XXX”

In that proposal form, an NCB of 50% amounting to Rs.5,271/- was shown and on the basis of his proposal form, the complainant was allowed no claim bonus and a policy of insurance (Annexure C-1) was issued in his favour.  The copy of report (Annexure R-5) by Chola Mandalam General Insurance Co. Ltd. clearly shows that the complainant, Sh. Mahinder Singh Gautam was paid an amount of Rs.44,237/- vide transaction dated 1.9.2012.  Hence, the evidence on record proves that the complainant had already received a sum of Rs.44,237/- from his previous insurer i.e. Chola Mandalam General Insurance Co. Ltd., nevertheless, he claimed no claim bonus from the OP, which was allowed to him. We feel that since the complainant made an undertaking that if his declaration was found to be incorrect, all benefits under the policy will stand forfeited, therefore, his wrong declaration is sufficient to deny any benefit to him.  In Tata AIG General Insurance Company Ltd. Vs. Gulzari Singh-II (2010) CPJ 272 (NC), it was found that a declaration regarding no claim bonus was wrongly made by the insured and it was held by the Hon’ble National Commission that insurance being contract of uberrima fides, there must be complete good faith on part of insured.  The contention of the complainant that the agent had filled wrong information was not accepted by the Hon’ble National Commission and the Hon’ble National Commission held that the State Commission had erred in awarding loss assessed by surveyor.

8.         In the instant case, though a plea has been raised by the complainant in his replication that his signatures were obtained on blank proforma by the OP and he had disclosed each and every fact to the OP at the time of obtaining new policy, yet, the same cannot be accepted.  The complainant did not take any such plea in his complaint or even in reply to the letter dated 1.11.2013 (Annexure C-3) that his signatures were obtained on blank proforma by the OP. Thus, the plea now raised in the replication is an afterthought. The complainant is not an illiterate person. He has affixed his signatures on the proposal form (Annexure R-4), the consumer complaint as well as replication filed by him in English. Therefore, his explanation at this stage that his signatures were obtained on blank proforma cannot be accepted.
9.         After scanning the entire evidence, it is quite evident that the complainant submitted a wrong declaration in the proposal form (Annexure R-4) with the OP that the rate of NCB stated by him was correct and that no claim had arisen in the expired policy. Since there was suppression of material facts by the complainant, therefore, if the claim of the complainant has been repudiated by the OP, no unfair trade practice or deficiency in service can be inferred on the part of the OP.
10.         For the reasons recorded above, we do not find any merit in the complaint and the same is dismissed with no order as to costs.
11.         The certified copies of this order be sent to the parties free of charge. The file be consigned.

	Sd/-	Sd/-	Sd/-
06/07/2015	[Suresh Kumar Sardana]	[Surjeet Kaur]	[P. L. Ahuja]
hg	Member	Member	President