Haryana

StateCommission

A/1057/2019

HDFC ERGO GENERAL INSURANCE CO. LTD. - Complainant(s)

Versus

PRAMO DEVI - Opp.Party(s)

VISHAL AGGARWAL

04 Dec 2020

ORDER

 

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

First Appeal No.    1057 of 2019

Date of Institution:  05.12.2019

Date of Decision:   04.12.2020

 

HDFC Ergo General Insurance Company Limited, SCO 237, Second Floor, Sector 12, Karnal and 5^th Floor, Tower-I, Stellar IT Park, C-25, Sector 62, Noida-201301 through Neeraj Kumar Manager-Legal.

 

 

Appellant-Opposite Party

 

Versus

 

Pramo Devi wife of Shri Jai Chand, resident of # 16A/27, Pram Nagar, Near Durga Gym, Kakroi Road, Sonepat, Haryana.

 

 

Respondent-Complainant

 

 

 

CORAM:    Hon’ble Mr. Justice T.P.S. Mann, President.

                   Shri Harnam Singh Thakur, Judicial Member.

                  

   

Present:     Shri Vishal Aggarwal, counsel for the appellant.

                    

                  

                            

O R D E R

 

 T.P.S. MANN, J.

 

Delay in filing of the appeal is condoned for the reasons as specified in the miscellaneous application.

2.      Opposite party-HDFC Ergo General Insurance Company Limited has challenged the order dated 01.10.2019 passed by learned District Consumer Disputes Redressal Forum, Karnal, whereby complaint preferred by complainant Pramo Devi under Section 12 of the Consumer Protection Act, 1986, was allowed and the opposite party directed to pay insured amount of Rs.9,60,000/- to the complainant with interest @ 9% per annum from the date of repudiation of the claim till its realization subject to furnishing of subrogation letter, transfer of ownership of vehicle, indemnity bond and undertaking by the complainant within 15 days in the name of opposite party and the opposite party also directed to pay Rs.25,000/- to the complainant towards compensation for mental and physical harassment and Rs.11,000/- as litigation expenses.

3.      According to the complainant, she had got her vehicle bearing registration No.HR-51AL-2050 comprehensively insured from the opposite party for the period commencing from 02.01.2018 to 01.01.2019 by paying premium amount of Rs.29,427/- and the value of the car assessed as Rs.9,60,000/- (IDV). Before issuing the policy, all the requisite documents, such as RC, address proof, etc. were thoroughly examined by the opposite party and photocopies of the same retained by the opposite party and the car was also inspected. On 20.05.2018, the complainant’s son Naveen, who was holding a valid driving licence, issued by Licensing Authority, Sonepat, was going from his house at Sonepat to Samalkha at the house of his maternal uncle and when he reached near the fields of Village Devdu then all of a sudden a massive fire broke in the engine due to short circuit. He came out of the car in order to save his life and thereafter telephonically informed fire brigade which came at the spot and brought the fire under control. However, the vehicle was completely burnt and beyond repair and in this regard DDR was also lodged at Police Station Sadar Sonepat, on 22.05.2018. As per the investigation conducted by the police qua the fire it was found that car caught fire on 20.5.2018 due to short circuit. The officials of the fire station, Sonepat also lodged entries in this regard in daily dairy register wherein it was stated that the vehicle had been completely burnt due to fire.  A sum of Rs.50/- was also given to the fire department for the charges levied in this regard. Intimation regarding the said accident was given to the opposite party and as a result of which, Surveyor was appointed and requisite formalities were completed by the complainant. Besides, necessary documents as demanded by the opposite party were submitted by the complainant and the damages were thoroughly inspected and necessary photographs were taken. The opposite party kept on delaying the matter for about 4 months without any satisfactory and reasonable cause and ultimately on 26.09.2018 the opposite party declined the claim of the complainant on false, frivolous and fictitious grounds.  There was thus deficiency in service on the part of the opposite party. Accordingly, the complainant preferred the complaint.      

4.      Upon notice, the opposite party put in appearance and filed written version, raising preliminary objections with regard to maintainability; cause of action; complainant being estopped by her own act and conduct; jurisdiction and concealment of true and material facts. On merits, it was pleaded that the claim under dispute related to the alleged incident of fire to the insured vehicle. The vehicle was insured under Private Car Comprehensive Policy valid from 02.01.2018 to 01.01.2019 subject to the provision of IMT and policy conditions, which was not disputed by the insured. According to the complainant, the insured vehicle caught fire on 20.05.2018 while her son Naveen was travelling from Sonepat to Samalkha. The incident of fire was intimated to the opposite parties on 22.05.2018. After the alleged accident was reported to the opposite party, the opposite party appointed an IRDA Licensed Surveyor as mandated under section 64UM of the Insurance Act, 1938 in order to assess the loss and damages. The opposite party also appointed an Investigator-cum-Forensic Expert in order to ascertain genuine cause of the fire. During the investigation and forensic analysis, it was found that the fire was not accidental in nature but was an incendiary fire. As per the investigation report, the cause and origin of fire was not accidental in nature. As per the report of the Expert, the fire did not break out due to self ignition.  As the fire was not caused by self explosion, self ignition or lightening but it was an incendiary fire, the claim of fire to the insured vehicle was beyond the scope of the policy and rightly repudiated. There was no deficiency in service on the part of the opposite party. The other allegations made in the complaint were denied and prayer made for dismissal of the complaint.

5.      The complainant tendered into evidence her affidavit (Exhibit CW1/A) and documents (Exhibit C1 to Exhibit C8), whereas, the opposite party tendered into evidence affidavit (Exhibit RW1/A) of Shweta Pokhriyal, affidavit (Exhibit RW1/B) of Zuber Ali Khan and affidavit (Exhibit RW1/C) of Manmeet Singh Makkar besides documents (Exhibit R1 to Exhibit R5).

6.      Having heard learned counsel for the parties and perusing the case file, learned District Forum allowed the complaint and directed the opposite party to pay Rs.9,60,000/- as insured amount to the complainant along with interest @ 9% from the date of repudiation of the claim till its realization; Rs.25,000/- to the complainant towards compensation for mental and physical harassment and Rs.11,000/- as litigation expenses.

7.      Learned counsel or the appellant has submitted that the insured vehicle caught fire on 20.05.2018, when the complainant’s son Naveen was driving the same from Sonepat to Samalkha. After the alleged incident of fire reported to the opposite party, IRDA Licensed Surveyor was appointed to assess the loss and damage. The opposite party also appointed an Investigator-cum-Forensic Expert in order to ascertain the genuine claim. During such analysis, it was found that the fire was not accidental in nature, rather it was incendiary. It was also reported that the fire did not break out due to self ignition. The claim filed by the complainant was thus not genuine and, accordingly, repudiated. Therefore, it has been prayed that the appeal be accepted, impugned order be set aside and the complaint be dismissed.

8.      Having heard learned counsel for the appellant and on going through the record, which stands requisitioned, the State Commission finds that as per motor survey report (Exhibit R-2), pre-accident condition of the vehicle was satisfactory. Though the incident had taken place on 20.05.2018 yet the Surveyor of the opposite party inspected the vehicle for the first time on 26.05.2018. The vehicle belonging to the complainant was inspected by Zuber Ali Khan, who submitted fire origin and cause investigation report (Exhibit R3) dated 28.08.2018 and fire claim of the complainant was repudiated on the basis of said report. Said Zuber Ali Khan had examined the vehicle at the workshop on 19.07.2018 i.e. after about two months of the accident. Further, the vehicle had been shifted from the place of the accident to the workshop with the help of crane. Possibility of the parts of the vehicle missing on the way and in the workshop could not be ruled out. Said Zuber Ali Khan also did not produce any certificate, from which it could be said that he was an independent forensic consultant.

9.      As per insurance cover, the IDV of the vehicle in question was Rs.9,60,000/-. The vehicle was totally burnt/damaged and not roadworthy any more. As such, the complainant was entitled to collect the IDV of the vehicle.

10.    In view of the above, the act of the opposite party in repudiating the claim of the complainant amounted to deficiency in service and unfair trade practice.

11.    Resultantly, the appeal is devoid of any merit and, accordingly, dismissed.

12.    The statutory amount of Rs.25,000/- deposited by the appellant while filing the appeal be disbursed in favour of the complainant/respondent against proper receipt and identification subject to appeal/revision, if any, but in accordance with law.

 

 

Announced 04.12.2020

(Harnam Singh Thakur) Judicial Member

(T.P.S. Mann) President

  D.R.