Haryana

Ambala

CC/255/2016

Amrik Singh - Complainant(s)

Versus

Rana Automobiles - Opp.Party(s)

S. Rashmi

22 Mar 2018

ORDER

BEFORE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMBALA.

                                        Complaint No.255 of 2016.

                                        Date of institution:-15.06.2016.

                                        Date of decision: - 22.03.2018.

Amrik Singh son of Shri Baisakha Ram resident of village Panjail, Ambala City.

                                                           ...Complainant.

Versus

1.Rana Automobiles V.P.O.Khuda, Jagadhari Road Ambala through proprietor/parnter.

2.Cholomandalam MS General Insurance Company Ltd. 2^nd Floor, Dare House, 2 NSC Road, Chennai-600-001 (Vide policy No.6729255 valid from 05.06.2012 to 04.06.2013).

 

                                                            …Opposite parties.

Complaint under section 12 of

 

Before:     Sh. Dina Nath Arora, President.

                Sh. Pushpender Kumar, Member.        

                   Ms. Anamika Gupta, Member.                  

               

Present: -  Ms.Suraj Rashmi Sharma, Advocate for complainant.

                OP No.1 has been given up.

                Sh.R.K.Vig,Advocate for opposite party No.2.       

Order

                In nutshell, the facts of the complaint are that the complainant is owner of tractor bearing registration No.HR54-A-8643 and the same was got insured with OP No.2 vide policy No.6729255 having validity from 05.06.2012 to 04.06.2013. On 01.05.2013 the tractor in question met with an accident and got badly damaged. Intimation regarding this was sent to the OP No.2 in time and relevant documents were also handedover to the surveyor of Op No.2. The tractor in question was repaired by Op No.1 vide job card no.237 dated 14.06.2013 and bill to the tune of Rs.72109/- was paid by the complainant at the time of delivery of tractor. In the accident, complainant had also received injuries.  The Op No.2 has repudiated the claim of the complainant without any genuine ground; therefore, the complainant got served legal notice upon the Op No.2 but to no avail. The act and conduct of the OPs clearly amounts to deficiency in service. In evidence, the complainant has tendered affidavit Annexure CA and documents Annexure C1 to Annexure C7.

2.                     Notice was sent to the Ops but learned counsel    for the complainant gave up Op No.1 vide her separate statement. On notice Op No.2 appeared only and filed its reply wherein several preliminary objections such maintainability, suppression of material fact and jurisdiction etc. have been taken. It has been submitted that the complainant without informing the OP No.2 took the vehicle to Op No.1 for repair and that too without prior inspection by the insurance company. As per the complainant the accident had taken place on 01.05.2013 which involved tractor-trolley and TATA 407 wherein one Jasbir and complainant had sustained injuries but no FIR under Section 279/337 IPC has been registered. The intimation regarding repudiation vide letter dated 08.08.2013 of the claim has already been given to the complainant. The complainant is bound as per terms and conditions of the policy to settle the claim within the framework and as such there arose no question of giving shelter to anyone, come what may and the claim is only settled when the same falls within the corners of terms and conditions of the policy.  The Op No.2 on receiving the information deputed the surveyor who on the basis of physical verification assessed the loss to the tune of Rs.42,913/-. There is clear cut breach of terms and conditions of the policy; therefore, the claim has rightly been repudiated. Other contentions have been controverted and prayer for dismissal of the complaint has been made. In evidence, the Op No.2 has tendered affidavit Annexure RA and documents Annexure R1 to Annexure R10.

3.             We have heard learned counsel for the parties and gone through the case file very carefully.

4.             Learned counsel for the complainant has argued that the accident had occurred on 01.05.2013 during the subsistence of the policy in question 05.06.2012 to 04.06.2013 Annexure C1 but when the claim on account of damage of the tractor in question has been lodged with the Op No.2, it repudiated the same on the ground of Limitation as to use wrongly and illegally.

                Per contra, learned counsel for the Op No.2 has argued that the insurance company has rightly repudiated the claim of the complainant vide repudiation letter dated 08.08.2013 Annexure R8 as there was breach of terms and conditions of the policy. He drew the attention of this Forum towards General Exceptions mentioned in Annexure R10 which are as under:

                        General Exceptions:

3. Any accidental loss damage and/or liability caused sustained or incurred whilst the vehicle insured herein is

a)     Being used otherwise than in accordance with the ‘Limitation as to use’

b)     Being driven by or is for the purpose of being driven by him/her in the charge of any person other than a driver as stated in the Driver’s Clause.

 

4.             Undisputedly, the vehicle of the complainant was insured with the Op No.2 at the time of accident. The main ground of the Op No.2 insurance company for rejection of the claim is that there was breach of condition No.3 of the policy because at the time of alleged accident there was 3 persons traveling in the insured vehicle including the driver whereas the permitted seating capacity of the vehicle as per the registration certificate is only one. There may be a condition in the policy regarding limitation to use but that does not mean that the insurer can take the shelter under that condition and repudiate the claim of the complainant which is otherwise proved to be genuine. It is worthwhile to mention here that the insurers’ decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such limitation clause does work in isolation and is not absolute. One needs to see the merits and good spirit of the clause, without compromising on bad claims. Rejection of claims on purely technical grounds in a mechanical fashion will result in policy holders losing confidence in the insurance industry, giving rise to excessive litigation. In the present case it appears that that insurance company is bent upon to reject the claim in this way or that way. Undisputedly, in the present case the surveyor was appointed by the insurance company who after physical verification gave his report and the same is placed on the case file as Annexure R3. Perusal of this very document reveals that the surveyor had assessed the net liability of insurer to the tune of Rs.42913/-. Since the surveyor appointed by the insurance himself has coincided the damage to the vehicle with accident, therefore, there was no need to lodge any police complaint/FIR for the claim as the damage to the vehicle was occurred during the subsistence of the policy.  It is a settled proposition of law that Surveyor is the best person to assess the loss and his report cannot be brushed aside unless there is cogent and convincing evidence. In the instant case also, no credible evidence has been produced on the basis of which Surveyor’s report could be dis-believed.

5.             Keeping in view the above facts and circumstances of the case it is held that the insurance company has wrongly rejected the claim of the complainant on the ground of limitation as to use of the vehicle.

6.                     Now we are coming on the point of compensation. The complainant in his arguments has stressed that he has spent Rs.72,109/- for repairing the vehicle (Annexure C4) but surveyor has wrongly assessed the amount of Rs.42913/-. The complainant has failed to rebut the report of surveyor Annexure R3. Accordingly, we held that the OP No.2 has wrongly and illegally repudiated the claim of the complainant and the impugned repudiation letter dated 08.08.2013 (Annexure R-8) is hereby quashed. The present complaint is allowed against OP No.2 with cost which is assessed as Rs.5,000/-. The OP No.2 is further directed to comply with the following direction within thirty days of the receipt of copy of the order:-

1. To pay a sum of Rs. 42319/- (as assessed by the surveyor in his report Annexure R3) to the complainant alongwith with simple interest @ 9% per annum from the date of filing of complaint till actual realization.

 

                   Copy of the order be sent to the parties concerned, free of costs, as per rules. File after due compliance be consigned to record room.

 

Announced on: 22.03.2018

 

                                                               

PUSHPENDER KUMAR      ANAMIKA GUPTA        D.N. ARORA MEMBER                                MEMBER                        PRESIDENT