Haryana

Panchkula

CC/28/2016

SHISH PAL SINGH. - Complainant(s)

Versus

RELAINCE GENERAL INSURANCE CO.LTD. - Opp.Party(s)

JAIMINI TIWARI.

19 Jul 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,  PANCHKULA.

                                                         

Consumer Complaint No	:	28 of 2016
Date of Institution	:	04.02.2016
Date of Decision	:	19.07.2016

                                                                                          

Shish Pal Singh S/o Late Sh.Rajvir Singh, R/o House No.428-A, Sector-15, Panchkula.

 

                                                                                      ….Complainant

Versus

 

1. Reliance General Insurance Co. Ltd., SCO 145-16, 2^nd Floor, Madhya Marg, Sector-9C, Chandigarh-160009, through its authorized representative.
2. Reliance General Insurance Co. Ltd., Reliance Centre, 19, Wal Chand Hira Chand Marg, Ballard Estate, Mumbai, through its authorized representative
3. Care Taker, Maruti Service Centre, Plot No.35-36, Indl. Area, Phase II, Panchkula.

                                                                   ….Opposite Parties

 

COMPLAINT UNDER SEC. 12 OF THE CONSUMER PROTECTION ACT, 1986.

 

Before:                 Mr.Dharam Pal, President.

              Mrs.Anita Kapoor, Member.

              Mr.S.P.Attri, Member.

 

For the Parties:     Ms.Jaimini Tiwari, Adv., for the complainant. 

Mr.Mohinder Bindal, Adv., for the Ops No.1 and 2.(Defence already struck off).

Op No.3 already ex-parte.

 

ORDER

 

(Dharam Pal, President)

 

1. The complainants have filed this complaint under Section 12 of the Consumer Protection Act, 1986 against the Ops with the averments that he got insured his vehicle bearing No.HR-03P-1211 from the Op No.1 vide policy bearing No.2010542311006140 for the period from 03.08.2014 to 02.08.2015. Unfortunately, the vehicle of the complainant met with accident on 15.03.2015 and the complainant informed the OP No.1 through Op No.3. The vehicle was taken to OP No.3 for repairs. The complainant was assured by the Op No.3 that as the vehicle was having valid insurance, the claim would be settled by the OP No.1 and the complainant would not have to pay anything from his pocket. When the vehicle of the complainant was repaired, the Ops No.1 and 2 were asked to pay the insurance amount but they refused to pay the amount. The vehicle of the complainant was unlawfully detained by the OP No.3 and the complainant was persuaded to pay the amount of Rs.29,439/- in order to get his vehicle released from the custody of the OP No.3. Thereafter, the complainant visited the office of Ops for settlement of claim but to no avail. The OP No.3 informed the complainant that because of misrepresentation of fact with regard to NCB, the claim of the complainant was repudiated. The complainant deposited NCB premium as additional endorsement to the policy. Thereafter, neither the complainant received any sort of correspondence from the Ops with regard to NCB or repudiation letter. The complainant also made many requests at customer care and even visited the Op No.1 but to no avail. Thereafter, on the request of the complainant, in the month of November, 2015, the Ops issued repudiation letter dated 04.04.2015 on the ground that NCB has been wrongly claimed was provided to the complainant without any stamp of OP. From the perusal of the repudiation letter, the Ops have taken GR (F) of Indian Motor Tariff which is reproduced as under:-

“In the event of the insured, transferring his insurance from one insurer to another insurer, the transferee insurer may allow the same rate of NCB which the insured would have received from the previous insurer. Evidence of the insured’s NCB entitlement either in the form of a renewal notice or a letter confirming the NCB entitlement from the previous insurer will be required for this purpose.

Where the insured is unable to produce such evidence or NCB entitlement from the previous insurer, the claimed NCB may be permitted after obtaining from the insured a declaration as per the following wording:

“I/We declare that the rate of NCB claimed by me/us is correct and that no claim as arisen in the expiring policy period (copy of the policy enclosed). I/We further undertake that if this declaration is found to be incorrect, all benefits under the policy in respect of Section 1 of the Policy will stand forfeited.”

Notwithstanding the above declaration, the insurer allowing the NCB will be obliged to write to the policy issuing office of the previous insurer by recorded delivery calling for confirmation of the entitlement and the rate of NCB for the particular insured and the previous insurer shall be obliged to prove the information sought within 30 days of receipt of the letter of enquiry failing which the matter will be treated as a breach of Tariff on the part of the previous insurer. Failure of the insurer granting the NCB to write to the previous insurer within 21 days after granting the cover will also constitute a breach of the Tariff.”

The Ops were duty bound to check from the previous insurer within 21 days after granting cover and the date of commencement of policy was 03.08.2014 but the Ops have failed to discharge their duty. This act of the opposite parties amounts to deficiency in service on their part. Hence, this complaint.

2. The Ops No.1 and 2 appeared through his counsel Mr.Rajesh Kaul who sought time for filing written statement and the case was adjourned to 04.04.2016 for filing written statement. On 04.04.2016, the counsel for the Ops No.1 and 2 again sought time for filing written statement and the case was adjourned to 18.04.2016. On 18.04.2016, none has appeared on behalf of the Ops No.1 and 2 and the case was adjourned to 04.05.2016 for filing written statement. On 04.05.2016 again none has appeared on behalf of the Ops No.1 and 2 and the defence of the Ops No.1 and 2 was struck off vide order dated 04.05.2016.
3. Notice was issued to the Op No.3 through registered post. But none has appeared on behalf of the Op No.3. It is deemed to be served and it was proceeded against ex-parte vide order dated 15.03.2016.
4. The complainant has tendered into evidence affidavit Annexure C-A alongwith documents Annexure C-1 to C-5 and closed the evidence.
5. We have heard learned counsel for the parties and have perused the record and have also considered the written arguments placed on record by Ops No.1 and 2.
6. It is the case of the complainant that he is the owner of Alto K10 VXI bearing registration No.HR-03P-1211 and got his vehicle insured from the Op No.1 for the period from 03.08.2014 to 02.08.2015 (Annexure C-1). The car met with an accident on 15.03.2015 thereafter, the claim was lodged but the Ops repudiated the claim of the complainant on the plea that no claim bonus was claimed by the complainant from the previous policy.
7. It is pertinent to mention here that the claim of the complainant was repudiated by the Op No.3 on the ground of misrepresentation of fact with regard to NCB and the Ops issued repudiation letter dated 04.04.2015. The Ops No.1 and 2 in their written arguments has also mentioned that on receipt of intimation from the complainant, they immediately appointed Sh.Ravi Kumar as an independent surveyor and loss assessor duly licensed by IRDA to assess the loss. The surveyor assessed the loss to the tune of Rs.22,539/- subject to the terms and conditions of the insurance policy and approval of claim by the competent authority. During the process of claim, the Ops came to know that the complainant had already availed one claim from the previous insurer i.e. Tata AIG General Insurance Co. Ltd. Hence, the complainant concealed the material facts from the OPs and the claim of the complainant had been repudiated due to the grounds mentioned above. But the Ops did not place on record any document in this regard.
8. The complainant in his complaint also mentioned about the clause (f) of GR 27 of India Motor Tariff, which is extracted hereunder, to confirm from the Policy issuing office, in respect of the previous policies, as to whether, any claim had been obtained by the complainant or not:-

“(f) In the event of the insured, transferring his insurance from one insurer to another insurer, the transferee insurer may allow the same rate of NCB which the insured would have received from the previous insurer. Evidence of the insured’s NCB entitlement either in the form of a renewal notice or a Letter confirming the NCB entitlement from the previous insurer will be required for this purpose.

Where the insured is unable to produce such evidence of NCB entitlement from the previous insurer, the claimed NCB may be permitted after obtaining from the insured a declaration as per the following wording:

“I/we declare that the rate of NCB claimed by me/us is correct and that no claim as arisen in the expiring policy period (copy of the policy enclosed). I/we further undertake that if this declaration is found to be incorrect, all benefits under the policy in respect of Section I of the policy will stand forfeited.”

Notwithstanding the above declaration, the insurer allowing the NCB will be obliged to write to the policy issuing office of the previous insurer, by recorded delivery calling for confirmation of the entitlement and rate of NCB for the particular insured and the previous insurer shall be obliged to provide the information sought within 30 days of receipt of the letter of enquiry, failing which the matter will be treated as a breach of Tariff on the part of the previous insurer. Failure of the insurer granting the NCB to write to the previous insurer within 21 days, after granting the cover will also constitute a breach of the Tariff.”

9. It is evident from the aforesaid extract clause (f) of the GR 27 of India Motor Tariff that the insurer was also duty bound to write to the previous insurer, within 21 days, after granting the cover for confirmation of the entitlement and rate of no claim bonus. Since the policy had been issued by the Ops in respect of the vehicle in question in favour of the complainant, it was their duty to obtain the information, as to whether, any claim had been obtained by the complainant in respect of the policy of the previous year, within 21 days but it failed to do so. Under these circumstances, the fault also lay on the shoulders of the Ops in not confirming about this factum, within the specified time, stipulated in the aforesaid clause (f) of GR 27 of India Motor Tariff. As stated above, in these circumstances, by no stretch of imagination, it could be said that by repudiating the claim of the complainant, as a whole, especially when the Ops were also at fault, on account of contravention of clause (f) of GR 27 of India Motor Tariff, it was not deficient, in rendering service, to some extent.
10. Here, we are fortified by the similar view taken by the Hon’ble National Consumer Disputes Redresal Commission, New Delhi in R.P. No.1397 of 2015 titled as “Bajaj Allianze General Insurance Co. Ltd. versus Tejas Trimbaklal Upadhaya & Anr.” decided on 18.02.2016.
11. Hence, the present complaint of the complainant deserves to succeed against the Ops and the same is partly allowed. The Ops are jointly and severally directed as under:-

(i)      To pay Rs.22,539/- to the complainant as assessed by the surveyor alongwith 9% interest p.a. from the date of repudiation of claim i.e. on 04.04.2015.

(ii)     To pay Rs.5,000/- as compensation for harassment and mental agony.

(iii)    To pay Rs.5,000/- as cost of litigation.

 

Let the order be complied within 30 days from the receipt of the certified copy of the order. A copy of this order be sent to the parties free of costs and file be consigned to the record room after due compliance.

 

Announced

19.07.2016        S.P.ATTRI         ANITA KAPOOR        DHARAM PAL

                          MEMBER          MEMBER                     PRESIDENT

 

 

Note: Each and every page of this order has been duly signed by me.

 

    

                                 

                                                         DHARAM PAL

                                                          PRESIDENT