Haryana

Yamunanagar

CC/226/2013

Deep Chand Saini S/o Lal Singh - Complainant(s)

Versus

Reliance General Insurance Company Ltd. - Opp.Party(s)

Atul Jaiswal

12 Jul 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

 

                                                                                    Complaint No. 226 of 2013

                                                                                    Date of institution: 18.03.2013  

                                                                                    Date of decision: 12.07.2017

 

Deep Chand Saini son of Shri Lal Singh, aged about 60 years, resident of House No.462, Kuldeep Nagar, Yamuna Nagar.

 

 …Complainant.

                                                            Versus

 

1. Reliance General Insurance Company Limited, 570 Nigam Cross Road, Next to Royal Industrial Estate Wadala (W) Mumbai-400031.

 

2. Reliance General Insurance Company Limited, Near kamani Chowk, Yamuna Nagar.

                                                                                                                                                                                                                                                                                                                            …Respondents.

              

BEFORE:       SH. ASHOK KUMAR GARG…………….. PRESIDENT.

                      SH. S.C.SHARMA………………………….MEMBER.

                      SMT. VEENA RANI SHEOKAND………....MEMBER.

                       

Present:          Shri Atul Jaiswal, Advocate for complainant

                      Shri Rajiv Gupta, Advocate for OPs.

 

ORDER (ASHOK KUMAR GARG, PRESIDENT)

 

1.                     The present complaint has been filed under section 12 of the Consumer Protection Act. 1986 (amended upto date) against the respondents (hereinafter respondents will be referred as OPs).

2.                     Brief facts of the complaint, as alleged in the complaint, are that truck/tralla bearing No.HR58A-5377 of the complainant which was comprehensively insured vide insurance policy bearing No.2004712334004544 valid from 14.03.2012 to 13.03.2013 for a sum insured of Rs.9,50,000/-, unfortunately on 30.07.2012 met with an accident at village Sainivas, Tehsil Siwana, District Bhiwani with another truck bearing No.HR64-2433 and badly damaged. Upon which complainant lodged the claim with the OPs Insurance company and OPs Insurance company appointed their surveyor M/s Arora Associates who inspected the damaged truck and submitted his report to the OPs Insurance company. All the documents i.e. FIR, Registration Certificate, Route Permit, Copy of Bilty, Driving License of truck Sonu along with its verification were handed over to the surveyor at the time of filing the claim form. However, the OPs Insurance Company did not pass the genuine claim of the complainant till today nor had repudiated the same despite many requests made to them by the complainant. A request was also made for passing the claim vide registered letter dated 17.09.2012 to the Regional Manager of OPs Company, but all in vain. Lastly it has been prayed that the OPs be directed to pay Rs.2,78,557/- on account of damage and repair of the said truck and also to pay compensation as well as litigation expenses.

3.                     Upon notice, Insurance Company appeared and filed its written statement taking some preliminary objections such as complaint is not maintainable; there is no negligence or deficiency in service on the part of the OPs and on merit insurance particulars and facts of accident on 30.07.2012 is denied being a matter of record. However, it has been admitted that on receipt of the intimation regarding accident dated 30.07.2012, the OPs Insurance Company immediately deputed M/s Arora Associates Surveyor and Loss Assessor to survey and asses the loss if any to the truck in question. The complainant was also desired to submit the necessary documents and fill up the claim form for processing the claim. It has been further mentioned that it has come in the police investigation  that at the time of accident the regular driver on the said truck namely Rajiv kumar was not driving the truck in question but the cleaner of said truck namely Sonu who was a unlicensed driver at that time and who was not knowing the driving skills was driving the truck in question in utter violation of the terms and conditions of the insurance policy and provision of motor Vehicle Act. These facts have been reported in a number of newspapers and even the remand papers submitted by the concerned police official. Further, it has been mentioned that Sonu was unlicensed driver which is duly substantiated by the claim Form submitted by the insured on 08.11.2012, wherein the insured has neither filled up the particulars of the driving license of the cleaner Sonu nor submitted any details of the same. Any Driving License of Sonu, if produced later, is forged and illegal documents prepared/produced by fabricating the record of Licensing Authority and as such said documents has no force in the eyes of law. So, in view of the facts mentioned above, no claim was payable under the policy in question. However, to quantify the loss the truck in question, a detailed survey of the damaged truck was conducted and after taking into consideration the age of the vehicle and relevant depreciation clause assessed the net loss to the tune of Rs.1,42,000/- on repair basis as per report submitted by the surveyor to the OPs Insurance Company, but this report was subject to terms and conditions of the Insurance policy and as per terms and conditions of the insurance policy no claim was payable to the complainant. Rest contents of the complaint were denied being wrong and incorrect. Lastly prayed for dismissal of the complaint.

4.                     In support of his case, learned counsel for the complainant tendered into evidence affidavit of complainant as Annexure CW/A, photocopy of Insurance cover note as Annexure C-1, photocopy of FIR as Annexure C-2, photocopy of Registration Certificate of Truck bearing truck No. HR58A-5377 in the name of Deep Chand Saini, Complainant as Annexure C-3, photocopy of bilty dated 29.07.2012 as Annexure C-4, photocopy of driving license bearing No.10018/TV/21011  as Annexure C-5, photocopy of verification report of DL issued by RTO/DTO Zunhevoto – Nagaland as Annexure C-6, photocopy of claim form as Annexure C-7, photocopy of letter dated 03.09.2012 as Annexure C-8, photocopy of estimate of repair bills as Annexure C-9 to C-13, photocopy of letter dated 21.12.2012 and 17.09.2012 as Annexure C-15 and C-16, photocopy of verification issued by RTO/DTO Zunhevoto – Nagaland under RTI as Anneure C-17, attested photocopy of judgment of M.A.C.T. case No.187 of 2012 decided on 29.11.2014 by  Hon’ble M.A.C.T. Kaithal as Annexure C-18 and closed the evidence on behalf of complainant.

5.                     On the other hand, learned counsel for the OPs tendered into evidence affidavit of Shri Gaurav Gaba, Manager Legal Reliance General Insurance  Company as Annexure RW/A, affidavit of Shri Amarjit Singh , Surveyor and loss assessor as Annexure RW/B, photocopy of FIR as Annexure R-1, photocopy of report under Section 173 Cr.P.C. as Annexure R-2, photocopy of surveyor report as Annexure R-3, photocopy of claim form as Annexure R-4, attested copy of Insurance policy along with its terms and conditions as Annexure R-5 and closed the evidence on behalf of OPs.  

6.                     We have heard the learned counsel for both the parties and have gone through the pleadings as well as documents placed on file very minutely and carefully.

7.                     It is not disputed that truck of the complainant bearing No.HR58-A-5377 was isnured for a sum of Rs.9,50,000/- vide insurance policy bearing No.2004712334004544 valid from 14.03.2012 to  13.03.2013 with the OPs Insurance company which is duly evident from the photocopy of Insurance policy (Annexure C-1/R-5).  It is also not disputed that truck in question met with an accident on 30.07.2012  which is also duly evident from the copy of FIR No. 142 dated 30.07.2012 (Annexure C-2/R-1) registered under Section 279, 337,338 and 304A IPC PS Siwana, District Bhiwani and further from the copy of report under Section 173 Cr.P.C.  as Annexure C-2/R-2. It is also not disputed that on intimation of the complainant, a surveyor and loss assessor Shri Amarjit Singh of Arora Associates, Chandigarh was deputed by the OPs insurance company who assessed the net loss to the tune of Rs.1,42,000/- of repair basis and submitted his report to the OPs Insurance company which is also duly evident from the copy of surveyor report (Annexure R-3).

8.                     The only grievance of the complainant is that his genuine claim has been wrongly and illegally withheld by the OPs insurance company on the false ground whereas the driver of the truck /so-called cleaner Sonu was having valid and effective driving license at the time of alleged accident. Learned counsel for the complainant draw our attention towards photocopy of driving license and verification report No.10018/TV/21011   issued in the name of Sonu son of Som Pal and valid upto 26.07.2014 with effect from 27.07.2011 for HTV/HGV, only and MC, LMV only with effect from 09.03.2010 issued by DTO/RTO Zunhevoto – Nagaland (Annexure C-5 and C-6). Learned counsel for the complainant draw our attention towards the photocopy of verification report obtained under RTI Act regarding verification  of driving license of Sonu (Annexure C-17) and argued that from the perusal of verification report of Driving license as well as driving license (Annexure C-5) it is clear that the so-called driver Sonu was having a valid and effective driving license at the time of accident. Learned counsel for the complainant further draw our attention towards the attested photocopy of judgment passed by Hon’ble MACT in MACT case No.187/2012 decided on 29.11.2014 (Annexure C-18) and argued that from the perusal of this judgment also it is clear that the Sonu S/o Shri Som Pal  was driving the truck  in question, who was having valid and effective driving license at that time as the entire award amount has been passed by Hon’ble M.A.C.T against Driver Sonu and owner Deep Chand Saini and the Ops Insurance Company jointly and severally. Learned counsel for the complainant further argued that the OPs Insurance Company has totally failed to prove that the driving license issued by DTO/RTO Zunhevoto – Nagaland (Annexure C-5) fake one or not issued by that authority and in the absence of any cogent evidence the OP Insurance Company has wrongly and illegally withheld the genuine claim of the complainant and lastly prayed for acceptance of the complaint. Learned counsel for the complainant referred the case law titled as Prithvi Raj Vs. OIC, 2005(1) CPC 688 wherein it has been held that

 

“Insurance Claim- only ground for repudiation of claim was that original driving licence was not produced- Duplicate copy of licence was duly produced- In the accident of insured Bus both driver and conductor had died- Burden to prove that driving licence was fake one has not been discharged by Insurance Company- Insurer directed to settle the claim as per assessment report of surveyor- United Insurance Company Versus Lehru 2003(2) S.L.T. 516 followed.

 

9                      On the other hand, learned counsel for the OPs argued at length that at the time of filing the claim form, the insured has not submitted any particulars of the driving license of the driver, cleaner Sonu nor submitted any details of the same. The DL issued by DTO/RTO Zunheboto – Nagaland is fake and illegal documents prepared/procured by fabricating the record of Licensing Authority and as such the said documents i.e. DL has no value in the eyes of law and requested for dismissal of the complaint. Learned counsel for the OPs referred the case law titled as United India Insurance Company Limited Vs. Harchand Rai Chandan Lal, 2004(2) CPC, 686 which is reproduced here as under:

Consumer Protection Act, 1986- Section 14 and 23- Insurance Policy- Burglary/theft – complainant/respondent had obtained an insurance policy against burglary and house breaking policy for a sum of Rs.7  lakhs- The term “Burglary and House Breaking” was defined in the terms of policy in which forcible and violent means or assault was necessary to prove an act of burglary or theft- Both the authorities below accepted the claim of claimant which cannot be sustained as element of force and violence conditions precedent for burglary and house breaking was not established – Appeal allowed.

 

and referred the another case law tilted as “Kuljit Singh Vs. Surender Kumar, 2015, 4 PLR, P-273”.

10.                   After hearing both the parties, we are of the considered view that the OPs Insurance Company has wrongly and illegally withheld the claim of the complainant. From the perusal of photocopy of DL and verification report  issued by DTO/RTO Zunheboto – Nagaland (Annexure C-5, C-6 and C-17). It is duly evident that so called driver/cleaner Sonu was having a valid and effective Driving License at the time of accident. Further, we have also perused the attested photocopy of judgment passed by Hon’ble M.A.C.T. Kaithal (Annexure C-8) in which also the Hon’ble Tribunal has held liable to the OPs Insurance Company to pay the entire amount to the claimants holding that the driver/Cleaner Sonu was having a valid license at the time of accident as OPs Insurance Company did not lead any evidence to prove that there was violations of terms and conditions of the Insurance policy on the part of the insured. In the present complaint also the OPs insurance company has also failed to prove that the said Sonu was not having a valid and effective Driving License at the time of accident.

11.                   Whereas on the other hand, the complainant has duly proved on the file by placing the photocopy of DL (Annexure C-5) and verification of DL (Annexure C-6), that Sonu was having valid and effective DL at the time of accident. The version of the OPs Insurance Company mentioned in the written statement that Sonu was unlicensed at the time of accident is not tenable and it seems that this ground has been created by the OPs Insurance Company just to save the skin from the liability. The case law referred by learned counsel for the OPs titled as United India Insurance Company Limited Vs. Harchand Rai Chandan Lal, 2004(2) CPC, 686, “Kuljit Singh Vs. Surender Kumar, 2015, 4 PLR, P-273”. (Supra) is not disputed but not helpful in the present case as the OPs insurance company neither repudiated the claim of the complainant on this ground nor it has been proved that license issued by DTO/RTO Zunhevoto – Nagaland was not valid and effective at the time of accident. When the OPs insurance company has not repudiated the claim of the complainant on the ground that Sonu was not competent to drive the vehicle and further was not having any connection with the place of issuing of the DL i.e. Zunheboto– Nagaland than how the OPs Insurance company can raise such objections at the time of filing of written statement. As such the OPs Insurance Company has wrongly and illegally withheld the claim of the complainant which constituted the deficiency in service and unfair trade practice on the part of the OPs.

12.                   Resultantly, in the circumstances noted above and after going through the case law referred above, we are of the considered view that the OPs Insurance Company has wrongly and illegally withheld the claim of the complainant. Accordingly, we partly allow the complaint of the complainant and direct the OPs Insurance Company to pay Rs.1,42,000/- the amount assessed by the Surveyor along with interest @ 6% per annum from the date of filing  the present complaint till realization and further also to pay Rs.2200/- as litigation expenses. A copy of this order be sent to the parties free of cost as per rules. File be consigned to the record room after due compliance.

 

Announced in open Court:

Dated: 12.07.2017.

                                                                                   

		(ASHOK KUMAR GARG) PRESIDENT,DCDRF, YAMUNANAGAR.
(VEENA RANI SHEOKAND) MEMBER	(S.C.SHARMA) MEMBER