DISTRICT   CONSUMER   DISPUTES   REDRESSAL FORUM,GURGAON-122001.

                                                                                           Consumer Complaint No: 396 of 2010                                                                                                                                       Date of Institution: 10.05.2010                                                                                                                                               Date of Decision: 04.11.2015.

Balbir Singh s/o Sh. Amar Singh, R/o Village and P.O.Khandsa, Tehsil and District Gurgaon.

                                                                                         ……Complainant.

                                                Versus

Reliance General Insurance Company, Group Floor, Palm Courts, Near Maharana Partap Chowk, Gurgaon.

                                                                                                ..Opposite party

Complaint under Sections 12 & 14 of Consumer Protection Act,1986                                                                  

BEFORE:     SH.SUBHASH GOYAL, PRESIDENT.

                     SMT JYOTI SIWACH, MEMBER

 SH.SURENDER SINGH BALYAN, MEMBER.

Present:        Sh. Subhash Grover, Adv for the complainant.

                    Sh. N.K.Kalra, Adv for the opposite party.

ORDER       SUBHASH GOYAL, PRESIDENT.       

The case of the complainant, in brief, is that he is registered owner of car make Hyundai i10 bearing Regd. No.HR-26-AR-1439 and the said vehicle was insured with the opposite party vide cover Note No.10800115966 which was valid from 14.03.2009 to 13.03.2010 with IDV of Rs.3,30,000/-. On 08.08.2009 the son of the complainant namely Krishan was driving the said vehicle. All of sudden a Neel Gai came on the road and said Krishan lost the control of the vehicle and the vehicle hit the Tractor make Swaraj bearing Regd. No.UP-14-2210 which was parked on the road. In the said accident Krishan died due to the injuries sustained by him in the accident. On 10.08.2009 the complainant moved an application to SHO, Tappal Aligarh and one GD Entry No.11A dated 15.08.2009 was registered in Police Station, Faridabad. Necessary information regarding occurrence was given to the opposite party and all necessary documents were submitted with the opposite party  for reimbursement of claim but the opposite party failed to reimburse the same. Thus, the opposite party was deficient in providing services to the complainant. The complainant prayed that the opposite party be directed to pay the claim to the tune of Rs.3,30,000/- with interest along with compensation of Rs.50,000/-. The complaint is supported with an affidavit and the documents placed on file.

2                 The opposite party in its written reply has alleged that opposite party issued policy/cover note No.1304782311017759 which was valid from 14.03.2009 to 13.03.2010. The said vehicle met with an accident on 08.08.2009. The loss was intimated and all the documents were submitted. However, on enquiry it was revealed that at the time of taking the present policy the petitioner filled the proposal form and submitted the previous policy of ICICI Lombard General Insurance Company (ICICILGICL). The present policy was issued in good faith believing the complainant’s proposal form showing that he has not taken any claim from the previous policy of the ICICILGICL whereas after the enquiry from the previous policy issued by ICICIGICL it was revealed that the complainant has availed 20 % NCB in the present policy by giving statement of not taking any claim from the previous insurer though he has taken the claim in his previous policy issued by ICICIGICL and thus, the complainant has submitted false declaration form and consequently his claim was rightly repudiated by the opposite party vide letter dated 01.02.2010 and thus, there was no deficiency in service on the part of the opposite party.

3                 We have heard the learned counsel for the parties and perused the record available on file.

4                 Therefore, from the facts and circumstances of the case, evidence on the file and the arguments advanced by the learned counsel for the parties, it emerges that the complainant has filed the present complaint against the OP alleging deficiency in service on their part on the ground that he was the registered owner of insured vehicle No.HR-26-AR-1439 which was insured vide cover note No.10800115966 and effective from 14.03.2009 to 13.03.2010. During the subsistence of the insurance policy i.e. on 08.08.2009 the insured vehicle met with an accident  and the matter was reported to the police. The complainant was also informed the opposite party about the occurrence and submitted all the necessary documents for reimbursement of claim but the opposite party has wrongly and illegally repudiated his claim vide letter dated  01.02.2010 on the ground

“that the complainant had taken 20 % No Claim Bonus from the opposite party under the pretext that he has not lodged any claim with the previous insurer though as per verification it was found that he had taken one claim from the previous insurer and thus, his declaration given to the opposite party was found incorrect.”

Learned counsel for the complainant has contended that as per clause (f) of GR 27 of India Motor Tariff 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 NCB but the opposite party failed to comply with the aforesaid clause. In support of his contentions learned counsel for the complainant has placed reliance on United India Insurance Co. Ltd Vs Bhupinder Singh in RP No.473 of 2013 decided on 01.04.2013 by the Hon’ble National Consumer Disputes Redressal Commission, National Insurance Co. Ltd Vs Nitin Khandelwal IV (2008) CPJ 1 (SC) and S.S.Arshi Vs The New India Assurance Co. Ltd in First Appeal No.471 of 2013 decided on 01.01.2014 by the Hon’ble States Consumer Disputes Redressal Commission, U.T. Chandigarh.

5                 However, the contention of the opposite party is that the claim of the complainant has rightly been repudiated by the opposite party vide letter dated 01.02.2010 as on enquiry it was revealed that at the time of taking the present policy the complainant filled the proposal form and submitted the previous policy of ICICI Lombard General Insurance Company (ICICILGICL). The present policy was issued in good faith believing the complainant’s proposal form showing that he has not taken any claim from the previous policy of the ICICILGICL whereas after the enquiry regarding previous policy issued by ICICIGICL it was revealed that the complainant has availed 20 % NCB in the present policy by giving statement of not taking any claim from the previous insurer though he has taken the claim in his previous policy issued by ICICIGICL and thus, the complainant has submitted false declaration form. Thus, the repudiation of the claim by the opposite party was justified. In support of his contention he has placed reliance on TATA AIG GENERAL INSURANCE CO. Vs Gulzari Singh in Revision Petition No.1255 of 2009 decided on 26.02.2010 by the Hon’ble National Consumer Disputes Redressal Commission, New Delhi.

6                 Therefore, after going through the facts and circumstances of the case and the evidence on file it is evident that the complainant has taken insurance policy from the opposite party and during the subsistence of the insurance policy his vehicle  met with an accident and he submitted the claim with the opposite party but it was repudiated by the opposite party. It also emerges that the complainant has submitted false declaration form to the effect that he has not claimed any compensation under the previous policy and therefore, the repudiation by the opposite party was justified. However, keeping in view the Socio Economic Benevolent Legislation in the form of Consumer Protection Act, 1986 and in view of the laid down by the Hon’ble Apex Court in case National Insurance Company Vs Nitin Khandelwal, 2008 CTJ 680 (Supreme Court )(CP) and the law  by the Hon’ble National Commission in case  United India Insurance Co. Ltd Vs Bhupinder Singh (supra) and  by the Hon’ble State Commission in case S.S.Arshi Vs The New India Assurance Company (supra) and to meet the ends of justice, we direct the opposite party to settle the claim of the complainant on non-standard basis i.e. 75 % of the insured amount subject to fulfillment of requirements by the complainant in terms of the insurance policy. However, complainant is not entitled to any compensation as there was no deficiency in service on the part of the opposite party. However, the complainant is entitled to litigation expenses of Rs.3100/-. Opposite party shall make the compliance of this order within 30 days from the date of receipt of the copy of this order failing which complainant will be entitled to interest@ 9 % p.a. from the date of filing of the present complaint i.e. 10.05.2010 till realization.  The parties concerned be communicated of the order accordingly and the file be consigned to the records after due compliance.

Announced                                                                             (Subhash Goyal)

04.11.2015                                                                                   President,

                                                                                                 District Consumer Disputes

                                                                                                  Redressal Forum, Gurgaon

(Jyoti Siwach)        (Surender Singh Balyan)

Member                 Member