BEFORE THE DISTRICT CONSUMER DISPUTES
REDRESSAL COMMISSION, JALANDHAR.
Complaint No.473 of 2018
Date of Instt. 13.11.2018
Date of Decision:05.07.2022
M/s Ajay International, Village Wadala, Near Ranvir Gas Godown, Nakodar Road, AS Farm Road, Jalandhar, Punjab through Shri Ajay Kumar, Proprietor.
..........Complainant
Versus
1. Royal Sundaram General Insurance Co. Ltd., Corporate Office: Vishrani Melaram Towers, No.2/319, Rajiv Gandhi Salai (OMR), Karapakkam, Chennai 600097 Through its Managing Director/Chairman.
2. Royal Sundaram General Insurance Co. Ltd., Branch Office Jalandhar, 4th Floor, City Square, Near Kesar Petrol Pump, GT Road, Jalandhar through its Branch Manager.
….….. Opposite Parties
Complaint Under the Consumer Protection Act.
Before: Dr. Harveen Bhardwaj (President)
Smt. Jyotsna (Member)
Sh. Jaswant Singh Dhillon (Member)
Present: Sh. Rakesh Kanojia, Adv. Counsel for the Complainant.
Sh. R. K. Sharma, Adv. Counsel for OPs No.1 & 2.
Order
Dr. Harveen Bhardwaj (President)
1. The instant complaint has been filed by the complainant, wherein it is alleged that the complainant is the registered owner of Toyota Innova Car Model 2016 bearing Engine No.1GDA030680 Chassis No.MBJJA8EM000503564 which it purchased from ANR Motors Pvt. Ltd., Kapurthala Road, Jalandhar. At the time of purchase of the vehicle, it was insured with Cholamandlam. The vehicle was registered with Registering Authority as PB-08-DN-5515. Later on, the complainant got the insurance policy renewed from the OP No.1 vide insurance policy No.VPC0906521000100 valid from 14.11.2017 to midnight of 13.11.2018. The renewed policy was purchased from M/s Grow Value Insurance Broker Pvt. Ltd., Jalandhar who have been duly authorized by OP No.1. The said broker-ship agency is now functioning under the OP No.2. The said vehicle met with an accident and the detailed facts of the accident are that the family had some mis-happening. The father-in-law of Shri Ajay Kumar expired and he had to go to Haridwar and Pehowa (Kurukshetra) Haryana for performing last rites of the deceased. On 10.08.2018, Ajay Kumar with other family members started for Haridwar at about 04:30 AM from Moga and after performing rites at Haridwar, the family left for Pehowa (Kurukshetra) at about 4 PM on the same day to perform Gati process of the deceased. Before the family reached Pehowa on Kurukshetra-Pehowa Road, at about 9 PM, the vehicle dashed with some stray animal, which came in front of the vehicle and the vehicle got stopped at a distance of about 10-15 feet. Ajay Kumar came out of the vehicle and saw the damage caused to the vehicle. At that time, 4-5 persons on the road side appeared and told that the vehicle was struck to a stray animal, may be NEEL GAI (Wild Cow) which ran from the site after having a hit by the vehicle. In the mean a passerby namely Shri Ravinder unknown to the deponent stopped his car, came out of his car to know the matter in whose presence all the persons again told that some stray animal struck into the vehicle. Shri Ravinder provided a lift to the family to Pehowa Kailash Dham as the family was getting late in performance of the Gati process of the deceased. The family left the vehicle under the control of the driver namely Surjit Singh to look after the same. Aforesaid Sh. Ravinder also sent the location of the accident to Nikhil Gupta son of Ajay Kumar, who informed Toyota on Toll Free Number, Company sent Recovery Crane bearing Regn. No.HR-65-A-2850 which toed the damaged vehicle to Globe Toyota Kurukshetra. Representative of Castle Toyota collected the vehicle from the site of accident and prepared a chart with regard to damages caused to the vehicle. On 11.08.2018 in the morning, Ajay Kumar planned to get the vehicle repaired from Jalandhar as Globe Toyota, Kurukshetra was far away and it was quite difficult to go to Kurukshetra for completing further formalities. As such, the vehicle was brought from Kurukshetra through Crane bearing Regn. No.HR-07-Y-7224 and was taken to ANR Motors Pvt. Ltd., Pathankot Road, Jalandhar for necessary repairs and the vehicle is still lying parked in the said company. The complainant paid a sum of Rs.8500/- for toeing the vehicle from Kurukshetra to Jalandhar. The complainant started process for getting claim against the damaged vehicle and filed claim No.PV00452950 on the basis of a valid insurance and filed requisite documents which the OPs acknowledged vide letter dated 23.08.2018. Claim cell appointed Sh. Jatinder Singh to assess the loss and informed the complainant vide letter dated 23.08.2018, but he did not allow the complainant to get the vehicle repaired as he had some doubt on the cause of loss although the complainant had explained the entire scenario to said Mr. Jatinder. The Surveyor of the company made an estimate assessing the loss to the tune of Rs.2,06,567.62 (exclusive of sales tax) but no further steps were taken by the Ops for the settlement of the claim of the complainant. Later on, the complainant approached Mr. Gupta (Claim Head at Chandigarh), also visited Toyota Agency, Jalandhar but the said Mr. Gupta put off the complainant to discuss the matter again but the complainant did not get any response from said Mr. Gupta. Vide letter dated 05.09.2018, the OPs showed their inability to entertain the claim of the complainant and repudiated the same. The complainant through his insurance broker brought his grievances to the notice of the OPs vide email dated 26.09.2018, but the same did not evoke any response. Later on, the company marked the investigation of the case to one Mr.Subham, who discussed the matter with the complainant and also sent him the location of the accident and also gave him contact number of Mr. Ravinder who witnessed the accident. But Subham did not contact the said Ravinder for the verification of the accident. Thereafter the complainant visited Claim Office, Chandigarh to discuss the matter, but unfortunately Mr. Gupta was not in the office and the complainant again discussed the matter with Mr. Jitender Kumar. The complainant made all earnest efforts for the settlement of its claim, sent emails, made other correspondence with the OPs, but the OPs illegally and unlawfully repudiated the legal and genuine claim fo the complainant on flimsy grounds that the cause of loss not relevant with the accident. The complainant sought information under RTI vide requisition dated 15.10.2018 to know about the final survey report and investigation report from the OPs. But the OPs failed to send any reply. The act and conduct of the OPs in repudiating the legal and genuine claim of the complainant is clear cut negligence and deficiency in service to the complainant and as such, necessity arose to file the present complaint with the prayer that the complaint of the complainant may be accepted and OPs be directed to settle the insurance claim of the complainant on the basis of valid insurance policy issued by the OPs. Further, OPs be directed to pay Rs.2,00,000/- as damages on account of unfair trade practice, negligence and deficiency in service and further OPs be directed to pay litigation expenses.
2. Notice of the complaint was given to the OPs, who filed reply and contested the complaint by stating that the complainant had taken a Private Car Package Policy from the OPs for his car Innova Crista 2.8 GX AT bearing registration No.PB-08-DN-5515 vide policy No.VPC0906521000100. The policy was issued for a period commencing from 14.11.2017 to 13.11.2018 subject to terms and conditions therein. It is further averred that a claim was lodged by the complainant under the above policy on 11.08.2018 alleging damage to the insured vehicle. Further, vide the claim form it was narrated that the car hit against a stray animal, on 10.08.2018 at 09:30 PM. That immediately on intimation of the claim the OPs appointed a surveyor to assess the loss. The surveyor vide his report assessed the loss to the tune of Rs.2,40,259/- without prejudice as to the claim admissibility. Thereafter the OPs called for the relevant claim documents in order to determine the claim admissibility. Subsequently, the claim documents were scrutinized and it was noted that the damage was precise and sharp to the bonnet as if it had hit against a metal part and that too without any mangling. It is further averred that the complainant has grossly violated the principle of utmost good faith which is the fundamental principle on which all contracts of insurance are based , by misrepresenting and suppressing the actual facts regarding the accident and lastly submitted that the complaint of the complainant is without merits, the same may be dismissed.
3. Rejoinder to the written statement filed by the complainant, whereby reasserted the entire facts as narrated in the complaint and denied the allegations raised in the written statement.
4. In order to prove their respective versions, both the parties have produced on the file their respective evidence.
5. We have heard the learned counsel for the respective parties and have also gone through the case file very minutely.
6. The complainant has alleged that he is owner of the Toyota Innova Car Model 2016 bearing No.PB-08-DN-5515 as per Ex.C-1. It has been alleged by the complainant that the vehicle was insured with Cholamandlam in the year 2016, but later on the policy was renewed from the OP No.1, vide insurance policy No.VPC0906521000100, from 14.11.2017 to 13.11.2018 as per Ex.C-2. The vehicle of the complainant met with an accident at Kurukshetra Pehowa Road on 10.08.2018. The claim was submitted on the basis of insurance alongwith the documents. The surveyor was appointed, who estimated and assessed the loss, to the tune of Rs.2,06,567.62 exclusive of sale tax, but the OPs repudiated the claim on the ground that the damage to the vehicle are not relevant to the cause of accident. The complainant has alleged that despite disclosing the place of accident to the OPs, the OPs have not considered the claim and have wrongly repudiated the same.
7. The complainant has filed on record the photographs of the vehicle Toyota Innova Ex.C-3, Ex.C-4 mentioning the detail and other photographs showing that the vehicle was brought to Jalandhar from Kurukshetra by engaging the Crane. The photographs have been proved as Ex.C-5, Ex.C-6 & Ex.C-7 and Ex.C-8 is the receipt showing that he has paid Rs.8500/- for engaging a Crane service. The complainant has proved his representations Ex.C-10 and information sought by the complainant through RTI Ex.C-11. The claim form has been proved by the OP Ex.O-2 and the report of the surveyor has been proved as Ex.O-3. The repudiation of the claim has been proved as Ex.O-4/Ex.C-9.
8. Perusal of the documents produced on record by both the parties and the oral evidence led by both the parties, this fact is proved that the policy was alive on 10.08.2018 when the accident took place. The complainant has categorically mentioned in his claim form Ex.O-2 that the stray animal hit front side on the car during driving. In this claim form, the place of accident has also been mentioned as Kurukshetra. The photographs Ex.C-5 to Ex.C-7 show that the car of the complainant has been brought from Kurukshetra to Jalandhar through Crane. The location as alleged was also sent to the surveyor by the complainant to Mr. Subham, who discussed the matter with the complainant. As per allegations of the complainant, the accident was witnessed by one Mr. Ravinder and the contact number of the Mr. Ravinder was also given to Mr. Subham, the investigator of the OPs, but Mr. Subham never contacted Mr. Ravinder for verification of the accident. The Surveyor was appointed by the OPs Mr. Jatinder, who has given his report Ex.O-3. Perusal of this report Ex.O-3 shows that the surveyor namely Jatinder Singh has investigated and made final inspection on 13.08.2018 at 02:00 PM. He was allotted the job of survey about the vehicle on 11.08.2018 at 04:11 pm. The loss description mentioned by the surveyor in his report is that the insured vehicle is hit with stray animal on front side. He has made main assessment after considering the depreciation also. The photographs have also been attached with the report. In his entire report, he has assessed the value as Rs.2,40,259/-. The page No.2 of this report, under the head of ‘Final Survey Validation Details’ shows that in the first column, which is the column of damages tally with the cause of accident, the word has been mentioned as ‘No’, but perusal of this shows that there is an over writing on this word and under this, the word ‘Yes’ was mentioned and the word ‘Yes’ has been changed to the word ‘No’. In the entire report, he has not mentioned the reason as to why the damages do not tally with the cause of accident. The law laid down by the Hon’ble Punjab & Haryana High Court, in a case titled as “New India Assurance Co. Ltd. Vs. Smt. Usha Yadav & Ors.”, is fully applicable to the facts of the present case. The Hon’ble High Court has observed that the insurance companies are only interested in earning the premiums and find ways and means to decline the claims.
9. In the present case also, the defence of the OP is that ‘the damage was precise and sharp to the bonnet as if it had hit against a metal part and that too without any mangling. If it would have hit against a stray animal, it would have sustained uneven impression to the bonnet and the impact out of horn is not good enough to press the bonnet deep and sharp at the given height’. From where this opinion has come, nothing has been proved by the OP. In the report of the Surveyor Ex.O-3, no opinion has been given by him as discussed above, the word ‘Yes’ has been changed to ‘No’. Had there been the word ‘No’ at the time of dictating the report, the reasons as mentioned in the written statement for damages not tallying with the cause of accident should have been there in the report. No expert opinion of any mechanic or any surveyor or investigator has been proved on record by the OPs to support the defence taken by them in the written statement in Para No.5 & 6. So, from all the angles the case of the complainant is proved and thus, the complainant is entitled for the relief as claimed.
10. In the light of above detailed discussion, the complaint of the complainant is partly allowed and OPs are directed to settle the insurance claim of the complainant within 15 days from the date of receipt the copy of order. The complainant is also directed to complete the requirements if any sought by the insurance company upon receipt of the notice by the insurance company. Further, the OPs are directed to pay a compensation of Rs.10,000/- for causing mental tension and harassment to the complainant and Rs.5000/- as litigation expenses. The entire compliance be made within 45 days from the date of receipt of the copy of order. This complaint could not be decided within stipulated time frame due to rush of work.
11. Copies of the order be supplied to the parties free of cost, as per Rules. File be indexed and consigned to the record room.
Dated Jaswant Singh Dhillon Jyotsna Dr.Harveen Bhardwaj
05.07.2022 Member Member President
