Haryana

Karnal

CC/198/2021

Abhilash Aroar - Complainant(s)

Versus

Royal Sundaram General Insurance Company Limited - Opp.Party(s)

Balwan Singh

24 Feb 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No. 198 of 2021

                                                        Date of instt.02.04.2021

                                                        Date of Decision: 24.02.2023

 

Abhilash Arora son of Shri Parmod Arora resident of house no.606, Dyal Pura Gate, Karnal.

                                               …….Complainant.

                                              Versus

 

Royal Sundaram General Insurance Company Ltd. registered office 21 Patullos Road, Chennai-600002, Tamilnadu through its CMD.

 

                                                                      …..Opposite Party.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.       

      Sh. Vineet Kaushik…….Member

      Dr. Rekha Chaudhary……Member

          

 Argued by: Shri Balwan Singh, counsel for the complainant.

                    Shri Ashok Vohra, counsel for the OP.

 

                    (Jaswant Singh President)

ORDER:   

                

                The complainant has filed the present complaint under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant got insured his vehicle i.e. car Fluidic Verna CRD 1.4 bearing registration no.HR-05AR-7009 with the OP for a sum of Rs.4,05,000/- under package policy no.VPC0904390000-100 with the period of insurance from 07.11.2017 to 06.11.2018 by paying a premium  of Rs.12,604/-. On 21.01.2018 at 6.00 p.m., the complainant coming from Kurukshetra to Karnal in his car and when he reached near Karneshwar Temple in Sector-7, Urban Estate, Karnal on G.T. Road, the car got out of control due to bursting of front left tyre and thereof the car hit into the back of a moving canter causing further severe damage to the front portion of the car i.e. vital damages to Engine and front seats on 21.01.2018 at 7.00 p.m. The accident took place due to bursting of tyre and no third party casualty reported. Hence, general diary no.08 dated 23.01.2018 was registered by P.P.Sector-6, Karnal wherein it is confirmed that due to bursting of tyre, the severe damages to the front portion of car have taken place and no criminal Act involving, death or bodily injury to any human being reported. The accident took place by chance without any mistake of anybody. Hence general diary for non-cognizable offence registered. The intimation with regard to said accident was also sent to OP on 23.01.2018. The vehicle was shifted to workshop of M/s Samta Motors Pvt. Ltd., Karnal through crane on 21.01.2018. OP appointed a surveyor Mr.B.B. Chawla for survey on 24.01.2018 and the surveyor inspected the vehicle on same day. The estimates prepared by the repairer were provided to the surveyor alongwith other requisite documents. The surveyor submitted his report on net salvage basis for Rs.3,54,000/-  (4,05,000/- (IDV)- wreck value Rs.50,000/- - excess clause Rs.1,000/-). The OP on 23.03.2018 through registered post informed the complainant that “with reference to the above mentioned claim, we observed from the claim papers that damages to the vehicle are not relevant to the cause of accident narrated in the claim form also there has been a misrepresentation of fact with regard to date of registration. Hence, we regret our inability to entertain the claim”. After this, complainant lodged complaint with Insurance Ombudsman, Chandigarh on 05.11.2018. Hearing conducted on 02.07.2019 and award was announced on 06.09.2019 whereby the complaint of the complainant was dismissed. But however, as per annexure XIII-A dated 19.09.2019 the insurance Ombudsman have stated that, “In the eventuality of your disagreeing with the enclosed award you may however, if you deem fit proper, move a fresh application at any other forum/court that may be considered by you as appropriate against the insurance company for the alleged deficiency of service, complained by you”. Hence complainant filed the present complaint.

2.             On notice, OP appeared and filed its written version, raising preliminary objections with regard to maintainability; cause of action; locus standi; barred by limitation and concealment of true and material facts. On merits, it is pleaded that the claim of the complainant was duly processed, considered on merits regarding the car bearing registration no.HR-05-AR-7009 which met with the accident and it is not payable as the claim of the complainant has been repudiated, vide speaking letter dated 23.03.2018 on the ground of misrepresentation of fact as the damages to the vehicle are not relevant to the cause of accident narrated in the claim form. The complainant has violated the terms and conditions of the policy but insured and insurer are bound to follow them strictly. The insurance in question is based on utmost good faith and both the parties i.e. insured as well as the insurer are bound by the terms and conditions of the contract of insurance. It is further pleaded that the vehicle in question had met with an accident during the policy with Iffco Tokio General Insurance Company and the claim was settled on net of salvage basis. The complainant has purchased the second hand vehicle from the market as per the mail confirmation received from Iffco Tokio confirming that the claim was settled on net of salvage basis. The complainant wants to have illegal gains from the contract of insurance which is against the principle of insurance. It is further pleaded that the complaint is badly barred by limitation as the alleged accident took place on 21.01.2018 and the complainant has filed the complaint after lapse of more than 3 years. It is further pleaded that complainant preferred to file his grievances/complaint before the Learned Ombudsman and the Ombudsman dismissed the contentions/pleas preferred by complainant, hence the complainant is stopped from filing complaint since the matter has already dismissed by the Ombudsman Chandigarh. The present complaint is hopelessly time barred. The complainant cannot get the extension of limitation by filing submission before the Ombudsman. Nobody can take benefit of his own wrongs. The matter has been dismissed on merits by the Ombudsman and the complainant cannot get privileges to file the present complaint regarding the same cause of action and the same parties to the alleged dispute in question. It is further pleaded that the alleged car met with an accident on 21.01.2018 while the complainant was driving the said vehicle and the left tyre got burst and the vehicle lost control and dashed to an ongoing canter-vehicle. The complainant gave the intimation of such accident on 23.01.2018 to the OP. So far as the concern of bursting of tyre is concerned the investigator Shri B.B. Chawla Surveyor and Loss Assessor has observed on the statement of complainant that the car has hit in rear side of the canter. But as per physical inspection of car, if car would have hit in rear side of canter then the hood of insured car would have been damaged in one direction and will be in a horizontal in nature. But the insured car is damaged only from one side upto pillar area which is not possible in such type of collusion as such this aspect is not satisfactory. As a matter of fact that the engine parts and upper front parts of insured car was damaged intentionally and they have no relevancy with nature and cause of accident as mentioned in the narration of accident in claim form and statement of complainant. Also, if car hood area is safe then how these internal parts could have been damaged, as such damages to the insured car is not accidental in nature and does not match with nature and cause of accident. Moreover, as per statement of complainant left front tyre of insured car got burst due to which car went out of control. But as per physical inspection of car the conditions of tyre was very low and was flat as such it is fault of complainant that he himself was inviting the problem by driving the car in such type of flat tyres, he should have taken some safety measures and would have replaced the tyre. It is also found on the statement of complainant that the car has hit in rear side of the canter but this aspect of complainant is not satisfactory because if car would have hit in rear of the canter then head lights of car must have come to contact at first place but it is observed insured car and both the headlights of insured car were safe. It is further pleaded that bumper cover is safe and internal parts are damaged which is also not satisfactory and do not co-insides with the nature and cause of accident. Thus, the damages to the internal parts of car have no relevancy with this accident, these damages clearly shows that damages are intentional to make the claim settled on total loss basis. It is further pleaded that as per documents available with the OP the present complainant is involved in criminal activity and in this connection he alongwith other co-accused was arrested by Delhi Police as per newspaper cutting alongwith photographs of complainant. There is no deficiency in service on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of insurance policy Ex.C1, copy of RC Ex.C2, copy of bill of Kaka Crane Service dated 21.10.2018 Ex.C3, copy of DDR  Ex.C4, copy of estimate of car from Samta Motors, Karnal Ex.C5, copy of repudiation letter dated 23.03.2018 Ex.C6, copy of survey report of B.B. Chawla Ex.C7, copy of Annexure-VI and Annexure VI –A with complaint dated 09.11.2018 Ex.C8, copy of proceeding before Insurance Ombudsman Ex.C9, copy of Annexure XIII-A dated 19.09.2019 Ex.C10, copy of complaint of Iffco Tokio General Insurance Company Ex.C11, copy of prescription of Virk Hospital showing treatment of complainant in the hospital dated 21.01.2018 Ex.C12 and closed the evidence on 04.07.2022 by suffering separate statement.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Purshottam Singhal Ex.OP1/A, affidavit of Shubham Grover Ex.OP2/A, affidavit of B.B. Chawla Surveyor Ex.OP3/A, copy of repudiation letter dated 23.03.2018 Ex.O1, copy of report of Perfect Investigator Ex.O2, copy of previous insurance policy Ex.O3, copy of policy schedule Ex.O4, copy of OPD slip of Virk Hospital Ex.O5, copy of statement of complainant Ex.O6, copy of DDR Ex.O7, copy of translation of DDR Ex.O8, copy of email dated 26.04.2018 of OP Ex.O9, copy of endorsement/policy of Iffco Tokio Ex.O10, copy of insurance policy of Iffco Tokio Ex.O11, copy of report of surveyor B.B. Chawla Ex.O12, copy of RC Ex.O13, copy of complaint  to Police Ex.O14, copy of history of OD claim Ex.O15, copy of order of Insurance Ombudsman dated 06.09.2019 Ex.O16, copy of letter dated 28.01.2019 Ex.O17, copy of submission of claim form Ex.O18, copy of newspaper cutting Ex.O19 and closed the evidence on 28.09.2022 by suffering separate statement.

6.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant got insured his vehicle with the OP. On 21.01.2018, the vehicle of the complainant met with an accident, In this regard A DDR no.08 dated 23.01.2018 was registered and the intimation with regard to said accident was also sent to OP on 23.01.2018. OP appointed a surveyor Mr.B.B. Chawla for survey on 24.01.2018 and the surveyor inspected the vehicle. The surveyor submitted his report on net salvage basis for Rs.3,54,000/-. The OP has repudiated the claim of the complainant, vide letter dated 23.03.2018 on the flimsy grounds and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP, while reiterating the contents of written version, has vehemently argued that a claim settled of abovesaid vehicle on NOS basis dated 28.06.2016 for Rs.4,59,000/- by its previous insurer i.e. Iffco Tokio General Insurance Company and complainant had purchased the second hand vehicle from the market.  The car in question met with an accident on 21.01.2018 and the left tyre got burst and the vehicle lost control and dashed to an ongoing canter-vehicle. Shri B.B. Chawla Surveyor and Loss Assessor/Investigator has observed that such damages to the insured car is not accidental in nature and does not match with nature and cause of accident. Thus, the claim of the complainant has been rightly repudiated, by the OP vide letter dated 23.03.2018 on the ground of misrepresentation of fact and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, the accident took place during the subsistence of the insurance policy. It is also admitted that the Insured Declared Value of the vehicle in question is Rs.4,05,000/-.

11.           The claim of the complainant has been repudiated by the OP, vide letter Ex.OP1/Ex.C6 dated 23.03.2018 on the ground which reproduced as under:-

“With reference to the above mentioned claim, we observed from the claim papers that damages to the vehicle are not related to the cause of accident narrated in the claim form.

Also, there has been a misrepresentation of the fact with regard to date of registration.

                Hence, we regret our inability to entertain the claim”.

12.           On receipt of intimation with regard to the incident, OP appointed Shri B.B. Chawla Surveyor and Loss Assessor and Perfect Investigator Shubham Grover. They have observed that the car has hit in the rear side of the canter. But as per physical inspection of the car, if car would have hit in the rear side of the canter then the whole of the insured car would have been damaged in one direction and will be in a horizontal in nature. But the insured car is only damaged from the one side upper pillar area, which is not possible in such type of collision. They further observed that at the engine parts and upper front parts of insured car was damaged intentionally and they have no relevancy with the nature and cause of accident. They further observed that if car hood area is safe then how these internal parts could have been damaged as such damaged to the insured car is not accidental in nature and does not match with nature and cause of accident. They further observed that as per version of the complainant, left front tyre of the insured car was got burst due to which car went out of control. But as per physical inspection of the car the conditions of the tyre was very low and was flat as such it is a fault of complainant who driving the car in such type of flat tyres. The bumper cover is also safe and internal parts were damaged, which is also not satisfactory and do not co-insides with the nature and cause of accident. They come to the conclusion that the damages to the internal parts of the car has no relevancy with this accident, these damages clearly shows that damages are intentional to make the claim settled on total loss basis.

13.           Complainant has purchased the second hand vehicle from the market as in the past there is already a claim settled of abovesaid vehicle on NOS basis dated 28.06.2016 for Rs.4,59,000/- by its previous insurer i.e. Iffco Tokio General Insurance Company and the claim was settled on net on salvage basis.

14.           To prove its version, OP has placed on file affidavit Ex.OP3/A of B.B. Chawla, Surveyor and Loss Assessor, affidavit Ex.OP2/A of Shubham Grover Perfect Investigator and his report Ex.O2. Complainant had removed his vehicle without spot survey. Thus, the OP has been deprived from their legitimate right.  The accident took place in a very busy place at about 7.00 p.m. and many persons would have passed there but no eye witness has been produced by the complainant before the investigator as well as the surveyor, which creates the doubt of alleged accident. Hence, in view of the above, we are of the considered view that no accident took placed alleged by the complainant and OP has rightly repudiated the claim of the complainant.

15.           Thus, in view of the above, the present complaint is devoid of any merits and same deserves to be dismissed and same is hereby dismissed. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:24.02.2023              

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

 

(Vineet Kaushik)        (Dr. Rekha Chaudhary)

                          Member                           Member