Haryana

Karnal

CC/73/2019

Sachin Gupta - Complainant(s)

Versus

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

Vishal Goel

16 Dec 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                          Complaint No. 73 of 2019

                                                          Date of instt. 11.02.2019

                                                          Date of Decision 16.12.2019

 

Sachin Gupta son of Shri Om Parkash, resident of House no.857/14, Chaura Bazar, Banso Gate, Karnal.   

                                                …….Complainant

                                        Versus

 

1. Royal Sundaram General Insurance Company Ltd. Registered office 21, Patullos Road, Chennai-600002 through its Authorized Signatory/Manager.

2. Royal Sundaram General Insurance Company Ltd. Corporate office Vishranti Melaram Tower, No.2/319, Rajiv Gandhi Salai (OMR), Karapakkam, Chennai-600097 through its Corporate Manager.

                                                                       

…..Opposite Parties.

 

           Complaint u/s 12 of the Consumer Protection Act. 

 

Before    Sh. Jaswant Singh……President. 

      Sh.Vineet Kaushik ………..Member

                Dr. Rekha Chaudhary…….Member

 

 Present:  Shri Vishal Goyal Advocate for complainant.

                   Shri A.K.Vohra Advocate for opposite parties.

                 

                   (Jaswant Singh President)

ORDER:                    

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that complainant purchased Chevorlet Beat Car, Month and Year of manufacturing 6/2015, bearing registration no.HR05-AQ-6182 in July, 2017 and the Registration Certificate of the Car was transferred in the name of the complainant by Registering Authority, Karnal. Complainant got insured the vehicle from OPs from 31.08.2017 to 30.08.2018. The policy was obtained and received by complainant at Karnal after making the payment of the premium, which was accepted by the OPs. The Insured Declared Value of the vehicle was assessed to be Rs.5,70,600/- by t he OPs. On 01.01.2018, the complainant was going from Karnal to village Uchani on his car and heater of the car was on and when he reached near NDRI, Karnal, heater vent smoke coming out from the car and then fire occurred in the car of complainant. The complainant tried his level best to control the fire but the fire became out of control and complainant saved his life by coming out from car. The complainant immediately called at phone number 100 and in the office of fire brigade, the fire brigade and the police also came at the spot. The fire brigade came at the spot and controlled the fire but till that time, the car of the complainant was totally destroyed due to fire. The photographs of the vehicle were clicked at the site and a G.D. no.13, dated 03.10.2018 was registered by Police Station Civil Lines, Karnal. It is alleged that as the incident took place on 01.01.2018 at about 9.30 p.m. and police officials and fire services officials were duly intimated on time and the fire brigade reached at the spot at about 9.43 p.m. and it is duly mentioned in the fire report that the complainant intimated the fire brigade office at about 9.32 p.m. The complainant at the time of incident with his full conscience act liked a prudent man and made his best efforts to control the fire and when the same was not get controlled on his part then he intimated the police and fire officials. As the vehicle is insured with OPs and period of insurance is from 31.08.2017 to 30.08.2018 and policy no.VPC0874179000100 was allotted to the complainant and the registration certificate of the vehicle is valid till 13.08.2030 so the complainant lodged his complaint with the OPs. The complainant also got parked his vehicle in Arpita Motors at Karnal and got prepared the estimate for the repair of the vehicle and Aripita Motors vide estimate dated 12.01.2018 prepared the estimate to the tune of Rs.8,08,881/-. The vehicle was totally damaged due to fire and has gone into total loss. The investigator was appointed by OPs and the queries of the investigator were duly answered and all the documents were provided to the Investigator appointed by the OPs but the claim of the complainant was repudiated by the OPs, vide letter dated 03.04.2018 with the observation “we observe from the claim papers that damaged to the vehicle are not relevant to the cause of accident narrated in the claim form.” Then the complainant lodged a complaint with Insurance Ombudsman and the OPs acknowledge the receipt of complaint of complainant no.RSA/20180504/ 00023894 and assured the complainant to review the complaint of the complainant and to give response within 10 days, vide letter dated 04.05.2018 but this time also, no positive response was received from the side of the OPs and the claim officer of the OPs called the complainant regarding repudiation of this claim. The complainant also sent an email to the OPs about his claim but vide reply dated 05.09.2018, the OPs regret and shown their inability to entertain the claim of the complainant. The complainant has written several letters to the OPs but nothing was done on their part. In this way there was deficiency in service on the part of the OPs. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OPs, who appeared and filed written version raising preliminary objections with regard to maintainability. On merits, it is pleaded that the vehicle in question is manufactured by General Motors and the vehicle model is Chevorlet Beat and same is registered in the year 2015. It is further pleaded that presently the general motors’ have wind up the operation and this model has become obsolete. It is further pleaded that the insurance is based on “Uberrima Fides” i.e. utmost good faith and at the time of obtaining insurance as well as taking the claim the Insured is under obligation to disclose all material facts, which are within his knowledge. It is further alleged that Principle of insurance is that it is based on “Indemnity” which impliedly means that, in case of any accident, the insured should be placed on the same position as he was before the loss. But, it does not meant that the insured can make profits out of Insurance contract. It is further pleaded that in the instant case, as per the claim form submitted, the complainant was going from Karnal to Uchani on 1^st January, 2018 at about 9.30 p.m. suddenly smoke emerged from the dash board and vehicle caught the fire. It is further pleaded that once the claim was intimated as a normal process, the OPs appointed the surveyor as well as investigator to verify the veracity claim and the findings of the surveyor as well as Investigator revealed that, there is strong suspicion of fraud involved. Some of the important point, which came to light as per findings of investigators are as under;

a. The vehicle is registered in 2015

b. The present complainant bought a vehicle second hand in cash.

c. before taking the insurance from OPs, the vehicle was insured with Universal Shampoo company and already this vehicle met an accident and claim was taken on net of salvage basis.

e. considering the important fact that the model has become obsolete and also the age of the vehicle, the Insured Declared Value of the vehicle diminishes year by year. But in the instant case, the complainant has taken the IDV as Rs.5,70,600/- which is much on higher side with regard to this vehicle.

It is further pleaded that there is a strong suspicion in this case that the policy was taken with an intention to get profits out of this contract and even our agent has exceeded his authority. For which a separate inquiry shall be conducted internally. It is further pleaded that based on the findings of investigator, going through the claim documents and after applying our minds. We have repudiated the claim with proper reasons. There is no deficiency in service on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence his affidavit Ex.CW1/A and documents Ex.C1 to Ex.C21 and closed the evidence on 05.09.2019.

4.             On the other hand, OPs tendered into evidence affidavit of Omkar S.Utture Ex.OW1/A and documents Ex.O1 to Ex.O11 and closed the evidence on 29.10.2019. In additional evidence OP tendered affidavit of Pushkin Bhatt.

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

6.             The case of the complainant, in brief, is that complainant got insured his Chevorlet Beat Car bearing registration no.HR05-AQ-6182 from OPs w.e.f 31.08.2017 to 30.08.2018. The Month and Year of manufacturing of the car was 6/2015. The Registration Certificate of the Car was transferred in the name of the complainant by Registering Authority, Karnal. On 01.01.2018 the said car got fired. The intimation in this regard was sent to police as well as to the OPs. Complainant lodged the claim with the OPs in this regard but OPs repudiated the claim of the complainant on the false and frivolous grounds.

7.             On the other hand, the case of the OPs, in brief, is that the vehicle in question is manufactured by General Motors and the vehicle model is Chevorlet Beat and same is registered in the year 2015. Presently the general motors’ have wind up the operation and this model has become obsolete. The insurance is based on “Uberrima Fides” i.e. utmost good faith and at the time of obtaining insurance as well as taking the claim the Insured is under obligation to disclose all material facts, which are within his knowledge. The Principle of insurance is that it is based on “Indemnity” which impliedly means that, in case of any accident, the insured should be placed on the same position as he was before the loss. But, it does not meant that the insured can make profits out of Insurance contract. In the instant case, as per the claim form submitted, the complainant was going from Karnal to Uchani on 1^st January, 2018 at about 9.30 p.m. suddenly smoke emerged from the dash board and vehicle caught the fire. The claim was intimated as a normal process, the OPs appointed the surveyor as well as investigator to verify the veracity claim and the findings of the surveyor as well as Investigator revealed that, there is strong suspicion of fraud involved. Policy was taken with an intention to get profits out of this contract and even our agent has exceeded his authority. For which a separate inquiry shall be conducted internally. On the findings of investigator, going through the claim documents the claim of the complainant was repudiated with proper reasons.

8.             Admittedly, the vehicle in question met with an accident during the subsistence of the policy. Intimation was sent to the police as well as to the OPs in this regard. The claim of the complainant was duly processed, considered by the OP and the same was not found payable and the same was repudiated on the ground that the policy was taken with an intention to get profit out of its contract. As per the OPs the model vehicle has become obsolete and also the age of the vehicle, the Insured Declared Value of the vehicle diminishes year by year. But in the present case, the complainant has taken the IDV as Rs.5,70,600/- which is much on higher side with regard to this vehicle. At the time of insurance of the every vehicle the vehicle has been got inspected by the insurance company and after verifying the condition and model of the vehicle the IDV of the vehicle assessed by the insurance company and not assessed by the customer. If the insurance company has taken the premium on higher side then he must ready to pay compensation on higher side. There is no fault on the part of the complainant because the IDV has been assessed by the agent of the OPs. If any wrong act committed by the agent of the OPs then OPs are liable for the same. In support of the complainant’s contention, learned counsel of complainant relied upon  Branch Manager, Central Bank of India Versus Bagwan Vishnoo Mahadeshwar 1(2004) CPJ 193, National Insurance Co. Ltd. Vs. Risheendran Nambiar and others in Revision Petition no.2153 of 2010, decided on 14.03.2018 and Post Office & Anr. Vs. Akhilesh Grover in Revision Petition no.1278 of 2016, decided on 06.10.2017.

9.             In Branch Manager, Central Bank of India’s case (supra) wherein deposits were regularly paid to the Agent, under Mini Deposit Scheme. Entries were made in the pass book evidencing payment. Agent Committed fraud and did not deposit the amount in bank. Under those circumstances, it was held by Hon’ble Maharashtra State Consumer Disputes Redressal Commission, Mumbai that the bank was accountable for the misconduct of the Agent. In Risheendran Nambiar’s case (supra) the insurer shall be responsible for all the acts and omissions of its agents including violation of code of conduct specified under clause (h) of sub section (3) and liable to a penalty which  may extend to one crore rupees.  In Akhilesh Grover’s case (supra) not delivering the speed post article to its addressee clearly constituted a willful act of deficiency in service of their part. The abovesaid judgments are fully applicable to the facts of the present case. Thus, we are of the considered view OPs are liable for the wrong act of its agent. Thus, act of the OPs are amounts to deficiency in service.

10.           Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OP to pay Rs.5,70,600/- the IDV of the vehicle to the complainant with interest @ 9% per annum from the date of repudiation of the claim till its realization.  We further direct the OP to pay Rs.20,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.5500/- for the litigation expenses.  This order shall be complied with within 30 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced:

Dated:16.12.2019

                                                                        President,

                                                          District Consumer Disputes

                                                         Redressal Forum, Karnal

 

           (Vineet Kaushik)     (Dr. Rekha Chaudhary) 

                    Member             Member