Punjab

Faridkot

CC/18/130

Sukjinder Singh - Complainant(s)

Versus

Royal Sundaram - Opp.Party(s)

Kulinder Singh Sekhon

07 Aug 2019

ORDER

      DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FARIDKOT

 

Complaint No. :      130 of 2018

Date of Institution:   06.08.2018

Date of Decision:      07.08.2019

 

Sukhjinder Singh Mangat, aged about 39 years, son of Gurpreet Singh Mangat, r/o House No. B-VI/29 Near Gurudwara Singh Sabha, Mohalla Talab, Faridkot, Tehsil and District Faridkot.

......Complainant

Versus

Royal Sundaram General Insurance Company Ltd, SCO No.82, 1^st and 2^nd Floor Sector 40-C, Chandigarh through its General Manager/Branch Manager.

.......Opposite Party

Complaint under Section 12 of the

Consumer Protection Act, 1986.

 

Quorum: Sh. Ajit Aggarwal, President,

                Smt Param Pal Kaur, Member.

 

Present: Sh Kulwinder Singh Sekhon, Ld Counsel for complainant,

              Sh Satish Kumar Jain,  Ld Counsel for OP.

 

ORDER

(Ajit Aggarwal, President)

                                                  Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against OPs seeking directions to OPs to make payment of insurance claim of Rs.35,841/-with interest and for further directing OPs to pay Rs.

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1,00,000/- as compensation for deficiency in service, harassment, inconvenience, mental agony and Rs.30,000/-as litigation expenses.

2                                          Briefly stated, the case of the complainant is that Innova car bearing registration no. PB-04-W-0092 of complainant is fully insured with OP vide Insurance Policy bearing no VPC0882339000100 valid from 12.09.2017 to 11.09.2018. It is submitted that on 29.06.2018, vehicle of complainant met with an accident and due intimation regarding this was given to OP, who appointed Surveyor J S Purba to inspect the vehicle. Said Surveyor inspected the vehicle and prepared his estimate report for damage caused to vehicle. Complainant submitted his claim to OP on 2.07.2018 and thereafter, OP sent message to complainant that their team would shortly contact him and then, he again received message that Jasjeet Singh has been appointed to inspect the loss and after inspection, claim of complainant against policy in question was entertained by OP. OP further sent a message to complainant regarding entertaining of his claim on 3.07.2018 and asked him to keep in touch with repairer and upon instructions of OP, complainant left his vehicle for repair at Toyota Chadha Super Cars Pvt Ltd, Village Malwala, Ferozepur and his vehicle remain parked there for about ten days, but no action for its repair was taken due to want of instructions from OP and then, they refused to repair his vehicle. Thereafter, complainant approached OP several times with requests to repair his vehicle, but all in vain and then,

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complainant got repaired his vehicle and paid Rs.35,841/-for repair. He also served a legal notice dated 11.07.2018 to OP but that also served no purpose. All this amounts to deficiency in service and trade mal practice on the part of OP and it has caused harassment and mental agony to him for which he has prayed for directions to Ops to pay Rs.35,841/-as repair charges and Rs.1,00,000/-as compensation for harassment and mental agony suffered by him along cost of litigation. Hence, the present complaint.

3                                        The counsel for complainant was heard with regard to admission of the complaint and vide order dated 08.08.2018, complaint was admitted and notice was ordered to be issued to the opposite parties.

4                                         On receipt of the notice, opposite party filed written statement wherein they have denied all the allegations levelled by complainant being wrong and incorrect and asserted that complaint is not maintainable as complainant has taken the policy by wrongly declaring eligibility of No Claim Bonus in the policy whereas he lodged a claim in the previous year with Iffco Tokyo General Insurance Co Ltd and thus, by wrongly declaring eligibility of 20% no claim bonus, he has indulged in suppression of material facts and has breached the principles of good faith. It is admitted that car of complainant was insured with them against policy in question for the period from 12.09.2017 to 11.09.2018. Further complainant

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had availed no claim bonus of 20% based on declaration in proposal form and he lodged claim for damage caused to his vehicle in accident dated 29.06.2018 and Surveyor appointed by answering OP assessed the loss and submitted his report, but after perusal of claim records, it was found that complainant has wrongly declared No Claim Bonus eligibility in the proposal form and this fact was confirmed by the them from previous insurer Iffco Tokyo through e-mail. Complainant has intentionally suppressed the material facts from OP that a claim was made in the previous year policy and thus, OP is not liable to pay for a claim under policy which was obtained by suppression of material facts or is based on misrepresentation. It is averred that they have rightly repudiated the claim of complainant vide letter dated 20.07.2018 and there is no deficiency in service on their part and prayed for dismissal of complaint with costs.

5                              Parties were given proper opportunities to prove their respective case. Counsel for complainant tendered in evidence affidavit of complainant Ex.C-1, and documents Ex C-2 to C-9 and then, closed his evidence.

6                           In order to rebut the evidence of the complainant, LD Counsel for opposite party 1 tendered in evidence, affidavit of V Hari Shankar as Ex OP-1 and documents Ex OP-2 to Ex OP-10 and then, closed the evidence.

 

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7                                        We have heard the learned counsel for the parties and have very carefully gone through the affidavits and documents on the file.

8                         From the careful perusal of record and evidence and documents placed on record, it is observed that case of complainant is that insured vehicle of complainant met with an accident and got damaged. He duly intimated OP and lodged claim with them but they wrongly repudiated the claim for no reason. In reply, OP admitted the insurance of said vehicle. It is also admitted that due intimation was given by complainant regarding said accident to OP. There is also no denial by OP that they repudiated the claim of complainant. Main ground taken for repudiating the claim of complainant by OP is that complainant availed a no claim bonus of 20% based on declaration in proposal form and he wrongly declared No Claim Bonus Eligibility in proposal form though in previous year, he availed claim under previous policy with Iffco Tokyo Insurance Company. Complainant has violated the terms and conditions of the policy in question and they have rightly repudiated the claim of complainant. As per OP, they rejected claim of complainant only on the ground that at the time of purchase of insurance policy, complainant suppressed the material facts and availed the benefit of NCB by stating that he had not lodged any claim with previous insurer. But during the investigation, it became clear that he had already received the claim from the previous insurer, which amounts to breach of terms and conditions of the policy.  Counsel for complainant argued that if the complainant did not disclose regarding lodging of claim with previous insurer, then in that case, the opposite party can verify this fact from the previous insurer within time. But opposite party kept mum, through entire insurance period. When the complainant lodged his claim, the opposite party repudiated the claim on the ground that complainant had taken the benefit of No Claim Bonus, so they cannot deny the payment of claim amount to the complainant. Moreover more or less they are entitled to recover the amount of NCB from the complainant, but not to reject the claim of the complainant straightway.

9               Ld Counsel for complainant has placed reliance on 2016 (2) CPC 459, titled as National Insurance Company Ltd Vs Jagir Kaur, whereas Hon'ble National Commission, New Delhi held that Accident of Vehicle. Surveyor appointed - Loss assessed. False statement at time of obtaining of insurance policy alleged. Repudiation of Claim. Deficiency in service. District Forum dismissed complaint. State Commission allowed appeal. Hence Revision. Proposal form shows that respondent/complainant claimed no claim bonus while renewing policy and also while charging premium no claim bonus of 20% was allowed. Survey report which is on record assessed loss on net salvage basis for Rs.2,09,000/-. District Forum's order also records that respondent/complainant urged that as

 

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per survey report respondent/complainant entitled to amount of Rs.2,09,000/- and amount to be awarded to her. Therefore, Petitioner/Insurance Company directed to pay to respondent/complainant 75% of amount assessed by surveyor i.e. Rs.2,09,000/- that comes to Rs.156,750/- with 9% interest from date of filing of complaint with salvage being given to petitioner/insurance company. Hence, revision partly allowed. Further in case tiled as National Insurance Co. Ltd. Vs Harpreet Singh- 2016 (1) CPR 910, whereas our Hon'ble National Commission, New Delhi held that for reimbursement of damage to Truck caused due to accident. Repudiation of claim on ground that respondent complainant obtained No Claim Bonus by concealment of misrepresentation of fact. Where insured is unable to produce evidence regarding his No Claim Bonus entitlement, he may be permitted to give a declaration in support of his No Claim Bonus. In instant case, admittedly no communication was sent by the petitioner to the previous insurer within 21 days after granting the insurance cover to the insured. This obviously amounts to breach of tariff on the part of the petitioner insurance company and disentitle the insurance company to take shelter of the plea of misrepresentation of facts on the part of petitioner. Complainant on the basis of false declaration given to petitioner paid 25% less premium. Equity demands that bonus payable to complainant in respect of his

 

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insurance claim should be decreased by 25%. Directions issued to petitioner insurance company to pay to respondent complainant 75% of claimed amount with 9% interest. Revision petition partly allowed. So, as per law settled by Hon'ble National Commission, New Delhi, the opposite party cannot reject the claim of the complainant straightway. They are liable to pay the claim even if, it is presumed that the complainant has breached any term and condition of the policy and in that case, he is entitled for the claim on non standard basis. Repudiation of entire claim by opposite party amounts to deficiency in service and trade mal practice .

10                                      In the light of above discussion, evidence placed on record and case laws discussed above, the present complaint is hereby partly allowed and opposite party is directed to make payment of Rs.26,880.75 i.e. 75% of Rs.35,841/-to complainant on account of payment made by complainant for repair of his insured vehicle alongwith interest @ 9% per annum from 20.07.2018 i.e the date when opposite party repudiated the claim of the complainant till final realization. Opposite party is  further directed to pay Rs.5,000/-(five thousand only) to complainant as consolidated compensation for harassment and mental agony suffered by him including litigation expenses. Compliance of the order be made within one month from the date of receipt of copy of this order, failing which, the complainant shall be entitled to proceed

 

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under section 25 & 27 of the Consumer Protection Act. Copy of the order be supplied to the parties free of costs. File be consigned to record room.

Announced in Open Forum

Dated : 07.08.2019                     

                                                     (Parampal Kaur)           (Ajit Aggarwal)

                                                             Member                         President