Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 94.
Instituted on : 22.02.2019
Decided on : 22.08.2022
Rajesh Kumar age 27 years, s/o Sh. Suresh, R/o H.No.596, Village Giwana, Teh. Gohana, District Sonepat(Haryana).
.......................Complainant.
Vs.
- Royal Sundaram General Insurance Co. Ltd.(Formerly known as Royal Sundaram Alliance Insurance Co. Ltd.,), Unit No.644-45/19, Civil Road, Opp.Services Club, Rohtak-124001(Haryana), through its Manager, Branch Office.
- Manager Registered Office, Royal Sundaram General insurance Co. Ltd.(Formerly known as Royal Sundaram Alliance Insurance Co. Ltd.,), #21, Patulos Road, Chennai-600002.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
DR. VIJENDER SINGH, MEMBER.
Present: Sh. Digvijay Jakhar, Advocate for the complainant.
Sh. Puneet Chahal, Advocate for the opposite parties.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case as per the complainant are that the vehicle of complainant Skoda Rapid bearing registration no.HR11J5760 was insured from the opposite parties under 0% depreciation scheme bearing policy no.VPC0886156000100 commenced from 29.09.2017 to 28.09.2018 midnight, for the IDV of Rs.700000/-. The complainant alongwith his friend Ravi Kant were going to Jind Bye pass Rohtak and his friend was driving the said vehicle. On the way a truck was going with rash driving and due to that vehicle of the complainant met with an accident on 30.08.2018(as per amended complaint filed). The car of the complainant was badly damaged and the complainant and his friend had taken the vehicle to the authorized service centre and on 31.08.2018, they informed the respondents about the said accident. Respondent appointed a surveyor namely Sh.B.B Chawla for further proceedings and complainant deposited all relevant documents alongwith the insurance policy to the surveyor at Skoda authorized Service Center. The surveyor inspected the vehicle and took photographs and signature on plane papers and assured the complainant for settlement of claim. Complainant requested the opposite parties to settle the claim but despite his repeated requests, claim amount has not been paid to the complainant. Complainant received a letter dated 09.01.2019 from the respondents in which they have stated that : “We observe from the claim papers that damages to the vehicle are not relevant to the cause of accident narrated in the claim form. Hence, we regret out inability to entertain the claim”. The act and conduct of the opposite parties is illegal and amounts to deficiency in service. Hence this complaint and it is prayed that opposite parties may kindly be directed to pay the amount of claim i.e. Rs.700000/- alongwith interest, compensation and litigation expenses as explained in relief clause.
2. After registration of complaint, notices were issued to the opposite parties. Opposite parties in their reply has submitted that complainant made a call on 31.07.2018 and informed the respondents at their toll free number about the accident. The complainant has not intimated to the police regarding the accident. Complainant has not intimated to the answering respondent immediately for conducting the spot survey. The accident occurred on 30.08.2018 whereas intimation of the same was submitted to the opposite party on 08.09.2018. The delay in intimation has denied the respondent of the right to conduct spot survey and properly verify the veracity of the claim. The insurance company appointed an IRDA approved independent surveyor for survey and assessment of loss of vehicle no.HR-11-J-5760. The respondent observed on perusal of report, submitted by the surveyor that there was no engine oil in the oil chamber and had recommended that the matter to be investigated. Therefore, the opposite party appointed the investigator to carry out the investigation and the investigator in his report has observed that the damages to the vehicle were not matching as damages to the internal parts and under the hood were noticed which were no relevancy to the nature of the accident as had been described in the claim form. Also some parts were badly rusted which was not possible in a short duration of time. As such opposite party vide its letter dated 09.01.2019 has repudiated the claim on the alleged grounds. All the other contents of the complaint were stated to be wrong and denied and opposite parties prayed for dismissal of complaint with costs.
3. Ld. Counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A to Ex.CW3/A, documents Ex.C1 to Ex.C20 and has closed his evidence on dated 13.11.2019. Ld. Counsel for the opposite parties in their evidence has tendered affidavit Ex.RW1/A & Ex.RW2/A, document Ex.R1 to Ex.R5 and has closed his evidence on dated 24.03.2021.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. We have minutely perused the documents placed on record by both the parties. The claim of the complainant has been repudiated by the insurance company on the ground that: “With reference to the above mentioned claim, we observe from the claim papers that damages to the vehicle are not relevant to the cause of accident narrated in the claim form”. The repudiation letter is Ex.C7/Ex.R5 dated 09.01.2019. The respondent counsel further submitted that there is delay in intimation to the insurance company and the previous insurer detail has not been provided by the insured, as such this aspect may be considered. It is also submitted that the IDV of car is on higher side.
6. Regarding the delayed intimation to the opposite party about the accident , reliance has been placed upon the order of Hon’ble State Commission, Haryana, Panchkula dated 20.09.2018 titled as Cholamandalam MS General Insurance Co. Ltd. Vs. Baljeet Singh and order dated 20.08.2018 titled as Iffco Tokio General Insurance Co. Vs. Balwant Rai whereby the Hon’ble State Commission has held that: “It is very clear from the circular of IRDA that the insurance company cannot repudiate the bonafide claims on technical grounds like delay in intimation and submission of some required documents. The decision of insurers to reject a claim of the claimant should be based on sound logic and valid grounds. The limitation clause does not work in isolation and is not absolute”. The aforesaid law is fully applicable on the facts and circumstances of the case. Regarding the other plea that manner of accident is not co-related with damages suffered in the vehicle, merely an assumption has been made by the opposite parties because to prove the same any authentic evidence is not placed on file. The surveyor in his report has taken the other plea that the IDV of the vehicle is on higher side. But no such assessment has been placed on record by the surveyor or by the insurance company to prove the fact that IDV of the vehicle is on higher side. Moreover insurance company issued the policy on dated 29.09.2017 and in this policy IDV of the vehicle has been specifically mentioned by the insurance company and the complainant gave some extra premium on account of additional cover i.e. depreciation waiver. The IDV is assessed by the insurance company itself and there is no role of the complainant in assessment of IDV. Hence this plea taken by the surveyor is also turned down. The perusal of Ex.R3 itself shows that surveyor has assessed the repair value as Rs.846164/- which exceeds the IDV of the vehicle i.e. Rs.700000/-. Hence the vehicle comes under the total loss and the opposite party is liable to pay the IDV of vehicle after deduction of salvage value, which we have assessed as Rs.1 lac i.e. to pay Rs.600000/-(Rs.700000/- less Rs.100000/-).
7. In view of the facts and circumstances of the case we hereby allow the complaint and direct the opposite parties to pay Rs.600000/-(Rupees six lacs only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 03.06.2019 till its realization and shall also pay Rs.5000/-(Rupees five thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant within one month from the date of decision. However complainant is directed to complete the formalities e.g. letter to the RTO for cancellation of R.C. and a copy of the same be supplied to the insurance company and thereafter opposite parties shall comply with the order dated 22.08.2022 of this Commission.
8. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
22.08.2022.
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Nagender Singh Kadian, President
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Tripti Pannu, Member.
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Vijender Singh, Member.
Rajesh Vs. Royal
Present: Sh.Digvijay Jakhar Adv. for applicant/complainant.
None for opposite parties.
File has been summoned on the application filed by ld. Counsel for the applicant/complainant for correction of order dated 22.08.2022 of this Commission on the ground that in the above mentioned order in para no.7, the date of institution is mentioned as 03.06.2019 instead of 22.02.2019.
Heard. After going through the file and hearing ld. Counsel for the applicant/complainant, it is observed that the date of institution of the present complaint is 22.02.2019 but due to clerical mistake, the same is mentioned as 03.06.2019 in para no.7 of the judgment. As such necessary correction is hereby made in the alleged order dated 22.08.2022 and it is directed that date mentioned as 03.06.2019 in para no.7 of this order be read as 22.02.2019. This order should be read as part of previous judgment already announced on 22.08.2022 of this Commission. Copy of this order be placed on the main file and will be annexed with the judgment dated 22.08.2022 and also supplied to both the parties free of costs. Misc. Application be attached with the main file. File be consigned to the record room after due compliance.
Member Member President/26.08.2022.
