Complainant Harjit Singh through the present complaint U/S 12 of the Consumer Protection Act 1986 (hereinafter for short the Act) has prayed for the issuance of the necessary directions to the opposite parties to pay full insured amount of Rs.6,00,000/- qua his claim immediately in terms of the insurance policy alongwith interest @ 18% P.A. from the date of accident of the vehicle till actual realization. Opposite parties be further directed to pay Rs.1,50,000/- as compensation on account of mental agony, physical harassment and deficiency in service on the part of the opposite parties alongwith Rs.15,000/- as litigation expenses, in the interest of justice.
2. The case of the complainant in brief is that he is owner of Car Model Verna CRDI SX bearing registration No.PB-06-T-0123 Engine No.D4FBCU066636 and the same was fully insured with the opposite parties vide policy/cover note No.0000000001595111-01 valid from 17.2.2015 to 16.02.2016 (midnight). The insured declared value of the vehicle was Rs.6,00,000/-. He has further pleaded that on 20.1.2016 his vehicle met with an accident on Batala- Gurdaspur G.T.Road near Sugar Mill Batala at about 8.30 PM and the vehicle was damaged. At that time the vehicle was being driven by Harwinder Singh son of Jatinder Singh who is his close friend. Matter was reported to the opposite party and they deputed their surveyor who visited the spot on the next day and assessed the loss to the vehicle as total loss. The car in question kept on parked on the side of the road on 10.2.2016 and the same was shifted to Showroom of Novelty Hyundai, Near Amritsar Bye Pass Batala with recovery van at the asking of surveyor of the opposite parties. The complainant is paying Rs.250/- per day for parking of the car in the abovesaid agency from 11.03.2016 and has also paid Rs.10,000/- as depreciation fee. At the time of accident the vehicle was being driven by a person having valid driving license issued by the competent authority. He has next pleaded that he lodged his claim with the opposite parties supported by all the requisite documents for payment on account of the loss suffered by him. The opposite parties asked him vide letter dated 28.05.2016 to furnish certain documents/information’s which were also fulfilled by him. The opposite parties repudiated his claim on the basis of fake and baseless observations vide letter dated 22.09.2016 which was received by him on 7.10.2016. Thus, there is deficiency in service and unfair trade practice on the part of the opposite parties. Hence this complaint.
3. Upon notice, the opposite parties appeared and filed their joint reply through their counsel taking the preliminary objections that the complainant has no cause of action to file the present complaint; the complainant has no locus standi to file the present complaint; the complainant has not come to this Ld.Forum with clean hand and suppressed the material facts from this Ld.Forum and there is no deficiency in service on the part of the insurance company. Actually, the claim intimation lodged with the company was on 13.2.2016. The vehicle was inspected by IRDA licensed independent surveyor Mr.Sarangal Singh and assistance also taken by company by A.P. Associates Consultants to collect the facts and documents regarding the claim. On scrutiny of the survey report, investigation report and claim documents submitted by the complainant, the following anomalies were noticed:-
i. Mr.Harvinder Singh is the driver at the time of accident as per details provided by complainant on 13.2.2016 during intimation of claim at our contact Centre and claim form.
ii. As per written statement provided by complainant at the time of loss vehicle was being driven by Mr.Harjit Singh.
As per written statement provided by Tejinder Singh (Owner of third party vehicle) at the time of material loss, the vehicle was being driven by Mr.Harjit Singh.
It was next pleaded that there is misrepresentation of facts by complainant about the details of the driver in the claim form and by making such false statement there is violation of declaration made by the complainant. So, the claim has been denied and repudiated vide letter dated 22.9.2016 in which the detail has been given. It was also pleaded that if there is any liability of insurance company, then in that case the liability is only as per Survey report.
On merits, it was submitted that the claim has been repudiated by the insurance company vide letter dated 22.9.2016 due to violation of declaration given by complainant in the claim form. All other pleadings made in the complaint have been denied and lastly the complaint has been prayed to be dismissed.
4. Complainant tendered into evidence his own affidavit Ex.CW1/A, affidavit of Sh.Tejinder Singh son of Satnam Singh Ex.CW-2/A and of Sh.Harwinder Singh son of Jatinder Singh Ex.CW-3/A alongwith other documents Ex.C1 to Ex.C8 and closed the evidence.
5. Counsel for the opposite parties tendered into evidence affidavit of Sh.Manish Laxman Ex.OP-1, alongwith other documents Ex.OP2 to Ex.OP19 and closed the evidence.
6. We have carefully examined all the documents/evidence produced on record and have also judiciously considered and perused the arguments duly put forth by the learned counsels along with the incidental scope of adverse inference for of some documents that have been somehow ignored to be produced by the contesting litigants. We observe that the prime dispute prompted at ‘non-settlement/repudiation’ of the complainant’s Car accident insurance claim by the OP insurers on the allegedly arbitrary/flimsy ground of two different versions as to the person driving the insured Car at the time of the accident.
7. We find that the claim form(s), the first intimation letter and also the deposing affidavits Ex.cw1/A, Ex.cw2/A & Ex.cw3/A, indicate the accidented Car being driven by Harvinder Singh, a close friend of the complainant (insured owner) who was in the other front seat of the Car at the material time of accident. However, the OP insurers have alleged (Ex.C6) that these deponents Harjit Singh (owner complainant) and Tajinder Singh (driver of the opponent’s Tractor Trolley involved in the said accident) have also stated in their other written versions (Ex.OP4 to Ex.OP6) to the designated surveyor(s) that Harjit Singh was driving the accidented vehicle and further the resulting misrepresentation/anomaly vitiates (Ex.OP2) the claim thriving it to repudiation under the applicable terms of the related policy. We find that these un-sworn statements made at the behest of the OP insurers designated investigator(s) have little evidentiary value measured against the depositions.
8. We find that the complainant has deposed his allegations vide affidavit Ex.Cw1/A duly supported by documents Ex.C1 – Driving License of the owner insured complainant and Ex.C2 – the related policy with an IDV Rs.6.0 Lac; Ex.Cw2/A – Affidavit of Tajinder Singh driver of the Third Party Tractor Trolley involved in the accident; Ex.C3 – the DL of Harwinder Singh driver; Ex.Cw3/A – affidavit of Harwinder Singh friend of owner driving the Car at the time of accident; Ex.C4 – Surveyor letter requisitioning documents & Repair estimates for Rs.14.20 Lac indicating the total loss etc (towing charges & others Ex.C5 & Ex.C7); Ex.C6, the final repudiation letter and Ex.C8 evidencing blood donated by the complainant before the accident as the reason for his not driving the Car, himself; vide all these the complainant has proved his allegations/contents of the complaint.
9. On the other hand, the OP insurers have duly deposed vide its affidavit Ex.OP1 (written reply) that the impugned claim was repudiated/closed Ex.OP2 on account of the anomaly of misrepresentation and non-submission of claim related documents etc; Investigator’s Report sans the requisite deposition Ex.OP3 along with witnesses statements Ex.OP4 to Ex.OP6; Photographs Ex.OP7; Final Survey Report Ex.OP8 along with Ex.OP9 assessing the OP loss liability at Rs.9.95 Lac confirming the vehicle to have been a case instance of ‘total loss’, thereby indicating a fair claim settlement @ IDV of the policy;
10. Thus, we find that the instant non-settlement/repudiation has neither been necessary nor fair measured against the fact of satisfactorily explained circumstances and as such the instant repudiation amounts to deficiency in service on the part of the OP insurers and that rakes them up to an adverse statutory award under the applicable Act.
11. In the light of the all above, we partly allow the present claim and thus ORDER the titled OP insurers to pay the impugned claim at the full IDV of the related policy besides to pay Rs.10,000/- as cost and compensation (for having caused delay and harassment) to the present complainant within 30 days of the receipt of the copy of these orders otherwise the aggregate awarded amount shall attract interest @ 9% PA from the date of orders till actually paid.
12. Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to records.
(Naveen Puri)
President
ANNOUNCED: (Jagdeep Kaur)
July 07, 2017. Member.
*MK*
