Chandigarh

DF-I

CC/537/2014

Narinder Kaur - Complainant(s)

Versus

SBI General Insurance - Opp.Party(s)

Vikram Tandon

20 Feb 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I, U.T. CHANDIGARH

============

Consumer Complaint  No	:	CC/537/2014
Date  of  Institution	:	12/08/2014
Date   of   Decision	:	20/02/2015

 

 

 

 

 

Narinder Kaur, D/o Sh. Buta Singh, R/o H.No.27-B, Street No.2B, Azad Nagar, Patiala.

….Complainant.

VERSUS

 

S.B.I. General Insurance, SCO 457-458, 1^st and 2^nd Floor, Sector 35-C, Chandigarh, through its Branch Incharge/ Manager.

….Opposite Party

 

BEFORE:   SH.P.L. AHUJA               PRESIDENT

          MRS.SURJEET KAUR             MEMBER

 

For Complainant	:	Sh. Vikram Tandon, Advocate.
For OP	:	Sh. Simrandeep Singh, Advocate.

 

PER SURJEET KAUR, MEMBER

 

 

          Succinctly put, the Complainant had taken an insurance policy (Annexure-c-1) from Opposite Party  through Broker namely, Berkeley Insurance Brokers Ltd., for his vehicle bearing No.PB-65-P-6061, valid from 26.12.2013 to 25.12.2014, by paying the requisite premium. It has been averred that the Opposite Party had given 25% ‘No Claim Bonus’ (for brevity NCB) at the time of issuing the aforesaid Policy. Unfortunately, the abovesaid vehicle met with an accident, on 27.12.2013, and was taken to Hira Automobiles Limited, Patiala (authorized dealer), who after assessing the loss, sent estimate of loss suffered by the vehicle along with claim form dated 2.1.2014 (Annexure C-3). On receiving the information, the Opposite Party deputed one Mr.K.P.S.Oberoi as Surveyor to assess the damage and loss to the vehicle. The Surveyor visited the agency and inspected the vehicle and submitted his report as well as assessment to the Opposite Party. It has been further averred that during investigation, the Opposite Party had come to know that last year also the Complainant had taken the accident claim from her previous insurance company, which was not informed by her at the time of taking insurance policy from the Opposite Party. Therefore, the Opposite Party issued a letter dated 09.01.2014 to deposit a deficit amount of Rs.3365/- on account of wrong NCB (25%) availed by the Complainant. The Opposite Party also issued an e-mail to deposit the said amount immediately (Annexure C-4). Ultimately, the Broker of the Complainant gave an amount of Rs.3365/- to the Agent of the Opposite Party on 21.01.2014, which was collected by the Agent of the Opposite Party from the office of the Broker being the difference of premium (Receipt Annexure C-5). It has been alleged that even after receiving the aforesaid deficit amount from the Complainant, the Opposite Party repudiated her claim vide letter dated 13.2.2014 (Annexure C-6) on the ground that the Complainant had given wrong declaration of NCB status which amounts to misrepresentation of material information. Left with no other option, the Complainant got her vehicle repaired from the aforesaid authorized dealer, after paying a sum of Rs.1,20,000/- from her own pocket, vide receipt dated 17.2.2014 (Annexure C-7). Eventually, the Complainant served a legal notice dated 20.6.2014 on the Opposite Party, but the same failed to fructify. Hence, alleging the aforesaid act & conduct of the Opposite Party as deficiency in service, the Complainant has filed the present Complaint.

 

2.      Notice of the complaint was sent to Opposite Party seeking its version of the case.

 

3.      Opposite Party in its reply, while admitting the factual aspects of the case, has pleaded that the Complainant had concealed the fact that she had already got benefit of N.C.B. from her previous insurance company namely, IFFCO TOKIO GIC Ltd. (for the period 26.12.2012 to 25.12.2013) and thus obtained the insurance policy from the answering Opposite Party by committing fraud and misrepresentation. It has been asserted that any insurance policy which has been secured by committing fraud and misrepresentation does not confer any right on the Complainant to seek the benefit under the policy. It has been pleaded that the Complainant has specifically mentioned in the proposal form/ declaration letter dated 23.12.2013 that she had not made any claim in the expiring policy. It has been further pleaded that the Complainant has not paid any NCB premium to any agent or any broker. The alleged receipt to this effect (Annexure C-5) was never issued by the Opposite Party. Since the NCB premium was not paid by the Complainant despite letter dated 9.1.2014, the Opposite Party issued a letter dated 7.2.2014 to her stating forfeiture of OD benefits under policy due to wrong declaration of NCB. While admitting that the claim of the Complainant stands repudiated on 13.02.2014, all other allegations leveled in the Complaint have been denied and a prayer has been made for dismissal of the Complaint as there is no deficiency in service on the part of answering Opposite Party. 

 

4.      The complainant has filed a rejoinder, wherein she has reiterated all the averments, contained in the complaint, and repudiated those, contained in the written version of Opposite Party.

 

5.      Parties were permitted to place their respective evidence on record in support of their contentions.

 

6.      We have heard the learned Counsel for the Parties and have also perused the record, along with the written arguments filed on behalf of both the parties.  

 

7.      It is the case of the Complainant that she is the owner of vehicle bearing Registration No. PB-65-P-6061. The Complainant got her vehicle insured from the Opposite Party for the period from 26.12.2013 to 25.12.2014 by paying the requisite premium (Annex.C-1). The vehicle met with an accident on 27.12.2013, therefore, the claim was lodged. During investigation, Opposite Party came to know that the Complainant had taken the accident claim from her previous insurance company which was not informed by her at the time of taking the policy. Accordingly, letter dated 9.1.2014 (Annexure-C) was issued to the Complainant to deposit a deficit amount of Rs.3365/- on account of wrong NCB (25%) availed by her. Annexure C-4 is the relevant                e-mail sent by the Opposite Party to the Complainant. But, the Opposite Party repudiated the claim of the Complainant on the plea that no claim bonus was availed by the Complainant even after receiving the claimed amount under the previous policy.

 

8.      As per Annexure-B which is the Surveyor Report, for the accident, the amount of the loss assessed was to the tune of Rs.1,10,129/-. The claim was repudiated on account of concealing of the fact of availing claim under the previous policy and receiving no claim bonus for the present policy.    

 

9.      The Complainant has contended in Para No. 4 of the Complaint that she deposited Rs.3365/- with Opposite Party in cash. Annex.C-5 dated 21.1.2014 is the photocopy of the register of the Broker. Authenticity of this document has been denied by the opposite party. The Complainant has not produced any affidavit of the person to whom the payment of Rs.3365/- was made and who made an entry on the page of register. Hence we do not place any reliance on this document.

 

10.      Pertinently, vide document Annexure-C dated 09.01.2014 (a copy of letter by the Opposite Party to the Complainant), Opposite Party has given an option to the Complainant to reinstate the benefits of the Policy in question by paying an amount of Rs.3365/- towards reinstatement of benefits of the policy. This fact shows that Opposite Party itself did not obtain the information whether any claim had been obtained by the Complainant or not in respect of the Policy of the previous year within 21 days as specified in Clause (f) of G.R. 27 of the Indian Motor Tariff.

 

11.      We feel that it was the duty of the Opposite Party, according to Clause (f) of GR 27 of India Motor Tariff, which is extracted hereunder, to confirm from the Policy issuing Office, in respect of the previous Policies, as to whether, any claim had been obtained by the complainant or not:-

 

“(f) In the event of the insured, transferring his insurance from one insurer to another insurer, the transferee insurer may allow the same rate of NCB which the insured would have received from the previous insurer. Evidence of the insured's NCB entitlement either in the form of a renewal notice or a letter confirming the NCB entitlement from the previous insurer will be required for this purpose.

 

Where the insured is unable to produce such evidence of NCB entitlement from the previous insurer, the claimed NCB may be permitted after obtaining from the insured a declaration as per the following wording:

 

“I/We declare that the rate of NCB claimed by me/us is correct and that no claim as arisen in the expiring policy period (copy of the policy enclosed). I/We further undertake that if this declaration is found to be incorrect, all benefits under the policy in respect of Section I of the Policy will stand forfeited.”

 

Notwithstanding the above declaration, the insurer allowing the NCB will be obliged to write to the Policy issuing office of the previous insurer, by recorded delivery calling for confirmation of the entitlement and rate of NCB for the particular insured and the previous insurer shall be obliged to provide the information sought within 30 days of receipt of the letter of enquiry, failing which the matter will be treated as a breach of Tariff on the part of the previous insurer. Failure of the insurer granting the NCB to write to the previous insurer within 21 days, after granting the cover will also constitute a breach of the Tariff.”

 

12.      It is evident from the afore-extracted Clause (f) of G.R.27 of India Motor Tariff that the insurer was also duty bound to write to the previous insurer, within 21 days, after granting the cover for confirmation of the entitlement and rate of NCB.  Since the policy had been issued by the Opposite Party, in respect of the vehicle,  in question, in favour of the complainant, it was its duty to obtain the information, as to whether, any claim had been obtained by the complainant, in respect of the Policy, of the previous year, within 21 days, but it failed to do so. Under these circumstances, the fault also lay, on the shoulders of the Opposite Party, in not confirming about this factum, within the specified time, stipulated in the aforesaid Clause (f) of GR 27 of India Motor Tariff. As stated above, in these circumstances, by no stretch of imagination, it could be said that by repudiating the claim of the complainant, as a whole, especially when the Opposite Party was also at fault, on account of contravention of Clause (f) of GR 27 of India Motor Tariff, it was not deficient, in rendering service, to some extent.

 

13.      The Surveyor and Loss Assessor vide report Annexure-B, assessed the loss, to the tune of Rs.1,10,129/- on repair basis. Report of the Surveyor and Loss Assessor, is based on the cogent and convincing material and data. No evidence was produced, on the record, to rebut the report of the Surveyor and Loss Assessor. It is, no doubt, true that the report of the Surveyor is neither binding, on the parties, nor the Consumer Fora, yet it being a very significant document, cannot be discarded lightly. 

 

14.      Here, we are fortified by the similar view taken by the Hon’ble State Consumer Disputes Redressal Commission, U.T. Chandigarh, in F.A. No. 131 of 2014 titled as “Niraj Kumar Sehgal Versus The Oriental Insurance Company Ltd. & Ors.”, decided on 23.04.2014.

 

15.      Hence, the present complaint of the Complainant deserves to succeed against the Opposite Parties, and the same is partly allowed. The Opposite Parties are directed, jointly and severally, to:-

 

[a]  Pay Rs.1,10,129/- to the Complainant, as assessed by the Surveyor as per survey report Annexure-B, along with interest @9% p.a. from the date of filing of the claim, till realization (minus) the benefit of no claim bonus given to the Complainant i.e. Rs.3365/-;   

 

[b]  Pay Rs.10,000/- on account of deficiency in service and causing mental and physical harassment to the Complainant; 

 

[c] Pay Rs.7,000/- towards costs of litigation

 

 

16.       The above said order shall be complied within 30 days of its receipt by the Opposite Party; thereafter, it shall be liable for an interest @12% per annum on the amount mentioned in sub-para [a] of Para above from the date of filing of the claim, till it is paid. The compensation amount as per sub-para [b] above, shall carry interest @12% per annum from the date of institution of this complaint, till it is paid, apart from costs of litigation of Rs.7,000/-.  

 

17.      Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room.

 

Announced

20^th February, 2015                                       

Sd/-

(P.L. AHUJA)

PRESIDENT

 

Sd/-

 (SURJEET KAUR)

“Dutt”                                                                                                      MEMBER