BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, KAITHAL.
Complaint no.284/16.
Date of instt.: 14.09.2016.
Date of Decision: 12.05.2017.
Vinod Kumar S/o Sh. Jai Singh, resident of V.P.O. Durjanpur, Tehsil Narwana, Distt. Jind.
……….Complainant.
Versus
- SBI General Insurance Company Ltd. through its Manager, Ist Floor, SCO-149, Red Square Market, CUE-1, near State Bank of India, Hisar, Tehsil & Distt. Hisar.
- SBI General Insurance Company Ltd. through its Manager, 7-B, Ground Floor, Pusa Road, Opposite to Metro Pillar No.153, Rajendra Park, New Delhi-110060.
..……..Opposite Parties.
COMPLAINT UNDER SEC. 12 OF CONSUMER PROTECTION ACT, 1986.
Before: Sh. Jagmal Singh, President.
Sh. Rajbir Singh, Member.
Smt. Harisha Mehta, Member.
Present : Sh. Harpal Singh, Advocate for complainant.
Sh. Nikhil Gupta, Advocate for the opposite parties.
ORDER
(JAGMAL SINGH, PRESIDENT).
The complainant has filed the present complaint under Section 12 of Consumer Protection Act, 1986, with the averments that he got insured his Car Volkswagen (Polo) bearing registration No.HR-32-F/7822 with the Ops vide cover note bearing No.0000000002521586 for the period valid w.e.f. 31.01.2015 to 30.01.2016. It is alleged that unfortunately on 14.05.2015, the above-said vehicle met with an accident in the area of Kaithal-Manas Road. It is further alleged that a DDR No.29 dt. 15.05.2015 was got registered in P.S. City Kaithal. Information regarding accident was given to the Ops. It is further alleged that the complainant lodged the claim with the Ops and submitted all the necessary documents but the Ops repudiated the claim of complainant vide letter dt. 02.09.2015. The said repudiation of claim is wrong and illegal. This way, the Ops are deficient in service. Hence, this complaint is filed.
2. Upon notice, the opposite parties appeared before this forum and filed reply raising preliminary objections with regard to maintainability; cause of action; locus-standi; that this forum has got no jurisdiction to entertain and try the present complaint as the policy in question was issued from Mumbai and the claim was processed and repudiated by the answering Op-SBI General Insurance Co. Ltd. from New Delhi, where the answering Op is having its office; that the claim was duly processed by the answering Op by way of appointment of an IRDA approved independent surveyor Mr. Anil Kumar Sehgal, surveyor & loss assessor for conducting the final survey and also deputed the investigator M/s. Royal Associates, Investigating & Detective Agency to verify the facts of the case; that the claim of complainant stand repudiated vide letter dt. 02.09.2015 as name of driver is mentioned as Mr. Vinod Kumar in DDR and moreover, it was found during the investigation that Mr. Vinod Kumar was driving the insured vehicle and he does not possess any driving licence. As per Driving Clause in the policy, the person driving the vehicle should hold an effective and valid driving licence at the time of accident. There is no deficiency in service on the part of answering Ops. On merits, the contents of complaint are denied and so, prayed for dismissal of complaint.
3. In support of his case, the complainant tendered in evidence affidavit Ex.CW1/A and documents Ex.C1 to Ex.C8 and closed evidence on 10.01.2017. On the other hand, the Ops tendered in evidence affidavit Ex.Rw1/A and documents Annexure-RA to Annexure-RG and closed evidence on 27.02.2017.
4. We have heard ld. counsel for both the parties and perused the case file carefully and minutely and have also gone through the evidence led by the parties.
5. Ld. Counsel for the complainant reiterated all the points mentioned in the complaint. He argued that the complainant got insured his Car Volkswagen (Polo) bearing registration No.HR-32-F/7822 with the Ops vide cover note bearing No.0000000002521586 for the period valid w.e.f. 31.01.2015 to 30.01.2016. He further argued that on 14.05.2015, the complainant alongwith his uncle’s son Amit Kumar were going from Kaithal to Manas Road, in the mean time suddenly, smoke came out from the above-said vehicle and then, they came out from the vehicle after parking on the road-side and in their sight, the fire broke out in the car. He further argued that the Fire-brigade, Kaithal was informed and a DDR No.29 dt. 15.05.2015 was got recorded in Police Station City, Kaithal. He further argued that the complainant lodged the claim with the Ops and submitted all the necessary documents but the Ops repudiated the claim of complainant vide letter dt. 02.09.2015. Ld. Counsel for the complainant submitted authorities cited in 2007(1) CPJ page 74 (Punjab State Commission) titled as Vaaho Photo Color Vs. UII; 2006(2) CPJ page 92 (Punjab State Commission) titled as NIA Vs. Dr. J.P.Jain; 2009(3) CPJ page 66 (NC) titled as OIC Vs. Kamper Concast Ltd. and 2002(2) CPJ page 396 (Rajasthan State Commission) titled as Kanhaiya Lal Toshnwal Vs. NIA. On the other hand, ld. Counsel for the Ops argued that this forum has got no jurisdiction to entertain and try the present complaint as the policy in question was issued from Mumbai and the claim was processed and repudiated by the SBI General Insurance Co. Ltd. from New Delhi. He further argued that the claim was duly processed by the Ops by way of appointment of an IRDA approved independent surveyor Mr. Anil Kumar Sehgal, surveyor & loss assessor for conducting the final survey and also deputed the investigator M/s. Royal Associates, Investigating & Detective Agency to verify the facts of the case. He further argued that the claim of complainant was repudiated vide letter dt. 02.09.2015 as name of driver is mentioned as Mr. Vinod Kumar in DDR and moreover, it was found during the investigation that Mr. Vinod Kumar was driving the insured vehicle and he does not possess any driving licence. Ld. Counsel for the Ops submitted an authority cited in 2016 (2) CPJ page 292 (NC) titled as NIA Vs. Dinesh Chandra Porwal.
6. From the pleadings and evidence of the case, it is clear that the claim of the complainant has been repudiated by the Ops vide letter dt. 02.09.2015, Ex.C1/Annexure-RA on the ground that Vinod Kumar, owner-cum-driver of the vehicle does not possess the driving licence. The complainant has not placed any copy of driving licence on the file, however, he submitted the above-mentioned authorities. The head-note of the authority in case Vaaho Photo Color Vs. UII (supra), is as under:-
“Insurance-Absence of effective driving licence at the relevant time-Repudiation of claim-Legality-Licence expired on 17.01.1999-Accident on 24.03.1999-Licence got renewed shortly thereafter, i.e. on 19.04.1999-No evidence that lack of driving skill on part of driver was primary or fundamental cause of accident-Insurer liable”.
The authority titled NIA Vs. Dr. J.P.Jain (supra) is also on the same footing.
In case OIC Vs. Kamper Concast Ltd. (supra), the vehicle caught fire and totally burnt and the Hon’ble National Commission has granted 75% of the amount assessed by the surveyor. The Hon’ble Rajasthan State Commission has decided the case Kanahaya Lal Toshniwal Vs. NIA (supra), the head-note of the same runs as under:-
“Appeal-Insurance-Repudiation of claim-Vehicle caught fire from electric wires-Reasonable care and caution exercised to protect the vehicle and contents-No negligence or carelessness of employees of complainant Company-Forum erred in dismissing complaint-Op liable to pay policy amount alongwith interest @ 12% p.a.”.
7. From the facts of the case, it is clear that the car caught fire and burnt. There is no evidence on the file that there was lack of driving skill on the part of driver, which was the cause of accident. The driver was not disqualified from holding the driving licence. Moreover, in the present case, the vehicle caught fire suddenly and it is not proved on the file by the Ops that the vehicle caught fire due to fault of any driving skill. In view of the above authorities and in the facts and circumstances of the case, we are of the considered view that there was no fault on the part of driver. At the most, the complainant has contravened the conditions of the insurance policy, for which the claim in respect of vehicle in question should have been settled by the Ops on the basis of the guidelines of non-standard settlement. Therefore, the Ops have wrongly repudiated the claim of complainant in toto.
8. Thus, in view of above discussion, we allow the complaint partly and direct the Ops to settle the claim of complainant on non-standard basis and to pay Rs.3,93,750/- i.e. 75% of Rs.5,25,000/- (insured value of the vehicle), subject to furnishing of subrogation letter and cancel the RC of vehicle in question by the complainant to the Ops within 15 days. Thereafter, the order be complied with within 30 days, failing which, the complainant shall be entitled interest @ 8% p.a. from the date of commencement of this order till its realization. No order as to costs. A copy of this order be sent to both the parties free of costs. File be consigned to the record room after due compliance.
Announced.
Dt.12.05.2017.
(Jagmal Singh),
President.
(Harisha Mehta), (Rajbir Singh),
Member. Member.
