Chandigarh

DF-I

CC/918/2022

VIKAS KUMAR - Complainant(s)

Versus

SHRI RAM GENERAL INSURANCE CO. LTD. - Opp.Party(s)

SURINDER SINGH DUHAN

06 Feb 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-I,

U.T. CHANDIGARH

                                     

Consumer Complaint No.	:	CC/918/2022
Date of Institution	:	10.11.2022
Date of Decision	:	6/02 /2024

 

Vikas Kumar aged 30 years son of Surender Singh, resident of VPO Manesar, Gurugram, District Gurugram. Presently resident of House No. 978, Village Kishangarh, Near Sarpanch House, Kishangarh, Chandigarh .

... Complainant

 

VERSUS

 

1. Shri Ram General Insurance Co. Ltd. Crop. Office E-8, EPIP, RIICO Industrial Area, Sitapur, Jaipur, 302022, through its Director/Manager/Authorized Signatory.

 

2. Shri Ram General Insurance Co. Ltd. having its office at SCO. 178, 1st Floor, Sector 38C, Chandigarh 160017, through its Manager/Authorized Signatory.

CORAM :	SHRI PAWANJIT SINGH	PRESIDENT
	SHRI SURESH KUMAR SARDANA	MEMBER

 

                                                                               

ARGUED BY	:	Ms. Kamlesh Nain, Advocate for complainant
	:	Sh. Sachin Ohri, Advocate for OPs

 

Per Pawanjit Singh, President

1. The present consumer complaint has been filed by the complainant under Section 35 of the Consumer Protection Act 2019 against the opposite parties  (hereinafter referred to as the OPs). The brief facts of the case are as under :-

1. It transpires from the averments as projected in the consumer complaint that the complainant is registered owner of Maruti Wagon having  registration No.HR55X0633 (copy of RC annexed as Annexure C-1) (hereinafter to be referred as subject car) which was got insured by the complainant from the OPs vide policy  Schedule Annexure C-2, by paying premium amount of Rs.18.105/- valid w.e.f. 20.2.2020 to 19.2.2021. On 24.7.2020 when one Jitender by driving the subject car was going to his friend’s house at Neoltha and reached near Chhichhrana Mandi,  one vehicle came from opposite direction with high beam light as a result of which the driver lost control and  the subject  vehicle struck against a tree  and the subject vehicle engulfed into fire and the same got burnt completely.  In this regard rapat Annexure C-3  was recorded at police station Urlana Kalan, Matlong, District Panipat.  Thereafter due information  about the said accident was also given to the OPs and fire report Annexure C-4 dated 28.7.2020 was also prepared by Fire Station officer, Haryana Fire Emergency Services, Panipat.   Thereafter the complainant raised claim with the OPs qua the subject car  but instead of granting the insurance claim to the complainant, the OPs have sent letter Annexure C-5 dated 23.2.2020 to the complainant seeking clarification from the complainant and intimated that due to misrepresentation on the part of the complainant with regard to cause of loss  and non  submission of the documents  the OPs are unable to pay the due claim.  Thereafter on 28.1.2021  vide letter Annexure C-6,  the OPs intimated the complainant that the complainant has not submitted the vehicular documents to their surveyor Mr. Sanjeev Chhabra  nor   produced the  subject vehicle   for final survey as a result of which the OPs  declared the claim of the complainant as no claim being the complainant not interested to pursue the claim despite of the fact that the complainant has already submitted the requisite document with the surveyor. The OPs have wrongly repudiated the claim of the complainant on flimsy grounds. Thereafter the complainant compelled to send legal notice Annexure C-7 dated 13.9.2021 but with no result. The aforesaid act amounts to deficiency in service and unfair trade practice on the part of OPs. OPs were requested several times to admit the claim, but, with no result.  Hence, the present consumer complaint.
2. OPs resisted the consumer complaint and filed their written version, inter alia, taking preliminary objections of maintainability, cause of action, concealment of facts. However, it is admitted that the complainant is registered owner of the subject vehicle and the subject car was insured with the answering OPs vide policy Annexure R-1 valid w.e.f. 20.2.2020 to 19.2.2021.  It is denied that the claim of the complainant has been closed  and stated that the same is still under process. It is however, alleged that the complainant was asked to submit certain documents for processing of claim and as the complainant could not produce the said documents which   were  mandatory for the assessment of the loss, the claim of the complainant was closed as no claim. It is further alleged that even  certain  discrepancies were found by the surveyor regarding the CNG  cylinder fitness  which was being used in the subject car regarding which the complainant was also asked to explain. It is further alleged that the surveyor has assessed the loss to the tune of Rs.2,52,285/-  less salvage . The copy of surveyor report is annexed as Annexure C-6. It is further alleged that as the complainant has not alleged in the complaint that the subject car  was exclusively used by him for self employment, thus, he is not a consumer. On merits, the facts as stated in the preliminary objections have been re-iterated. The cause of action set up by the complainant is denied.  The consumer complaint is sought to be contested.
3. In rejoinder, complainant reiterated  the claim put forth in the consumer complaint and prayer has been made that the consumer complaint be allowed as prayed for.

2. In order to prove their case, parties have tendered/proved their evidence by way of respective affidavits and supporting documents.
3. We have heard the learned counsel for the parties and also gone through the file carefully, including the written arguments.
   1. At the very outset, it may be observed that when it is an admitted case of the parties that  the complainant is registered owner of the subject car as  is also evident from copy of RC Annexure C-1 and the same was insured with the OPs vide Annexure C-2 the policy document which was valid w.e.f. 20.2.2020 to 19.2.2021 and the same met with an accident  on 24.7.2020  and engulfed into fire on the relevant date, time and place  as is also  evident from the copy of DDE Annexure C-3 and the fire report Annexure C-4  and the   claim of the complainant has not been settled by the OPs till date and the same has been closed/repudiated  by OP as is evident from letter Annexure C-5 dated 23.2.2020 and another letter Annexure C-6  dated 28.1.2021, the case is reduced to a narrow compass as it is to be determined if  the OPs are unjustified in repudiating the genuine claim of the complainant and the complainant is entitled for the relief as prayed for, as is the case of the complainant or if the OPs  are justified in closing the claim  of the complainant and the complainant being not maintainable is liable to be dismissed.
   2. As per case of the complainant he has submitted all the requisite documents as asked by the surveyor for the settlement of the claim which fact has been denied by the OPs who came with a specific defence in their written version that the claim of the complainant has neither been repudiated nor has been closed as alleged in para 8 of the  written version of the OPs. However, this defence of the OPs that the complaint of the complainant has neither been  closed nor repudiated stands falsified from the letter Annexure C-5 dated 23.2.2020 vide which the OPs have conveyed to the complainant that:-

       “hence we regret our inability to consider your    claim on the ground of misrepresentation.”

 

3.  Similarly vide letter Annexure C-6 dated 28.1.2021  the OPs had again  conveyed to the complainant that:-

“Therefore, we presume you are not interested to pursue the claim of, hence claim file is closed as “No claim”.

 

4. The main ground on which the OPs have countered the claim of the complainant is that the complainant has not submitted certain documents as asked by the OPs before the surveyor i.e. CNG cylinder fitness certificate, previous policy of the vehicle, service history and sale and purchase affidavit, driving license  of the driver etc. makes it clear that the OPs have asked the complainant to submit almost 22 documents which otherwise not recovery relevance with the case or for the settlement of the claim as even prior to issuance of subject policy the complainant was registered owner of the subject car as  is evident from copy of Annexure C-1 the copy of RC and these documents ought to have been verified by the Ops insurance company even before the issuance of the  subject policy.  Moreover, the complainant has specifically  stated that he has already submitted the documents with the surveyor and even the surveyor report Annexure R-6  nowhere shows  the complainant has not submitted the documents and so far as the driving license  of the driver is concerned the surveyor has verified the said driving license to be correct  alongwith RC of the vehicle and after inspecting the vehicle the surveyor has assessed the liability of the OP  insurance company as Rs.2,52,285/-. Thus, one thing is clear from the entire evidence led  by the parties  on record as discussed above that the OPs have closed/repudiated the claim of the complainant on flimsy grounds by asking the complainant to submit several documents which are otherwise not relevant for the settlement of the claim especially when all the documents required for the settlement of the claim were verified  by the surveyor and the surveyor after finding the subject accident and claim to be genuine   has assessed the liability of the insurance company to the tune of Rs.2,52,285/-.  
5. The learned  National Commission in case titled as New India Assurance Company Ltd. Vs. Rabindra Narayan I (2010) CPJ 80 (NC) held as under:-

“The Report submitted by the Surveyor is an important piece of evidence and has to be given due weight and relied upon until and unless it is proved by some cogent and reliable evidence that the Report submitted could not be relied upon.”

 

(vi)  The Hon’ble National further recently in case titled as Oriental Insurance Co. ltd vs. Arss Infrastructure Project Ltd. II (2023) CPJ 468 (NC) held as under:-

“(i) Insurance — Surveyors’ report — Survey and investigation are one of fundamentals in settling claim, and cannot and should not be disregarded or dismissed without cogent reasons, though it also goes concomitantly that survey or investigation should be convincing and pass test of credence in scrutiny — State Commission has not gone into contents of surveyors’ reports at all on ground that reports were filed belatedly before it — Reports were in any case available before State Commission and as such it ought to have examined their contents rather than dismissing them outright — Depending upon circumstances State Commission could have even imposed terms including cost for belatedly filing reports but to treat them as suspicious and to perfunctorily dismiss them outright merely because they were filed belatedly was not approach either justified or called for — No need to examine surveyors’ reports at this stage at any great length since both parties agree that settlement may be made on basis of respective surveyor’s assessment of actual loss in each case.”

 

6. The  Hon’ble National Commission further in case titled as Detco Textiles Pvt . Ltd. versus New India Assurance Company Ltd. & anr. II (2023) CPJ 535 (NC) held as under:-

“The Surveyor conducted a very detailed inspection of the premises and assessed the loss after due verification of documents. He assessed the total loss to the building, plant & machinery and furniture etc. at Rs.11,21,18,099/- after making necessary deductions of Rs.5,605,905/- towards excess clause and taking care of the process charges, debris removal, architects fee and goods held in trust arrived at the net adjusted loss of Rs.10,65,12,194/-. For every item, the Surveyor had explained the basis of arriving at the amount. The Complainant on the other hand had not placed any evidence to establish that the assessment made by the Surveyor was incorrect. The Complainant, therefore, cannot be allowed the amount beyond the assessment of the Surveyor. We see no reason not to agree with the assessment made by the Surveyor.”

 

7. As held above the surveyor report is an important piece of evidence and has to be given due weightage and can only be ignored if there is any other cogent evidence otherwise, which the complainant has failed to lead by way of any concrete evidence.
8. In view of the foregoing it is safe to hold that the OPs are unjustified in closing/repudiating the claim of the complainant and the complainant is entitled for the claim amount as assessed by the surveyor.  

4. In the light of the aforesaid discussion, the present consumer complaint succeeds, the same is hereby partly allowed and OPs are directed as under :-

      

1. to pay ₹2,52,285/-.  to the complainant(s) alongwith interest @ 9% per annum from the date of  closure of the claim i.e. 28.1.2021 till onwards
2. to pay an amount of ₹10,000/- to the complainant(s) as compensation for causing mental agony and harassment to him;
3. to pay ₹10,000/- to the complainant as costs of litigation.

5. This order be complied with by the OPs within 45 days from the date of receipt of its certified copy, failing which, they shall make the payment of the amounts mentioned at Sr.No.(i) & (ii) above, with interest @ 12% per annum from the date of this order, till realization, apart from compliance of direction at Sr.No.(iii) above.
6. Pending miscellaneous application(s), if any, also stands disposed off.
7. Certified copies of this order be sent to the parties free of charge. The file be consigned.

Announced 6/02/2024 mp			Sd/- [Pawanjit Singh] President
			Sd/-
			[Suresh Kumar Sardana] Member