Punjab

Ludhiana

CC/19/294

Smt.Rajwant Kaur - Complainant(s)

Versus

Shriram General InsuranceCo.Ltd. - Opp.Party(s)

Jaswant Singh Adv.

06 Mar 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No:294 dated 14.06.2019.                                                        Date of decision: 06.03.2023.

 

Smt. Rajwant Kaur wife of Shri Gurdeep Singh, r/o. House No.100/1, Village Kanech, near Doraha, district Ludhiana.                                                                                                                                             ..…Complainant

                                                Versus

Shri Ram General Insurance Company Ltd., SCO 18-19, 3^rd Floor, Jandu Tower, Ludhiana-141003 through its Manager                                                                                                                                …..Opposite party 

Complaint Under Section 12 of the Consumer Protection Act.

QUORUM:

SH. SANJEEV BATRA, PRESIDENT

SH. JASWINDER SINGH, MEMBER

MS. MONIKA BHAGAT, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant            :         Sh. J.S. Cheema, Advocate.

For OP                           :         Sh. Vyom Bansal, Advocate.

 

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                In brief, the facts of the case are that  the complainant is the owner of Tata LPT 1109 Goods Carrying Vehicle bearing registration No.PB-10-CM-1362,  model 2009 which was comprehensively insured with opposite party vide policy No.105029/31/18/010029 w.e.f. 128.03.2018 to 17.03.2019 covering risk of Rs.4,49,511/- on payment of premium of Rs.19,917/-. The vehicle was being driven by Sh. Gurdeep Singh husband of the complainant who is holding a valid and effective driving licence. On 15.03.2019 at about 6.45 AM, the vehicle met with an accident two kilometer after crossing Rohtak Toll Plaza,  P.S. Deegal, District Rohtak, Haryana as the vehicle struck with a tractor trolley loaded with bricks. Amarjit Singh, Cleaner was sitting on left side of the driver seat got fracture on his leg at two times and Gurdeep Singh also suffered minor and hidden injuries on his left knee. Amarjit Singh was taken to civil Hospital, Rohtak. In the accident, total front of the vehicle has been damaged. Gurdeep Singh, driver of the vehicle reported the matter to P.S. Deegal. Hero Honda parts were loaded in the said vehicle which were shifted to some other vehicle No.PB-22-J-4865. The owner of the tractor being influential person and police forced the driver to compromise the matter. The complainant submitted that her son Onkar Singh intimated the opposite party on toll free number on same day at about 04.30 PM. The opposite party also deputed surveyor for assessment of loss who inspected the vehicle at the spot and took photographs of the damaged vehicle in the police station and all the documents were handed over to the surveyor at the time of inspection. The complainant lodged the claim with the opposite party along with all the relevant papers vide claim No.10000/31/19/C/106748.  On 16.03.2019, the complainant hired crane for taking the vehicle to get it repaired and parked at Harjeet Denting Motor Workshop, Near Jiffco Resorts, Sahnewal who prepared estimate of Rs.2,75,000/- as repair charges which was also informed to the officials opposite party. The local surveyor of opposite party again visited the workshop and inspected/surveyed the vehicle and clicked photographs and also verified the all recording of mobile of Onkar Singh son of the complainant. The officials of the opposite party came at the workshop for taking blood of driver and cleaner. The complainant further stated that she many times requested the opposite party for payment of compensation and Sh. Vikas Bhalla, Incharge of the opposite party office at Ludhiana. She also approached Jaipur office of the opposite party on telephone who assured to do the needful but they failed to pay the amount of compensation to the complainant. The vehicle is lying parked at the workshop in damaged condition and workshop owner is demanding rent of parking of vehicle. The opposite party has been delaying the matter on one excuse or the other due to which complainant suffered loss of Rs.2000/- per day due to non-plying of the vehicle since 15.03.2019 besides loss of Rs.2000/- per day as parking charges imposed by workshop owner. This amounts t deficiency in service o the part of the opposite party due to which the complainant suffered mental pain, agony and harassment. The complainant also served legal notice dated 22.05.2019 upon opposite party to make the payment of Rs.2,75,000/- along with interest @18% per annum and damages of Rs.2000/-per day since 15.03.2019 along with compensation of Rs.1,00,000/- and Rs.3300/- as cost of legal notice but with no result. Hence this complaint whereby the complainant has prayed for directing opposite party to make the payment of Rs.2,75,000/- along with interest @18% p.a. along with damages of Rws.2000/- per day since 15.03.2019 and compensation of Rs.1,00,000/- besides litigation expenses of Rs.25,000/-.

2.                Upon notice, the opposite party appeared and filed written statement by taking preliminary objections that the complaint is not maintainable, suppression of material facts by the complainant, the complainant is not covered under definition of Consumer Protection Act, 1986 etc. Under the head of factual submissions, the opposite party alleged that the vehicle of the complainant Tata Motors LPT 1109 bearing registration No.PB-10CM-1362  was insured vide policyNo.105029/31/18/010029 from 18.03.2018 to 17.03.2019 by it. The benefits under the policy are governed by the terms and conditions of the policy and the liability of the opposite party is limited to the insured perils occurring within policy period subject to conditions and exceptions mentioned in the terms and conditions of the policy. The intimation for claim towards damaged to the insured vehicle by external means was intimated on 15.03.2019 at 05.2056 PM to opposite party by the complainant and the same was registered vide claim No.10000/31/19/C/106748 and as per the intimation Mr. Gurdeep Singh was driver of the insured vehicle and Mr. Amarjeet Singh was the cleaner of the vehicle. The opposite party further alleged that the claim was allotted to IRDA registered independent surveyor Mr. Ravinder Kumar, Insurance Surveyor and Loss Assessor for conducting spot survey and assessment of the loss to the insured vehicle who visited the damaged vehicle and clicked photographs, collected the required documents, statements and submitted his report of Rs.1,52,944/- as net liability of the opposite party on the MOTOVEYS portal of insurance company. Thereafter, upon receiving the survey report the authorized officials of the opposite party applied their mind and sent the matter for Forensic Examination with SIFS Forensic Science Laboratory India to examine the blood found in the insured vehicle. The said Laboratory submitted its report dated 14.05.2019 whereby it was concluded that blood samples collected from the cabin area of the vehicle is O+VE while the blood group of Gurdeep Singh is A+VE and that of helper Amarjeet Singh is AB+VE. Thereafter, upon application of the mind by the authorized officials of the opposite party upon considering the entire facts and survey report and Forensic report the claim of the insured was found not payable for the reason deliberate and willful misrepresentation by the insured as to cause of loss as the damages to the vehicle are not arising out of an accident as represented by insured and the claim was also  denied for want of documents pending from the insured and the same was intimated to the complainant vide letter dated 28.05.2019. The opposite party further alleged that it has rendered full services without any deficiency to the complainant. The complainant has leveled frivolous, bald and vague allegations without any base against the opposite party and the sole intention of the complainant is to harass the opposite party by instituting such false and frivolous claims.

                   On merits, the opposite party reiterated the crux of averments made in the preliminary objections and factual submissions. The opposite party has denied that there is any deficiency of service and has also prayed for dismissal of the complaint.

3.                The complainant filed replication reiterating the facts mentioned in the complaint and controverted those mentioned in the written statement filed by the opposite party. The complainant stated that the report of the surveyor is procured one and is not binding upon her. All the documents were supplied to the opposite party and the surveyor well in time.

4.                In support of her claim, the complainant tendered her affidavit Ex. CW1 in which she reiterated the allegations and the claim of compensation as stated in the complaint and also tendered affidavit Ex. CW2 of Sh. Gurdeep Singh son of Maghar Singh. The complainant also tendered documents Ex. C1 is the copy of driving licence of Gurdeep Singh, Ex. C2 is the copy of registration certificate of the vehicle, Ex. C3 is the copy of permit issued by Punjab Government, Ex. C4 is the copy of national permit, Ex. C5 is the copy of insurance policy, Ex. C6 is he copy of the fitness certificate, Ex. C7 is the copy of legal notice, Ex. C8 is the copy of postal receipt, Ex. C9 is the copy of letter dated 29.05.2019, Ex. C10 is the copy of Aadhar card of the complainant and closed the evidence.

5.                On the other hand, counsel for opposite party tendered affidavit Ex. RA of Sh. Amandeep Sharma, Assistant Clams Manager of the opposite party  along with documents Ex. R1 is the copy of certificate cum policy schedule, Ex. R2  is the copy of claim intimation slip, Ex. R3 is the copy of survey report, Ex. R4 is the report of Forensic Science Laboratory of India,  Ex. R5 is the copy of letter dated 28.06.20019 written by opposite party to the complainant and closed the evidence.

6.                We have heard the arguments of the counsel for the parties and also gone through the complaint, replication, affidavit and annexed documents and written reply along with affidavit and documents produced on record by both the parties.   

7.                The vehicle make Tata LPT 1109 Goods Carrying Vehicle bearing registration No.PB-10-CM-1362 owned by the complainant Rajwant Kaur met with an accident on 15.03.2019 at about 06.45AM in the area of P.S. Deegal, District Rohtak, Haryana with a tractor trolley loaded with bricks. According to the complainant, at that time the vehicle was driven by Gurdeep Singh and Amarjit Singh was sitting besides him. Amarjit Singh suffered grievous injuries while Gurdeep Singh escaped with minor superficial injuries. On receiving intimation, Mr. Ravinder Kumar, Insurance Surveyor and Loss Assessor visited the spot, clicked the photographs and assessed the loss to the tune of Rs.1,52,944/-  as net liability as per report Ex. R3. The opposite parties resorted to forensic examination with SIFS Forensic Science Laboratory of India who after collecting the blood from the insured vehicle gave a report and tentatively concluded that driver was different in the vehicle at the time of occurrence. Thereafter, the opposite party has chosen not to pay the claim due to the complainant vide letter Ex. C9 = Ex. R5, the operative part of which is reproduced as under:-

“With reference to the captioned claim preferred by you, we wish to state that there have been deliberate and willful misrepresentations on your part as to the cause of loss as the damages to the vehicle are not arising out of an accident as represented by you. Hence we regret our inability to consider your claim on the ground of misrepresentation Also below mention documents are pending.

• Exact cause of loss
• Exact spot photos
• Insured and driver statement on Rs. 10/- stamp
• Driving license
•  KYC Form

We hope you will appreciate our stand that payment of any claim has to be in accordance with the terms and conditions of the policy issued. While expressing our inability to pay this claim due to the above mentioned reason, we reiterate our commitment to pay all admissible claims fairly and promptly.”

8.                The repudiation letter has not referred to the report of SIFS or any other facts and circumstances on the basis of which they were able to opine that there have been deliberate and willful misrepresentation on the part of the complainant so to cause loss as damages to the vehicle not arising out of the accident as represented by the complainant. The law requires that revocation letter should be self explanatory The letter is also silent to which of the terms and conditions of the policy has been invoked to deny the claim of the complainant.

9.                Perusal of blood examination report Ex. R4 shows that the investigation regarding sampling was conducted on 23.04.2019 at far distance place from the place of accident in the area town Sahnewal, Punjab. The samples of blood were lifted from the accidental vehicle lying there and the report was prepared on 14.05.2019. The report Ex. R4 also suggests that there were dry blood stains. There is an inordinate and unexplained delay about two months in collecting the samples. The samples were not collected in the presence of either the complainant or her representative. During this long period, there always remains suspicion that the samples so collected were of the same person (s) that got smeared on the parts of the cabin of the vehicle itself at the time of accient. Even the affidavit of any expert/investigator who visited the spot, collected the sample and analyzed the same has not been tendered in evidence. As such, the findings of the report by itself are not sufficient to conclude that there was a different driver in the vehicle.

10.              Assuming that the driver was different, it was the duty of the opposite party to find out who else was driving the vehicle. The presence of cleaner Amarjit Singh is not disputed. His licence was also not verified. So considering the above said facts and circumstances, the opposite party was not justified in denying the claim of the complainant.

11.              Sh. Ravinder Kumar, Surveyor vide his report Ex. R3 has given his report and has assessed the insurance company’s liability as Rs.1,52,944.05/-. The complainant has not controverted the facts mentioned in the written statement, so far as the surveyor report Ex. R3 is concerned as the complainant has neither filed any objections to controvert the averments made in the written statement. As such, it would be just and appropriate if the opposite party is directed to consider and pay the claim of Rs.1,52,944/- to the complainant as per survey report Ex. R3 along with composite compensation of Rs.10,000/-.

12.              As a result of above discussion, the complaint is party allowed with direction to the opposite party to consider and pay the claim of Rs.1,52,944/- to the complainant as per survey report Ex. R3 within 30 days from the date of receipt of copy of order. The opposite party shall further pay a composite costs of Rs.10,000/- (Rupees Ten Thousand only) to the complainant within 30 days from the date of receipt of copy of order. Copies of the order be supplied to the parties free of costs as per rules. File be indexed and consigned to record room.

13.              Due to huge pendency of cases, the complaint could not be decided within statutory period.

 

(Monika Bhagat)          (Jaswinder Singh)                      (Sanjeev Batra)                          Member                            Member                                       President         

 

Announced in Open Commission.

Dated:06.03.2023.

Gobind Ram.

 

 

Rajwant Kaur Vs Shri Ram GIC                          CC/19/294

Present:       Sh. J.S. Cheema, Advocate for complainant.

                   Sh. Vyom Bansal, Advocate for OP.

 

                   Arguments heard. Vide separate detailed order of today, the complaint is party allowed with direction to the opposite party to consider and pay the claim of Rs.1,52,944/- to the complainant as per survey report Ex. R3 within 30 days from the date of receipt of copy of order. The opposite party shall further pay a composite costs of Rs.10,000/- (Rupees Ten Thousand only) to the complainant within 30 days from the date of receipt of copy of order. Copies of the order be supplied to the parties free of costs as per rules. File be indexed and consigned to record room.

 

(Monika Bhagat)          (Jaswinder Singh)                      (Sanjeev Batra)                       Member                     Member                                       President         

 

Announced in Open Commission.

Dated:06.03.2023.

Gobind Ram.