Haryana

Fatehabad

CC/155/2021

Chandan Royal - Complainant(s)

Versus

Shri Ram General Insurance Company Limited - Opp.Party(s)

Rajesh Verma

01 May 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION; FATEHABAD.

                                                          Complaint case No.155 of 2021.

                                                         Date of Instt.: 02.07.2021.                                                                 Date of Decision: 01.05.2024.

 

Chandan Royal son of Shri Khyali Ram resident of Thakar Basti, Ward No.20 near Bal Bhawan, Fatehabad Tehsil & Fatehabad.

                                                                   ..Complainant.

                              Versus

1.Shri Ram General Insurance Company Limited, E-8, EPIP-RIICO Industry Area, Sitapur, Jaipur (Rajasthan) 302022 through its Branch Manager.

2.Shri Ram General Insurance Company Limited Branch  Office SCF-P29,1^st Floor, Sector-14, Gurugaon through its Branch Manager.

 

                                                                   ..Opposite Parties.

          Complaint U/S 35 of the CP Act,2019       

Before:                  Sh.Rajbir Singh, President.

                             Dr.K.S.Nirania, Member.                                                         Smt.Harisha Mehta, Member.                                         

 

Present:                 Sh.Rajesh Kumar, Advocate for complainant.                                            Sh.U.K.Gera, Advocate for Ops.

                  

ORDER

SH.RAJBIR SINGH, PRESIDENT

                              Brief facts of the present compliant are that the complainant is a registered owner of vehicle car bearing Registration No.HR36X-3907; that he got his vehicle insured with Ops vide policy No.10087/31/31/000633 having validity from 18.08.2020 to 17.08.2021; that the vehicle in question met with an accident on 31.12.2020; that he got his vehicle repaired by spending a sum of Rs.55000/- on it; that he handed-over all the requisite documents including the bills to the surveyor who assured that the same would be settled soon but to no avail; that the complainant visited the Ops with a request to settle the claim but they wrongly and illegally repudiated the claim vide letter dated 02.01.2021 on the ground of concealment of NCB despite the fact that he had never applied for NCB at the time of getting the insurance of the vehicle; that the complainant kept on requesting the Ops and even got served legal notice upon them but to no avail. The act and conduct of the Ops clearly amounts to deficiency in service on their part.

2.                          On notice Ops appeared and file their joint reply wherein several preliminary objections such as cause of action, maintainability and concealment of material facts etc. have been taken. It has been further submitted that as per the policy of insurance and GR 27, if the insured is unable to produce such evidence of NCB entitlement from the previous insurer, the claimed NCB may be permitted after obtaining a declaration from the insured and the complainant had made a declaration that he is agreed to accept a policy subject to conditions prescribed by the company; that the complainant has got the benefit of NCB by making declaration and on the other hand it has been informed by the previous insurer i.e. Bharti Axa General Insurance the policy was issued in the name of one Ravinder Kumar for the  period 22.07.2019 to 21.07.2020, therefore, he is not entitled for any claim and his claims are forfeited; that the complainant is bound by the terms and conditions of the policy but he has deliberately and willful misrepresentations on his part regarding the previous policy in order to take higher slab of NCB in the present policy; that the complainant himself has not complied with the terms and conditions of the policy of insurance, therefore, he is not entitled for any claim.  Other contentions have been controverted and prayer for dismissal of the complaint has been made.

3.                          In evidence, the complainant has tendered affidavit Ex.CW1/A with documents Annexure C1 to Annexure C9. On the other hand the Ops have tendered affidavit Ex.RW1/A with documents Annexure RW/1 to Annexure RW/4.

 

4.                          Undisputedly, at the time of damage to the vehicle in accident on 31.12.2020, it was insured with Ops (Annexure C2) and the complainant had lodged his claim with the Ops vide Annexure C1. Perusal of the Annexure C2 (insurance policy) reveals that the previous insurer i.e. Bharti Axa General Insurance Company in previous policy No.2311202876089500000 had given the NCB discount upto 50 %.  The complainant has come with the plea that the Ops have wrongly and illegally repudiated the claim of the insured vehicle despite the fact that it got damaged during the subsistence of the policy. The Ops in their reply have mentioned that the complainant had concealed the fact of availing NCB benefit upto 50 % in the previous policy with previous owner, therefore, he is not entitled for any compensation/claim on account of damage of the insured vehicle.

5.                          Admittedly, Ops are insurer of vehicle No. HR36-X-3907 owned by complainant. Currency of this insurance runs from 18.08.2020 to 17.08.2021. Erstwhile insurer of complainant’s vehicle was Bharti Axa General Insurance Company Ltd.  In the entire text of complaint; complainant has not uttered a word that: his vehicle was previously insured with Bharti Axa General Insurance Company Ltd. and he was enjoying 50% No Claim Bonus. Instead, this plea has come in the written statement filed by the OPs. Why the complainant has not come forward with clean hands by not disclosing material facts in the proposal form, while claiming insurance of vehicle from OPs that erstwhile insurer of his vehicle was Bharti Axa General Insurance Company and he has not taken any claim from that insurer and was enjoying 50% No Claim Bonus under previous insurance policy. This material fact was required to be disclosed by him while filing proposal form with OPs.

6.                          The complainant in support of his plea that he got his damaged vehicle repaired from M/s Auto Centre, Hisar, M/s B.K.Motors, Hisar and M/s Grewal Auto Guarrage, Hisar has placed on file bills to the tune of Rs.4484/-, Rs.16510/- and Rs.13450/- (Rs.34444/-) issued by these respective workshops. The complainant in his complaint has specifically mentioned that after the accident he took his vehicle to Auto Market, Hisar. Allegedly, the accident occurred on 31.12.2020 and the bills for the repairing of the vehicle are of 02.01.2021 and 03.01.2021 and this fact is enough to reach at the conclusion that the vehicle got damaged and repaired during the currency of the year. Perusal of the case file reveals that the Ops have not produced on the case file report of the surveyor despite the fact that the claim vide claim form Annexure C1 was lodged with the Ops on 01.01.2021. As per the Ops the complainant being guilty of breach of good faith is not entitled to any compensation and his claim was rightly rejected. The act and conduct of the Ops shows that it had rejected the claim without sound logic and valid grounds and even by ignoring the merits and good spirit of the terms and conditions. In the case in hand, the vehicle met with an accident and got repaired by the complainant during the currency of the policy, therefore, the Insurance Company is liable to indemnify the owner of the vehicle when the insurer has obtained comprehensive policy for the loss caused to the insurer.  There may be certain conditions in the policy but that does not mean that the insurer can take the shelter under that conditions and repudiate the claim of the claimant, which is otherwise proved to be genuine. Even if, we assume that there was a breach of condition of the insurance policy, the Insurance Company ought to have settled the claim on ‘non-standard’ basis.  The Insurance company cannot repudiate the claim in toto. On this point, reliance can be taken from case law titled as Dr.ChanderKant Parshuram Mahajan Vs. New India Assurance Company Limited & Anr. Decided by Hon’ble National Commission in Revision Petition No.698 of 2018 on 25.10.2018. Hon’ble State Commission of Haryana while disposing of First Appeal No. A/827/2018 on 19.10.2023 in case titled as New India Insurance Company Vs. Jasbir Singh has relied upon the judgment titled as United India Insurance Company Ltd. vs. M/s Jindal Poly Buttons Limited & Branch Manager and held that “because insured has taken benefit of no claim bonus by making false declaration his insurance claim would be reduced proportionately. In that case, surveyor accessed the loss at Rs.1,74,955/-. Complainant’s claim was repudiated on the ground that he had obtained a false no claim bonus of 20% while taking insurance policy in question. Revision Petition was allowed partly. It has been further held that Accordingly, on aspect of quantum of compensation as awarded through impugned order dated 17.05.2018; interference in present appeal is warranted. Accordingly, while relying upon above cited judgment on Hon’ble National Consumer Commission; it is now held that complainant-Jasbir Singh is entitled to 50% of Rs.50,100/- (amount accessed by surveyor) which comes to Rs.25,050/-. This amount (Rs.25,050/-) will also carry interest @8% per annum, from date of filing of complaint (02.02.2018) till realization. Impugned order dated 17.05.2018 stands modified in above terms. Present appeal is disposed off accordingly being partly allowed.

7.                          In view of the above findings made by the Hon’ble National Commission as well as Hon’ble State Commission, we are of the opinion that repudiation of the insurance claim by the Insurance Company was not justified and the end of justice would be met if we direct the Ops to pay 50 % of the amount of total i.e. Rs.34444/-(amount spent by the complainant on the repairing of his insured vehicle. Accordingly, the present compliant is partly allowed and the Ops are directed to pay a sum of Rs.17,222/- to the complainant i.e. 50 % of the total amount of Rs.34444/- alongwith interest @ 7% per annum from the date of filing of present complaint till actual realization. We also direct the Ops to further pay a sum of Rs.11,000/- for mental agony and harassment including litigation expenses to the complainant.  The order be complied within a period of 45 days from today failing which the amount would carry interest @ 9 % per annum from the date of filing of the complaint till its realisation. 

8.                          In default of compliance of this order, proceedings against respondents shall be initiated under Section 72 of Consumer Protection Act, 2019 as non-compliance of court order shall be punishable with imprisonment for a term which shall not be less than one month, but which may extend to three years, or with fine, which shall not be less than twenty five thousand rupees, but which may extend to one lakh rupees, or with both. A copy of this order be sent to the parties free of cost. This order be also uploaded forthwith on website of this Commission, as per rules, for perusal of parties herein. File be consigned to the record room after due compliance.     

Announced in open Commission.                                                            Dated: 01.05.2024

 

                                                                                                        

(K.S.Nirania)                      (Harisha Mehta)                (Rajbir Singh)                  

  Member                                Member                                           President