Complainant Nitin Anand through the present complaint has sought the necessary directions to the opposite parties namely Shriram General Insurance Co.Ltd. through its Manager to pay the insurance claim  of Rs.7,00,000/-. Opposite parties be further directed to pay Rs.25,000/- as compensation for harassment and mental agony alongwith Rs.15,000/- as litigation expenses.

 2.          The case of the complainant in brief is that he got insured the vehicle car TAVERA bearing No.PB-01-8757 from the opposite parties vide policy No.10003/31/13/455194 valid upto 22.11.2013. The opposite parties had also assessed the maximum value of the insurance of Rs.7,00,000/- and Car TAVERA was also financed by the opposite parties. On 11.6.2013, the said car met with an accident and he bourn all the expenses on the repair of the vehicle and spent Rs.1,45,000/- out of which the opposite parties paid the insurance claim of Rs.60,000/- to him. He has further pleaded that on 2.8.2013 he was going to Jugial from Mamoon with his driver namely Arjun son of Madan Lal. A Santro car was coming from the side of Partap World School side. His car Tavera was got fully damaged while escaping the said Santro car and his driver namely Arjun received minor injuries but he received serious injuries. He informed the opposite parties about the said accident and a representative Mr.Sanjeev Mahajan of the opposite parties visited the spot and inspected the vehicle and prepared the loss report of the vehicle car and told him the car Tavera has got totally damaged. On 2.9.2013 he submitted the necessary documents as directed by the opposite parties. On 20.09.2013 and 8.10.2013, he visited the office of the opposite party No.1 at Pathankot to enquire the matter. Thereafter, he visited the office of the opposite parties on different dates but the opposite parties lingering on the matter on one or the other pretext. He has next pleaded that he was using the said vehicle car Tavera as taxi and was earning his livelihood from the said car. He was earning Rs.30,000/- per month after deduction of all the expenses and the said car Tavera is lying in the workshop for repair for the last one year and he has already spent huge amount of Rs.2,00,000/-. The opposite parties number of time advised him to get the second hand parts of another car Tavera to the repair the abovesaid car Tavera. The opposite parties also advised him to sell the said car to any other person and paid outstanding amount of the installment. He has paid more than Rs.7,00,000/- to the opposite parties but the opposite parties still claiming the amount of Rs.2,00,000/-. The opposite parties have not paid anything to him on account of insurance and now refused to pay anything to him. A legal notice dated 10.6.2014 had already sent to the opposite parties but till date no reply has been received. Thus, there is deficiency in service on the part of the opposite parties. Hence, this complaint.

3.        Upon notice, the opposite parties appeared and filed its written version through its counsel, taking the preliminary objection that complainant has no cause of action to the file the present complaint;  the complainant has not come to Ld.Forum with clean hands and concealed the material facts. The claim amount of Rs.1,54,191/- has already been paid as per Survey report and as per instructions the amount of claim has been duly credited in the loan account of the complainant as the vehicle was hypothecated as such the complaint is liable to be dismissed on this ground.; On One side his loan amount has been decreased/reduced to the amount of Rs.1,54,191/- and now he is again claiming which clearly shows his malafide intention. The liability of insurance company is only as per Survey report and Surveyor Sanjeev Mahajan Surveyor and Loss Assessor has duly submitted his report the liability of insurance company is only of Rs.1,54,191/- and the complainant is not entitled for any other amount from the insurance company.; The complaint is liable to be dismissed as the amount of Rs.1,54,191/- has been duly paid as per Survey report and as per terms and conditions of the policy. On merits, it was submitted that the complainant may put strict proof regarding the alleged accident. It was wrong and denied that complainant borne all the expenses for the repair of vehicle and paid the amount of Rs.1,45,000/- out of which the opposite parties paid the claim of Rs.60,000/- to the complainant. The matter of fact is that the amount of Rs.58,779/- has been duly paid as per Survey Report and the Surveyor duly assessed the loss and submitted the report after verifying all damaged parts. The liability of Insurance Company is not more than assessed by Surveyor. All other averments made in the complaint have been vehemently denied and prayed for the dismissal of the complaint.

4.                Complainant tendered into evidence his own affidavit Ex C1/A, along with the other documents exhibited as Ex.C1 to Ex C12 and closed the evidence.

5.        On the other hand, the opposite parties tendered into evidence affidavit of M.K.Banavari, authorized signatory Ex.OP1 along with the other document exhibited as Ex.OP2 to OP9 and closed the evidence.

6.      We have carefully gone through the pleadings of both the parties; arguments advanced by their respective counsels and have also appreciated the evidence produced on record with the valuable assistance of the learned counsels for the purposes of adjudication of the present complaint.

7.        We find that the insured Tavera vehicle has been a case of ‘total damage’ (Ex.C4 Estimates) as a result of the admitted Road Traffic Accident and thus attracted the full claim payment of Rs.7.0 Lac as per the Certificate of Insurance (Ex.C2). The OP insurers however paid an insurance claim of Rs.1,54,191/- as per the Claims approval Sheet (Ex.OP2) on the strength of the Survey Report Ex.OP3 alleged to have been issued by Sanjeev Mahajan Surveyor & Loss Assessor. Ex.OP3 is unsigned and un-supported by affidavit and it is wondered how the OP insurers could have relied upon the same in settling an insurance claim of substantial amount of Rs.7.0 Lac. It surely speaks of mala fide on its part. The letters Ex.OP5 & Ex.OP7 suggesting urgent repairs lose their vitality in the light of the ‘total loss’ and absence of any settlement and/or any cogent evidence disproving the same. Even the name of the surveyor has been wrongly mentioned in the written reply. The defense stand poorly prosecuted and raises suspicion. The complainant has also deposed in his affidavit that the Surveyor had declared ‘total loss’ to the vehicle during the course of survey but somehow the OP insurers filed the ‘un-signed’ and sans deposition (affidavit) i.e., ‘un-deposed’ survey report for Rs.1,54,191/- and hurriedly (and unceremoniously) paid the same in the Loan A/c of the complainant with its own sister concern. It is pertinent here to mention that the Complainants’ Loan was being repaid regularly and there was no credit- authority with the OP insurers to deposit the claim amount in the Loan A/c. Presently, the vehicle Loan stands fully repaid as per the Ex.C5 the statement of Loan account and the OP insurers are directed not to deposit the award amount/ any amount in any other account of whatsoever but pay the same directly to the complainant in his hands.         

8.       In the light of the all above, we find the OP insurers guilty of deficiency in service and thus ORDER them to pay the full insurance claim amount of Rs.7.0 Lac (less the already paid claim amount of Rs.1,54,191/-) to the complainant in terms of the insurance policy. Since there is inordinate delay caused by the opposite party in settling insurance claim and as such we direct the opposite party to pay the above insurance claim amount alongwith interest @9% p.a. from the date of filing of this complaint till actually paid besides Rs.10,000/- as compensation for the harassment, mental torture and financial loss suffered due to deficiency in service and another Rs.5,000/- as litigation expenses within 30 days of the receipt of the copy of these orders failing which proceedings u/s 27 CPA shall be initiated against the opposite party.

9.       Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to records.

                                                                                           (Naveen Puri)

                                                                                                   President.      

ANNOUNCED:                                                                          (Jageep Kaur)

April 20, 2015.                                                                                Member

*MK*