The present complaint filed U/s 12 of the Consumer Protection Act' 1986 (for short, 'the Act') by the complainant Som Raj prays for the necessary directions to the opposite parties to  release Rs.2,64,689/- alongwith interest @ 18% P.A. till realization to him alongwith Rs.50,000/- as damages, mental and physical harassment due to the negligence and irresponsible attitude of the opposite parties in discharging their due duties towards their customers on the whole payment till the date of realization.

2.      The case of the complainant in brief is that he is the registered owner-cum-driver of the vehicle/Chervolet-Tavera NEO LS B3 BS3 bearing Registration No.HP02D  0451 Shimla, Engine No.6KD03296 Chasis No.MA6A6G764H003122. He got insured the vehicle with opposite party no.2 vide insurance policy No.10003/31/16/265171  by paying total premium Rs.17,154/- which was valid for the period from 22.9.2015 to 21.09.2016 and he is holder of valid driving licence valid for MV.GV. MV and LMV/CAB valid upto 20.3.2017 bearing No.PB-3520040060772 issued by DTO, Pathankot. Unfortunately, the vehicle met with an accident on 18/09/2016 at about 7:00PM, when he was going to Pathankot from Taragarh by driving his said vehicle carefully with reasonable speed on the left side of the road, but when he reached near Railway Crossing Near M G N College in the meantime some cattle appeared in front of the vehicle and in order to save it, he applied its brakes at once, due to which the vehicle became out of his control resultantly it turned towards left side and  struck against a tree, resultantly the front bumper, head lights, radiator and Engine of the vehicle got broken and besides the vehicle suffered other extensive damages. He also suffered simple injuries. He informed the Insurance Company regarding extensive damages caused to his vehicle due to said accident and he recorded his claim with the opposite parties at No.1000/31/17/C/041719 and he also got the DDR registered at No.020 on 07.12.2016 with the Police Station Kanwan at about 11:00AM.  He got his vehicle repaired from the workshop by spending a sum of Rs.2,64,689/- but the opposite parties till date have not released the insurance claim to him despite repeated requests, which act of the opposite parties is not fair and it shows negligence and irresponsible attitude of the opposite parties in discharging their duties towards customers. Thus he has suffered financial loss besides mental and physical harassment. He also served a legal notice through his counsel on 19.12.2016 upon the opposite parties but of no use. Hence this complaint.

 3.        Upon notice, the opposite parties appeared and filed their joint written reply through its counsel taking the preliminary objections that the complainant has no cause of action to file the present complaint; there is no deficiency in service on the part of insurance company. Actually, the claim has been intimated on 20.9.2016 and the Surveyor Sanjeev Mahajan has been duly appointed to assess the loss. As per intimation narrated by him, the vehicle was parked by driver at roadside in Himachal and some person stolen the Engine Bonut and other parts of the car. No FIR was lodged.  During the survey no physical damages was found at the time of survey. So, the claim has been made as no claim as per terms and conditions of the policy and the letter dated 28 September, 2016 duly sent. Actually, the claim of the complainant is not covered under the policy. The general exceptions clearly provides that the company shall not be liable under the policy in respect of “3(a) Consequential loss, depreciation, wear and tear, mechanical or electrical breakdown, failure or breakages nor for damage caused by overloading or strain of the insured vehicle nor for loss or damage to accessories by burglary, housebreaking of theft unless such insured vehicle is stolen at the same time.” It has further stated that the Survey has been duly conducted by the surveyor and his report is very much clear in this regard and the complainant has not come to the Forum with clean hands. On merits,  it was submitted that as per surveyor report, who inspected the vehicle, there is no physical damage on the vehicle and as per story narrated by the insured the vehicle was parked by driver at roadside in Himachal and someone stolen the parts of vehicle. No alleged accident took place. It has further submitted that actually, the claim has been intimated on 20.9.2016 and the Surveyor Sanjeev Mahajan has been duly appointed to assess the loss. As per intimation narrated by him, the vehicle was parked by driver at roadside in Himachal and some person stolen the Engine Bonut and other parts of the car. No FIR was lodged.  During the survey no physical damages was found at the time of survey. So, the claim has been made as no claim as per terms and conditions of the policy and the letter dated 28 September, 2016 duly sent. All other averments made in the complaint have been vehemently denied and lastly prayed that the complaint may be dismissed with costs. 

4.       Counsel for the complainant tendered into evidence affidavit of complainant Ex.C1, alongwith other documents Ex.C2 to Ex.C8 and closed the evidence. 

5.          Counsel for the opposite parties tendered into evidence affidavit of Shailesh Jindal Assistant Manager Legal Ex.OP-1, alongwith other documents Ex.OP2 to Ex.OP-5 and closed the evidence.

6.     We have carefully examined the documents/evidence produced on record (along with the scope of ‘adverse inference’ for that ignored to be produced) to adjudicate their respective ‘claims’ as pleaded forth by the present litigants in the light of the arguments as put forth by their learned counsels, while adjudicating the present complaint.

7.       We find that the present dispute had prompted at the OP insurer’s repudiation (Ex.OP3) of the complainant’s accident insurance claim (Ex.OP2) of the insured vehicle Chevrolet Tavera Neo HP-02-D-0451 that had got badly damaged in a Road Side Accident on 18.09.2016. Incidentally, the repairs had been alleged to have cost Rs.2,64,689/- (Ex.C1) to the complainant whereas the opposite party insurers had repudiated the related insurance claim in terms of the appointed Surveyor’s report (Ex.OP2) alleging of many missing car-parts as consequential loss and that had eroded the insurers’ liability to settle the impugned claim. However, the OP insurers have failed to produce the surveyor’s deposition and/or other supporting evidence to prove that the loss incurred to the car has not been an outcome of Road Side Accident but on account of occurrence of ‘consequential’ damage.

8.       On the other hand, the complainant has filed his deposition (affidavit Ex.C1) and GDR # 020 dated 07.12.2016 (Ex.C7) but somehow has omitted to produce/file the Repair Bills and/or any other cogent evidence to prove the alleged repairs @ Rs.2,64,689/-. However, we find that the OP insurers have also not categorically denied the non-receipt of repairs-assessment and repairs-bills etc.        

9.        Thus, we find that the impugned repudiation of the instant insurance claim at the hands of the OP insurers certainly infringes the consumer rights of the complainant all the more so at the face of their own inadvertent mistaken interpretation of the applicable governing law. Presently, we find that the OP insurers have not been able to justify the impugned ‘claim-repudiation’ and did not even attempt to settle the ‘claim’ as of ‘now’ during the ‘pendency’ of the present complaint to show/exhibit its bonafide intentions but it chose otherwise and thus we hold it guilty of ‘deficiency in service’ and ‘unfair trade practices’ etc.

10.     In the light of the all above, we partly accept the present complaint and thus ORDER the OP Insurers to pay the full amount of the impugned claim (under the related Policy) to the complainant within 30 days of the receipt of the copy of these orders along with Rs.5,000/- as compensation besides Rs.3,000/- as cost of litigation, otherwise the aggregate award amount shall attract interest @9% PA from the date of the present orders till actually paid.  

11.     Copy of the orders be communicated to the parties free of charges. After compliance, file be consigned to record.  

               (Naveen Puri)

                                                                              President   

Announced:                                                     (Jagdeep Kaur)       

January,24 2018                                                        Member

*MK*