Complainant Suresh Kumar through the preset complaint filed U/s 12 of the Consumer Protection Act, 1986 (hereinafter, for short called ‘the Act’) has sought relief against the opposite party to make payment of the full insurance claim on account of totally damaged car to him alongwith interest @ 18% per annum from the date of due till its actual realization and the opposite party be also directed to pay compensation amounting to Rs.2,00,000/- alongwith Rs.1,00,000/- as litigation expenses to him, in the interest of justice.
2. The case of the complainant in brief is that he got insured his Car Volkswagen Vento bearing Registration No.PB-06-R-7272 from the opposite party which was valid for the period with effect from 10.9.2015 to 9.9.2016 and opposite party has issued policy in this regard to him. Opposite party has assessed the value of the vehicle as Rs.5,50,000/- on which amount the policy was issued and premium was paid by him. Thus, he is consumer of the opposite party. He has further pleaded that on 25.2.2016 his car met with an accident and the car was totally damaged. He reported the matter to the Local Police vide D.D.R. No.46 dated 14.3.2016 in this regard. The officials of the opposite party had visited the spot and had taken the photographs of the damaged car. He has completed all the formalities and deposited all the requisite documents with the opposite party. Thereafter the opposite party has appointed a Surveyor for assessing the loss and two times, the Surveyors have been appointed and even a Estimate was prepared regarding the damaged vehicle by VW Pathankot CPL Cars Private Ltd, Dalhousie Road, Mamun, Pathankot in which they had assessed the loss to the tune of Rs.6,18,696.67 Paise but the opposite party did not make the payment of insurance amount to him so far. He requested the opposite party number of time to make the payment but of no avail. It was next pleaded that the act and conduct of the opposite party not to make the payment of Insurance claim-cum-loss assessed to him is illegal, null and void, against the rules and regulations of the opposite party. Thus, there is deficiency in service on the part of the opposite party.
3. Upon notice the opposite party appeared and filed its written version 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 the opposite party. Actually the claim of the complainant was pending with the insurance company for non providing of documents. The complainant filed the present complaint but has not provided relevant documents demanded by the insurance company. The letter dated 2nd June 2016 has been sent to the complainant, in which some documents are demanded, which includes copy of details of towing of damaged car from loss site to garage at Pathankot, legible copy of driving license of driver at the time of loss, copy of medical bills in respect of third party injuries to Sifa wife of Sheru and Jatun daughter of Sheru who were injured in the said accident and the copy of compromise if any reached between the insured and third party injured person. The complainant neither gave any reply nor provided the documents. So, the claim of the complainant has been made as No Claim vide letter dated 21 July, 2016 who is at fault and failed to fulfill his part of obligations; the complainant has not come to the Forum with clean hands and concealed the material facts and the complaint of the complainant is bad for non joinder of necessary parties. On merits, it was submitted that the complaint of the complainant is premature and he is at fault who failed to fulfill his part of obligations. Even otherwise the vehicle has been duly surveyed by the surveyor and he duly submitted his survey report after verifying each and every part of the damaged vehicle. The liability of the insurance company is only as per survey report and as per terms and conditions of the policy. But as already stated the claim has been closed due to non submission of documents. All other averments made in the complaint has been vehemently denied and lastly prayed that the complaint may be dismissed with costs.
4. Complainant tendered into evidence his own affidavit Ex.C1 and of Sanjeev Mahajan Surveyor Ex.C7, alongwith other documents Ex.C2 to Ex.C6 and closed the evidence.
5. Counsel for the opposite party tendered into evidence affidavit of Arvind Sharma Authorized Signatory Ex.OP-1 alongwith other documents Ex.OP-2 to Ex.OP-10 and close the evidence.
6. We have carefully examined all the documents/evidence produced on record and have also judiciously considered and perused the arguments duly put forth by the learned counsels along with the incidental scope of adverse inference for some documents that have been somehow ignored to be produced by the contesting litigants. We observe that the prime dispute prompted at the non-settlement & subsequent closure of the complainant’s accident-claim of his insured Car on the pretext of non-submission of demanded documents by the opposite party insurers.
7. We further find that the complainant has competently proved his allegations through his affidavit Ex.C1 and other documents exhibited here as: Ex.C2 insurance policy with an IDV of Rs.5.50 Lac; Ex.C3 the accident DDR 046 of 14.03.2016; Ex.C4 Repair Estimates of the accidented Car for Rs.6,18,696.67 p by the insurer’s Surveyor along with his deposed affidavit Ex.C7; and lastly the Ex.C5 and Ex.C6 the accidented Car’s valid RC Registration Certificate and the Complainant’s valid DL Driving License, respectively.
8. On the other hand, the OP insurers have failed to produce any cogent evidence to justifiably explain the delay caused in settlement of the impugned claim. The OP insurer’s affidavit Ex.OP1 imputes non-submission of documents by the complainant as reason of ‘delay’ and subsequent closure (non-settlement) of the impugned claim. In support, Ex.OP2 to Ex.OP7 i.e., demands letters repeatedly requisitioning the same vague documents stand produced. Out of these, the DL already stood submitted awaiting verification by the issuing authorities whereas the other documents did not pertain to the subject matter comprising the impugned claim. Further, Ex.OP8 & Ex.OP9 are the OP survey estimates of Rs.6.18 Lac confirming the total-loss of the accidented car whereas Ex.OP10 has been the claim, itself. Further, it has not been the case of the OP insurers to contest/oppose the repair estimates as acceptable to the complainant and confirming the accidented car as a case of total loss. And, that dyes the present delay and subsequent closure of the impugned insurance claim into the ‘hue’ of ‘deficiency in service’ coupled with ‘unfair trade practice’ under the provisions of the applicable statute. To sum it up all, we find that the OP insurers have arbitrarily delayed its settlement to subsequently close the impugned insurance claim in question and have since failed to produce any cogent evidence to support the alleged grounds/ basis of such delay and closure etc and in its absence these shall amount to ‘bald’ statements, only. Thus, the OP insurers’ impugned delay and closure of the insurance claim does not entail legality under the applicable law and need be set-aside.
9. Presently, coming to the quantum of settlement of claim, we find that the contesting sides have mutually consented upon the surveyor’s repair estimates of Rs.6.18 Lac that overshoots the related policy’s IDV of Rs.5.50 Lac and thus a final settlement at policy’s IDV shall be fair settlement of claim. Somehow, none of the sides have opposed/contested the surveyors’ repair estimates and that rakes the OP insurers liable for payment as per the terms of the related Policy in line with the extant IRDA guidelines on the subject
10. In the light of the all above, we partly allow the present complaint and thus ORDER the OP insurers to settle and pay the impugned insurance accident claim to the full IDV (but duly limited by the terms as applicable under the related Policy) to the complainant besides to pay him a sum of Rs. 10,000/- as compensation (for the harassment inflicted) and as cost (of litigation) within 30 days of the receipt of the copy of these orders otherwise the aggregate awarded amount shall attract interest @ 9% PA form the date of the orders till actual payment.
11. Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to records.
(Naveen Puri)
President
ANNOUNCED: (Jagdeep Kaur)
December 28 2016. Member.
*MK*
