The present complaint filed U/s 12 of the Consumer Protection Act' 1986 (for short, 'the Act') by the complainant Kashmir Chand prays for the necessary directions to the opposite parties to pay the car repair bill amounting to Rs.28,212/- as per insurance policy and also directed to pay Rs.25,000/- as litigation expenses for mental and physical harassment and other relief which he may be found entitled to.

2.      The case of the complainant in brief is that he is  owner of vehicle bearing no.PB-06-AC-7786 Hyundai Xcent and the said car was hypothecated with Cholamandalam Investment Finance Company Ltd and insured with the opposite parties vide insurance cover note dated 19.08.2015. Unfortunately, the car met with an accident on 29.12.2015 and the same was got repaired from Gurdaspur Auto Mobile Agency and the intimation regarding the accident was given to opposite parties and their representatives. The Automobile Agency repaired the car and issued bill to the tune of Rs.28,212/-. The intimation regarding the bill amount was also given to the opposite parties but subsequently he received letter dated 19.0.1.2016 from the opposite parties wherein his claim was turned down/revoked with remarks that he has concealed the earlier claim. The said revocation letter is illegal, null and void in order to escape from their liability for paying the bill amount. Hence this complaint.

 3.        Upon notice, the opposite parties appeared and filed its written reply through its counsel taking the preliminary objections that the complainant has no cause of action to file the present complaint and there is no deficiency in service on the part of insurance company. The letter dated 19.1.2016 has been sent to the complainant. There is no liability of the insurance company as the complainant has given wrong declaration at the time of getting the policy and wrongly got no claim bonus from the opposite party. The opposite party during inquiry came to know that the vehicle was previously insured with Bharti Axa General Insurance Company and the claim was lodged under previous policy by the complainant. So, the contract of insurance has been vitiated by false declaration thereby disentitling the complainant from claiming the benefits under the policy. So, it is the complainant who is at fault and as such there is no liability of the insurance company. On merits, it was submitted that the vehicle was previously insured with Bharati Axa General Insurance Company, so no question of knowledge of this fact to the opposite party arises. It was further submitted that the letter dated 19.1.2016 is legal and valid. All other averments made in the complaint have been vehemently denied and lastly, the complaint has been prayed to be dismissed with costs.

4.       Complainant tendered into evidence his own affidavit Ex.C1, alongwith other documents Ex.C2 to Ex.C6 and closed the evidence. 

5.          Counsel for the opposite parties tendered into evidence affidavit of Arvind Sharma, Authorized Signatory Ex.OP-1, alongwith other documents Ex.OP2 to Ex.OP10 and closed 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 complainant’s accident claim repudiation (Ex.C2/Ex.OP3 of 19.01.2016) by the OP insurers alleging ‘false declaration’ of ‘Nil Claim’ by complainant to avail of ‘No Claim Bonus’ thus causing breach of the Policy’s conditions.

7.       We further note with concern that the OP insurers have failed to produce the alleged ‘false declaration’ purported to have been submitted by the complainant and/ or related ‘proposal-form’ and/or any other cogent evidence to prove allegation of ‘false declaration’ by the complainant to avail of ‘No claim Bonus’ and in its absence the ‘allegation’ shall amount to merely a ‘bald statement’. Further, it has not been the case of the OP insurers that ‘No Claim Bonus’ was allowed by them on the verbal ‘declaration’ of the complainant and it has been the custom, precedent and practice prevalent in the insurance industry. And, that dyes the present repudiation Ex.C2/Ex.OP3 of 19.01.2016 into the ‘hue’ of ‘deficiency in service’ coupled with ‘unfair trade practice’ under the extant provisions of the applicable statute. To sum it up all, we find that the OP insurers have arbitrarily repudiated the insurance claim in question and have since failed to produce any cogent evidence to support the alleged grounds/basis of repudiation and in its absence these shall amount to ‘bald’ statements, only. Thus, the OP insurers’ impugned repudiation of the insurance claim does not entail legality under the applicable law and need be set-aside.

8.       Presently, coming to the quantum of settlement of claim, we find that the complainant has filed an accident insurance claim for Rs.28,212/- duly accompanied with parallel estimates (Ex.C3) but has not contested the designated surveyors’ estimates of net liability of Rs.21,182.30 p. Somehow, the OP insurers have neither opposed nor have contested the complainant’s claim estimates and that rakes them up liable for payment as per the terms of the related Policy in line with the extant IRDA guidelines on the subject

9.       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 in full (but duly limited by the terms as applicable under the related Policy) to the complainant besides to pay him Rs.5,000/- 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. 

10.     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)       

September,09 2016                                                    Member

*MK*