Haryana

StateCommission

A/1144/2017

NATIONAL INSURANCE CO.LTD. - Complainant(s)

Versus

SUKHCHAIN SINGH - Opp.Party(s)

R.C.GUPTA

07 May 2024

ORDER

 

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

HARYANA PANCHKULA

                  

  Date of Institution:31.08.2017

                Date of final hearing: 07.05.2024

                                                Date of pronouncement:13.05.2024

 

First Appeal No.1144 of 2017

 

 

IN THE MATTER OF

 

National Insurance Company Ltd. through its Sr. Divisional Manager (Motor Claim Hub),  Railway Road, Karnal, now through its authorized signatory of Regional Office, SCO No.332-334, Sector 34-A, Chandigarh.

.….Appellant.

 

Through Counsel Shri R.C. Gupta, Advocate

 

Versus

 

Sukhchin Singh son of Shri Malook Singh, R/o VPO Singhara, Tehsil Nissing, District Karnal.

 

….Respondent.

 

Through counsel Shri J.K. Narang, Advocate

 

 

CORAM:   S.C. Kaushik, Member.

 

Present:-    Shri J.P. Nahar, counsel for the appellant.

                   Shri Munish Kumar Garg, counsel for respondent.

 

O R D E R

S. C. KAUSHIK, MEMBER:

 

                   Delay of 51 days in filing of the present appeal is hereby condoned for the reasons stated in the application for condonation of delay.

2.                Present appeal is preferred against the order dated 14.06.2017 in Consumer Complaint No.82 of 2016, passed by learned District Consumer Disputes Redressal Forum, Karnal (now ‘learned District Commission’), vide which complaint filed by the complainant-Sukhchain Singh was allowed and opposite party (‘OP’) was directed as under:-

“As a sequel to the foregoing reasons, we accept the present complaint and direct the opposite party to pay Rs.8,58,000/- with interest @ 9% per annum from the date of filing the complaint till its realization. We further direct the opposite parties to pay Rs.11,000/- to the complainant on account of mental agony and harassment suffered by him and for the litigation expenses.”

 

3.                Brief facts of the complaint filed before learned District Commission are that the complainant got insured his Mahindra XUV car bearing registration no.HR-05AH-5005 from the OP for the period 08.02.2014 to 07.02.2015 for the declared value of Rs.12,20,000/-. It was alleged that in the month of September, 2014, said car met with in Mohali an accident with an Endeavour Car, while being driven by his son Harmandeep Singh and complainant was informed by his son regarding the accident. Thereafter, the car was Toe-chained to Karnal to company’s authorized service station. It was further alleged that since, no one suffered any injury in the accident, so the matter was not reported to the police. Information regarding the accident was given to the OP at Karnal office without any delay upon which OP deputed a surveyor, who inspected the vehicle. The surveyor was of confirmed opinion that the vehicle had been totally damaged and was beyond repairs. The surveyor started negotiating for the settlement of the claim and started advising him for repair of the vehicle. The surveyor also told that the insured declared value of the vehicle was wrongly taken as Rs.12,00,000/-, whereas the same was not more than Rs.10,50,000/-. Thereafter, the complainant visited the office of the OP for settlement of the claim as per insured declared value of the vehicle, but his claim was not settled. Later on, claim of complainant was repudiated, vide letter dated 09.07.2015 on flimsy grounds with mala-fide intention. Thus, there was deficiency in service on the part of OP.

4.                Upon notice, OP appeared before learned District Commission and filed its written version by submitting therein that the spot survey was not arranged by the complainant and information of the accident was not given immediately after the accident. It was further submitted that there was manipulation/cutting in the record of P.P.Automotive Private Limited, submitted by the complainant. Moreover, no satisfactory reply was given by the complainant to the queries raised by Shri R.N. Sharma, Investigator. Even toll receipt of Dera Bassi, Shambhu Barrier was not supplied. Crane receipt of M/s Jatindera Crane Services, Mohali submitted by the complainant was found fake. It was further alleged that it was unbelievable that the vehicle had suffered total/major loss and the driver or any other occupant did not receive any injury. It was further submitted that there was no deficiency in service on the part of the OP and the claim of the complainant was rightly repudiated. Finally, prayed for dismissal of the complaint.

5.                After hearing the parties, learned District Commission accepted the complaint of complainant and issued directions to the OP as mentioned above in 2^nd para (supra).

6.                Aggrieved from the impugned order passed by learned District Commission, OP-appellant has preferred the present appeal for setting aside the impugned order by accepting the present appeal.

7.                The arguments have been advanced by Mr. R.C. Gupta, learned counsel for the appellant and Mr. J.K. Narang, counsel for respondent. With their kind assistance, contents of the appeal has also been properly perused and examined.

8.                It is admitted fact that the complainant-present respondent got insured his car bearing registration No.HR-5AH-5005 with the present appellant-OP and the same met with an accident during subsistence of the insurance policy. It is also admitted that the accident had taken place at Mohali and the vehicle was shifted to M/s P.P. Automotive Private Ltd. Karnal without getting spot survey done from the surveyor of the present appellant-OP. It is also an admitted fact that intimation regarding the accident was given by respondent-complainant to present appellant-OP upon which on Shri Daya Ram Gupta surveyor was appointed, who assessed the loss and submitted his interim report. It is also admitted that he assessed the loss on net salvage basis as Rs.7,98,000/- and even got signed the consent letter from the respondent-complainant and also prepared the final survey report and assessed the loss on net salvage basis as Rs.7,95,500/-. The appellant-OP also appointed Shri R.N. Sharma as investigator, who also submitted his report as total damage, but lateron, the claim of the complainant was repudiated, vide letter dated 22.05.2015. The claim of the complainant was repudiated on seven grounds, which are reproduced as under:-

“1.               Spot survey not got arranged nor the company informed immediately after the accident.

2.                Manipulation/cutting in the record of M/s P.P. Automotive Pvt. Ltd. Karnal, submitted by you.

3.                No satisfactory reply received to the query raised by Shri R.N. Sharma, investigator.

4.                Even toll receipt of Dera Bassi/Shambhu Barrier Toll not supplied.

5.                Crane receipt of M/s Jitendera Crane Service, Mohali, submitted by you is found fake.

6.                It is unbelievable that the vehicle has suffered total/major loss and there is sufficient damage on driver side and window, driver or any other occupants have not been received any injuries since no medical record has been submitted.

7.                Concealment of facts is there, which is violation of terms and conditions of the policy of insurance.”

 

9.                As per the appellant-OP, spot survey was not arranged by the respondent-complainant and information of the accident was not given immediately after the accident. Moreover, there was manipulation/cutting in the record of P.P. Automotive Private Limited, submitted by the respondent-complainant. However, no satisfactory reply was given by the respondent-complainant to the queries raised by Shri R.N. Sharma, Investigator. Further, the toll receipt of Dera Bassi, Shambhu Barrier was not supplied. Crane receipt of M/s Jatindera Crane Services, Mohali submitted by the respondent-complainant was also found fake. Further as per the appellant-OP it was unbelievable that the vehicle had suffered total/major loss and the driver or any other occupant did not receive any injury. So, the claim of respondent-complainant was rightly repudiated.

10.              On the other hand, as per the respondent-complainant, the accident had taken place at Mohali and the vehicle was shifted to M/s P.P. Automotive Private Ltd. Karnal without getting spot survey done from the surveyor of the present appellant-OP. The respondent-complainant clarified in his letter dated 07.10.2014 that the accident had taken place at Mohali Chandigarh on 26.09.2012, but he was not aware of the fact that the spot survey was to be got done. He further clarified that the police report was not lodged as none had suffered any injury in the accident.

11.              From the perusal of records and abovementioned discussion, it is established and not disputed as well that the vehicle got damaged in an accident and the same was shifted to M/s P.P. Automotive Private Ltd. Karnal, where the survey was also conducted at the workshop of P.P. Automotive. The vehicle must have been shifted from the place of accident to the workshop with the help of some crane and non-production of toll tax receipt does not lead to the conclusion that the vehicle was not shifted to the workshop with the help of some other vehicle or the crane. Even if, the place of accident was not shown to the investigator, then also it cannot be considered that the accident had not taken place at Mohali. The accident had taken place on 20.09.2014, whereas the investigator submitted report on 15.04.2015. Even if, the place of accident was shown to the investigator, it could not be possible to find out any evidence regarding accident after such a long period. Therefore, showing the place of accident to the investigator could not serve any fruitful purpose to find out the genuineness of the claim of the respondent-complainant. Further, the reports prepared by Daya Ram Gupta, Surveyor clearly indicate that he conducted survey and assessed the loss, while the vehicle was lying at P.P. Automotive Private Ltd. G.T. Road Karnal. Therefore, in such a situation even if no copy of job card or gate entry was provided by the Works Manager of M/s P.P. Automotive Private Limited to the investigator that could not make the claim of the respondent-complainant false in any manner.

12.              Moreover, the investigator opined that it seemed that the insured had concealed the facts, but he has not given the basis of arriving at such a conclusion. It is not always necessary that the occupants of vehicle which meets with an accident resulting in extensive damage to the vehicle must suffer injuries in the accident. Manipulation/cutting in the record of M/s P.P. Automotive Private Ltd. Karnal or finding fake the crane receipt produced by the complainant also could not give any right to the present appellant-OP to decline the genuine claim of the respondent-complainant regarding the loss suffered on account of damage to his vehicle in an accident. The fact remains that the vehicle of the respondent-complainant was damaged in the accident during subsistence of the insurance policy, therefore, insurance company was liable to indemnify for the loss.

13.              Now, the question arises that whether the present respondent-complainant is entitled for the loss as per report of the surveyor after deduction of the salvage value of Rs.3,60,000/- and amount of Rs.2000/- as excess clause out of the insured declared value i.e. (Rs.12,20,000- Rs.3,62,000= Rs.8,58,000) as assessed by learned District Commission or not?

14.              In this regard it is pertinent to mention here that perusal of Ex.OP-3 (Revised/Addendum Interim Report) prepared by Daya Ram Gupta, Surveyor & Loss Assessor, clearly shows that correct IDV of vehicle is Rs.10,83,811/-. Operative part of that report is reproduced as under:-

“Note:- IDV of vehicle is Rs.12,20,000/-. Correct IDV of vehicle comes to Rs.10,83,811/- insured did not agree to settle the loss on correct IDV. Keeping in view IRDA regulation regarding IDV, loss was discussed with insured and after lengthy discussion, he agreed to keep the wreck (with R.C) & settle the loss on next of salvage basis for Rs.8,00,000/- as full and final payment, subjected to deduction of excess clause, leaving the wreck (With R.C) with insured submission of all necessary documents required, approval from concerned insurance office and fulfillment of all other terms and conditions of policy of insurance & grave his written consent for final approval.”

Further, the perusal of Ex.OP-4 clearly shows that the complainant-respondent also gave his consent to this offer/report, which is reproduced as under:-

“Agreed for the recommendations for total sum of Rs.8,00,000/- (Rs. Eight lacs only) settled by Shri Daya Ram Gupta, Surveyor & Loss Assessor as full & final payment of our claim (On Net of Salvage Basis) of vehicle No.HR-05AH-5005, Policy No.4215003/31/13/6100005181, from 08.02.2014 to 07.02.2015 from National Insurance Co. Ltd.., D.O near Kishroe Cinema, G.T. Road, panipat, Haryana under intimation from National Insurance Co. Ltd., Claim Hub Karnal/D.O Panipat/R.O II Chandigarh subjected to deduction of excess clause, leaving the wreck (With R.C.) with the insured, submission of all necessary documents required, approval from concerned insurance office & fulfillment of all other terms and conditions of the policy of insurance.”

 Learned District Commission while passing the impugned order over looked this consent given by the respondent-complainant.

15.             In view of the above observations and discussion, impugned order passed by learned District Commission is modified to the extent that the complainant is entitled for the loss as per consent given by him i.e. Rs.8,00,000/- instead of Rs.8,58,000/-. However, remaining part of the impugned order i.e. interest & compensation etc. remains as it is. In view of above, present appeal stands disposed off accordingly.

16.              Statutory amount of Rs.25,000/- deposited at the time of present appeal be refunded to the appellant against proper receipt, identification and as per rules.

17.              A copy of this order be provided to all the parties free of cost as mandated by the Consumer Protection Act, 2019. This order be uploaded forthwith on the website of the Commission for the perusal of the parties.

18.              Application(s), pending, if any, stands disposed off in terms of the aforesaid order.

19.              File be consigned to record room alongwith a copy of this order.

 

Pronounced on 13^th May, 2024                                                                                                

                                                                                                            S.C. Kaushik                                                                                                                        Member                                                                                                                                 Addl. Bench

 R.K