Haryana

StateCommission

CC/112/2015

MANJEET SINGH - Complainant(s)

Versus

TATA AIG GEN.INSURANCE CO. - Opp.Party(s)

SATBIR MOR

20 Feb 2017

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

Complaint No  :      112 of 2015

Date of Institution:   03.07.2015

Date of Decision :   20.02.2017

 

Manjeet Singh s/o Sh. Ishwar Singh, Resident of H.No.1161, Sector-14, Sonipat, Haryana.

                                      Complainant

Versus

1.      Tata AIG, General Insurance Company Limited, Lotus Tower, 1^st Floor Community Centre, New Friends Colony, New Delhi-110025 through its Manager Claims.

2.      Tata AIG, General Insurance Company Limited, 2^nd Floor, SCO No.6, SCO Complex, Sector-14, Gurgaon-122001, Ph.0124-6454701.

3.      Patel Auto Services Private Limited, authorised Mercedes Benz Service Workshop, Plot No.GP 86, Maruti Industrial Area, Sector-18, Gurgaon, Haryana through its Managing Director.

                                      Opposite Parties

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Mr. Balbir Singh, Judicial Member.

                                                                            

Argued by:          Shri Pardeep Solath, Advocate for Complainant.

Shri Rajneesh Malhotra, Advocate for Opposite Parties No.1 & 2.

None for Opposite Party No.3.

 

                                                   O R D E R

 

BALBIR SINGH, JUDICIAL MEMBER

 

                   Manjeet Singh-complainant purchased a second hand car bearing registration No.HR-CH01AG-3456 make Mercedes-Benz, Model GL 350 for a consideration of Rs.65,51,000/- from Sinder Pal- its registered owner through Jatin Dahiya-authorised person, in the month of January, 2014. Sale price was paid in the months of January, 2014 as well as March, 2014. Certificate of Registration (Exhibit C-2) of the vehicle was issued in the name of the complainant in March, 2014. The car was insured with Tata AIG General Insurance Company Limited (for short ‘the Insurance Company’)-Opposite Party No.1 vide Insurance Policy bearing No.010094104900 dated 22^nd March, 2014 (Exhibit C-3) for the period from March 13^th, 2014 to March 12^th, 2015. The Insured Declared Value (IDV) of the car was Rs.65,00,000/-.

2.                In the month of June, 2014, the back light (tail light) of the car was damaged in a minor accident and the complainant received an amount of Rs.32,340/-, as claim amount, from the Insurance Company as the Insurance Policy was having the facility of cashless repair.

3.                On 16^th August, 2014 at about 10:00 P.M., the complainant was driving the above mentioned car on Sher Shah Suri Marg (Grand Trunk Road). When the vehicle reached near Murthal 51 Mile Stone, a stray animal suddenly appeared on the road; the driver tried to save the animal due to which the vehicle stepped up the divider of the road, turned turtle and struck with a trolla. The car was badly damaged. Intimation regarding this accident was given to the Insurance Company as well as the Police on next day. The vehicle was taken to Patel Auto Service Private Limited-Opposite Party No.3, Gurgaon by obtaining services of Anand Crane Service, as desired by the Insurance Company. An amount of Rs.2500/- was paid to Anand Crane Service vide bill Exhibit C-6. A tentative estimate (Exhibit C-7) for repair of the vehicle, amounting to Rs.83,51,608.78 including taxes, was prepared by the opposite party No.3 on 28^th August, 2014. The cost estimate of repair was sent to the surveyor of the Insurance Company namely Ashwani Thapar. The complainant was informed telephonically that the cost of repair was more than the insured amount (IDV). So, the Insurance Company decided to declare it a case of total loss. As per advice of the surveyor, the damaged vehicle was shifted from the premises of the opposite party No.3. The complainant submitted the required documents as desired by the Manager Claims-Naveen Chikara so that the case of total loss may be processed. The complainant was also given offer by Naveen Chikara-Manager, to receive a vehicle of 2011 model, in lieu of his claim.

4.                On October 13^th, 2014 the complainant received an email from Naveen Chikara-Manager to submit the attested copies of the documents and also to arrange to shift the vehicle to T&T Motors for some technical inspection. The Insurance Company was not willing to bear the expenses for shifting the vehicle to T&T Motors. Facing this situation, the complainant made an online complaint on 3^rd December, 2014 to the Insurance Regulatory & Development Authority (IRDA) of India. On the basis of that complaint, the opposite party No.1 assured for speedy resolution of the complaint vide email dated 4^th December, 2014. Ultimately, vide letter dated 16^th January, 2015 (Exhibit C-24) the claim of the complainant was repudiated mainly on the ground that it could not be established that any such accident took place; that the market value of the vehicle at the time of insurance was approximately Rs.35-38 lacs; that the complainant did not cooperate at the time of investigation and that the vehicle was not purchased by the complainant from the registered owner.  Regarding this accident, the entries were made in the Daily Diary Register of Police Station Murthal, District sonipat, on 17^th August, 2014 on the statement of the complainant.

5.                Aggrieved by the repudiation of his claim, the complainant filed complaint under Section 17 of the Consumer Protection Act, 1986 seeking direction to the opposite parties to pay Rs.65,00,000/-, that is, the insured amount (IDV) of the vehicle with interest @ 24% per annum; Rs.5.00 lacs as compensation for harassment and Rs.50,000/- as cost of proceedings.

6.                The Opposite Parties No.1 and 2 have taken plea in their written version that the State Commission has no jurisdiction to decide this complaint; that the complainant is not covered under the definition of “consumer” as defined in Section 2(1)(d) of the Consumer Protection Act, 1986 (for short ‘the Act, 1986’) and that the complaint is barred by limitation. They have also taken plea that in fact the market value of the above mentioned vehicle was in between Rs.35-38 lacs and the same was got insured for an amount of Rs.65,00,000/- disproportionately misleading the Insurance Company fraudulently to grab huge claim amount. In fact, in the year 2013, when Sinder Pal was registered owner of the car and the same was insured for an amount of Rs.40.00 lacs only, it was involved in an accident and considering it a case of total loss, an amount of Rs.21.00 lacs was paid to the registered owner by M/s HDFC Ergo GIC Limited/Insurance Company.

7.                Apart from it, the complainant also received an amount of Rs.32,340/- as claim regarding damage caused to the car in question on 24^th June, 2014. In fact, no such accident took place. As per report of the investigator (Exhibit R-5) of the Insurance Company namely Vikas Kumar, at the time of spot inspection, persons available there did not verify that any such accident took place on 16^th August, 2014 near 51 Mile Stone, Murthal. Moreover, the complainant did not cooperate during the investigation and spot inspection despite information given time and again telephonically and by sending email messages. The complainant also did not manage to shift the car to T&T Motors for technical inspection. It is admitted that regarding the accident dated 16^th August, 2014 information was received at the call centre of the Insurance Company and the information was also sent to the Murthal Police Station by the complainant on August 17, 2014.

8.                Vikas Kumar Investigator has also mentioned in his report (Exhibit R-5) that the place of occurrence was shown to the persons living nearby but none of them was available to recall any such incident. Moreover, no damage was caused on the under carriage. It appears that no such accident took place and no damage was caused to the car vehicle. The claim of the complainant has been repudiated considering the report (Exhibit R-6) of the surveyor Ashwani Thapar as well as the report (Exhibit R-5) of the investigator Vikas Kumar. The value of the new car of the same model is Rs.73.00 lacs and therefore it is clear that nobody would buy a four years old car already got repaired for an amount of Rs.65,51,000/-. The car vehicle has been got fraudulently insured for Rs.65,00,000/- on the basis of false and fabricated receipt. Moreover, the complainant purchased the car from Jatin Dahiya whereas the registered owner of the car was Sinder Pal. It cannot be believed that cost of repair of the damaged vehicle can be Rs.83,51,608.78. It is prayed that the claim of the complainant has been validly repudiated on the basis of reports of the Investigator and Surveyor (Exhibit R-5 and R-6) appointed by the Insurance Company. The complainant is not entitled to receive any amount as claimed in the complaint and therefore the complaint be dismissed with costs.

9.                In his evidence, the complainant tendered his own affidavit (Exhibit CW1/A) and documents Exhibits C-1 to C-25.

10.              The Opposite Parties No.1 and 2 in their evidence tendered affidavit of Mohd. Azhar Wasi-authorised representative and tendered documents Exhibits R-1 to R-6.

11.              Counsel for the parties have been heard. File perused.

12.              In this case the opposite parties have taken plea that the car vehicle was purchased by the complainant on the basis of documents executed by Jatin Dahiya and in fact Sinder Pal was the registered owner of the vehicle at the time of its purchase. On the basis of the documents executed by Jatinder Dahiya and mentioning payment of the sale price amount Rs.65,51,000/-, the registration certificate of the car vehicle was transferred in the name of the complainant in the month of March, 2014 soon after the total sale price was paid by the complainant. After making payment of the sale price amount and transfer of the registration certificate, car vehicle was got insured from the Insurance Company regarding the period March 13^th, 2014 to March 12^th, 2015. An amount of Rs.1,63,570/- was paid as premium. It is admitted fact that mentioning the IDV of the car vehicle as Rs.65,00,000/-, the car vehicle was got insured for a period of one year on payment of premium amount of Rs.1,63,570/- vide insurance policy Exhibit C-3.  

13.              In the considered opinion of this Commission, much discussion is not needed regarding ownership of the car vehicle. Version of the complainant is that the car vehicle was paurchased by him through authorised person Jatin Dahiya. Record does not show that Sinder Pal, who was earlier registered owner of the vehicle, ever raised any objection claiming ownership of the car vehicle after the same was purchased by the complainant. Moreover, registration authority also issued Registration Certificate (Exhibit C-2) in the name of the complainant. The Insurance Company cannot be allowed to raise this plea in this complaint. So, findings can be safely given that the complainant is the registered owner of the car vehicle and he purchased the car on payment of Rs.65,51,000/-. The amount of Rs.65,51,000/- has been mentioned in the Income-tax Balance Sheet (Exhibit C-1) also.

14.              Merely, because in the year 2013 the car vehicle in question was involved in some other accident and an amount of Rs.21.00 lacs was received by Sinder Pal, the then registered owner of the vehicle as insurance claim considering it a case of total damage, findings cannot be given that the market price of the car vehicle was Rs.35-40 lacs or less than Rs.65.00 lacs, which is the sale price of the car vehicle. In fact, the opposite parties themselves had taken plea in their written version that the actual sale price of a new Mercedes-Benz, Model GL 350 car was Rs.73.00 lacs at the time of alleged accident.   It was in the knowledge of the Insurance Company at the time of providing insurance policy that the insured vehicle was manufactured four years back.  When the insurance policy was provided, photographs of the vehicle were obtained and the documents i.e. registration certificate etc. were also shown by the complainant. The IDV of the vehicle was assessed as per consent of both the parties. The Insurance Company is stopped from taking this plea in this complaint and to decline the claim of the complainant. There may be possibilities that the officers of the Insurance Company might not have raised any objection regarding the market value of the vehicle so that the Insurance Company may get more premium amount. The opposite parties have taken plea that it is an act of fraud and misleading. If it be considered as a case of fraud, certainly finding can be given that the officers of the Insurance Company were also involved in this case of fraud. The opposite parties did not take any disciplinary action against any officer or employee of the Insurance Company and did not file a criminal complaint regarding commitment of fraud against the complainant or any other officer and officials of the Insurance Company. In these circumstances, findings can be safely given that the market value of the insured car at the time of accident was Rs.65,00.000/-. In these circumstances, findings can be safely given that the complainant is covered under the definition of “consumer” as defined in Section 2(1)(d) of the Act, 1986 and this Commission has jurisdiction to decide this complaint.

15.              It is admitted fact that the information regarding the accident dated 16^th August, 2014 was given to the Insurance Company as well as Murthal Police Station on next day, that is, 17^th August, 2014. It is mentioned in the copy of the DDR (Exhibit C-5) also.

16.              During the course of arguments, learned counsel for the opposite parties No.1 and 2 urged that as per reports of the Investigator and Surveyor (Exhibits R-5 and R-6), the complainant did not cooperate during the investigation and did not accompany the Investigator to the place of occurrence despite informed telephonically and email messages.

17.              Regarding any such telephonic conversation, no document is adduced in evidence in this case. However, a few email messages (Exhibits C-9 to C-23) have been adduced in evidence.  Thus, the net result is that the complainant was asked to shift the car vehicle to T&T Motors and was asked to accompany the Investigator at the time of spot inspection. It is evident from the documents Exhibits C-9 to C-23 that the complainant had shown his inability to shift the car vehicle and to visit the place of occurrence as he used to live at Chandigarh in those days. In view of this Commission, the claim of the complainant cannot be repudiated merely because the complainant did not shift his car vehicle to T&T Motors for technical examination because the Investigator did not make it clear in his message that for what purpose and what type of technical examination there was need to shift the vehicle to T&T Motors. Moreover, the Insurance Company also did not agree to bear the expenses of shifting of the vehicle.

18.              The main point to repudiate the claim of the complainant was mentioned in the report that at the time of spot inspection, the persons available did not verify regarding any such accident and that from the damage caused to the vehicle, it does not appear that any such accident took place as mentioned in the version of the complainant. This Commission feels that much importance cannot be given to the reasons given by the Investigator in his report (Exhibit R-5). The accident took place on Sher Shah Suri Marg (G.T. Road) one of the busiest roads in India. The accident took place at 11.00 P.M. on 16^th August, 2014 and the Investigator visited the place of occurrence sometimes in the last days of November, 2014. The persons in whose presence the accident took place were not supposed to be available after more than a period of three months at the place of occurrence. Moreover, the Investigator intentionally did not mention the names of those persons from whom he verified regarding this accident. Moreover, if the complainant could not be available time and again, even then the Investigator was supposed to complete the investigation properly after adopting the required procedure.  

19.              During the course of arguments when it was specifically pointed out that the total estimate for repair of the car vehicle is Rs.83,51,608.78; the IDV of the vehicle is 65,00,000/- and in the earlier insurance policy the vehicle was insured for an amount of Rs.40.00 lacs, learned counsel for the complainants urged that complainant’s vehicle was totally damaged and if the insurer feels that the amount of Rs.65,00,000/- that is, the IDV of the vehicle is more than the actual market price, then he has no objection if direction is given to the insurer to get the car vehicle repaired in all respects. Learned counsel for the complainant has urged that when the car vehicle was damaged due to accident and it is a case of total damage, at least the complainant is entitled to get his car repaired because due to fear of such type unfortunate incident, the complainant had paid the huge amount of Rs.1,63,570/- as premium to the Insurance Company only for a period of one year.

20.              The contention of the learned counsel for the complainant appears to be quite reasonable. The complainant had spent huge amount as premium for providing the Insurance Policy only for a period of one year. So, it becomes the duty of the Insurance Company to get the damaged vehicle repaired through authorised agency of Mercedes.

21.              Resultantly, complaint filed by the complaint is allowed with costs and litigation expenses to the tune of Rs.10,000/-, to be paid by the opposite parties No.1 and 2 to the complainant. The opposite parties No.1 and 2 are directed to get the car vehicle repaired from an authorised agency of Mercedes positively within a period of three months from the date of receipt of this order. After repair of the car, two engineers of the manufacturer of the car, would examine the vehicle and issue a certificate with respect to the repair and vehicle to be fit and free from any defect. The complainant is also awarded an amount of Rs.25,000/- as compensation to be paid by the opposite parties No.1 and 2 on account of un-necessary harassment and mental agony.

22.              The complaint stands partly allowed accordingly.

 

Announced: 20.02.2017

(Balbir Singh) Judicial Member

(Nawab Singh) President

 

CL