CONSUMER DISPUTES REDRESSAL COMMISSION – X

GOVERNMENT OF N.C.T. OF DELHI

Udyog Sadan, C – 22 & 23, Institutional Area

(Behind Qutub Hotel)

New Delhi – 110016

Case No.102/2021

Bhim Singh

S/o Sh. Karan Singh

R/o K-103, Saurav Vihar

Delhi-110044.                                                                …..COMPLAINANT

Vs.

Tata AIG General Insurance Company Ltd.

Through its Representative

 3^rd Floor, Plot No.16/116-A, Sai Square

 Civil Lines, Kanpur-20801.

Also at :  DIJ-415, 4^th Floor

DLF Tower B, Jasola Vihar

New Delhi-110025.

Also At:  15^th Floor, Tower-A

Penisula Business Park

Ganpatrao Kadam Marg

Off Senapati Bapat Marg

Lower Parel, Mumbai-400013.                           …..RESPONDENTS

Date of Institution-23.03.2021

   Date of Order-  23.02.2024

O R D E R

RITU GARODIA-MEMBER

1.  The complaint pertains to deficiency on the part of OP in repudiating the claim of the complainant.

2. The facts as stated in complaint are : the complainant insured his vehicle bearing No.DL-01-LAA-9679 (Mahindra Supro CV) vide policy No.0160127776 valid from 04.08.2019 to 03.08.2020.

3. It is stated that the complainant could not ply his vehicle due to Covid and could not pay the instalment. The vehicle was kept in  his native village in Distt. Auraiya, U.P.

4. In the intervening night of 26.7.2020 and 27.7.2020, around 12.30 to 1.00 a.m, the aforesaid vehicle caught fire due to short circuit.  The complainant called the police and the fire brigade.  The Police officials reached the place of incident in thirty minutes but the fire brigade could not access the vehicle due to the narrowness of the street.  By 2.30 a.m. the vehicle was burnt. The complainant’s statement was recorded by police official at P.S. Dibiyapur vide General Diary No.44 at about 2.40 a.m.  OP insurance company was also informed about the incident.

5. Two different companies i.e. M/s Fastidious Insurance Surveyor and Loss Assessor and M/s Wide Eyed Investigation Pvt. Ltd. had been appointed to investigate the incident.  Both the companies filed their report.  The contents of both the report were same.  Report states that fire was below the cabin of the vehicle and flames were travelling upwards and the fire was not due to short circuit. 

6. The complainant’s claim was not processed.  The complainant sent a legal notice dated 03.02.2021.  The complainant prays for re-imbursement of his claim amounting to Rs.4,00,000/- and payment of a sum of Rs.6,00,000/- towards loss of business, mental agony, litigation charges.

7. OP in its reply submits that the complainant procured “Auto Secure Commercial Vehicle Package Policy” from answering Opposite Party for his Mahindra Supro CV Mini Truck bearing registration number DL 01 LAA 9679 valid for the period from 04.08.2019 to 03.08.2020 for an IDV of Rs.4,00,000/-.

8. On receiving intimation of a claim under the policy, OP appointed an an independent investigator ‘Wide Eyed Investigation Pvt. Limited to investigate the matter a independent IRDAI licensed surveyor ‘Fastidious Insurance Surveyor & Loss Assessor’ to inspect the vehicle.  The said Investigator and Surveyor submitted their report dated 24.11.2020 and 24.02.2021 respectively.

9. The report stated that the cause of fire was not due to short circuit.  The pattern of the fire shows that fire intensified below the cabin of the vehicle over the land surface and fumes of fire were travelling towards upwards into the vehicle.  The report further stated that fire was deliberately caused to the undercarriage of the vehicle.

10. OP denies that the complainant called the fire brigade.  OP repudiated the claim vide letter dated 26.2.2021. 

11. Complainant in its rejoinder submits that the surveyor submitted his report after seven months.  The complainant has denied the averments made in the reply of OP.  The complainant received a letter dated 03.02.2021 from OP requesting for his comments on the discrepancies noted in the claim. The complainant also received the repudiation letter dated 26.02.2021

12. Complainant has filed evidence by way of affidavit which are exhibited as under:

1. Copy of insurance cover with Tata AIG General Insurance Company and Bajaj/Allianz Insurance Company note is exhibited as Ex.CW-1/1 & 2.
2. Copy of photographs of burnt vehicle are exhibited as Ex.CW-1/3.
3. Copies of General Diary are  exhibited as Ex.CW-1/4 & 1/5
4. Copy of legal notice and tracking report is exhibited as Ex.CW-1/6.

13. OP has filed evidence by way of affidavit which are exhibited as under:

1. Copy of special Power of Attorney dated 01.10.2021 is exhibited as RW-1/X.
2. Copy of SPA dated 06.09.2022 is exhibited as RW-1/Y.
3. Copy of Insurance Policy with terms and conditions is exhibited as RW-1/1.
4. Copy of General Diary dated 27.7.2020 of PS Dibiyapur is  exhibited as RW-1/2.
5. Copy of claim form of complainant is exhibited as RW-1/3.
6. Copy of investigation report is exhibited as RW-1/4.
7. Copy of Survey report is exhibited as RW-1/5.
8. Copy of written statement of complainant is exhibited as RW-1/6.
9. Copy of loan statement is exhibited as RW-1/7.

14. The Commission has considered the pleadings and material on record.  It is admitted by both the parties that the complainant’s vehicle bearing No. DL-01-LAA-9679 (Mahindra Supro CV) was insured by OP vide Policy No.0160127776 valid from 04.08.2019 to 03.08.2020 for an IDV of Rs.4,00,000/-.

15. OP has filed General Diary No.044 dated 27.07.2020 at 14.40 in P.S. Dibiyapur wherein the son of the complainant stated that vehicle in question was burn due to short circuit.

16. The investigation report dated 24.11.2020 by WideEyed Investigation Pvt. Ltd.  is placed on record.  The narration of incident in the said report is as follows :  
17.  

17. The report further states that  

“We also obtained the video when the IV caught fire and observed that the IV caught fire under the cabin.The fire was spread under and in front of vehicle while battery and CNG kit were installed under tray body of IV.

Insured confirmed that fire broke out in the vehicle due to short circuit, we precisely observed that flames of fire were travelling from parked surface to the vehicle which is unfeasible as fire broke out due to of self-ignite.

In self ignition flames must travel within the vehicle as the cabin of the vehicle was closed chamber or by the vehicle to the parked surface on further it is noticed that spread of fire on the parked surface is greater than the vehicle.

Last but not least video is self-explanatory that people were there at the time of incident and capturing the whole incidence over the handset and no one trying to safeguard the vehicle by extinguishing the fire which is the breach of policy condition 4 as well and leads to that he was willing to save the vehicle and seems that vehicle was deliberately thrust into the fire.

The fitness was expiring after two days from the date of loss.Discrepancies exist between the insure and the driver’s statement and in the video it seems that vehicle was set on fire.Hence the insured tried to get the insurance benefits by hiding the facts.However, the final decision to settle the claim exclusively lies with the insurer.

18. OP vide letter dated 03.02.2021 invited the comments of the complainant, relevant portion is as follows: 
19.  

19. The Surveyor report dated 24.02.2021 by Fastidious Insurance Surveyor & Loss Assessor is placed on record.  The relevant portion is as follows :  “Survey:

As per instructions from the office TATA AIG General Insurance Company Ltd, we have visited the workshop and inspected the damaged vehicle.  During the survey we took photographs of the vehicle.

• As per GD (General Diary Report) that the said vehicle was parked at the time of loss and caught fir due to short circuit.  While as per investigation report & undersigned opinion is that observing the fire model it is not case of short circuit.  Nature of fire was found intensified below the cabin of the vehicle intensified below the cabin of the vehicle.
• As per arranged evidences during the course of investigation the incidence had captured by localities it seems that the fire originated from the parked surface i.e. Land and flames were been travelling towards up the vehicle.  Such kind of fire pattern is clearly notice to when an object is burning and we put another object over above it to catch the fire.  According to said fact this fire has been deliberately burned undercarriage of the vehicle.
• It’s clearly observed no efforts were seen by anyone for loss minimization and to extinguish the fire.
• According to auto loan repayment statement and history of insured that some of the EMI’s has been bounced by the insured.
• Last but not least as per insured statement vehicle had caught fire due to of electrical short circuit and while conducting the survey we observed that load body of the vehicle is also completely burnt when vicinity has no presence of electrical circuit.
• As per insured statement he had intimated for this incidence to police authority and fire brigade department during the loss.  But he is not able to produce any record in regards to intimation & Fire brigade report as well.

20. The claim was repudiated by OP vide 22.02.2021, relevant portion is as follows : 

“With reference to your reply on dated 15.2.2021 for our previous letter dated 03.03.2021.We found that no such substantial representation has been made by you in support of claim.

From the above, it is evident that the damages to the vehicle are done deliberately & did not occur as reported in the claim form and General diary detail vide no.-044 on dated 27.07.2020.Hence we regret that we are unable to entertain this claim and close the claim as repudiated on the grounds clearly mentioned in this letter.”

21. The complainant has annexed a report by Fire Services, Uttar Pradesh which shows that the fire services were intimated on 27.2.2020 at 1.10 a.m.  The said report also states that fire brigade could not reach the vehicle which was on fire.  The villages used submersible pump and PRV (Pressure Reducing Valve) to douse the fire.  The fire brigade left the place of incident at 2.30 a.m.

22. Hon’ble Apex Court in Kamlesh Vs. Shriram General Insurance Civil Appeal  I(2020)CPJ88(SC)  has observed that:

4) The appellant also claimed compensation and costs. In its counter affidavit the stand taken by the respondent was as under:

“6. That the respondent appointed independent surveyor Shri S.K. Tiwari for spot survey on intimation of the alleged fire loss of the insured Truck. The Surveyor submitted spot report dated 23.6.2009 after inspecting the spot and vehicle on 3.6.2009. The spot surveyor in its report apart from pointing out the damages to the insured truck due to alleged fire, specifically gave observations to the effect that “it is the case of manipulations and fabrication. It needs further investigation”. The spot surveyor also submitted zerox copy of newspaper (Dainik Jagaran Daily) dated 3.6.2009. The observation of the spot surveyor to the effect that green grass and leaves etc. surrounding the burnt parts was well in order i.e. smiling, is very significant.

7. That in the light of observations and recommendation made by Spot Surveyor, the answering respondent got the matter investigated and through Sri Prabhakar Rai, Advocate who submitted is detailed report dated 31.8.2009.

……….

The investigator also categorically concluded in his report based upon various facts, statements and circumstances that the said incident of accident and fire is doubtful.”

…………..

The matter was considered by the National Commission as under:-

“7. I have given a thoughtful consideration to the arguments advanced by the learned counsel for the parties. Though it has been argued by the learned counsel for the appellant that the truck was deliberately put on fire to get the insurance claim, but no independent proof has been filed by the appellant to prove that the damage was stage managed. Even the statements of the reporter as well as of the sales man of the petrol pump relied upon by the investigator have not been filed because those persons have refused to give any statement in writing. This appeals to logic that if a truck is purchased only 2-3 months back, why the truck owner will put the truck into fire, because in any case the insurance claim can be awarded to the value of IDV at the most. Learned counsel for the Insurance Company has not been able to pin point any purpose behind the deliberate action of the owner of the truck to put the truck on fire. Clearly there is delay in giving intimation to the police and no proper justification has been given by the complainant. Though, it is true that it is not a case of theft where immediate intimation to the police is required yet the role of FIR in such a case cannot be minimised.

The Apex Court has upheld that insurance has not filed proof that the truck was deliberately put on fire.

23. OP has denied the claim on the basis of investigation report and surveyor report. Both the reports admitted that the vehicle in question was burnt on the intervening night of 26.07.2020 and 27.07.2020.

24. The investigation report dated 24.11.2020 indicates that a self-explanatory video recording revealed the vehicle caught fire from beneath the cabin, with no attempts made by bystanders to extinguish the flames. However, there is no documented record of such a video, nor is there an affidavit from the investigator who referenced it. Additionally, the report mentions the inability to contact the fire brigade. Conversely, the complainant has submitted a fire service report stating that villagers utilized submersibles and PRVs to combat the fire. The fire brigade could not reach the burning vehicle due to narrowness of street. The report notes disparities between the statements provided by the driver and the insured but does not offer any specific details regarding these inconsistencies.

25. Subsequently, OP relied on the surveyor report dated 24.02.2021. The report indicates that the surveyor visited the workshop to examine the damaged vehicle and took photographs. However, there is no indication of the burnt vehicle being taken to any workshop or of any repair assessment being conducted by a workshop. The surveyor did not specify the date or location of the inspection. It can be deduced that the surveyor reiterated the conclusions drawn by the investigator in their earlier report. Moreover, the report emphasizes the absence of a short circuit in the vicinity. Nevertheless, it is essential to recognize that fires can also result from internal short circuits.
26. Top of Form
27. Bottom of Form

Top of Form

26. Hence, we find OP guilty of deficiency in service in repudiating the claim of complainant and direct OP :

1. To pay IDV of the vehicle i.e. Rs.4,00,000/-
2. To pay Rs.25,000/- as compensation for mental harassment and physical inconvenience.
3. To Pay Rs.5,000/- towards litigation expense.

27. File to be consigned to record room.  Orders to be uploaded and complied with within 30 days of the date of order.