ORDER

28.06.2024

Sh. Sanjay Kumar, President

1. The factual matrix of the present case is that complainant on 30.01.2012 complainant got insured his car having registration no. DL 3CAK 6169 Honda CRV upto 29.01.2013 and paid Rs.40,100/- premium on 31.01.2012 for insured value of Rs.12,00,000/-. It is stated that on 05.09.2012 complainant’s vehicle was stolen by some unknown person and reported to police. It is stated that police registered FIR no.740 Police Station Noida, Sec.58, Distt. Gaudam Budh Nagar, UP.
2. It is stated that on 05.09.2012 respondent office was also informed vide claim no.620530713 and request no.989036 was registered but unfortunately complainant has not received any reply. It is stated that police failed to trace out the vehicle and filed untraced report on 14.10.2012 which was informed to the agent and OP  office and all documents tendered. It is stated that a legal notice dated 16.01.2013 sent to OP of head office Mumbai but no reply received. It is stated that complainant has not received the claim than another notice sent on 31.05.2013 but again no reply received.
3. The complainant is seeking direction against OP to pay Rs.12,00,000/- compensation with interest @ 12% from the date of filing of complaint till final realization, to pay Rs.50,000/- towards humiliation and inconvenience and Rs.22,000/- as litigation cost.
4. OP1 and 2 filed WS and taken preliminary submission that present complaint does not discloses true and correct facts and liable to be dismissed. It is stated that complainant has no locus standi to file the present complaint and it is a case of fraud and misrepresentation. It is further stated that on receipt of intimation of  claim by answering respondent on 05.09.2012 an investigator M/s Vikaas Kumar and Associates was appointed to investigate the claim. It is stated that investigator  had observed that the subject vehicle was previously owned by one Mr. Inderpal singh who informed the investigator that vehicle was severely damaged and the claim was settled on total loss. It is stated that the present complainant had purchased the said accidental vehicle from one Mr. Surinder Singh scrap dealer for Rs.3,00,000/-. The copy of scrap dealer statement and investigation report dated 24.06.2013 filed on record, therefore, present complaint is liable to be dismissed.
5. It is stated that it is observed from the investigation that the complainant had later reinsured the subject vehicle with OP 1 and 2 by getting it cosmetically repaired for a sum of Rs.12,00,000/- and at that time the complainant had hidden the fact that he had purchased the said vehicle  for Rs.3,00,000/- only which amounts to serious misrepresentation of the facts and was in violation of principle of “Ubrima Fides” i.e the principle  of utmost good faith. It is stated that based on the said facts a letter dated 25.07.2013 and 24.08.2013 was sent to complainant seeking his clarification and letter dated 25.03.2013 also sent to Sr. Superintendent of Police Gautam Budh Nagar, UP and Director Vigilance DJB vide letter dated 15.05.2013 informing them of the modus operendi of the complainant and requested to SSP Police to reinvestigate the subject theft claim lodged by the complainant. It is stated that in view of these facts present complaint is liable to be dismissed.
6. It is stated that it was also observed during investigation that the complainant had also purchased three other vehicles in accidental condition and out of that one Honda City having registration no. DL 7CF 9348 has also been reported stolen. It is stated that said vehicle has been insured against third party with M/s Iffco Tokio General Insurance company ltd. and comprehensively insured with TATA AIG General Insurance co. ltd. It is stated that complainant is trying to rebenefit out of the insurance policy by fraud and misrepresentation, therefore, present complaint is not maintainable and liable to be dismissed.
7. On merit all the allegations are denied and contents of preliminary submission are reiterated.
8. As per record complainant has not filed rejoinder to the WS.
9. Complainant filed evidence by way of his affidavit and reiterated contents of the complaint. The complainant relied on copy of RC Ex.CW1/1, copy of insurance policy Ex.CW1/2, copy of FIR and untraced report Ex.CW1/3 and Ex.CW1/4, copy of certificate of insurance Ex.CW1/5, copy of keys Ex.CW1/6, copy of election I card Ex.CW1/7, vehicle enquiry report Ex.CW1/8, legal notice dated 16.01.2013 Ex.CW1/9 and CW1/10, legal notice dated 27.05.2013 and postal receipt Ex.CW1/11 and CW1/12.
10. OP1 and 2 filed evidence by way of affidavit of Mohd. Azhar Wasi Head Claim Officer. In the affidavit contents  of WS reiterated. OP relied on copy of statement of scrap dealer Ex.OPW1/1, copy of investigator report Ex.OPW1/2, copy of letter dated 25.07.2013 and 24.08.2013 Ex.OPW1/3, copy of letter dated 23.05.2013 Ex.OPW1/4 and copy of letter dated 15.05.2013 Ex.OPW1/5.
11. Written arguments filed by complainant as well as OP1 and 2.
12. We have heard Sh. Nagender Lakra counsel for complainant and Sh. Ishan Waswani proxy for Sh. Manoj Kumar counsel  for OP and perused the record.
13. It is admitted case  of the parties that complainant is the registered owner of Honda CRV having registration no. DL 3CAK 6169 and got insured the vehicle on 30.01.2012 upto 29.01.2013 and paid premium of Rs.40,100/- for insured sum of Rs.12,00,000/-. According to complainant on 05.09.2012 the vehicle was stolen by come unknown person and FIR was registered at Police Station Sec. 58, Distt. Gautam Budh Nagar, UP having no. 440. The complainant also alleged that OP insurance company was informed on same day on 05.09.2012 vide claim no.620530713 and request no. 989036. According to complainant an untraced report filed by concerned court on 14.10.2012. The complainant also served legal notice dated 16.01.2013 and 31.05.2013.
14. According to OP the complainant had purchased an accidental vehicle from one Surender Singh (Scrap Dealer) for a sum of Rs.3,00,000/-. This fact came to the knowledge of OP insurance company  when on receiving the intimation of claim an investigator M/s Vikaas Kumar and Associates appointed to investigate the claim. The vehicle was owned by one Inderpal singh who informed the investigator that the vehicle was severely damaged and claim was settled on total loss. The detailed investigation report filed on record by OP insurance company alongwith statement of Mr. Surender Singh Scrap Dealer. The OP alleged that complainant has misrepresented and played fraud. The OP further established that letter dated 25.07.2013 and 24.08.2013 were sent to complainant to see clarifications but no reply given by complainant. The OP further alleges that during investigation it has also came to the knowledge that complainant purchased three other vehicles in accidental condition and thereafter one Honda city having registration no. DL 7CF 9348 reported to be stolen which was insured against third party with IFFCO Tokio General Insurance Co. and comprehensively insured with Tata AIG General Insurance Co. Ltd.
15. The complainant in his evidence admitted the fact that M/s Vikaas Kumar and Associates investigated the claim, however claimed that the report is false. However, he has not disputed or contradicted the detailed investigation report filed on record by OP Insurance co. He has also not denied the letter dated 25.07.2013 and 24.08.2013 wherein the investigated facts were required to be clarified. The investigation report establish on record that complainant by misrepresenting and concealing the true and correct facts that he had purchased a total loss car from scrap dealer Mr. Surender Singh for Rs.3,00,000/- but complainant claimed that he has purchased from one mechanic named Maqsood for Rs.12,00,000/-. The complainant failed to file any documentary evidence of purchasing the car in question for Rs.12,00,000/-. The OP filed the statement of Surender Singh who is accident car dealer and purchased from one Inderpal Singh. In these circumstances where complainant concealded the true facts and misrepresentated violated the declaration made by him in the proposal form and also failed to give any plausible and satisfactory reply to the clarification sought by OP insurance company. In these special circumstances of the case the OP insurance company is fairly, justifiably and legally denied the claim to the complainant.
16. On the basis of above observation and discussion we are of considered opinion that present complaint is liable to be dismissed. No order as to cost. File be consigned to record room.
17. Copy of the order be given to the parties free of cost as per order dated 04.04.2022 of Hon’ble State Commission after receiving an application from the parties in the registry. The orders be uploaded on www.confonet.nic.in.

Announced in open Commission on  28.06.2024.

SANJAY KUMAR                                                  NIPUR CHANDNA                          

       PRESIDENT                                                           MEMBER