Delhi

North

RBT/CC/157/2022

HARSHDEEP ARORA - Complainant(s)

Versus

TATA AIG GENERAL INSURANCE CO LTD - Opp.Party(s)

25 Nov 2024

ORDER

District Consumer Disputes Redressal Commission-I (North District)

[Govt. of NCT of Delhi]

Ground Floor, Court Annexe -2 Building, Tis Hazari Court Complex, Delhi- 110054

RBT/CC No/157/2022

[DCDRC-V (NW) CC Number518/2018]

In the matter of

Sh. Harshdeep Arora

S/o Sh. Kamaljeet Singh

R/o C-1648A, Sushant Lok

Gurugram-122002                                                                                            ...Complainant

Versus

TATA AIG     General Insurance Company Ltd.

301-308, Third Floor, Aggarwal Prestige Mall

Plot Number2, Road Number44, Near-M2K Cinema

Rani Bagh, Pitampura

New Delhi-110034                                                                                         …Opposite Party

 

ORDER
25/11/2024

Ms.Harpreet Kaur Charya, Member

The present complaint has been received by way of transfer vide order NumberF.1/SCDRC/Admn./Transfer/2022/330 dated 16/04/2022 of Hon’ble Delhi State Consumer Dispute Redressal Commission where the matter was transferred from DCDRC-V (North West) to this Commission.

1. Complaint under Section 12, of the Consumer Protection Act, 1986 has been filed by Sh. Harshdeep Arora, against, TATA AIG, General Insurance Co. Ltd. as Opposite Party (OP) with the allegation of deficiency in services.
2. Facts as per the complaint are, the complainant purchased a two wheeler Royal Enfield Classic-350 bearing registration NumberHR-26-CZ-8402 for Rs.1,33,116/- and got it insured from OP. A premium of Rs.10,647/-was paid for three year policy cover for a period from 03/10/2016 to 03/10/2019 with the IDV of Rs. 1,06,493/-.
3. On 20/11/2017, the complainant had duly locked and parked the insured vehicle at around 8:15p.m outside his residence i.e. first floor, F-1/18, DLF, Ph.-I, Gurugram-122002. Next morning i.e. on 21/11/2017 around 9:15 a.m. the complainant found that the insured vehicle was not there.
4. On 22/11/2017 an FIR bearing number0571/2017 was registered under Section 379, IPC with PS: DLF Phase-I, Gurugram. OP was also informed on 21/11/2017 around 1:00 p.m. on their Customer Care Number and the Claim bearing number0820573108A was registered.
5. On 26/11/2017, Mr.Tarun Sangal, from M/s. Globe Claims Agency was appointed as Surveyor who visited the residence of the complainant for inspection and collected all the relevant documents.  The complainant was informed by Mr. Tarun Sangal that there are certain procedures to be complied such as- informing the RTO Authority about the theft of the vehicle and handed over relevant forms to the complainant.
6. The complainant has alleged that in the first week of December, 2017 he contacted Mr. Tarun Sangal for handing over the relevant documents where he was asked to send through courier. He was further asked to wait for the untraced report, which was filed by the Police authority in court on 03/04/2018.  The certified copy of the said report was obtained by the complainant on 07/04/2018.
7. It has been stated by the complainant that he tried to reach out Mr.Tarun Sangal but he did not respond to the complainant’s call.  On 09/04/2018, the complainant came to know that the claim was being handled by one Mr. Gulshan Dogra from Claims Team, who informed that OP had addressed a letter dated 28/03/2018 to the complainant. On request of the complainant, a copy of the said letter was re-dispatched from the office of OP and accordingly received by the complainant on 10/04/2018.
8. In letter dated 28/03/2018, the complainant found that the vehicle number, the policy number, claim number and date of report of claim were wrongly mentioned, thereby showing gross negligence on the part of OP.  The same were brought to the notice of OP vide letter dated 11/04/2018.  Despite continuous follow up through calls and emails, the claim has been repudiated vide an email dated 02/05/2018.
9. On 08/05/2018, the complainant received a letter wherein the particulars of vehicle number were erroneous which showed that letter date 11/04/2018 sent by the complainant seeking rectification was ignored. A detailed email dated 14/05/2018, explaining the errors was written by the complainant to Mr. Gulshan Dogra.
10. The complainant has also alleged that on 17/05/2018; again the complainant received a repudiation letter in the same format after inserting the details of the complainant’s claim. The rejection was on the ground that the scratching/grazing of the vehicle key and unjustifiable doubts about the vehicle being stolen with the key at the ignition point.
11. On 25/05/2018, the complainant replied to the said letter clarifying the possession but there was no response from the office of OP and the claim was no reconsidered.
12. A legal notice dated 03/07/2018, was issued to OP. despite delivery on 06/07/2018 the same was neither replied nor complied.  The complainant has alleged that OP has repudiated his bonafide claim which has caused financial loss as enumerated in the table below:-

Sr.Number	Particulars	Amount
	Insured Declared Value of the Vehicle as on the date of filing the claim	Rs.1,06,493/-
	Interest @18% p.a. for the period from 21.11.2017 to 31.07.2018	Rs.13,286.82/-
	No Claim Bonus as per the terms of policy	Rs.3,549.00

13. The complainant has prayed for directions to OP to pay a sum of Rs.1,23,328./- as per the table (above) alongwith further interest @18% p.a. w.e.f. 01/08/2018 till realization; Rs.50,000/- on account of damages for not settling the claim in time bound manner thereby causing mental agony and harassment to the complainant andRs.30,000/- as legal expenses.
14. The complainant has annexed copy  of Tax invoice Insurance policy certificate and registration certificate as Annexure-C-1(colly), Copy of FIR Number0571 dated 22/11/2017 as Annexure-C-2, copy of documents handed over to Surveyor  as Annexure-C-3, Copy untraced report as Annexure-C-4, copy of letter dated 28.03.2018 as Annexure-C-5, copy of reply dated  11/04/2018 as Annexure-C-5, copy of email exchanged between complainant and OP as Annexure-C-7, copy of letter dated 08/05/2018 as Annexure-C-8(colly), copy of email dated 14/05/2018 as Annexure-C-9, copy of letter dated   08/05/2018 received by complaints as Annexure-C-10, copy of letter dated 25/05/2018 by complainant as Annexure-C-11, copy of legal notice alongwith postal receipt and track report as Annexure-C-12 (colly) with the complaint.
15. Notice of the present complaint was issued to OP.  Thereafter, written statement was filed on their behalf.
16. In the written statement OP has raised several preliminary objections such as the complainant had approached the commission by concealing the true facts; complaint was devoid of merits; the claim of the complainant was repudiated on the ground that on perusal of the claim documents and scrutinizing the vehicle key, it was observed that the insured submitted two keys out of which one is unused/fresh key and 2^nd key was a scratched/grazed key and look like a used one.  The 2^nd key seemed to be a duplicate key which was provided to avoid suspicion of the key getting lost alongwith with the vehicle as from the statement of the complainant the probability of vehicle key was left in the ignition was high and which resulted in gross negligence of insured in safeguarding the vehicle.  This amounts to breach of condition 4 and Condition 8 of the terms and conditions of the Insurance policy.

Condition-4

“The insured shall take all reasonable steps to safeguard the vehicle from loss or damages and to maintain it in efficient condition and the Company shall have at all times free and full access to examine the vehicle or any part  thereof or any driver or any employee of the insured.  In the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle be driven before the necessary repairs are effected any extension of the damage or any further damage to the vehicle shall be entirely at the insured’s own risk.”

Condition -8

The due observance and fulfilment of the Terms, Conditions and Endorsement of the Policy in so far as they relate to anything to be done or complied with by the insured and the truth of the statements and answers in the said proposal shall be conditions precedent to any liability of the Company to make any payment under this policy.”

17. Issuance of policy cover; registration of claim and appointment of Investigator are not disputed. Rest of the contents of the complaint has been denied with the prayer for dismissal the complaint. OP has not annexed any document with their written statement
18. Rejoinder to the written statement was filed by the complainant reiterating the averments made in the complaint and denied those of the written statement.   It has been alleged that the observations made by the OP are vague with the intention to reject the claim.   It has been reiterated that the complainant had duly locked and parked the vehicle.
19. Parties filed their respective evidences by way of affidavit.  The complainant has got himself examined, reiterating the contents of his complaint and has got exhibited  the Tax invoice, Insurance Policy Certificate and the Registration Certificate as Ex.CW1/1(colly), FIR Number0571 dated 22.11.2017 as Ex.CW1/2, copy of documents handed over to  the claims Surveyor  as Ex.CW1/3, Untraced Report as Ex.CW1/4, letter from TATA AIG dated 28.03.2018 as Ex.CW1/5, reply dated 11.04.2018 as Ex.CW1/6, copy of emails exchanged between the Complainant and Representative of OP as Ex.CW1/7, letter dated 08.05.2018 as Ex.CW1/8, copy of email dated 14.05.2018 as Ex.CW1/9, copy of letter dated 08.05.2018 received on 17.05.2018 as Ex,CW1/10, copy of letter sent by complainant dated 25.05.2018 as Ex.CW1/11 and copy of legal notice along with postal receipts and track report as Ex.CW1/12
20. Sh.Sanjay Bhagat, Vice President-Auto claims, has been examined on behalf of the OP.  He has also repeated the contents of the written statement and got exhibited the copy of the insurance policy of the complainant alongwith policy wording as Ex.OPW-1.
21. We have heard the arguments of the Ld. Counsel for the complainant and OP and have perused the material placed on record. We have gone through repudiation letter 08/05/2018 (Ex-CW1/8) wherein the claim of the complainant has been rejected on the ground of breach of Condition Number4 and Condition Number8.  the repudiation letter is being reproduced here under :-

Condition-4

“The insured shall take all reasonable steps to safeguard the vehicle from loss or damages and to maintain it in efficient condition and the Company shall have at all times free and full access to examine the vehicle or any partthereof or any driver or any employee of the insured.In the event of any accident or breakdown, the vehicle shall not be left unattended without proper precautions being taken to prevent further damage or loss and if the vehicle be driven before the necessary repairs are effected any extension of the damage or any further damage to the vehicle shall be entirely at the insured’s own risk.”

Condition -8

The due observance and fulfilment of the Terms, Conditions and Endorsement of the Policy in so far as they relate to anything to be done or complied with by the insured and the truth of the statements and answers in the said proposal shall be conditions precedent to any liability of the Company to make any payment under this policy.”

22. It is observed that the OP has not issued one but three repudiation letters in the present complaint.

 

S.Number	Repudiation letter dated	Vehicle Number	Claim Number
	28.03.2018	DL5SAS4303	0820466617A
	08.05.2018	DL5SAS4303	0820573108A
	08.05.2018	HR26CZ8402	0820573108A

 

The policy cover with respect to vehicle bearing registration number HR26CZ8402 and the claim number is 0820573108A. Pursuant to receipt of letter date 28/03/2018, the complainant wrote a letter dated 11/04/2018 bringing the error to the notice of OP. In the said letter the complainant has also updated his address with the OP. thereafter, again a repudiation letter dated 08/05/2018 bearing the wrong vehicle number DL5SAS4303 was issued to the complainant rejecting the claim on the same ground as mentioned in letter dated 28/03/2018. Thereafter, the complainant vide email dated 14/05/2018 again brought the discrepancy in the letter dated 08/05/2018 wherein the wrong vehicle number was mentioned.

23. Upon receipt of the email dated  14/05/2018, the complainant who informed by the OP that repudiation letter bearing correct vehicle details will be issued.   Finally, a letter dated 08/05/2018 was issued to the complainant bearing the correct vehicle number and Claim number.  This letter is issued in the back date as it is evident from the email dated 17/05/2018 wherein the complainant has stated that he has not received the letter which was stated to be dispatched on 14/05/2018. This reflects the unscrupulous practices which undermine the integrity of the insurance contract and working of the management and operation of the Claim Department of OP. 
24. The claim has been rejected on the ground that on perusal of the claim documents and scrutinizing the vehicle key it was observed that the complainant had submitted two keys in which one was unused/fresh key and 2^nd key finally scratched/grazed and so that it looks like a used one.  This raised serious doubt on the credibility of the complainant statement.  On the above facts, OP believed that the vehicle got stolen alongwith the original ignition key at its ignition point and complainant is concealing the said facts from OP.  Thus, there is breach of Condition-4 & Condition-8 of Policy Terms & Condition.  OP has not filed the surveyor report or any such statement as referred in the Repudiation letter.  No documents have been filed by OP in support of their decision to reject the claim.   The best piece of evidence would have been Forensic Expert Report of the keys handed over by the complainant.  But sending keys for forensic examination has neither been alleged nor filed by the OP.  Therefore, OP has failed to prove that there was breach of terms and conditions by the complainant.
25.  The rejection of the genuine claim of the complainant without any substantive evidence is not sustainable.  Therefore, we hold that the OP has rejected the claim in an arbitrary and baseless manner without application of mind.  This act of OP amounts to deficiency in services and unfair trade practice.  It will not be out of context to point out that OP has been repudiating claim in a mechanical manner and are indulging into practice of ‘cut copy paste’.
26. The policy was purchased for a period of three years.  Since, the vehicle was stolen in the 2^nd year of insurance cover so as per policy schedule Ex.CW-1/1 (Colly), the IDV for the period 03/10/2017 to 02/10/2018 is Rs.1,06,493/-.  The complainant is also entitled for a refund of premium paid for the 3^rd year (03/10/2018 to 02/10/2019).
27. Hence in the facts and circumstances of the present complaint and in the interest of justice we direct OP to :-

1. Pay Rs.1,06,493/-being the IDV of the insured vehicle as per policy schedule/Certificate.
2. Pay interest @7% p.a. from date of theft  i.e. 21/11/2017 on IDV till realization.
3. Refund Rs.3,549/- being the premium paid by the complainant for the 3^rd year.
4. Pay Rs.30,000/- as compensation for harassment and mental agony inclusive of litigation expenses.

The order be complied within 30 days from the receipt of the order. In case of non-compliance amount awarded in Clauses  (a), (c) and (d) above  shall carry simple interest @9 % per annum from the date of order till realisation.

Office is directed to supply the copy of this order to the parties as per rules.  Order be also uploaded on the website.  Thereafter, file be consigned to the record room.

 

 

 

(Harpreet Kaur Charya)                Member	(Ashwani Kumar Mehta)                          Member     (Divya Jyoti Jaipuriar)           President