Chandigarh

DF-II

CC/472/2015

M/s Kumar Brothers Pvt. Ltd. - Complainant(s)

Versus

TATA AIG General Insurance Company Ltd. - Opp.Party(s)

Sh. Gaurav Bhardwaj Adv.

31 Aug 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II, U.T. CHANDIGARH

============

Consumer Complaint  No	:	472 of 2015
Date  of  Institution	:	26.08.2015
Date   of   Decision	:	31.08.2016

 

 

 

 

M/s Kumar Brothers Pvt. Ltd., SCO No.7-8, Sector 11-D, Chandigarh through its Director Parmod Kumar.   

             …….Complainant

 

Versus

 

1]  Tata AIG General Insurance Company Ltd., SCO 232-234, Second Floor, Sector 34-A, Chandigarh through its Manager.

 

2]  Tata AIG General Insurance Company Limited, Peninsula Corporate Park, Piramal Tower, 9^th Floor, Ganpatrao Kadam Marg, Lower Parel, Mumbai 400013 through its Managing Director.

 

3]  EM PEE Motors Pvt. Ltd., Plot No.177-H, Industrial Area, Phase-1, Chandigarh

 

 ………. Opposite Parties

 

BEFORE:  SH. RAJAN DEWAN           PRESIDENT

                                MRS.PRITI MALHOTRA        MEMBER

   

 

Argued By: Sh.Gaurav Bhardwaj, Counsel for the complainant.

Sh.Rajesh K Sharma, Counsel for OPs No.1& 2

Sh.S.R.Bansal, Counsel for Opposite Party No.3.

 

PER PRITI MALHOTRA, MEMBER

 

         As per the case, the complainant got the vehicle bearing Regd. NO.CH-01-AK-0123 insured from Opposite Party No.1 vide policy Ann.C-1 effective from 5.1.2015 to 4.1.2016.  It is stated that the terms & conditions of the policy were not supplied to the complainant.  Unfortunately, the said insured vehicle met with an accident on 18.3.2015 near Sirhind while overtaking a trailer. The Opposite Party No.1 was informed about the accident and the vehicle was taken to Opposite Party NO.3 for repairs.  It is also averred that the claim was duly lodged with OPs No.1 & 2 and the Surveyor duly conducted the survey of the vehicle.  However, no police report was lodged as there was no third party loss.  It is further averred that the insured vehicle was repaired by Opposite Party No.3 and a bill for Rs.6,74,500/- was raised, but OPs No.1 & 2 refused to pay the said repaired amount, as such the complainant paid the billed amount and took delivery of the vehicle on 5.6.2015  (Ann.C-4 & C-5). It is submitted that the complainant received a letter dated 26.6.2015 from the Opposite Party NO.1 vide which they sought clarification from the complainant and raised objection regarding odometer reading and also about the previous accident and non-OEM parts.  It is also submitted that the complainant duly explained his position and clarified that odometer was not working and a clarification in this regard was given to the Surveyor.  It is further submitted that the vehicle was insured after pre-inspection by the OPs, so any concealment or fitting of non-OEM parts does not arise, as the policy was issued after satisfied with the inspection (Ann.C-6 & C-7).  It is pleaded that the complainant waited for the response of the OPs NO.1 & 2, but till date the claim has not been paid by the OPs.  Hence, this complaint has been filed alleging the above acts & conducts of the OPs NO.1 & 2 as deficiency in service.

 

2]       The Opposite Parties No.1 & 2 have filed reply and admitted the insurance of the vehicle, damage to the insured vehicle during the currency of insurance, receipt of intimation about the loss, appointment of Surveyor to assess the loss, repair of the vehicle as well as repudiation of the claim filed by the complainant.  It is stated that the complainant did not reply to the queries raised by the Surveyor vide letter dated 30.3.2015 (Ann.R-5) and finally the Surveyor assessed the loss to the tune of Rs.2,19,441/- and submitted his report dated 20.6.2015 (Annexure R-11).  It is pleaded that after the receipt of the survey report, the matter was further investigated and during investigation, it was noted that the vehicle had previously met with an accident and a claim for the same was filed with the erstwhile insurer-M/s ICICI Lombard GIC for damage in an alleged accident on 16.3.2014. It is submitted that the Surveyor vide his report dated 20.6.2015 assessed the loss to the tune of Rs.2,19,444/- but recommended NO-Claim.  It is also pleaded that the claim was rightly repudiated by the company as the vehicle was driven while the driver was under the influence of alcohol and driver details were manipulated. It is further submitted that the complainant had taken the vehicle back without necessary repairs and got the vehicle temporarily repaired from a local workshop. Pleading no deficiency in service and denying rest of the allegations, it is prayed that the complaint be dismissed. 

         The Opposite Party NO.3 has filed short reply admitting the repair of the vehicle in question and payment made by the complainant for repairs.  Rest of the allegations have been denied being not related to the answering Opposite Party and finally prayed for dismissal of the complaint qua it.

 

3]       Rejoinder has been filed by the complainant thereby controverting the assertions of the OPs.

 

4]       Parties led evidence in support of their contentions.

 

5]       We have heard the ld.Counsel for the parties and have also perused the record.

 

6]       The ld.Counsel for the complainant submitted that the complainant got his vehicle insured vide policy No.010107225500 valid from 5.1.2015 to 4.1.2016 from OPs No.1 & 2.  Unfortunately, the said vehicle met with an accident on 18.3.2015 near Sirhind while it was being driven by the driver, who was coming from Patiala to Chandigarh after dropping one of the relative of the complainant at Patiala.  The counsel for the complainant claimed that as there was no third party damage, so no police intimation was given regarding the accident.  The ld.Counsel for the complainant further submitted that the said vehicle was submitted for repairs with Opposite Party No.3 and repair bill amounting to Rs.6,74,500/- was raised by Opposite Party No.3, which was paid by the complainant.  It is stated by the ld.Counsel for the complainant that the claim lodged for the reimbursement of the said expenses incurred by the complainant for the repair of the vehicle till date has not been finalized by the OPs No.1 & 2.

 

7]       The ld.Counsel for OPs No.1 & 2 submitted that they duly admitted the insurance of the vehicle in question and intimation of the claim.  Further claimed that they deputed duly competent surveyor to inspect the vehicle to assess the loss caused to the insured vehicle with respect to the terms & conditions of the policy in question.  It is submitted that the Surveyor so appointed while inspecting the damaged vehicle observed certain discrepancies to the effect that at the time of pre-inspection of the vehicle in question on 05.1.2015, the mileage of the vehicle was 52952 Kms and at the time of Survey on 20.3.2015, it was 53024 Kms, which means that the vehicle was driven for just 72 Kms, whereas the complainant claimed that his vehicle met with accident, while his driver was coming back from Patiala to Chandigarh after dropping one of his relative at Patiala and disputed that the place of accident, as claimed by the complainant, is itself approximately 60 Kms. from Chandigarh.  It is further submitted that in order to clarify, the Surveyor vide letter dated 30.3.2015 called for the complainant to clarify the above fact, but the complainant failed to reply the queries raised by the Surveyor.  

 

8]       It is submitted by ld.Counsel for Opposite Parties NO.1 & 2 that while inspection, it was noticed that the vehicle was previously met with an accident, the claim of which was denied by the previous insurer company i.e. ICICI Lombard GIC, as the driver of the vehicle was under the influence of alcohol & claimed that at that time, the complainant had taken back his vehicle from the Service Centre without necessary repairs and got it temporarily repaired from local workshop with Non-OEM parts (made in Taiwan). Submitted further that the Surveyor appointed by the OPs No.1 & 2 in the present case observed that the damage to the vehicle was not coincide with the cause of accident. It is further submitted that the Surveyor vide its report dated 20.6.2015 assessed the loss to the tune of Rs.2,19,441/-, but recommended ‘No Claim’.  Further claimed that the complainant even failed to reply the letters issued by OPs No.1 & 2 on 26.6.2015, 23.7.2015 and 14.8.2015. It is further claimed that since the complainant mis-represented the cause, place and time of accident and had concealed the correct information and had tried to cover the old damage, which was already existed on the alleged date of accident, hence the OPs No.1 & 2 have repudiated the claim of the complainant.

 

9]       Nowhere it is disputed that the complainant got insured his vehicle in question vide policy No.010107225500 valid from 5.1.2015 to 4.1.2016 issued by OPs No.1 & 2.  It is also a matter of record that before issuing the policy in question, the pre-risk inspection was got done through Auto Risk Agency, engaged by Opposite Parties NO.1 & 2.  As it is admitted by OPs No.1 & 2 in their reply that the ‘pre-risk inspection’ of the vehicle in question was got done through Auto Risk, an Agency engaged by OPs NO.1 & 2, then they cannot take the plea that the vehicle in question was already met with an accident before the issuance of the policy in question and also cannot take the plea that the claim lodged with the previous insurance company was repudiated for the reasons that the driver of the vehicle was under the influence of liquor.  When once it is proved that the vehicle was thoroughly inspected by an Agency of OPs No.1 & 2 before generating the policy in question, then Opposite Parties NO.1 & 2 cannot deny the claim for the reason that the damages to the vehicle, are not coincide with the cause of accident and relates back to the previous accident occurred during the coverage of the previous policy. 

 

10]      In our opinion, before underwriting the policy in question, the OPs NO.1 & 2 were at liberty to enquire about any previous claim from the previous insurance company at their end, which they ignore for the reasons best known to them.  They even failed to enquire the factum about any previous claim from the complainant. It is well observed that the insurance companies are primarily concerned with the insurance premiums only and in haste they issue the policies and whenever any claim is preferred within the period of indemnification, they left no stone unturned to find way out to deny the claim. Similarly in the present complaint, the OPs No.1 & 2 failed to enquire from the complainant as well as from the previous insurance company about any claim raised by the complainant in past.  Further, it is observed that had there been any discrepancy regarding the vehicle in question as alleged by OPs No.1 & 2 in their reply that would have been noticed at the time of pre-risk inspection got done at the behest of OPs NO.1 & 2 and it would have certainly got mentioned in the pre-risk inspection report (Ann.R-4). A bare perusal of that report reveals that no discrepancy or any damage, was noticed at the time of pre-risk inspection, which proves that the captioned vehicle got damaged on the date mentioned by the complainant, was well covered under the policy in question.  The objection regarding the reading of the Odometer was well explained by the complainant that it was not functioning properly at the time of accident and complainant having knowledge of the same. 

11]      From the above discussion, the claim of the complainant is found genuine but to the extent of the assessment made by the Surveyor as the complainant has not challenged the assessment made by the Surveyor in his Survey Report (Annexure R-11).  So, we believe the assessment made by the Surveyor as correct and genuine, as he is a duly competent and qualified person. 

 

12]      In view of the foregoing discussion, we are of the opinion that the deficiency in service on the part of the OPs No.1 & 2 is proved.  Therefore, the complaint stands allowed against the OPs No.1 & 2 and dismissed qua OP No.3.  The OPs No.1 & 2 are jointly & severally directed as under:-

 

[a] To pay an amount of Rs.2,19,441/-, as assessed by the Surveyor   (Ann.R-11), along with interest at the rate of 9% per annum from the date of Survey Report i.e. 20.6.2015 till it is paid;

 [b] To pay an amount of Rs.15,000/- as compensation to the complainant;

 [c] To pay an amount of Rs.7000/- as litigation expenses. 

         This order shall be complied with by the OPs No.1 & 2 jointly & severally within a period of 45 days from the date of receipt of its certified copy, failing which the OPs No.1 & 2 shall be liable to pay the amount as mentioned in sub-para [a] above along with interest at the rate of 12% per annum from the date of Survey Report i.e. 20.6.2015 till it is paid and also on the compensation amount of Rs.15,000/- from the date of filing this complaint till realization, apart from paying the litigation expenses.

         The certified copy of this order be sent to the parties free of charge, after which the file be consigned.

Announced

31^st August, 2016         

                                     Sd/-

(RAJAN DEWAN)

                                       PRESIDENT

 

 

Sd/-

(PRITI MALHOTRA)

MEMBER