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

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1]  Daljit Singh s/o S. Gurbax Singh, Prop. of M/s Fortuna Hardware Supply Co., having its office at SCO No. 39, 1^st Floor, Sector 31-D, Chandigarh.

2]  M/s Fortuna Hardware Supply Co., having its office at SCO No. 39, 1^st Floor, Sector 31-D, Chandigarh, through its Sole Prop. Sh.Daljit Singh.

…..Complainants

                 V E R S U S

1]  TATA AIG General Insurance Co. Ltd., P.O. Box No. 9407, Chakala, MIDC Post Office, Mumbai – 400093.

2]  TATA AIG General Insurance Co. Ltd., SCO No. 232-233, 2^nd Floor, Sector 34-A, Chandigarh.

3]  Godkey Insurance Brokers Pvt. Limited, through its Director Rohit Kapoor, having its Office SCO No. 100-101, 2^nd Floor, Sector 34-A, Chandigarh.

                      ……Opposite Parties

CORAM: SH.P.D.GOEL                    PRESIDENT

         SH.RAJINDER SINGH GILL       MEMBER

         DR.(MRS).MADANJIT KAUR SAHOTA  MEMBER

Argued by:     Sh.Vikas Bali, Counsel for Complainants.

          Sh. Rajneesh Malhotra, Counsel for OP Nos.1 & 2.

           Mr.Rajeev Mehan, Representative of OP-3.

PER P.D.GOEL,PRESIDENT

         The complainants have filed the present complaint under Sec.12 of the Consumer Protection Act (as amended upto date) “hereinafter referred to as the Act”. The Complainant No.1 got his Honda City car bearing No. CH-4L-0678, which was in the name of Complainant No.2, comprehensively insured with the OPs under Cashless Policy (“Depreciation Reimbursement Endt.TAO1”), valid from 25.09.2010 to 24.9.2011, after paying the entire premium of Rs.16,181/-. During the currency of the said policy, on 12.1.2011 the vehicle met with an accident near Panipat, while it was driven by the driver of the Complainant namely Sh. Chela Ram Chaudhary. Intimation about the accident was given to the OPs and the vehicle was towed to the Workshop of Joshi Auto Zone, Chandigarh for repairs/assessment of damages etc. Thereafter, a surveyor was appointed by the OPs, who inspected the vehicle on 21.1.2011 and got the necessary information and documents from the Complainant. Finally, an estimate of Rs.3,71,408.13 was calculated by the said Surveyor and the Complainant was assured that the claim would be sanctioned within a short span of time, as the vehicle was insured under the Cashless Policy. Thereafter, the ordeal of the Complainant started, as the OPs did not release the claim amount, despite visiting the OPs several times for the purpose. When all the frantic efforts made by the Complainant failed to elicit any fruitful results, he got served a legal notice dated 04.02.2011, as a measure of last resort, calling upon the OPs to release the claim amount, but to no avail. Hence, this complaint alleging that the aforesaid acts of the OPs amount to deficiency in service and unfair trade practice.

2.             Notice of the complaint was sent to OPs seeking their version of the case.

3.             OP Nos.1 & 2 in their joint written statement, admitted that the car in question was insured for IDV of Rs.6.90 lacs under the insurance policy for the period from 25.9.2010 to 24.09.2011. It was also admitted that on receipt of information regarding the accident, Sh.P.K. Bansal of M/s PEE KAY & Co. was appointed as Surveyor to survey the vehicle and to give the assessment of the damage. The said surveyor gave his detailed survey report dated 10.3.2011 on the basis of pre-dismantle condition as the insured had not given instructions to the Workshop to start the repairs. The Surveyor specifically stated that he had sent the letter to the insured on 8.2.2011 for getting the vehicle repaired. However, he did not receive any response and, therefore, the Surveyor worked out the tentative liability on repair basis in a pre-dismantled condition. It was further pleaded that while taking the present insurance policy, the Complainant had concealed the factum of having made a claim under the previous insurance policy and had claimed NCB under the present policy. As such, there was false declaration and no clam was liable to be paid and all the benefits were liable to be forfeited. All other material contentions of the complaint were controverted. Pleading that there was no deficiency in service on their part, a prayer has been made for dismissal of the complaint.

4.             Initially OP-3 appeared but subsequently it absented and hence, it was proceeded against exparte vide order dated 16.08.2011.

5.             Parties led evidence in support of their contentions.

6.             We have heard the learned counsel for the parties and have also perused the record.

7.       It is the case of the complainant that on the unlucky day of 12.01.2011, the vehicle in question, which was insured with the OP for the period from 25.09.2010 to 24.09.2011 for a sum assured of Rs.6,90,000/- met with accident near Panipat. It has been argued that M/s Joshi Automotives Pvt. Ltd. has prepared an estimate of Rs.3,71,408.12P.  The surveyor of the company assessed the loss but the claim was not released despite service of legal notice dated 04.02.2011.

8.       The OP raised the plea that on receipt of the intimation regarding the accident, Sh.P.K. Bansal of M/s PEE KAY & Co. was appointed as Surveyor to survey the vehicle and to give the assessment of the damage. The said surveyor gave his detailed survey report dated 10.3.2011 on the basis of pre-dismantle condition as the insured had not given instructions to the Workshop to start the repairs. The Surveyor specifically stated that he had sent the letter to the insured on 8.2.2011 for getting the vehicle repaired. However, he did not receive any response and, therefore, the Surveyor worked out the tentative liability on repair basis in a pre-dismantled condition to the extent of Rs.1,44,568.39 P as per his report (Annexure R-3).

          The learned counsel for OP has argued that while taking the present insurance policy, the Complainants had concealed the factum of having made a claim under the previous insurance policy and had claimed NCB under the present policy.

9.       During the course of arguments, learned counsel for the parties very fairely and squarely conceded that the claim has not been repudiated by the OPs No.1 and 2 till date. So, we are of the opinion that the claim is pre-mature. To meet the ends of justice, it would be appropriate to direct the complainants to cooperate with the OPs No.1 and 2 and to allow the surveyor of the OPs No.1 and 2 to inspect the vehicle for assessing the net liability of the claim as per the terms and conditions of the insurance policy.

10.      As a result of the above discussion, the complainants are directed to allow the surveyor to inspect the vehicle for assessing the net liability of the claim as per the terms and conditions of the insurance policy and thereafter the OPs No.1 and 2 are directed to settle/decide the claim within 90 days from the date of receipt of the certified copy of this order. However, it is made clear that, in case, the complainants are not satisfied with the claim, they have a right to approach the Forum again, as per law. No order as to costs. The complaint stands disposed of accordingly. 

11.      Certified copies of this order be sent to the parties free of charge. The file be consigned.