Haryana

Karnal

CC/46/2022

Savita Chawla - Complainant(s)

Versus

The Manager, Shriram General Insurance Company Limited - Opp.Party(s)

Vineet Kumar

15 Sep 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                       Complaint No. 46 of 2022

                                                        Date of instt.25.01.2022

                                                        Date of Decision:15.09.2023

 

Savita Chawla wife of Shri Manoj Kumar, resident of main Bazar, VPO Kunjpura, District Karnal, age 46 years. Aadhar card no.831030725991. Mobile no.92530 78633.

 

                                               …….Complainant.

                                              Versus

 

1.     The Manager, Shri Ram General Insurance Co. Ltd. SCO 410, 1^st floor, Old Mughal Canal, Karnal. Mobile no.0184-3205663/3204511.

 

2.     Manager, Shri Ram General Insurance Co. Ltd. E-8, EPIP, Sitapura Industrial Area, Jaipur, Rajasthan-302022.

 

                                                                      …..Opposite Parties.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

 

Before   Sh. Jaswant Singh……President.       

      Sh. Vineet Kaushik…….Member

      Dr. Rekha Chaudhary……Member

          

 Argued by: Shri Vineet Kumar, counsel for the complainant.

                    Shri Narender Kumar, counsel for the OPs.

       

                    (Jaswant Singh President)

 

ORDER:   

                

                 The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant is the registered owner of Mahindra and Mahindra XUV-500 W10 AWDAT bearing registration no.HR-30K-6006. The said vehicle was insured with the OPs, vide policy no.10062/31/21/007473, valid from 28.06.2020 to 27.06.2021, for the sum insured of Rs.10,50,000/-. The complainant paid premium of Rs.35,463/- against the said policy. On 02.06.2021, the said vehicle has been stolen from near Railway Line, Lal Bagh Jhuggi, Shahadra Delhi, complainant reached Delhi in evening at house of her relative on 01.06.2021 and parked the said vehicle. On 02.06.2021, when complainant came out and found that said vehicle is not parked there. After the said incident, complainant reported the matter to the police of police of Police Station Mansoravar Park, Shahadra registered FIR no.014361 dated 03.06.2021 regarding the said accident. Thereafter, complainant informed the matter to the OPs. The complainant has submitted entire relevant documents and lodged a claim against the said vehicle within time and OPs assured that claim against the said vehicle will be released as soon as possible. Now, OPs have refused to issue the claim amount by saying that in the insurance policy there is higher model 2015 is mentioned instead of model 2012.  Infact, the abovesaid typical mistake is on behalf of the OP as the form was filled by the agent of OP and he inadvertently mentioned the higher model of vehicle as 2015 instead of 2012. Thereafter, OPs admitted their fault but they instead of paying the whole claim amount offer only Rs.6,12,849/- instead of Rs.10,50,000/-. By not issuing the claim amount and other benefits by OPs, complainant has suffered a mentally, financially and physical harassment. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

2.             On notice, OPs appeared and filed their written version raising preliminary objections with regard to maintainability; jurisdiction and concealment of true and material facts. On merits, it is pleaded that complainant got insured her vehicle make Mahindra and Mahindra XUV-500-W10 AWD AT, Model 2012 bearing registration no.HR-30K-6006 single owner for IDV of Rs.10,50,000/- for a period  from 28.06.2020 to 27.06.2021. On the declaration of the complainant the vehicle in question was considered for Model 2015 as per her averment and as such IDV was calculated on the basis of higher model and as such premium was charged accordingly. The Ideal IDV for such type of vehicle with Model 2012 as per vehicle master for 9^th year is Rs.6,12,849/-. As such no claim more than Rs.6,12,849/- is payable to complainant. The market value of vehicle in question cannot be more than Rs.6-7,00,000/- looking into frequent change of ownership and accidental repairs history. No claim Bonus to the tune of 0% was applicable due to change in ownership and earlier claims. The vehicle in question was sold three times before transfer of ownership in favour of complainant. There is claim history for IDV of vehicle in question. Firstly, the date of loss was 09.07.2010 and at that time claim to the tune of Rs.2,73,000/- was paid by the Iffco Tokio GIC, secondly date of loss was 25.12.2017 for which HDFC GIS paid claim and lastly date of loss was 02.06.2021 for which Shriram GIC paid claim. As such, it can be safely concluded that since vehicle in question frequently changed hands and with frequent claims as such there is suspect of fraud element in claim form submitted for theft claim by the complainant and as such in depth investigation was  conducted and it was rightfully found that vehicle in question has been knowingly, in order to get higher claim amount, was got insured by the complainant for higher IDV for causing wrongful low and in order to get the wrongful gains. The market value of vehicle in question cannot be more than Rs.6-7,00,000/- looking into frequent change of ownership and accidental repairs history. It is further pleaded that on receipt of belated intimation of claim, OPs opened claim no.1000/31/22/C/ 004674 and asked her to provide information and documents in order to process the claim, but she tactfully submitted limited documents despite repeated letters issued by OPs in order to process the claim religiously. OP, vide letter dated 13.07.2021 asked complainant to submit following clarification/documents, which are reproduced as under:-

1.     Previous policy

2.     Sale purchase agreement alongwith transaction details

3.     As per your RC your vehicle is 2012 model while as per your policy your vehicle is 2015 model. Kindly clarify the reason.

4.     Certified copy of final report issued by court with case diary.

5.     Loan repayment sheet and non-repossession letter from financer.

6.     Last service detail/repairing bill/last load challan/toll tax receipt/last fuel bill.

7.     Original registration certificate/if lost then a complaint copy acknowledged by police as vehicle original.

8.     Registration Certificate theft with vehicle and form 26 (3 copies).

9.     You have take the higher side IDV according to the 2012 model. vehicle please clarify the reason for same.

 

                Further, OPs, vide letter dated 17.08.2021 asked to submit the following documents, which are produced as under:-

1.     Sale purchase agreement alongwith transaction details

2.     Certified copy of final report issued by court with case diary.

3.     Original registration certificate/if lost then a complaint copy acknowledged by police as vehicle original.

4.     Registration Certificate theft with vehicle and form 26 (3 copies).

5.     You have take the higher side IDV according to the 2012 model. vehicle please clarify the reason for same.

3.            Further, OPs requested the complainant to submit all required documents within 10 days from date of this letter. Thereafter, OPs sent letters dated 27.10.2021 to complainant for deposition of the documents. It is further pleaded that complainant could not give any satisfactory reply for mentioning the higher model at the time of purchase of policy and on submitting the claim documents. It clearly points out that claim under policy is not payable for flouting the principle of Uberrima faith. It is further pleaded that complainant submitted wrong information to the OP. As per complainant, they lodged FIR at Police Station Mansarover Park Shahdra Police Station dated 03.06.2021 but the FIR states that the source/type of Fir is through web application and further submitted wrong toll tax receipt dated 01.06.2021, ticket no.60645 for vehicle no.HR-80-6006 to mislead and misguide the OP for getting the fake compensation. There is no deficiency in service and unfair trade practice on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal fo the complaint.

4.             Parties then led their respective evidence.

5.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of RC Ex.C1, copy of insurance policy for the year 2020-2021 Ex.C2, copy of insurance policy for the year 2019-20 Ex.C3, copy of FIR dated 03.06.2021 Ex.C4, copy of final report u/s 173 Cr.P.C. Ex.C5, copy of pollution certificate Ex.C6, copy of aadhar card Ex.C7 and closed the evidence on 26.08.2022 by suffering separate statement.

6.             On the other hand, learned counsel for the OPs has tendered into evidence affidavit of Santosh Kumar Sharma, Senior Executive Legal Ex.OP1/A, copy of cover note Ex.OP1, copy of policy schedule Ex.OP2, copy of policy wording Ex.OP3, copy of claim for Ex.OP4, copies of letters dated 13.07.2021, 17.08.2021, 27.10.2021 and 10.01.2022 Ex.OP5 to Ex.OP8, copies of applications dated 13.06.202 Ex.OP9 and Ex.OP10, copy of higher IDV clarification Ex.OP11, copy of vehicle history Ex.OP12, copy of information report dated 03.10.2021 Ex.OP13, copy of vehicle history report for registration Ex.OP14, copy of RC status Ex.OP15, copy of RC Ex.OP16, copy of vehicle particulars Ex.OP17, copy of police report Ex.OP18, copy of bank passbook Ex.OP19, copy of theft investigation report Ex.OP20, copy of certificate of insurance and police schedule of Royal Sundram Co. Ex.OP21 and closed the evidence on 03.03.2023 by suffering separate statement.

7.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.

8.             Learned counsel for complainant, while reiterating the contents of the complaint, has vehemently argued that complainant has got insured his car with the OPs and paid premium of Rs.35,463/-. On 02.06.2021, the said vehicle was stolen from near Railway Line, Lal Bagh Jhuggi, Shahadra Delhi. Complainant got registered an FIR No.014361 dated 03.06.2021 in the concerned police station. Intimation was also given to OPs and complainant lodged claim alongwith required documents. The claim of the complainant has been repudiated by the OPs on the ground that in the insurance policy model of the vehicle has been mentioned as 2015 instead of model 2012.  Infact, it is only typical mistake and same was done by the OPs as the insurance cover and claim form were filled by the agent of OPs. OPs offered only Rs.6,12,849/- instead of Rs.10,50,000/- and lastly prayed for allowing the complaint.

9.             Learned counsel for OPs, while reiterating the contents of the written version, has vehemently argued that complainant got insured her vehicle for the IDV of Rs.10,50,000/- by disclosing the model of vehicle as 2015, infact model of the vehicle 2012 and the value of the such model is not more than Rs.6 to 7 lakhs. As such no claim more than Rs.6,12,849/- is payable to complainant. He further argued that inspite of issuing the various letters and reminders, complainant had not provided the required documents and lastly prayed for dismissal of complaint.

10.           Admittedly, the vehicle of the complainant was insured with the OPs. It is also admitted that the vehicle of the complainant had been stolen during the subsistence of the insurance policy.

11.           The claim of the complainant has been denied, vide letter Ex.OP8 dated 11.01.2022, on the ground that which is reproduced as under:-

“With reference to above theft claim a careful perusal of the claim document and after independent inquiry, it is inferred that at the time of policy you giving higher model of vehicle and thus taking higher IDV which is in violation of the principle of Utmost good faith. Moreover, even after getting the policy you never pointed out the mistake and nor go it corrected. So we offer to payment as per the ideal IDV as per the actual model of the vehicle and the premium paid towards the higher IDV to be returned to you.

        As per the principle of indemnification the actual loss to the insured has to be indemnified and as per the ideal IDV is payable, but at the policy punch time you filed wrong date of registration in vehicle details hence vehicle IDV shown higher side by system and after receiving of the policy you did not submit any request to endorse the correct date of registration to insurer, which has constituted theft of your above vehicle and breach of our motor policy condition no.08.

12.           The claim of the complainant has been denied by the OPs on the abovementioned ground.  The OPs have alleged that at the time of obtaining the policy, complainant had disclosed the higher model of vehicle and had taken higher IDV. The Ideal IDV for such type of vehicle with Model 2012 as per vehicle master for 9^th year is Rs.6,12,849/-, as such, no claim more than Rs.6,12,849/- is payable. 

13            In her statement Ex.OP18, the complainant has herself stated that due to typographical error, the higher model was got written in the insurance policy and she has no knowledge about it. Furthermore,  the complainant got insured her vehicle for the period from 28.06.2019 to 27.06.2020, vide insurance policy Ex.C3 from Royal Sundram General Insurance Company. In the said policy, the model of the car in question is mentioned as 2012 and the IDV has been shown Rs.11,33,118/-. But the present policy issued by the OPs, the model is mentioned as 2015 and IDV is mentioned as Rs.10,50,000/-. In the previous policy the Royal Sundram General Insurance Company, on considering the model of the vehicle in question had assessed the IDV value of Rs.11,33,118/-.  The present policy would have been issued by the OPs after depreciating the value from the IDV mentioned in the previous policy. Position would have been different if the IDV in the previous policy was lesser than from the present policy. Hence, it is proved on record that the IDV of the vehicle has been assessed Rs.10,50,000/- while considering the previous policy and after seen the RC of the vehicle and not due to higher model as alleged by the OPs. Insurance companies got insured the vehicles on the basis of previous insurance policy and on inspection of the vehicle and other documents.  It appears that there is only a clerical mistake on the hands of the OPs and for that complainant cannot be blamed as complainant had paid the premium of value of Rs.10,50,000/-. Thus, the plea taken by the OPs has no force.

14.           Furthermore, if for the sake of argument, if it is believed that the higher IDV of the vehicle in question was assessed in the insurance policy due to higher model, in that case also, it was the duty of the OPs to confirm the actual model of the vehicle in question from the previous insurance company and RC of the vehicle. Moreover, the application form for renewal of insurance policy, was filled up by the representative of the OPs himself and it was his duty to fill up on seeing the original documents i.e. RC, previous insurance policy and other required documents. Hence, there is no fault on the part of the complainant. 

15.           Further,  Hon’ble Punjab and Haryana High Court in case titled as New India Assurance Company Ltd. Versus Smt. Usha Yadav & others 2008 (3) RCR (Civil) 111, has held as under:-

“It seems that the Insurance Companies are only interested in earning the premiums which are rather too stiff now a days, but are not keen and are found to be evasive to discharge their liability. In large number of cases, the Insurance companies make the effected people to fight for getting their genuine claims. The Insurance Companies in such cases rely upon clauses of the agreements, which a person is generally made to sign on dotted lines at the time of obtaining policy. This is, thus pressed into service to either repudiate the claim or to reject the same. The Insurance Companies normally build their case on such clauses of the policy, but would adopt methods which would not be governed by the strict conditions contained in the policy”.

16.           Keeping in view, the ratio of the law laid down in aforesaid judgments, facts and circumstances of the present complaint, we are of the considered view that act of the OPs while repudiating the claim of the complainant amounts to deficiency, which is otherwise proved as genuine one. 

17.           As per insurance policy Ex.C2/OP2, the insured declared value (IDV) of the vehicle in question is Rs.10,50,000/-. Hence, complainant is entitled for the said amount alongwith interest, compensation on account of mental agony & harassment and litigation expenses.

18.           Thus, as a sequel of above discussion, we allow the present complaint and direct the OPs to pay Rs.10,50,000/- alongwith interest @ 9% from the date of  denial of the claim till its realization. The OPs are also directed to pay an amount of Rs.25,000/- to the complainant on account of mental agony and harassment suffered by him and Rs.11,000/- for the litigation expense. Complainant is also directed to complete all the formalities with regard to transfer/cancel of the RC of the vehicle in question. This order shall be complied within 45 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 15.09.2023    

                                                                  President,

                                                       District Consumer Disputes

                                                       Redressal Commission, Karnal.

 

(Vineet Kaushik)             (Dr. Rekha Chaudhary)

                     Member                          Member