Orissa

Sambalpur

CC/78/2017

Binod Sharma - Complainant(s)

Versus

The New India Assurance Company Ltd. - Opp.Party(s)

H.K.Babu, J.P.Mishra, D.K.pandey & associates

01 Aug 2022

ORDER

PRESIDENT, DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR

Consumer.Case No.- 78/2017

Present-Dr. Ramakanta Satapathy, President,

  Sri. Sadananda Tripathy, Member

 

Sri. Binod Sharma,

S/O- Birdi Chandra Sharma

R/O-Talbhatapada, Po/PS-Khetrajpur,

Dist-Sambalpur, Odisha.                                                        …………..Complainant

 

Vrs.

The New Indian Assurance Company Ltd.

Through his Senior Divisional Manager, Sambalpur

At- Chhabra Complex, PO-Budharaja,

Ps-Ainthapali, Dist-Sambalpur                                               ……….….Opp. Parties

Counsels:-

1. For the Complainant    :-            Sri. H.K.Babu, Advocate & Associates.
2. For the O.P                    :-            Sri B.K.Purohit, Advocate & Associates.

 

DATE OF HEARING :04.07.2022 DATE OF JUDGEMENT : 01.08.2022

Presented by Dr. Ramakanta Satapathy, PRESIDENT:

1. The case of the Complainant is that the complainant purchased one TATA ACE PICK UP. Bearing regd. No. OD-15C 9822. On 19.09.2017 at about 3.00Am. Chittaranjan Singh was the driver of the vehicle. To save one another vehicle coming from opposite direction on Ring road, Durgapali village applied his break but the own vehicle was capsized on the right side of the road. The front glass, head light, fiber indication, mirror etc. got damaged. In Khetrajpur Police Station on 28.09.2017 station diary was made by the Complainant. The Complainant spent Rs. 42,546/- in Jalan Auto Mobiles to-wards spare parts and Rs. 5000/- to-wards repairing. A claim, was lodged bearing claim No. 55090031170190000031 before the insurer O.P. The O.P. refused to settle the claim and issued letter No. 550900/MTD/2017/1268 dated 10.10.2017 stating that the Complainant had lodged a OD claim in his previous policy No. 3313/00014122 before Cholamandalam General Insurance Co. Ltd, the said fact has been suppressed at the time of taking policy from the O.P.

On 16.10.2017 one of the agent of O.P. asked to put signatures on the proposal and submitted a copy of the previous policy of Cholamandalam G.I.C. Ltd.The Complainant is an uneducated person and on good faith without knowing the terms and condition of the policy has taken and policy. The repudiation made by the O.P. is not proper.

2. The O.P. in its version submitted that the Complainant is not a ‘Consumer’ and there is not deficiency on the part of the O.P. The Complainant paid Rs. 18,806/- to-wards premium to-wards own damage and the legal liability for the total value of the vehicle amounting to Rs. 3,00,000/-. Rs. 1813/- for own damage and Rs. 14,540/- for third part, personal accident coverage for the owner-driver and other one employee and against that GST was Rs. 2453/-. It is a renewal policy and made declaration that there was no claim with previous insurer M/s Cholamandalam MS G.I.C. Ltd and availed “ No claim bonus (NCB) of 25%. On 20.09.2017 the insured vehicle met an accident. The surveyor & loss Assessor Sri. Satyajit Pattanaik in final report assessed the net liability of O.P. Rs. 29,018/- subject to terms and conditions. The O.P. when sort for NCB confirmation from Cholamandalam Insurance Co. Ltd. the Insurance Company intimated that there was an OD Claim of the insured Binod Sharma for the vehicle No. OD-15C-9822. The O.P. intimated vide letter dated 10.10.2017 for explanation. The Complainant received the letter but did not submit any reply. The O.P. repudiated the claim vide letter dated 27.10.2017. The repudiation made by the O.P. as proper. The Complainant with dishonest intention declared that he has no claim of the earlier insurer.
3. Perused the documents filed by both the parties. The insurance policy taken by the Complainant from the O.P. was valid on the date of accident. i.e. 19.09.2017. it is also admitted by both the parties that the insurer paid Rs. 18806/- insurance premium for the period 17.02.2017 to 16.02.2018 for the vehicle No. OR15C-98822. It is also admitted by the O.P. that damage was caused to the alleged vehicle in the accident. Taking in to account the facts of the case the following issues are framed:

 

 

103606587.  

1. Whether the Complainant suppressed the OD claim made before M/S Cholamandalam General Insurance Co. Ltd. and violated the policy terms?
2. What relief the Complainant is entitled to get?

Issue No.1 Whether the Complainant suppressed the OD claim made before M/S Cholamandalam General Insurance Co. Ltd. and violated the policy terms?

          The Complainant in his complaint admitted that policy N. 3313/00014122 was obtained from Cholamandalam General Insurance Co. Ltd. which was issued on 17.02.2016. The Complainant has availed NCB 25% while renewing the old policy with O.P. vide policy No. 55090031160100001154. In the said policy important notice is given:

“ The insured is ………………….is found to be incorrect, all the benefits (including claim) under section-1 of this policy will stand forfeited.”

          The O.P. has sought for NCB clearance from earlier insurer on 09.10.2017 and got information that the complaint has lodged a OD claim. Accordingly the O.P. issued letter dated 10.10.2017 to explain within 7 days of receipt of the letter. The Complainant remained silent for which letter dated 27.10.2017 was issued repudiating the claim. The procedure followed by the O.P. is in accordance with policy terms and conditions.

          No doubt the Complainant has sustained loss due to accident but cannot take the benefit suppressing material facts. Ignorance of law is not excused. The Complainant not uttered a single word in his complaint about OD claim. The O.P. relied on TATA AIG G.I.C Ltd. & another Vs Gulzari Singh case reported in II (2010) C.P.J 272 (NC) wherein Hon’ble National Commission held that declaration regarding ‘No Claim Bonus’ wrongly made by insured, the role of agent is after thought, suppression of material facts with regard to having received claims from the previous Insurance Company violated the terms and condition of the policy.

          In the aforesaid back-ground as the Complainant has not come to Commission with clean hand, violation of policy terms are proved.

          The issue is answered in favour of the O.P. although the Complainant is a consumer by paying premium to the O.P.

Issue No.2 What relief the Complainant is entitled to get?

          As the Complainant suppressed materials facts not entitled to get any relief.

          Accordingly, it is ordered:

ORDER

          The complaint is dismissed on contest. The O.P is not deficient in its providing service to the complaint.

          Order pronounced in open court on this 1^st day of August     2022.

          Supply free copies to the parties.