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

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Mrs.Gursharan Kaur r/o House No.1043, Sector 49-A, Chandigarh.

….…Complainant

                            V E R S U S

1.        The New India Assurance Company Ltd., Regional Office, SCO 36-37, Sector 17-A, Chandigarh, through its Manager.

2.        The New India Assurance Company Ltd., Branch Office, SCO 347-48, Sector 35-B, Chandigarh, through its Manager.

                                   ..…Opposite Parties

CORAM:        SH.RAJINDER SINGH GILL, PRESIDING MEMBER

              MRS. MADHU MUTNEJA, MEMBER

Argued by:       Sh. HPS Kochhar, Adv. for complainant.

Sh. A.S. Virk, Adv. for OPs

PER MRS. MADHU MUTNEJA, MEMBER

             Briefly put, the complainant had got her Santro car insured from the OPs from 10.10.2009 to 9.10.2010. A premium of Rs.3185/- had been paid by the complainant to the OPs.  Unfortunately, the vehicle met with an accident on 19.3.2010. The vehicle was repaired at KLG Hyundai, Chandigarh and the complainant spent an amount of Rs.49,095/- on repairs.  The complainant lodged a claim with the OPs for settlement of her claim on 29.4.2010.  She was shocked to learn that her claim was likely to be repudiated on the ground that she had enjoyed the benefit of no claim bonus at 20% which came to Rs.2,117/-. The complainant has submitted that she was not aware of the grounds on which NCB is given to the policy holders and since she had been getting her car insured from the OPs for the past 10 years, she had always deposited the amount demanded as premium from the representatives of the OPs when it became due. 

              The complainant has also submitted that when she came to know of the reason for the rejection of her claim, she had offered to pay the OPs the no claim bonus amount alleged to have been taken by her.  The OPs had meanwhile informed her that since she had lodged a claim of Rs.1651/- in respect of damage to her wind screen, she was not entitled to her present claim.  Alleging that the lapse, if any, in this regard is on the part of the OP (Insurance Company) and not the policy holder (complainant), the complainant has made a prayer that the OPs be directed to accept the no claim bonus from her and thereafter settle her claim.

2.        The OPs in their written reply have submitted that after the claim was lodged by the complainant, it was found that the complainant had enjoyed the benefit of NCB to the extent of 20% during the year.  In fact, she had got a claim for Rs.1651/- on 7.7.2010.  Since she had not disclosed this fact to the OPs at the time of getting the insurance policy for the current year, her present claim was not tenable and hence they had rightly repudiated the claim.  They have further submitted that when the complainant lodged her claim for the loss suffered on the car, a surveyor had been appointed who assessed the loss to the car for Rs.23,327.66.  However, since the complainant had accepted the no claim bonus, her claim could not be processed and hence had been repudiated due to non disclosure of previous claim.  In view of the above, they have prayed for dismissal of the complaint. 
3.        Parties led evidence in support of their contentions.
4.        We have heard the ld. counsel for the parties and have also perused the record. 
5.        A perusal of the record shows that the complainant has been paying regular premium against the car for the past 10 years to the OPs.  She has submitted that she has always made payment of the amount demanded/claimed from her.  The calculations, if any, are made by the agents/officials of the of the OPs.  The contention of the OPs is that since the complainant has taken a claim in the previous year for Rs.1651/-, she was not entitled to ‘no claim bonus’ which has been  taken by her.  Hence they have repudiated her claim.  In our opinion, this contention of the OPs seems very unfair and unjustified since it is their own agents/officials who assess and determine the amount to be paid against the policy by the insured. The fault, if any, lies with the official/agents of the OPs who should have at the time of issuance of the policy ensured to check all previous dues/claims and records to determine the amount due as premium for the current year.  It was their own fault that they had given a deduction for no claim bonus when the deduction should not have been made.  The customer would not know the policies and conditions or the extent of no claim bonus in such a situation.  We cannot, therefore, agree with the contention of the OPs for disallowing the claim. 
6.        In view of the above, we allow the complaint in favour of the complainant. However, the amount payable will be as per the surveyors report and not the amount spent by the complainant.  The complainant has spent Rs.49,095/- but the surveyor has allowed Rs.23,327.66 as per his report.  Hence the OPs shall pay a sum of Rs.23,327.66 to the complainant after deducting Rs.2,117/- as the amount of no claim bonus which was due from her at the time of issuance of the policy. The OPs shall also pay Rs.5,000/- as compensation for harassment caused to the complainant and Rs.5,000/- as litigation expenses
7.        This order be complied with by the OPs within thirty days from the date of receipt of its certified copy, failing which they shall be liable to pay the aforesaid amount with interest @ 12% per annum from the date of the order till the amount is actually paid to the complainant. 

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